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Home My WebLink About104 CHRISTIANSEN WAY; ; CB962307; Permit*-' BUILDING PER MI 32/04/9b 4 27 Page 1 of 1 Job Address 104 CHRISTIANSEN WY Saite Peimit lyoe ELECTRICAL Parcel No Lot# Valuation 0 Occupanry Group Reference* Description TEMPORARY POWER POLE-CONSTRJCT CARLSBAD BY THE SEA Permit No CB962307 Project No A9603294 Development No Appl/Ownr DPR CONSTRUCTION 2796 CARLSBAD BL\/T> CARLSBAD CA 92008 619 * A *Fees red 12/to/96 C00.1 Cl 02 C-KMT 20 00 Construction Type NEW Status ISbUED Applied j.V04/Sb Api/Issue 12/04/96 Entered By RMA 720-7031 A A -it Fees 20 fO Z"\ ? V :>y-\\ / ^ Adjustments 1 1 c ^ \ ~- 4"" s.C,i Total Fees 21; <, fl '"<~ ir ^^^-^ / V v / "^•7/-i Ualan"! Fee description / ~~~ -^ , / '^f ^ \ H^ftl t s / / *-~ /~^ "~ y* ~t-r -^^"^"™^r~\ ^ ^ _, -~~^ - -v. Enter Y for Electric 3~s_=>-uo' Fc-fej.* ^^ ^-^^^"^ Entei Y for Temporary \*,vice X.> "~^=|5"'"" y^ ^> ELECTRICAL TOTAL '^ J ' 1 ,\ 4v S \ \ / \ i\ A ^^. ffl ^ jy ' \ tj£ 1r^ \ w^kfr , if-4 -BJtfe^\ \ 20 Y^fr>/J -" \ Ext fe V ,"—— _,_ i_x ^- „. ^*^^ \ iy \ io ,o\ ^ — -,'. ^ 10 Ai\ V^) \ 2° 00 00 00 36 00 00 00 Data Y Y IMCORPORATED (, ~\\ o A"^-, * v/ / \ \ CLEARANCE CITY OF CARLSBAD 2075 Las Palmas Dr Carlsbad CA 92009 (619) 438 1161 >tfft&t PERMIT APPLICATION fc^-^^Ma rr>y City of Carlsbad Building Department ^kl*^y 2075 Las Palaas Or Carlsbad CA 92009 (619) 438 1161 N^Jg^ 1 PEHMTl 1TPE From List 1 (see back) give code of Permit Type l^ \/W t-*" For Residential Protects Only From List 2 (see back) give Code of Structure Type Net Loss/Gam of Dwelling Units 2. PROJECT INFORMATION <- ^{/ Address I LS"t ^^'tf\^i I-'H Bi/ildmg or Suite No Nearest Cross Street C*7(Z^l-Kj 17 /H/^" PLAN CHECK NO Q Q^ p "I EST VAL PLAN CK DEPOSIT /> VALID BY / (J^/L^ DATE h ( 1 1 <? / W "1 K. ""--^ {LI — •» FOR OFFICE USE ONLY ^*M>. C-A ^Z~>S LEGAL DESCRIPTION Lot No Subdivision Name/Number Unit No Phase No CHECK BELOW IF SUBMITTED D 2 Energy Calcs O 2 Structural Calcs D 2 Soils Report D1 Addressed Envelope ASSESSOR S PARCEL EXISTING USE PROPOSED USE DESCRIPTION OF WORK SQ FT Z-'# OF STORIES # OF BEDROOMS # OF BATHROOMS 3 UUIM IALTI FtKiAJN lit flitterem trom applicant; NAME (last name first) , ,•pcTZ-fJ \AlVU tVL-^l ( CITY STATE ADDRESS T^ ZIPICPE AYTELEP"ONE.... .4" APPLICANT fclujN 1HAL71UH U AtihN'I FOR CUN 1 HAU1UR UUWNER UAGtNl FUR OWNEH NAME (last namelirst) CITY \AjH-|fM^V ADDRESS STATE C-A- ZIP CODE PAY TELEPHONE 5 PROPERTY OWNER NAME (last name first) CITY ADDRESS STATE ZIP CODE DAY TELEPHONE 6 CONIKAL.1UK N AME (last name first)ADDRESS STATE LIC # ZIP CODE LICENSE CLASS DAY TELEPHONE CITY BUSINESS LIC # CITY NAME (last name nrst) \^&\J \ NA til's) ADDRESb |( STATE (^/- ZIPCODE c\00l£<-l DAY TELEPHONE Workers Compensation Declaration I hereby artirm that I have a certificate ot consent to self insure issued by the Director of Inaustnal Relations or a certificate of Workers Compensation Insurance by an admitted insurer or an exact copy or duplicate thereof < ertified by the Director of the