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Home My WebLink About1075 PALM AVE; TP; CB140296; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 02-06-2014 Permit No: CB140296 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 1075 PALM AV CBAD St: TP PME Status: Parcel No: 2051910500 Lot#: 0 Applied: Reference #: PC#: Project Title: Applicant: EDSON RES-TEMP POWER POLE FOR FUTURE CONSTRUCTION EDSON LEGACY TRUST 10-09-12 1075 PALM AVE CARLSBAD CA 92008 619 931-3822 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES Entered By: Plan Approved: Issued: Inspect Area: Owner: EDSON LEGACY TRUST 10-09-12 1075 PALM AVE CARLSBAD CA 92008 ISSUED 02/06/2014 RMA 02/06/2014 02/06/2014 $0.00 $158.00 $0.00 $0.00 $158.00 Total Fees: $158.00 Total Payments To Date: $158.00 Balance Due: Inspector: FINAL APPROVAL Date Z '//-N Clearance: $0.00 NOTICE: Please take NOTICE that approval of your project includes the "lmp::,sition" of fees, 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 Car1sbad 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 FURTHER NOTIFIED that your r;ght 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 f hih NTI '1milr h I • THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING □ENGINEERING 4-. «,~ ¥ CITY Of CARLSBAD JOB ADDRESS Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 email: building@carlsbadca.gov www.carlsbadca.gov SUITEf/SPACEI/UNIT# □BUILDING □FIRE Plan Check No. Est. Value SWPPP CT/PROJECT# PHASE# # OF UNITS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) T~P. pow(;¥ FtJ(l- PAT!OS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS YES[) "'° ves0No0 YES□No□ APPLICANT NAME (Secondary Contact) ADDRESS CITY STATE ZIP PHONE FAX EMAIL CONTRACTOR BUS. NAME ADDRESS ADDRESS STATE ZIP CITY STATE ZIP FAX PHONE FAX EMAIL ARCH/DESIGNER NAME & ADDRESS STATE UC.# STATE LIC.# CLASS CllY BUS. UC.# (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair an)'. 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 !Chaoter 9, commending with Section 7000 of Division 3 of the Business and Professions Code} or that he is exem refrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any appUcantfor a permit subjects the applicant to a civil penalty of not more than five hundred dollar O ). J!)§.section need completed if the permit is for one hundred dollars ($100) or less. LJ Certiflca f Exemption: I certify that in the pelformance 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. ARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and clvil fines up to one hundred thousand dollars (&100,000), In to the cost of compensation, damages as provided for in Section 3706 of the labor code, Interest and attomey's fees. □AGENT DATE OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from Contractor's License Law for the following reason: D as owner of the property or my empl.oyees with wages as their sole compensation, will do the work and the struCtl.ire is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's icense Law does not apply to an OW!'ler 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 ale. 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). as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and ProfesSlons Code: The Contractor's license Law does not apply lo an owner of ~perty who builds or improves thereon, and contracts for such projects with contractor{s) licensed pursuant to the Contractor's License Law). (!1 I am exempt under Section _____ ,Business and Professions Code for this reason: / 1.~ally plan to provide the major labor and materials for construction of the proposed property improvement. OYes ~o 2 (have have not) signed an application for a building permit for the prop:ised work. 3. contracted with the following person (firm) to provide \he proposed construction (include name address/ phone/ contractors' license number): ,,-:. J P. 4. I plan to provide p:irtions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name/ address I phone 1tontractors' 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/ type of work): 25PROPERTYOWNERSIGNATURE 5~ ~ □AGENT 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? Yes No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air Quality management district? Yes No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Yes 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. CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction lending agency for the performance of the work this perrmt Is issued (Sec 3097 (1) Civil Code) Lender's Name Lender's Address APPLICANT CJ;RTIFICATION I certify that I have read the appllcatlon and state lhatthe above Information Is oonect and that the infcnnatlon on the plans Is accurate. I agl88 to comply with all City on:llnances and State laws relating to bulldlng constructlon. I hereby authorize representative of the City of Carlsbad lo enter upon the alx>ve menOOned ,:rope,tytir inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CllY OF CARlSBAD AG<\INST AU_ LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN AN'/ WAY ACCRUE AG<\INST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: M OSHA pem,lt is requred for excavations over 5'0' deep and demolioon or caistruction of structures over 3 stories in height. EXPIRATION: Every pennit Issued by the Buik:ling Offcial under the provisbns of this Code shall expire by limitation and beCXJrne null and vok'.I W the buik:ling or'Mlrk authorized by such pe!mil is notcomrnencad 'Mthin 1 &I days from the date of s001 pennlt or if the building or 'Mlrk alAhorized by sl.dl pem,it ·is suspended or abandoned at any firne after the 'M'.llk is commenced for a penod of 1 &I d<¥i (Section 100.4.4 Unifonn Buik:ling Code). ...@S' APPLICANT'S SIGNATURE 45 DATE 2-/ '1/IL-/ • STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. Fax (760) 602-8560, Email building@carlsbadca.gov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008. CO#: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY STATE Carlsbad CA PHONE FAX EMAIL OCCUPANT'S BUS. UC. No. DELIVERY OPTIONS PICK UP: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. j_) MAIL TO: CONTACT (Listed above) CONTRACTOR (On Pg. j_) OCCUPANT (Listed above) MAIL/ FAX TO OTHER: ________________ _ ..S APPLICANT'S SIGNATURE ASSOCIATED CB#·------------- NO CHANGE IN USE/ NO CONSTRUCTION CHANGE OF USE/ NO CONSTRUCTION DATE ZIP Inspection List Permit#: CB140296 Type: PME Date lnspe_c_tion Item 02/07/2014 32 Const. Service/Agricultural 02/07/2014 32 Const. Service/Agricultural Monday, February 10, 2014 Inspector Act RI PB AP EDSON RES-TEMP POWER POLE FOR FUTURE CONSTRUCTION Comments Page 1 of 1