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Home My WebLink About1295 CARLSBAD VILLAGE DR; 100; CO120053; Certificate of Occupancy01-02-2013 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Certificate of Occupancy Cert of Occ# 00120053 Permit Type COFO Related Bldg Permit* CB121336 Bldg Address 1295 CARLSBAD VILLAGE DR CBAD St 100 Parcel No 1561907003 RECORD COPY Issue Date 12/17/2012 Occupant Name NCHS CARLSBAD FAMILY MEDICINE Contact Name MIKE DELEON Phone# Phone# 760-736-6737 Building Owner NORTH COUNTY HEALTH PROJECT INC 150 VALPREDA RD SAN MARCOS CA 92069 Description of Use MEDICAL OFFICE Phone# I certify that this building or portion complies with the California Building Code for the group and division of occupancy and the use for which the proposed occupancy is classified The above information is true and correct, and I make this statement under penalty of perjury Signature of Building Official Date FOR DEPARTMENTAL USE ONLY Date Routed Use Zone Occupancy Group B Construction Type 5B Inspected By Inspected By Inspected By Date Date 7-2-/3 Date Approved Approved Approved Disapproved Disapproved Disapproved Comments Is the applicant or future building occupant required to submit a business Dian, acutely hazardous matenals regisfralion fonn of nsk management and prevenlion program under Sections 25505,25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? Yes No Is the apfilicani or future building occupant required to obtain a permit from Ihe air pollution control distnct or air Quality management district? Yes l4o Is the facility to be constnjcted wittim 1 000 feet of the outer boundaiy of a school site? Yes No IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT C O H.STR UCT.lb LEN D I N G' A G'E.N C Y I hereby afftrm that there i3 a constnjction lending agency for the performance of the work this permit is issued (Sec 3097 (i) CMI Code) Lender's Nam Lender's Addres I certfiy (ftatf have nssd Ifu appfJcaCJon ^ state that tfis obcm I hetetiy aulhonze representative of the City of Carislad to enter upon Ihe above mentioned property br inspection purposes I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CtTY OF CARLSBAD AGAINST Aa UABIUTIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUBICE OF THE GRANTING OF THIS PERMFT OSHA An OSHA permi B requied ta-excavatKXis o\w S'ff deep and defiBlitDO or EXPIRATION Ever/pemiit issued by the BuMingOflicialundertheprDvisiorisof this CodeshaBexpiB 180 days twi the date of such permit or if the buiUng or wofttauthon^ by such permt is suspended or abandon^ Buiiding Code) jS^APPUCMTS SIGNATURE DATE STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at finaf inspection. CERTIFICATE OF OCCUPANCY (Commercial Projects Only Fax (760) 602-8560, Email www buildinaOcarlsbadca gov or Mail the completed fomi to City of Carlsbad. Building Division 1635 Faraday Avenue, Carlsbad, California 92008 C0#' <0ff1c« use Only) CONTACT NAME Mike DeLeon c/o North County Health Services OCCUPANT NAME North County Health Services ADDRESS 150 Valpreda Road BUILDING ADDRESS 1295 Carlsbad Village Drive CITY San Marcos STATE CA ZIP 92069 CITY STATE ZIP Carlsbad CA 92008 PHONE 760-736-6737 FAX 760-720-7204 EMAIL mike.deleon@nchs-health.org OCCUPANT'S BUS LIC NO 1207484 [7] MAIL TO Ofl [7] FAX TO CONTACT {Listed at»ve) [] MAIL TO Off QFAXTO t \ [7] BUSINESS ADDRESS Q CONTRACTOR (Listed on page 1 of appllcatlori) [/] ASSOCIATED CB# 121336 I I NO CHANGE IN USE / NO CONSTRUCTION I I CHANGE OF USE / NO CONSTRUCTION ^^^APPUCANT'S SIGNATURE DATE 11/26/2012