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Home My WebLink About1000 BEACON BAY DR; ; CB961620; Permitc BUILD 08/3U/96 12: 38 Job Address: 1c)OL) BEACON BAY '3R F'ermi t Type : ELECTRICAL Parcel. No: Valuation: 0 Occupancy Group : Description: 100 AMP PED. I Page 1 of 1 Appl,/Ownr : FOSHAY ELECTRIC 7676 ENGINEER ROAD kkk Fees ------ - -- Fees Ail jus tmen t s Total Fees Fee descr Enter "Y" f Single Pha x ELECTRICA ------I----- ING PERMIT Permit No: CE961620 Prolect No: A9602314 Development No : Suite: 9394 OB/3Vf96 Const-ruct ion Lot# : Reference#: Applieci : U8/3 0 / 9 b Apr/Issue: 08/30/9b Entered Fy: MDP 619 277-7676 CITY OF CARLSBAD 2075 Las palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMlT APPLICATION City of Carlsbed Building Department 2075 Las Palms Dr., Carlsbad, U 92009 (619) 438-1161 From List 1 (see back) give code of Permit-Type: For Residential Projects Only: From List 2 (see back) give ......................................................... PLAN CHECK NO. 76 - /&m Esr- VAL Code of Structure-Type: Net Lms/Gain of Dwelling Units 2. PRC"lNFORMATI0N PIAN CK DEFOSlT VALtD. BY DATE FOR OFFICE USE ONLY ui ing or Suite No. Yl .beacon by B& Address 1000 Nearest Cross Street (&.,,~c~,\ AL DESCRIPTION Lot No. Subdivision NamdNumber Unit No. Phase No. 0 2 Enerm Calcs 0 2 Structural Calcs 0 2 Soils Rewrt 0 1 Addressed Enveloce SQ. FT. # OF STORIES # OF BEDROOMS # OF BATHROOMS i i eren rom app ican ~r$~&~~L~dil, t%,kADDRESS 7b7(, ~/l~~~~ CITY STATE ZIP CODE DAY TELEPHONE STATE LIC. # Workers' Compensation Declaration: I hereby aftirm that I have a certihcate ot consent to selt-insure issued by the Director of Industnal 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). fl INSURANCE COMPANY Sa &-c 0 mucy ~0.w C8 \ @ IRATION DATE \ / 1 9 7 Ceroticate ot Exemption: 1 certity that in the performance ol 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 Uwner-Builder Declaration: 1 hereby atfirm that 1 am exempt from the Contractors Llcense Law tor the tOlIOWing 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 contractom 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 (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 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 [SSOO]). 0 0 0 Business and Professions Code for this reason: SIGNATURE DATE COM-ON FOR NON-RESmTIAL mLDINC PERMITS mLY: 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? Is the applicanr or future building occupant required to obtain a permit from the air pollution control district or air qualiry management dism'ct? Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? IF ANYOF THE ANSWERS AREYES, AFINACCERTlFICATEOF OCXXJPANCY MAY NOT BE ~AFIERJULY 1,1989 UNLESS THE APPLICANT HAS MET OR IS MEIXING THE REQUIREMENTS OF THE OFFICE OF JMERGENCY SERVICES AND THE AIR WLLUTION CONTROL DISIRICT. 1 hereby attirm that there is a construction lending agency tor the performance ot the work for which this permit is issued (Sec 30Y71 I) Civll Code). 0 YES 0 NO 0 YES 0 NO 0 YES 0 NO LENDER'S NAME LENDER'S ADDRESS Tb. AP 1 certity that I have read the application and state that the above intormation 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 ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS THE CXNOF CARISBA0 AGAKN~ALLLIABILITES, JUDGMENTS, COSIS AND EXPENSES WInM MAY IN ANY WAY ACXXUE AGAIN= SAID CXN 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. Code shall expire by limitation and become null and void if the the date of such permit or if the building or work authorized by r a period of 180 days (Section 303(d) Uniform Bui i APPLICANT'S SIGNATU DATE: &!$y'u icant PINK: Finance 8 PERMIT# CB961620 DESCRIPTION: 100 AMP PED. TYPE: ELEC JOB ADDRESS: 1000 BEACON APPLICANT: FOSHAY ELECTRIC CONTRACTOR: OWNER: REMARKS: MW/JOE SPECIAL INSTRUCT: TOTAL TIME: CD 39 LVL DESCRIPTION EL Final Electrical CITY OF' CARLSBAD INSPECTION REQUEST FOR 09/19/96 BAY DR INSPECTOR AREA PLANCK# CB961620 OCC GRP CONSTR. TYPE VN STE : LOT: PHONE: 619 277-7676 PHONE : ACT COMMENTS M DATE DESCRIPTION ***** INSPECTION HISTORY ***** ACT INSP COMMENTS WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self-insure for = A. workers' compensation as provided by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation, as required by section 3700 issued. My workers' compensation insurance carrier and policy number are: / B. of the Labor Code, for the performance of the work for which this permit is INSURANCE COMPANY POLICY NO. EX PI RATION DATE: ---&-x!!