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Home My WebLink About2736 LOKER AVE W; A; CB023574; PermitCity of Carlsbad cJ_u ( . 1635 Faraday Av Carlsbad, CA 92008 11-26-2002 Miscellaneous Permit Permit No: CB023574 Building Inspection Request Line (760) 602-2725 Job Address: 2736 LOKER AV WEST CBAD St: A Permit Type: MISC Subtype: OTHER Parcel No: Lot#: 0 Valuation: $0.00 Reference #: Project Title: HISAMITSU DEMO NON-BEARING PARTIONS Applicant: DESIGN/BUILD TENANT IMP. SUITE B 9770 CARROLL CENTER RD. SAN DIEGO, CA 92126 619-954-9519 Total Fees: $60.00 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES Owner: Total Payments To Date: PERMIT $0.00 Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 11/26/2002 MOP 11/26/2002 11/26/2002 2136 1V26/02 0002 01 02 Balance Due: $60.00 $0.00 $0.00 $60.00 CGP 60 °00 $60.00 Clearance: ------ NOTICE: Please take NO ICE that approval of your project includes the ·1 sitio of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions.· You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. PERMIT APPLICATION FOR OFFICE USE ONLY PLAN CHECK NO. O& CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST.VAL._~~~~~~~~~- Plan Ck. Deposit--------- Validated By __________ _ Date ______________ _ 1. PROJECT INFORMATION Address (include Bldg/Suite #) IA.a Business Name (at this address) ;)7 ,::;? h Lt, l?e-c k . Lot No. ~ Subdivision Name/Number Unit No. Phase No. [o+-.s '3-<. i "'-c.lus;~ ,..A· Cc-.r-l5\:.c..cJ. -rr~d _. 74--21 O'?""/? /1,:; Wu.f ~t-c A +41 #,'s""-~,-+:s v Legal Description :P c.a;e.{s A-~ 3 a .f= Total # of units /037.;l. Assessor's Parcel # Existing Use Proposed Use ,2..0<;. -08( -z.2:,-00 0 Description of Work SQ. FT. #of Stories # of Bedrooms # of Bathrooms '.De..VlA-0 ,z.017 -1:.~e..,-/"!5 p=~./, ,/;~ CONTACT PERSON (If different from appllcantl Name Address 3. APPLICANT U:f'Contractor O Agent for Contractor O Owner City 0 Agent for Owner State/Zip Telephone# Fax# Name I)e..siSV'-Bv, l ct -r:t: 4. P.ROj'ERfY OWNER City ._5;.~f t'<'Z> State/Zip (!.,/ Telephone /(2(5" 8) S4"1 -8'.fs-!;;' . V 'f • 'fi:V~(,,, Name ;/.G Fe-h,.,,c Telephone # 5. CONTRACTOR • COMPANY NAME (Sec. 7031 .5 Business and Professions Code: Any City or County which requires a permit to construct, alter, 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 Law [Chapter 9, commending with Section 7000 of Division 3 of the Business and 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 th~n Jive hundred dollars ($5001). Des"~"'-i?u~\e: -r-::i;: '77'7D (;c..;-,o(I ~~/.,, i?J. S-lr-. 6 s ~-Dtt!(D C'/J 4;r/Z(,,,,. (<;?S£)5'~7'k°'5 Name Address City St'ii'te/Zip Telephone # State License# 4&(p~ 4 License Class J3 City Business License# l '2 I ;3o4-(o Designer Name State License# 4-~'>S'4- 6. WORKERS' COMPENSATION Address fss City Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: State/Zip Telephone O I have and 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..---'(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 ~ C<J~ ~-~ Policy No. /"&j f?"? (R (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS) Expiration Date /-/ S--0 3 0 CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to tlon coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE_.L.....,.L'.:.i!!:::;2:~~::2:C~~::::....::::::.. _________________ _ DATE 11 -Z~ -02... 7. OWNER·B I hereby affirm that I am exempt from the Contractor's License Law for the following reason: 0 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). 0 I, as owner of the property, am exclusively ~ontracting with licensed contractors to construct the project (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 contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). 0 I am exempt under Section ------Business and Professions Code for this reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES ONO 2. I (have I 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 I address I phone number I contractors license number): 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name I address I phone number I contractors license number)=------------------------------------------------ 5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name I address I phone number I type of work): _______________________________________________________ _ PROPERTY OWNER SIGNATURE ----------------------- COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONL V DATE _________ _ Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? 0 YES O NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site 7 0 YES O 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. 8. CONSTRUCTION LENDING AGENCY 1 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 NAME---------------LENDER'S ADDRESS ________________________ _ 9. APPLICANT CERTIFICATION 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 Cit~ 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 and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the building Off~1cial u r the provisions of this Code shall expire by limilation and become null and void if the building or work authorized by such permit is not commenc withi 80 d om the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenc r a R iod 1 days (Section 106.4.4 Uniform Building Code). DATE ___ f_l _-_.26.-=-. __ 0_Z. __ YELLOW: Applicant PINK: Finance ~ ~ City of Carlsbad Bldg Inspection Request Permit# CB023574 Title: HISAMITSU For: 01/27/2003 Description: DEMO NON-BEARING PARTIONS Type: MISC Sub Type: OTHER Job Address: 2736 LOKER AV WEST Suite: A Lot 0 Location: APPLICANT DESIGN/BUILD TENANT IMP. Owner: Remarks: Total Time: CD Description Act Comment Inspector Assignment: Phone: 6199544735 Inspector: ~::: ~ f<u ,~/L-,-:- 0(t:i 1Ilf-s-as~ Requested By: RANDY Entered By: KAREN 14 Frame/Steel/Bolting/Welding /}:£._ l'(:o-re:/) bYt.--(j)i,;,A-r, ~ 21 Underground/Under Floor L.fi!_ __________________ _ Associated PCRs/CVs Inspection History Date Description Act lnsp Comments