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Home My WebLink About2878 VIA CONQUISTADOR; TP; CB983925; Permit11/16/9ts 10:24 Page 1 of l BUILf;ING Job Ad,kess: 2878 VIA CONOUISTADOR Permit Type: ELECTRICAL Parcel No: Valuation: O PERMIT Permit No: CB~8jjlS Sui tP: ~ Lot#: Project No: A98u512J Development No: Occupancy Group : Reference#: Construction Type: NEW Status: ISSUED Applied: 11/16/➔~ Apr/Issue: 11/lb/98 Entered By: BT 439-1999 Description: TEMP POWER POLE Appl/Ownr : TEMP POWER SYSTEMS 750 N CITRACADO PKWY #4 ESCONDIDO CA Fees Req uired *** Fees: Adjustments: Total Fees: Fee description Enter ''Y' for Ele Enter "Y" for Tern CITY OF CARLSBAD Collected & Credits ~a W16/98 0001 01: o 002 C-PRMT • U CJ 20-00 20.00 Ext fee Data 10.UO Y 10.00 Y 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 PERMIT ~ APPLICATION FOR OFFICE USE ONLY 2. 9, $ PLAN CHECK NO. ~ ? 'c:J' I ;;J CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 EST. VAL. _______ _...dr?"--__ ..-- (760) 438-1161 Plan Ck. Deposit -----,~11-..,....:-----~:::"•d By ;i fl le ft t 1. PROJECT IN~l,.8 t/4 Address !include Bldg/Suite #) Business Name lat this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Existing Use Proposed Use Description of Work sa. FT. #of Stories II of Bedrooms I ol Bathrooms 2. • CONTACT PERSON llf different ·horn eppili:antl Name Address City State/Zip Telephone# Fax II n!Jpr Contractor • • . C:1 ~ Aga~rt~ Name Address City 4. PROPERTY OWtjER 011.@JA,e_,,J.- Name Address City State/Zip Telephone II S. CONTRACTOR. COMPANY NAME (Sec. 7031.5 Business and Professions Code: Anv City or Countv which requires• 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 exam tion. A~violation of Section 7031.5 by any •PPl_!Pe':)bfor a permit sub~s the appl~nyto ~i_!.pe~IJY ot not l'!?'J th live h~r dolla s 1$500 ~w/J /-6{;l)'U. sysn~s 7'~~-e1~ Mc..v< 't E~t>/D<!> 01-~ 7~ ~ - Name State License # _________ _ Address City State/Zip !?-1:' \ T/ 0 el!Pb~e ~ License Class__________ City Business License # ---1~=.J.<:.....1.. ~-.&:--2"""-"--d - Designer Name Address City State/Zip Telephone State License # _________ _ 6. WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: D I have and will maintain a certificate of consent to sell-Insure for workers' compensation es provided by Section 3700 of the Labor Code, for the performance o_l~ork for which this permit is issued . .,.e:J I have and will maintain workers' compensation, es required by Section 3700 of the Labor Code, for the performance of the work for which this p rmit is issued. My worker's ~pen~on)lfjl,rance carrier~ poli;,dlumber are: _ / Insurance Company C:.'1A/'I" • C,.-?S ~,,fCT7 L.(2 Policy No. /0 2'98 <J?-9$. V-Expiration Date.;./1_~-+...,;,/'+-...,;_-'--- fTHIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1$1001 OR LESS) D 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' Compense on Laws of California. WARNING: Failure to ■ecure workera' com ■etlon covarage 11 unlawful, end ahlln aubject an employar to crlmlnlll penelt thousand dollars ($100 I, dlt colt of compenutlon, damaga1 u provided for In Section 3706 of the_..,..,,...,.. SIGNATURE. __ -J..__c..::,...i~_-L,,a..e::....=::s..£...=-.!=:=--------------DATE _.L..J.'-J-....£.--l:~-LL....<'--- ' ... ,. 1· ' . 7. OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: D I, as owner of the property or my employees with wages es their sole compensation, wlll do the work ind the structure is not intended or offered for aele (Sec. 7044, Business and Professions Code: The Contractor's license Law does not apply to an owner of property who builds or Improves thereon, end who does such work himself or through his own employees, provided that such Improvements are not Intended or offered for Hie. II, however, the building or lmprovemant Is sold within one veer of completion, the ownar-bullder wlll have the burden of proving that he did not build or Improve for the purpoH of Hie). D I, es owner of the property, ■m exclusively contracting 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, end contracts for such projects with contractor(1I licen■ed pursuant to the Contractor's License Law). D I am exempt under Section ______ Business end Professions Code for this reason: 1. I personally plen to provide the major labor and materials for construction of the proposed property Improvement. 0 YES ONO 2. I (have / have notl signed an application for• building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction (Include name I address / phone number / contractors license numberl: 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise end provide the major work Onclude name / address / phone number/ contractors license number): _______________________________________________ _ 5. t will provide some of the work, but I have contracted (hired I the following persona to provide tha work Indicated (Include name / address / phone number / type of work):. _________________________________________________________ _ PROPERTY OWNER SIGNATURE ______________________ _ DATE _________ _ Is the epplicant or future building occupant required to submit • business plan, acutely hazardous m1teri1l1 registration form or risk management end prevention program under Sections 25505, 25533 or 25534 of the Presley-Tinner Hazardous Substance Account Act? 0 YES O NO Is the applicant or future building occupant required to obtain • permit from the air pollution control distri_ct or ■Ir quality management district? 0 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 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 POUUTI0N CONTROL DISTRICT. 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) Clvil Code). LENDER'S NAME ______________ _ LENDER'S ADDRESS _______________________ _ r9, APPLICANT CERTIFICATION I certify that I have read the application and stata that the above information ts correct end that the Information on the plans is accurate. I agree to comply with ell City ordinances and State laws relating to building construction. I hereby authorize representatives of the Cltt 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 Official und the provisions of this Code shall expire by limitation end become null and void ii the building or work authorized by such permit is not com ced withi 365 ays from the date of such permit or ii the building or work authorize v such ermit is suspended or abandoned et any time alter the work c .;.-;,t.~-,. eriod of 180 days (Section 106.4.4 Uniform Building Code). WHITE: File YELLOW: Applicant PINK: Finance