HomeMy WebLinkAbout1170 HARBOR VIEW LN; ; CB012787; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008 ,
04-01-2003 · Electrical Permit Permit No: CB012787
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Reference #:
Project Title:
1170 HARBOR VIEW LN CBAD
ELEC
2061401100 Lot#:
SCOIRTINO -UPGRADE ELEC
100 TO 200 AMPS
0
Owner:
Status:
Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
ISSUED
08/27/2001
JM
08/27/2001
04/01/2003
Applicant:
SCIORTINO ANTHONY T&JODY E SCIORTINO ANTHONY T&JODY th 9 04/01/03 0002 01
CGP 608 MISTY ISLE PL
RALEIGH NC 27615
Electric Issue Fee
Single Phase per AMP
Three Phase per AMP
Three Phase 480 Per AMP
Remodel/Alteration per AMP
Remodel Fee
Temporary Service Fee
Test Meter Fee
Other Electrical Fees
Additional Fees
TOTAL PERMIT FEES
Total Fees: $45.00
0
0
0
100
608 MISTY ISLE PL
RALEIGH NC 27615
Total Payments To Date: $35.00
Date:
$10.00
$0.00
$0.00
$0.00
$25.00
$0.00
$0.00
$0.00
$10.00
$0.00
$45.00
Balance Due:
Clearance:
$10.00
pproval of your project includes the ~lmpos ion" of fees, dedications, reservations, or other exactions hereafter collectively
ions." Y ave 90 days from the date this permit was i sued to protest imposition of these fees/exactions. If you protest them, you must
follow the protest pr ures 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 Carlsbad 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 right 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 N Tl . ·1 r hi i h ' I i x ·r
02
10.00
PERMIT APPLICATION ,
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
1.
Otvvr&w
Address (include Bldg/Suite #}
Legal Description Lot No. Subdivision Name/Number
2.
City Name
3. _ta:owner O Agent for Owner
Name City
4. PROPERTY OWNER
:5~ e 11-S
Name Address City
5. CONTRACTOR • COMPANY NAME
FOR OFFICE USE ONLY
PLAN CHECK NO . c.(Ji!Z, z & 1
EST. VAL. _________ _
Plan Ck. Depo~1-r-:::-,.--------,,----
Validated By--""..._,;.,,,,.:--11-----."'-:f-r---r-......,'"+-,
Date _________ -f-.ff---c,-"+t::,,
Unit No. Phase No. Total # of units
# of Bathrooms
0-39.53
State/Zip Fax#
State/Zip Telephone#
State/Zip Telephone#
(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 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 [$5001).
Name Address City State/Zip Telephone#
State License # _________ _ License Class _________ _ City Business License # _______ _
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:
0 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.
0 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
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 [$1001 OR LESS}
0 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:
~ 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
~-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).
0 I, as owner of the property, am exclusively contracting with licensed contractors 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}.
0 I am exempt under Section ______ Business and Professions Code for this reason:
1 .
2.
3.
I personally plan to provide the major labor and materials for construction of the proposed property improvement. J8[ YES ONO ,1\./0 ~ ltJ I IV l/t(J0/1'
I (have ~ not} signed an application for a building permit for the proposed work.
I have c~cted with the following person (firm} to provide the proposed construction (include name / address / phone number / contractors license number):
l\)l} ON C✓
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}:. _________ ---:r,-----:r ~:n:;?1f~~---::;t_'.:::::;~:::--------,~-:--::::~;;;--:;;~---------
DATE e --:2£ -0 J PROPERTY OWNER SIGNATURE -~4~~p.1,,_..1L.:.:..J.:.._..:i..L..:=.!::.1i2,::_LJ""'5 ____ _ ' COMPLETE THIS SECTION FOR NO
Is the applicant or future buildin o upant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention
program under Sections 25505, 2 533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? 0 YES O NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? O YES O NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES O 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 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 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 over 5'0" deep and demolition or construction of structures over 3 stories in height.
EXPIRATION: Every permit issued by the building Official under the provisions of lhis Code shall expire by limitation and become null and void if the building or work
authorized by such permit is not commenced within 180 days from the date of such permit or if lhe building or work authorized by such permit is suspended or abandoned
at any time after the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code).
APPLICANT'S SIGNATURE __________________________ _ DATE ____________ _
WHITE: File YELLOW: Applicant PINK: Finance
/ I Ob ----&,f
City of Carlsbad Bldg Inspection Request
For: 04/11/2003
Permit# CB012787
Title: SCOIRTINO -UPGRADE ELEC
Description: 100 TO 200 AMPS
Type: ELEC Sub Type:
Job Address: 1170 HARBOR VIEW LN
Suite: Lot 0
Location:
APPLICANT SCIORTINO ANTHONY T&JODY E
Owner: SCIORTINO ANTHONY T&JODY E
Remarks:
Total Time:
CD Description Act Comment
39 Final Electrical L1f!.._ F,.,,c.j
Associated PCRs/CVs
Inspection History
Date Description Act lnsP Comments
Inspector Assignment: JE ---
Phone: 7607303953
Inspector: ----
Requested By: NA
Entered By: CHRISTINE
04/04/2003 33 Service Change/Upgrade -AP JE CALL FOR METER RELEASE 1106-G6
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