insurer thereof filed with the Building Inspection Department (Section 3800 Lab C) INSURANCE COMPANY POLICY NO EXPIRATION DATE Z- Certificate ot 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 Compensation Laws of California SIGNATURE DATE 8 OWNER BUILDER DEdARATION TJwnerTJuiIaer Declaration I hereby artirmtnan am exempt trom the Contractors ucense Law tor the Tollowing 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 Pi ofessions 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) licen ed 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 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 [$500]) SIGNATURE DATE COMPLK'I'E THIS SECTION FOR NQN RESIDENTIAL BUILDING PERMIT ONLY Is the applicant or future building occupant required to submit a business plan acutely hazardous matenals registration form or nsk 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 O 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 AFTER JULY 1 1989 UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE ATR POLLUTION CONTROL DISTRICT 9 CONS'l'KUCJI'lON LENDING AGENCY I hereby affirm that there is a construction lending agency tor trie performance ot the work tor which this permit is issued (.bee 3097(i) Civil code) LENDER S NAME LENDER S ADDRESS I certify tnat 1 have read the application and state that the above information is correct T agree to comply witn 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 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 PERMTI 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 authonzed by such permit is not commenced within 365 days from the date of such permit or if the building or work authonzed by such permit is suspended or abandoned at any, time after the work is commenced for a penod of 180 days (Section 303(d) Uniform Building Cede) APPLICANTS SIGNATURE \ A h . , ^ . /^N_ DATE! WHITE FilW YELLOW Applicant PINK. Finance CITY OF CARLSBAD INSPECTION REQUEST PERMITtf CB962307 FOR 01/03/97 DESCRIPTION 2 TEMPORARY POWER POLES-CONSTR CARLSBAD BY THE SEA,104 A&104 B FOR SDGE TYPE ELEC JOB ADDRESS 104 CHRISTIANSEN WY STE APPLICANT DPR CONSTRUCTION PHONE 619 720-7031 CONTRACTOR PHONE OWNER PHONE INSPECTOR AREA PLANCK# CB962307 OCC GRP CONSTR TYPE NEW LOT REMARKS MW/WHITNEY/720-7031 SPECIAL INSTRUCT 104 A & 104 B TOTAL TIME CD LVL DESCRIPTION 32 EL Const Service/Agricultural INSPECTOR ACT COMMENTS DATE DESCRIPTION ***** INSPECTION HISTORY ***** ACT INSP COMMENTS 8 PARKING ANY TIME R26 n PARKING ANY TIME R28 R49M CAR TR -Jl \ ff/S^r PWL^ $&{-%__ City of Carlsbad Building Department WORKERS COMPENSATION DECLARATION hereby affirm under penalty of perjury one of the following declarations I have and will maintain a certificate of consent to self insure for workers compensation as provided by section 3700 of the Labor Code for the performance of the work for which this permit is issued y' I have and will maintain workers compensation as required by section 3700 • B of the Labor Code for the performance of the work for which this permit is issued My workers