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Home My WebLink About1040 BUENA PL; ; CB051553; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Building Inspection Request Line (760) 602-2725 Electrical Permit Permit No: CB051553 04-2d-200; Job Address: Permit Type: ELEC Status: ISSUED Parcel No: 155251 2400 Lot #: 0 Applied: 04/29/2005 Reference #: Plan Approved: 04/29/2005 Issued: 04/29/2005 Project Title: VANDERMEIJ RES-CHANGE ELECT Inspect Area: 1040 BUENA PL CBAD Entered By: RMA PANEL FROM 100 TO 200 AMP PANEL Applicant: VANDERMEIJ HENDRIKUS 1040 BUENA PL CARLSBAD CA 92008 Owner: VANDERMEIJ HENDRIKUS 1040 BUENA PL CARLSBAD CA 92008 Electric Issue Fee Single Phase per AMP Three Phase per AMP Three Phase 480 Per AMP RemodeVAlteration per AMP Remodel Fee Temporary Service Fee Test Meter Fee Other Electrical Fees Additional Fees TOTAL PERMIT FEES 100 0 0 0 $1 0.00 $25.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $35.00 Total Fees: $35.00 Total Payments To Date: $0.00 Balance Due: $35.00 02 35.00 review, set aside, void, or annul their imposition. PERMIT APPLlCATlON CITY OF CARLSBAD BUlLDlNG DEPARTMENT Address Iinclude BldgSuIte XI Legs\ Oescription Lot No. Subdivision Neme/Number Unit No. Phase No. Total # of units Business Name (at this address) FOR OFFICE USE ONLY PLAN CHECK NO. c‘/?05/553 EST. VAL. Plan Ck. Deposit Assessor’s Parcel # Existing Use Proposed Use Y of Bedrooms t of Bathrooms Issuance, also requires thg applicant for such permit to file a dgned statement that he is licensed punuant to the provisions of the Contractor‘s Ucense Law fChapter 8, commending with Section 7000 of Division 3 of the Businese and Professions Code) or that he Is exempt therefrom, and the basis for the albed exemption. Any violation of Section 7031.6 by any applicant for a permit subjects the applicant to e clvil penalty of not more than five hundred dollam [060011. Name Addreas City Statenip Teiephone X License Class City Business Ucense X . Stet0 LiCOMe # Designer Name Address city statanip Telephone [3 of the work for which this permit la Issued. 0 issued. My worker’s compensation insurance carrier and pdicy number are: insurance Company Poky No. Expiration Date (THIS SECTION NEE0 NOT M COMPLETED IF THE PERMIT IS FOR ONE HUNDRED WUARS [IlOOl OR LESS1 0 CERTIFICATE OF EXEMPTION I cdfy that In the performance of the work for wMch this permit is issued, I shall not employ any parson In any manner so as to become subject to the Worken’ Compamation Laws of Califomla. WARNING: klu, t0m.c~. workem’ cornpenutkn coverage I. UnhWM, .nd W .utrl.cc M empl0y.r to crhnM pmdtiu ad clvil tines up to me hundrmd thousand ddlen {$100,000), In ditlon to the cost of compscuatlon, damageJ 08 prwMd for in Section 3706 of the Lsbw cod., htemt and attorney’s fees. I have and will malntaln a certificate of consent to self-insure for workers’ cornpensetion as provided by Section 3700 of the Labor Code, for the Performance I have and will maintain workers’ compensation. as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is ithin 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 exclushrely contracting with licensed contractors to construct the proJect (Sec. 7044, Business and Professions Code: The actor’s Llcenae Law does not apply to an owner of property who bullds or improves thereon, and contrects for such projects with contractor(s) licensed ent to the Contractor’s Llcense Law). I am exempt under Section I personally plan to provide the major labor and matdels for conaructlon of the proposed property Improvement. 0 YES &O I@J I have not) signed an epplicatlon for a building permit for the prbposad work. Business and Professions Code for this reeson: program under Sections 25506, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? 0 YES NO Is the applicant OT future buildlng occupant required to obtain a permit from the air pdlution control district or air quality management district? -0 YES Is the facility to be constructed withln 1,OOO feet of the outer boundary of a school site? 0 NO 0 YES 0 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 EMERQENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. I certify that I have read the appHcation and state that the above information Is correct end thet the informatlon on the plans is accurate. i ape to comply with ali City ordinances and State lawe relating to building construction. I hereby authorize representatives of the Cit) 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 AU UABtLITIES, 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 requhd for excavations over 5’0” deep and demolition or construction of structures over 3 storlea in height. EXPIRATION Evew permit issued by he building Offkial under the provisions of this Code shall expire by limitation and become null and void if the building or work authorbd by such permit Is any time after the work is pW”fiit Of if the building or work authorlzd by such permit is suspended or abandoned Uniform Building Code). APPLICANT’S SiGNATURE WHITE: File YELLOW: Applicant PINK: Finsnce City of Carlsbad Bldg Inspection Request For: 05/10/2005 Permit# CB051553 Inspector Assignment: Title: VANDERMEIJ RES-CHANGE ELECT I Description: PANEL FROM 100 TO 200 AMP PANEL Type: ELEC Sub Type: Job Address: 1040 BUENA PL Suite: Lot 0 Location: APPLICANT VANDERMEIJ HENDRIKUS Owner: VANDERMEIJ HENDRIKUS Remarks: Total Time: Phone: 7608455970 OR 8 Inspector: Requested By: NA Entered By: CHRISTINE CD Description Act Corn m en t 34 Rough Electric WL a 39 Final Electrical fl( Associated PCRs/CVs Date Inspection History Description Act lnsp Comments