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Home My WebLink About1785 CHESTNUT AVE; ; CB973808; Permitf 6 U I L E. I N G PERMIT 12/15/97 09:u3 Pacre 1 of 1 Job Address: 1785 CHESTNUT AV Permit No: CB973808 Proiect No: A97049u* D e v e1o pme nt W o: Permit Type: ELECTRICAL Parcel No: 205-230-06-00 Valuation: ° Orcupancv Group: Reference*: Description: OVERHEAD TO UNDERGROUND : CONVERSION Suite: Lot#: Anpl/Ownr : OSHIMA, ALLEN 1785 CHESTNUT AVE CARLSBAD, CA. 92008 *** Fees Required *** *** 2281 12/15/97 0001 01 02 C-PRHT 35-00 (Construction Type: VN Status: ISSUED Applied: 12/15/97 Apr/Issue: 12/15/97 Entered By: MDP 760 729-5465 Fees Collected & Credits * * A Fees : Adjustments: Total Fees: Fee description 35. 00 .00 as, o o Total Credits: Total Payments: Balance Due; Units Fee/Unit Enter "Y" for Electric Issue Fee > Remodel/Alter Per AMP > * ELECTRICAL TOTAt iuo .25 . 00 . 00 35.00 Ext fee Data I 0 . 0 0 Y 25 . 00 35.00 FINAL APPROVAL DATE r» FARAMCI= CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760)438-1161 1. PROJECT INFORMATION Meln Hlgashi FOR OFFICE USE ONLY PLAN CHECK NO. EST. VAL. Plan Ck. Deposit Validated By Date Address (include Bldg/Suite ») 1785 Chestnut Ave Business Name (at this address) Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Total » ot units Assessor's Parcel *Existing Use Proposed Uce Description ot Work SQ.FT. Conversion from overhead, elecjrie,aj, 2. CONTACT PERSON IttdHferent from applicant) Allen Oshima, 1785 Chestnut Ave., tot Stones » of Bedrooms lS^^ J^al -------- . ------ _ Carlsbad, California 92008 760-729-5465 * of Bathrooms Name 3. , |APPLICANT D Contractor .Hlgashi Address O Agent for Contractor * LH Owner City D Agent for Owner State/Zip Telephone tt Fax * Name 4. PROPERTY OWNER Hlgashi Address City State/Zip Telephone # Name Address City State/Zip Telephone f 5. CONTRACTOR -COMPANY NAME "'" " """" :"~"" """": "* "-^""-^-—•-:-^-:-~- T ••• -^- --~"'~ -~;~- ";;•:*•; •.;-,,- '^—— (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, elter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Lew [Chapter 9, commending with Section 7000 of Division 3 of the Business end Professions Code) or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($5001). Name State License * Address License Class City State/Zip City Business License * Telephone f Designer N»me Address City State/Zip Telephone State License #'_ __ 6. WORKERS' COMPENSATION ' ........... " •-•••-•-••-•••-- ^-_-~—- -.—;;—• ....... — :r:;-~rr' ^.T'V." .'"..•; • ...... /' • Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: Q I have end will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. Q I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My worker's compensation insurance carrier and policy number are: Insurance Company _ ; _ Policy No. _ Expiration Date _ (THIS SECTION NEED NOT K COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1*1001 OR LESS) Q CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shell not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage Is unlawful, and ahail subject an employer to criminal penalties and civil fines up to one hundred thousand dollars l»100.000). In addition to the cost of compensation, damages as provided for In Section 3706 of the Labor code. Interest and attorney's fees. SIGNATURE _ DATE _ . _ 7. OWNER-BUILDER DECLARATION " " ' ' ' "'-"' T'"""- : •' ' r^r--?^' :;-•:< ••:.."