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Home My WebLink About106 CHRISTIANSEN WAY; ; CB981279; Permit04/29/98 15 58 s "106 CHRIS1IANSEN WY Permit Tvpe ELECTRICAL Parcel No Valuation ° Occupancy Group ™TC™ Description 100 AMP METERED PEDISTAL- CARLSBAD LUTHERAN HOME Appl/Ownr CARLSBAD LUTHERAN HOMES IF 2^20 S FREMON1 AV ALHAMBRA CA *** Fees Required *** T M r PFRMIT Permit No CB981279 BUILDING PERMIT proiect No A9801689 Development No Suite Construction Type Status ISSUED Applied 04/29/98 Apr/Issue 04/29/98 Entered By RMA 626 570-5650 Collected & Credits Fees Adjustments Total Fees Fee description 35 0* f l , < >.* _r*« fotaX i / f /'i,/ X, r sai 0001 02 C-PR3 5 35 00 10 00 Y 25 00 APPROVAL II CITY OF CARLSBAD 2075 Las Palmas Dr Carlsbad CA 92009 (619) 438 1161 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr Carlsbad CA 92009 (760)438 1161 ECT INFORMATION&rJ/A FOR OFFICE USE ONLY PLAN CHECK NO EST VAL ____ Plan Ck Deposit Validated, B Date Address (include Bldg/Suite #)Business Narsre (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total # of units Assessor s Parcel #Existing Use Prop'AMP Description of Work SO. FT #of Stories # of Bedrooms # of EJathrooms CONTACT PERSON (if {different from applicant) -262.4 Name Address City 3 APPLICANT D Contractor D Agent for Contractor Q Owner D Agent for Owner State/Z/p Telephone #Fax # Name 4 Address City State/Zip Telephone # SeA /Ly£Telephone* V? </•"«? Name 5 CONTRACTOR COMPANY NAME (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 commending with Section 7000 of Division 3 of the Business and Professions Code! or that he is exempt therefrom and the basis fcr 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]) Name State License # Address License Class City State/Zip City Business License # Telephone # 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 Q 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 Q I have and will maintain workers compensation as required by Section 3700 of the Labor Code for the performance of the work for which ihis permit is issued My worker s compensation insurance carrier and policy number are Insurance Company Policy No Expiration Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) Q 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 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 provided for in Section 3706 of the Labor code interest and attorney s fees SIGNATURE DATE 7 OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor s License Law for the following reason Q 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) Q I as owner of the property am exclusively contracting with licensed contractors to construct the project (Sec 7044 Business and Professions Code The Contractors License Law does not apply to an owner of property who builds or improves thereon and contracts for such projects with contractcr(s) licensed pursuant to the Contractor s License Law) Q 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 f~l YES |~|NO 2 I (have / 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 number / 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 number / 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 / address / phone number / type of work) PROPERTY OWNER SIGNATURE DATE COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY 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? Q 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? Q YE O NO Is the facility to be constructed within 1 000 feet of the outer boundary of a school site? f~l YES I") 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 8 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 30970) Civil Code) LENDER S NAME LENDER S ADDRESS 9 APPLICANT CERTIFICATION I certify that I have read the application and state that the above information is correct and that the information on the plans is accurate 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 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 ofer 5 0 deep and demolition or construction of structures over 3 stories in height EXPIRATION Every permit issued bythe Building OHicial under the provisions of this Code shall expire by limitation and become null and void if the building or work authorized by such permit is njX^omrrjsnc^tif within 365 days from the date of such permit or if the building or work authorized by such permit i suspended or abandoned at any time after thrfiwnilflsrpffirnf; fnrji period of 180 days (Section 106 4 4 Uniform Building Code) I 1AmAPPLICANT S SIGNATURE.DATE WHITE File YELLOW Applicant PINK Finance CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB981279 FOR 05/28/98 DESCRIPTION 100 AMP METERTD PEDISTAL-IRRIG CARLSBAD LUTHERAN HOME TYPE ELEC JOB ADDRESS 106 CHRISTIANSEN WY APPLICANT CARLSBAD LUTHERAN HOMES PHONE CONTRACTOR PHONE OWNER PHONE INSPECTOR AREA PLANCKtf CB981279 OCC GRP CONSTR TYPE NEW STE LOT 626 570-5650 REMARKS B/DIANA/720-7031 SPECIAL INSTRUCT PLEASE SEE ROD INSPECTOR TOTAL TIME —RELATED PERMITS—PERMIT# TYPE STATUS CD 32 WMC»80042 WMETER ISSUED LVL DESCRIPTION ACT COMMENTS EL Const Service/Agiicultural DATE DESCRIPTION *•>*** INSPECTION HISTORY ***** ACT INSP COMMENTS ;/< ~ y<r**- „ * »!.{ 'V/* Itjrf . m.