compensation insurance carrier and policy number are INSURANCE COMPANY POLICY NO EXPIRATION DATE fe^4 Nj6,-£ q M ij H-i- ^ 6? I o / .. _ (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 Signature Date 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 92OO9 1576 • (619) 438 1161 • FAX (619) 438 O894 O2 25 PH PST 1J./O6/96 B 0 I Page ACORD GERTIFICATFOFI IABlUTVaiU3lRA|i|C£ "^iT^1 PRODUCER TH Alburger Basso de Grosz °£j 301 Island Paakwav £" r (J BOX MI/ S CERTIFICATE IS ISSUED AS A MATTER OF- INFORMATION LY AND CONFERS NO RIGHTS UPON THE CERTIFICATE LDER THIS CERTIFICATE DOES NOT AMEND EXTEND OR FER THE COVERAGE AFFORDED BY THE POLICIES BELOW COMPANIES AFFORDING COVERAC E ueunociu «_A ynuuj. iiov ° A St Paul Fire & Marine CV1PAN DPR Construction Inc a Roval Indemnity Company 6333 Greenwich D I- #170 San Diego CA 92122 --VIPAN Reliance CVIPANY , MP D CDVEBAGSS THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE 1 OLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT TERM OR "-ONOITtON OF ANY CONTRAC~ OR OTHER DOCUMENT /VITH RESPECT" TO WHICH 'HIS CERTIFICATE MAY BE ISSUED OH MAY PERTAIN THE INSURANCE AFFORDED 3Y THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES UMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS CO LTH AL A B C TYPE OF INSURANCE POLICY NUMBER 'OATE" "^ !^ERALUAB,ur, KK08300237 liyOV IX OJMMERC ALbENEPAL IABL1T ' wAIMS jIAOE X CCJR X OWNERS COST AC OPS POT AUTOMOBILE LIABILITY T1^ ALTTO KK08300237 liyOL/' 1 ALL JWNED AUT b ~ | CHEDU^D AUT X HIP AUTOS X \ON^3WN C ALT-S (3ARAGS LIABIUTY | AN AUTJ 1 FSCTWE POLICY -XP1RATIQN (OtVYY) DATE (HUlUOCVYY) LIMITS K n-'m/T 2 ^ERALAGGRE^AE 2.000000 P JDL "S. JMP A(_u 2,000 000 RSOMAL ACV \UUP 1 000 000 ' AC -I'—* RRENC- 1000000 RE AVIAu A 1 1 000 000 -IE EXP A v er ? 000 )* 02/01/'J7 COMB NED SINGLE WIT 1000000 3"3D<L NJLR Pi ei =s MIL INJUH Per _aen ROP R"^ DAMAb AUT^"~NL AAC"C NT 1 JTHER MAN ALTJ JNL ACu AC_ n£ NT AGoRE ATE _|XCESS UABIL RH'N201472 1 11/01/S _X_| LVIBRE LAP TIM OTHER ~HAN LMBRE LA F^RM WORKERS COMPENSATION AND J-.-7AJ (11 fl7/m /O EMPLOYERS LIABIUTY (JM14236101 02/01/9 THE PPrPRIET R I 1 |N, PAP.TNERS/SXE J~IVE ,' OP"IC RS ARE j I C OTHER | 1 02/01/9^ ACH^CCJRHENC ^000000 "-"""" AGuHECAT ^ 000 000 WCilATL 1DTH f ni/01/97 ^^ -IV1ITS 5 ACH AC" D ST 1 000 000 L 2 bEAb P 3 C IMIT 1 000 000 SSAS A 6 /IP 0 1 000 000 DESCRIPTION OF OPEflATIONSvLOCATIONS/VEHICLES/SPECIAl. ITEMS RE JOB #0393002 Carkbad b> the Sea 201 Grand \veiiue CarlsbadXA "J2008 The Cirv of Carbbad anil Caliloi ma Lutheran Honicb are named as additional insureds as respects liability pel endoisement attached CEBTlpCATEttOUJSB "CAWTl SHOI. Cm OF CARLSBAD ^P, 1200 CARLSBAD VILLAGE DR 30 ACC CARLSBAD C\ 92008 ^ SX\' AUTHOR J I#D 23-^ (1/9*> JLO ANY OF THE ABOVE DESCRIBED POLIC ES 3E ANC L D BEFORE ~h NATION DATE THEREOF THE ISSUING COMPANY WILL SJKSaueoBVOl MAIL DAYS wnrrrEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE L^~ «3irx?«o*n\row3rv^jt<rf«n3oertTC»T?Bv?ctKsr!^N2CT\r^ ZED REPRESENTATIVE ^—^~ ' S /?^J&S^£, if ACORD CWPORA-TTON 138S