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Home My WebLink About290 HEMLOCK AVE; A | B; CB911493; PermitBUILDING 11/01/91 14 23 Page 1 of 1 Job Address 290 HEMLOCK AV Permit Type ELECTRICAL Parcel No 204-240-4.2-OU Valuation 0 Construction Type NEW Occupancy Group Description TPP (MS808)BLDG A PERMIT Str Permit No CB<U1493 Project No Development No Fl Ste 5066 11/01/91 0001 01 C-PRKT 20.00 02 Class Code Appl/Ownr BERNSTEIN, ROGER 514 VIA DE LA VALLE #30. SOLANA BEACH, CA *** Fees Required Status Applied Apr/Issue Validated By 619-755-7308 ted & Credits ISSUED 11/01/91 11/01/91 RS Fees Adjustments Total Fees Fee description Enter "Y" for Elec Enter "Y" for Temp * ELECTRICAL TOTAL 00 00 20 00 Ext fee Data 10 00 Y 10 00 Y 20 00 APPROVAL DATE/A/'^/ CLEARANCE 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 <619) 438-1161 FliKMIT ITfFE A B C U Commercial U New Building Q Tenant Improvement D Industnal D New Building D Tenant Improvement D Residential D Apartment D Condo D Single Family Dwelling D Addition/Alteration D Duplex D Demolition D Relocation D Mobile Home D Electncal D Plumbing D Mechanical DPool D Spa D Retaining Wall D Solar d Other 2 PROJECT INFORMATION PLAN CHECK NO. EST VAL PIAN CK DEPOSIT, VALID BY DATE FOR OFFICE USE ONLY Address '0 NearesFCross Street LEGAL DESCRIPTION or suite No Lot No Subdivision Name/Number Unit No Phase No CHtXJK BELOW IF SUfiMll ItlJ D 2 Energy Calcs D 2 Structural Calcs D 2 Soils Report D 1 Addressed J 4 b 6 ASSESSOR'S PARCEL DESCRIPTION OF WORK — -|~ SQ FT EXISTING USE V^/3 ^G? £x> <2j£_ # OF STORIES (JUN i Atrr HEKbUN (.11 airterent trom appncantj NAME ADDRESS CITY STATE ZIP CODE APPLICANT U COIN 1 KAC 1 OK NAME jg^/5 ^.l-S^-T? CITY U/^>-TA~ PROPERTY OWNER NAME CUT CONTRACTOR LJAGLN1 FOR CON 1 KAC 1 OK >3UVVNI ADDRESS STATE O4- ZIPCODE^2^£)g"<$^~ ADDRESS STATE ZIP CODE A «. X Envelope PROPOSED USE DAY TELEPHONE iK LJAGEN1 I-OR OWNhR DAY TELEPHONE 7 / ^' ~- 3 §-<2>f> DAY TELEPHONE CITY ADDRESS ^-» CJ X&C7JK. I fc *& J STATE CVt- ZIP CODE DAY TELEPHONE "? tf Y ^ 3 STATE LIC # J3/<S> /y5~llCENSE CLASS ^ '/^ CITY BUSINESS UC # CITY STATE AlJUKtSb ZIP CODE DAY TELEPHONE STATE UC # WOKKhRi> COMPENSAllUN Workers' Compensation Declaration I hereby allirm that I have a certificate ot consent to sell insure issued by the Director of Industrial Relations, or a certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified by the Director of the insurer thereof filed with the Building Inspection Department (Section 3800, Lab C) INSURANCE COMPANY <3?/l/O C/£>L/AfT</ POUCY NO EXPIRATION DATE ploy any person in any mCertificate ot Lxemption I certify that in the performance of the work tor 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 SIGNATURE DATE 8 OWNER-BUUJJiERDEClARAnON Owner Builder Declaration Thereby affirm that! am exempt from the Contractors License Law For the following reason D 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) D I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec 7044, Business and Professions Code The Contractor's Ijcense 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) D I am exempt under Section Business and Professions Code for this reason (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, commencing with Section 7000 of Division 3 of ihe 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 than five hundred dollars [$500]) SIGNATURE DATE COMPLETE THIS SECTION FOR NON RESIDENTIAL BUILDING PERMITS ONLY Is the applicant or future building occupant required to submit a business plan, acutely hazardous matenals registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley Tanner Hazardous Substance Account Act? D YES D NO Is the applicant or future building occupant required to obtain 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? D YES D NO IF ANY OF TI IF. ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED AFTER JULY 1, 1989 UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT 9 CONSTHUI.T1ON LENDING AGKNCY I hereby atlirm that tnere is a construction lending agency lor the perlormance ot the work lor which this permit is issued Ibec 30970J Civil Code) LENDER'S NAME LENDER S ADDRESS 10 AHFUCJVNI ChHTIFlLAllON 1 cerlity that 1 have read me application and state that the alxwe inlormation is correct I agree to comply with all City ordinances and State laws relating to building construction I hereby authorize representatives of the City of Carlsbad to enter upon the above mentioned property for inspection purposes I AI.SO 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 SATO 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 stones in height Expiration Every permit issued by the Building Official under the provisions of this Code shall expire by limitation and 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 suspendedxn abandoned at any time after the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code) APP .NTS/JCNA;DATE WHITE File YELLOW Applicant PINK. Finance PERMIT* CB911493 DESCRIPTION: TPP (MS808)BLDG A TYPE: ELEC JOB ADDRESS: 290 HEMLOCK AV APPLICANT: BERNSTEIN, ROGER CONTRACTOR: OWNER: REMARKS: RS/GARY/744-3561 SPECIAL INSTRUCT: CITY OF CARLSBAD INSPECTION REQUEST FOR 11/05/91 PHONE: PHONE: PHONE: INSPECTOR AREA PLANCKtf CB911493 OCC GRP CONSTR. TYPE NEW STR: FL: STE: 619-755-7308 INSPECTO TOTAL TIME: —RELATED CD LVL 33 EL PERMITS — PERMIT# CB901079 SE900106 CB910770 RW910144 DESCRIPTION Service Change/Upgrade TYPE CONDO SWRSD RETAIN ROW ACT fsL STATUS ISSUED ISSUED ISSUED ISSUED COMMENTS DATE DESCRIPTION INSPECTION HISTORY ***** ACT INSP COMMENTS