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Home My WebLink About2691 STATE ST; ; CB921219; PermitA • +-: l #: n y r... v. (,t ot..p. t OH l ' DER 4 AMP. EE- ff : y A {>.l. wn:t : e Enter Y !:ill gl t ELEL 1 9 R quue i CITY OF CARLSBAD T [ " N 0204 11/23/92 0001 01 02 C-PRMT 20-00 t • l Ext f c~ 10. 10. D y f, A 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APl>UCATION PLAN CHECK NO. City of carlsbad Building Depart11ent 2075 Las Pal""'5 Dr., carlsbad, CA 92009 (619) 438-1161 PIAN CK DEPOSIT l ~.VAL =· BY ___ -=.-=.-=--=--=--=--=--=--=--=--=--=--=--=--=--=--- A~ inmerc1al □New Bulldmg D lenam Improvement B -D Industrial □ New Building D Tenant Improvement C -□ Residential D Apartment □ Condo □ Single Family Dwelling 9,Md.won/ AJteration □ Duplex □ Demolition □ Relocation □ Mobile Home 0'€fectrical □ Plumbing □ Mechanical □ Pool □ Spa D Retaining Wall □ Solar □ Other 2. PROJECr INFORMATION FOR OFFICE USE ONLY Address 'Lb""\\ sm~ ~o~~as Nearest Cross Street LEGAL DESCRIM ION r~ 3sutx11V1s1on Name/Number 0mt No. Phase No. CHECK BEWW IF SOBMl 11 Eb: □ 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report □ 1 Addressed Envelope ASSESSOR'S PARCEL PROPOSED USE 0 DESCRIPTION OF WORK # OF STORIES rom app 1can NAME CITY ADDRESS .2...i-9°[ I. ZIP CODE s: ,· DAY TELEPHONE NAMEO'5(Cfl.._ CilY~S~~ 5. PKUP7 NAME tit£ c.f(Z..l.c_ STATEC-4. ZIP CODE/ ?-fl.5l./ DAY TELEPHONE CllY STATE ADDRESS ZIP CODE DAY TELEPHONE NAME CilY STATE STATE LIC. # ADDRESS ZIP CODE LICENSE CLASS DAY TELEPHONE CilY BUSINESS LIC. # CilY STATE ZIP CODE DAY TELEPHONE STATE LIC. # 7. WOltkERS' WMPENSAIIUN Workers' Compensatmn Declaration: I hereby afhrm that I have a cert1hcate of consent to self-msure issued by the Ulrectorof lndustnal 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 POLICY NO. EXPIRATION DATE Cernhcate of Exemptmn: I cernfy that m the performance of the work for which this pennu 1s 1ssued1 I shall not employ any person many manner so as to become subject to the Workers' Compensation Laws of California. SIGNATURE DATE 8. OWNffi-B0II.DIM DF!CtARA'ilUN Owner-Builder Declarat1on: I hereby affirm that I am exempt from the Contracto?s License Law for the followmg 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 Llcense 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 Llcense 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). □ 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 pur3uant to the provisions of the Contractor's Llcense Law (Chapter 9, commencing 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 than five hundred dollars [$500]). SIGNATURE DAU! CoMPLEIE 'I HIS SECI ION FOR NON-RESIDEN I IAL BUILDING PERMI IS ONLY: 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? □YES □NO Is the applicant or future building occupant required to obtain a pennit from the air pollution control district or air quality management district? CYES □NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ YES □ NO IF ANY OF THI! ANSWERS ARE YES, A FINAL CERTIFICATI! OF oa:IJPANCY MAY NOT BE ISSUED AFlllR JULY 1, 1989 llNLF.SS THI! APPUCANT HAS MET OR IS MEETING TIIE REQUIREMENTS OF TIIE OFFICE OF EMERGENCY SERVICES AND TIIE AIR POLLUTION WNTROL DISfRICT. 9. WNSIRUCIION il!NDING AGENCY I hereby aiurm that there 1s a constructmn lendmg agency for the performance of the work for which this permit 1s issued (Sec 3097(1) C1V1i Ccxle). LENDER'S NAME LENDER'S ADDRESS IO. AJSPUCAFH CfilliFiCA:OON I cerufy that I have read the apphcauon and state that the above mformauon 1s correct. I agree to comply with all City ordmances 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 ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS THI! CITY OF CARISBAD AGAINST ALL L1A111IJT1ES, JUDGMENTS, CDSTS AND EXPENSES WlDCII MAY IN ANY WAY NDIUE AGAINST SAID CITY IN OONSF.QUENCE OF TIIE GRANTING OF TIDS 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 Official under the provisions of chis 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 suspended or abandon ny time after the work is commenced for a pericxl of 180 days (Section 303(d) Uniform Building Code). DATE: ______ _ YEil.OW: Applicant PINK: Fmance • CITY OF CARLSBAD INSPECTION REQUEST PERMIT# CB921219 FOR 12/02/92 INSPECTOR AREA PD PLANCK# CB921219 OCC GRP DESCRIPTION: OH TO UNDER 40 AMPS PER KELLEY TYPE: ELEC JOB ADDRESS: 2691 APPLICANT: OCEANSIDE CONTRACTOR: OWNER: STATE ST ELECTRIC REMARKS: MH/JIM/722-6880 SPECIAL INSTRUCT: TOTAL TIME: CD 39 LVL DESCRIPTION EL Final Electrical CONSTR. TYPE NEW STR: FL: STE: ::'i:;:::'~ CL PHONE: INSPECTO• ACT COMMENTS t!!.._~~~- ~--------------I ***** INSPECTION HISTORY***** DATE DESCRIPTION ACT INSP COMMENTS