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Home My WebLink About2832 VIA CONQUISTADOR; ; CB091484; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 09-09-2009 Electrical Permit Permit No: CB091484 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: Applicant: Building Inspection Request Line (760) 602-2725 2832 VIA CONQUISTADOR CBAD ELEC 2225921800 Lot#: LIGHTHOLDER RES-4 NEW 15 AMP 0 Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: CIRCUITS IN PANEL TO ADD 6 NEW OUTLETS IN GARAGE Owner: ISSUED 09/09/2009 RMA 09/09/2009 09/09/2009 PRISM ELECTRIC LIGHTHOLDER SHARON O SOLE&SEPARATE PROPERTY TRUS 2006 SILVERADO ST SAN MARCOS 92078 760 420 9996 Electric Issue Fee Single Phase per AMP Three Phase per AMP Three Phase 480 Per AMP Remodel/Alteration per AMP Remodel Fee Temporary Service Fee Test Meter Fee Other Electrical Fees Additional Fees TOTAL PERMIT FEES 0 0 0 0 2832 VIA CONQUISTADOR CARLSBAD CA 92009 $10.00 $0.00 $0.00 $0.00 $0.00 $10.00 $0.00 $0.00 $0.00 $0.00 $20.00 Total Fees: $20.00 Total Payments To Date: $20.00 Balance Due: Inspector: Clearance: _____ _ $0.00 NOTICE: Please take NOTICE that approval of your project includes the "Im sition" of ees, 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. You are hereby FURTl~ER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any fees/exa • «1~ ~ CITY OF CARLSBAD Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718/ 2719 Fax: 760-602-8558 www .ca rlsbadca .gov SUITE#/SPACE#/UNIT# Plan Check No. Est. Value Date # BATHROOMS TENANT BUSINESS NAME CCC. GROUP AIR CONDITIONING FIRE SPRINKLERS YES □ NO □ YES □ ND□ CONTACT NAME /If Different Fom App/leant) ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE FAX PHONE FAX EMAIL EMAIL PROPERTY OWNER NAME CONTRACTOR BUS. NAME ADDRESS CITY STATE ZIP PHONE EMAIL ARCH/DESIGNER NAME & ADDRESS STATE LIC. # (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 fCha'fter 9, commending with Section 7000 of Division 3 of the Business and Professions Code) or {hat he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 703 .5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500}). Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following dec/arstions: D I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of lhe Labor Code, for the pertormance of the work for which this permit is issued. ~ have and will maintain workers' compensa_tion, as required by Section 3700 of the Labor Code. for the pertormance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Insurance Co. 5-k,<, ,/12 F✓n d.. Policy No. --Z/ 3 -(){) 2 g--a r:2 Expiration Date 6 / I ,I 2 a JD This section need not be completed if the permit is for one hundred dollars ($100) or less. 0 Certificate of Exemption: I certify that in the pertormance of the worl< 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 secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), In addition to the cost of compensation, damages as ovided for in Section 3706 of the Labor code, Interest and attorney's fees. ~ CONTRACTOR SIGNATURE t---:::;~~~~::.--..,..------ I hereby aflirm that I am exempt from Contractor's Ucense Law for the following reason: □ 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). □ 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 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). □ 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. □ Yes □ No 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 address/ phone/ 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/ address/ phone / 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/ phone/ type of work): ~ PROPERTY OWNER SIGNATURE DATE Is the applicanl or future building occupant required lo submit a business plan, aculely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardolis Substance Account Act? O Yes O No Is the applicant or future building occupant required to obtain a pennit from the air pollution control district or air quality management district? O Yes O No Is the facility to be constructed within 1,000 reel of the outer boundary of a school site? O 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. I certify that I have read the application and state that the above infonnation Is correct and that the infonnation on tile plans is accurate. I agree to comptywith alt City ordinances and State lav.s relating to building construction. I hereby authorize representawe of the City of Car1sbad I:> enter upon the above mentilned 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 stolies in height. EXPIRATION: Every pern,it issued by the Buikling Official under the provisions of this Code shall expire by fmltation and become null and void if the buiding or WOO( au1horized by such pem,it is not rormenced ~ 180 days from the date of such pennit or if the buiding or WOO( authorized by such pennlt is suspended or abandoned at any time after the WOO( is commenced for a period ol 180 days (Section 106.4.4 Unibm Building Code). _,1$ APPLICANT'S SIGNATURE DATE I) City of Carlsbad Bldg Inspection Request For: 09/11/2009 Permit# CB091484 Inspector Assignment: Title: LIGHTHOLDER RES-4 NEW 15 AMP Description: CIRCUITS IN PANEL TO ADD 6 NEW OUTLETS IN GARAGE Type: ELEC Sub Type: Phone: 8586686093 Job Address: 2832 VIA CONQUISTADOR Suite: Lot: O Location: Inspector: ~ ,1 APPLICANT PRISM ELECTRIC Owner: LIGHTHOLDER SHARON O SOLE&SEPARATE PROPERTY TRUS Remarks: Total Time: CD Description 34 Rough Electric ~-~&,~ Act Comments 1$ -- Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act lnsp Comments Requested By: KYLE Entered By: CHRISTINE