• I hereby affirm that I am exempt from the Contractor's License Law for the following reason: Q I, as owner of the property or my employees with wages as their sole compensation, will do the work .and the structure Is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon, and who does such work himself or through his own employees, provided that such Improvements are not Intended or offered for sale. If, however, the building or Improvement Is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or Improve for the purpose of sale). Q I, as owner of the property, em exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Lew does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractorls) licensed pursuant to the Contractor's License Law). n I am exempt under Section _ Business end Professions Code for this reason: QNO1. I personally plan to provide the major labor and materials for construction of the proposed property Improvement. Q YES 2. I (have / have not) signed an application for a building permit for the proposed work. .3. I have contracted with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors license number): 4. I plen to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone number / contractors license number): ^______^___^___________________^_^__^_^^________ 5. I will provide some of the^work, but I have contracted (hired) the following persons to provide the work Jndiceted (Include name / eddress / phone number / type of work):, /f?2(n e work Indica .(i*jf . PROPERTY OWNER SIGNATURE n DATE 'COMPLETE THIS SECTION FOR NON-OfStDBfTlAl BUILDING PERMITS W»tY?JifFT^^ '" •v--"'f •""-"•• ~" Is the applicant or future building occupant required to submit e business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tenner Hazardous Substance Account Act? O YES D NO Is the applicant or future building occupant required to obtein a permit from the air pollution control district or air quality management district? D YES D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? O YES D 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. is," CONSTRUCTION"LENDING AGENCY ";"":"""""'""""^•'•---•-?rr*^ •• • --• •-.-.-• I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is issued (Sec. 3097(i) Civil Code). LENDER'S ADDRESSLENDER'S NAME S.' APPLICANT CERTIFICATION :";"l!';' ' '•" "" --"--•• =-----~---"---^-:—-~r^^ ^ - •- , •. • •.-.. • I certify that I have read the application and state that the above information is correct and that the information on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the CitV of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavations over 5'0* deep end demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the Building Official under the provisions of this Code shall expire by limitation end become null and void if the building or work authorized by such permit is not commenced within 365 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the worlds, cprnmencedjor a period of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE WHITE: File YELLOW: Applicant PINK: Finance CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB973808 FOR 12/16/97 INSPECTOR AREA DESCRIPTION: OVERHEAD TO UNDERGROUND PLANCK* CB973808 CONVERSION OCC GRP TYPE: ELEC CONSTR. TYPE VN JOB ADDRESS: 1785 CHESTNUT AV STE: LOT: APPLICANT: OSHIMA, ALLEN PHONE: 760 729-5465 CONTRACTOR: PHONE: OWNER: PHONE: REMARKS: C/729-5465 SPECIAL INSTRUCT: SERVICE BOX INSPECTION INSPECTOR TOTAL TIME: CD LVL DESCRIPTION 34 EL Rough Electric ACT COMMENTS DATE DESCRIPTION ***** INSPECTION HISTORY ***** ACT INSP COMMENTS NOTICECITY OF CARLSBAD • ^ ^^ " " ^"^ "™~ 438-3550 BUILDING DEPARTMENT 2075 LAS PALMAS DRIVE DATE \ Ih - « to ~ 1 « TIME. LOCATION. PERMIT NC o, 8 FOR INSPECTION CALL 438-3101. RE-INSPECTION FEE DUE? | | YES FOR fUPTTHER INFORMATION, CONTACT // PHONE BUILHNG INSF*BWDR CODE ENFORCEMENT OFFICER UNSCHEDULED BUILDING INSPECTION DATE / £ - /£^ *? 7 INSPECTOR /O PERMIT* -"- PLAN CHECK* JOB ADDRESS _ DESCRIPTION TIME ARRIVE: TIME CODE DESCRIPTION ACT COMMENTS 33 flP Atf- CITY OF CARLSBAD BUILDING DEPARTMENT DATE NOTICE 438-3550 2075 LAS PALMAS DRIVE TIME, LOCATION. PERMIT NO.°\ *1 - 3 D FOR INSPECTION CALL 438-3101. RE-INSPECTION FEE DUE? | | YES FOR FURTHER INFORMATION, CONTACT PHONE CODE ENFORCEMENT OFFICER