-W ----- Z-EQafiLC ------ QQ2 ---- W-GZ-L~3-Z5-S-& ...................... obl I97 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) 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 C. workers compensation laws of California. Warning: Failure to secure workers' compensation coverage is unlawful, and shall be 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 provided for in Section 3706 of the Labor Code, Interest and attorney's fees. March 3, 1995 @ 2075 Las Palmas Dr. - Carlsbad, CA 92009-1576 (619) 438-1161 FAX (619) 438-0894 AnON ONLY AND THIS CERTIFICATE Westland Insurance Brokers AFFORDED BY THE , '. 0. Box 85481 San Diego, CA 92186-5481 (619) 584-6400 .................................................................................................................. mwRm FOSHAY ELECTRIC 7676 ENGINEER ROAD SAN DIEGO, CA 92111 COMPANIES AFFORDING COVERAGE COMPANY L-m A SAFECO INS. COMPANY THIS IS TO CERTIFY THAT THE POUCIES OF INSURANCE USTEED BELOW HAVE BEEY ISSUE3 TO THE INSURED NAUED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT. TERM OR C3NDITION OF ANY CONTRACT OR OTHER DOCUWENT WITH RESPECT TO WhICH RIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, ME INSURANCE AFFORDED BY 7dE POLICIES DESCRIBED HEREIN IS SUWECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF S lWE OF INSURANCE :0 TR .. .. ................... .......... : : 0"NMAS 6 CONTRACToFlS PROT. ..... ... .. .. .. ................................................................ .................................................... :*LIToYoBLE l.lm&m ANT ALnO Au. OmaO AUTOS SCHEDULE0 AUTOS HRED mOS NOKOWNED AUTOS :H POLICIES. UMlTS SHOWN MAY HAVE BEEN REDUCED BY PAID CWMS. WllTS POUYEFFECT~VE mucrO(PIR*m DATE (?&&OOm) DATE@MDDm) POLICY NUMBER GENERAL AGGEGATE s i'R00vcTsCoMPx)p AGG. S ! pDlsoNAL6ADV.tNJJRY S ....................................................................................... EACH cccuRF€NcE f FIRE DAMAGE (anV me fire) 5 COMBINED SINGLE LlMK BODICY I- s (Per perm) SODICY IWURY (Per accdent) s AGGEGATE s ........ ............ : :Uh4BfELUFoFuA : . OTHER THAN UMBFlELiA FoFlM ................................................................................................................................................................................................................................................................ STATUTW LIMITS : w~3coIIPMsIm ............................................................. Ai AND WC8133555M :01/01/96 01/ 01/97i."HACC!E .................... .f ..... ?.~.o.o.!?~ 00.c Eypu)YER(F UIBW ........................................................................ OTHER .................. DLSEASE - PoClCY LIMil s . .1.,.0 00 p oc :DISESE-EACHEMPLOY~ s 1,000,OOC ............................................................................................................................................................................................................... .............................................................................................................................................................................................................. DESCRPM(( OF O~llONS/IRCATDNSIVMICI€YS?€CUL myS RE: LICENSE NUMBER - #209306 * 10 DAYS NOTICE OF CANCELLATION FOR NON PAYMENT OF PREMIUM. SHOULD ANY OF RE ABOVE DESCRIBED POUClES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITEN NOl7CE TO THE CEKTIFICATE HOLDER NAMED TO THE iHE CITY OF CARLSBAD BLDG/ELECTRICAL PERMIT DEPT. 2075 US PALMAS LEFT, BUT EAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LlABlUPl Ci ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. .I CARLSBAD CA 92008