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Home My WebLink About1200 CARLSBAD VILLAGE DR; ; CB031830; Permit07-07-2003 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Electrical Permit Permit No CB031830 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 1200 CARLSBAD VILLAGE DR CBAD ELEC 1561803400 Lot# CITY HALL COUNCIL CHAMBER CHANGE OUT ELEC PANEL Applicant CITY OF CARLSBAD Status Applied Entered By Plan Approved Issued Inspect Area Owner CITY OF CARLSBAD ISSUED 07/07/2003 SB 07/07/2003 07/07/2003 PUBLIC AGENCY 00000 PUBLIC AGENCY 00000 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 SO 00 '0 - • , $0 00 0 -'SO 00 0 " ' SO 00 0 ' SO 00 , , SO 00 SO 00 SO 00 x ' $0 00 'so oo, so oo' . ' , '' / Total Fees $000 Total Payments To Date $0 00.Balance Due $000 PPROVAl CLEARANCE. PERMIT APPLICATION.* - "^ CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 FOR OFFICE USE ONLY PLAN CHECK EST VAL Plan Ck Deposit Validated Date M/Address [include BIdg/Suite ft]Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total ft of units Assessor's Parcel ft Existing Use Proposed Use Qrl escription of WorkurncH-SO. FT tfot Stories It of Bedrooms ft of Bathrooms ^^ Name Address City State/Zip 'W+wj H,l Telephone #Fax Name Address ity Ere State/Zip Telephone # Name Address City State/Zip Telephone ft t^^wv^^wrfm*»«»iB^»—'srii?rir««»"«^»*««wj&™<WiW!«^»^HJr*s't> ww SK'^Tp-^f'swr^T'fw^^arrf^.'s-,'* *•"*«,'- """iss '^fTT3^Bri'"^p^"^"^^^^"^iw^'^^^KWJ™i^^"«'™^*!!':i'^^'T;*!?t'*y*:!!!KSISiaCONTRACTORyiCOMFWNYjNAMEfL^ rflWW jJE^W-SL.,* iUliJ! J-alll!1, JlrtS1 ,ifel^»*Al (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 fjve hundred dollars [$50011 Name State License ft Address License Class City State/Zip City Business License ft Telephone ft Designer Name State License ft _ f6TSi3,w6 R KERSifCOMPlNSATION Address City State/Zip Telephone ^rsBr^P:t!P^^^^!rp'"TlJ.F"V r^ •*, vj>i,£ „. )*$&' ^trf "*rw 4.4% "j. j?-> iw&E : 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 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 this permit is issued My worker's compensation insurance earner end 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 la unlawful, and shall subject an employer to criminal penalties and civil fines up 1o 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 •TTSSdWtfElifcffi^ 1 hereby affirm that i am exempt from the Contractor's License Law for the following reason d 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) n 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) C] I am exempt under Section Business and Professions Code for this reason 1 1 personally plan to provide the major labor and materials for construction of the proposed property improvement O YES QNO 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 1 have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type work) s~~>_ , _^ . , . PROPERTY OWNER SIGNATURE DATE COMPLETE .JHIS'SECTION^pRA/OAtflf^pfeVTMiiBUILDlNGjF 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? d YES CD NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? n YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Q YES LD 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 g^lpPJjg^UCTlM^ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(i) Civil Code) LENDER'S NAME LENDER S ADDRESS ^ _ _^ ____ -,4",5i- a^jwr jf*- ix t⁢ ¥3fi » ts$®m I certify that ..---- > -., —, . T-- r v . - -.,* - - i * » . '•*, ^'^^^.^•"W ^ ""^^^'^"'3-^^' $H 3$"TT! 's L;r ,1"'"™ ' -r^tf'~->iw~~t.T.?«~—ii^t'i^"* r3~~'m**tf r>~M 'iifii ;'~ttJad*»e 'i'^'MSVil" V g»i'*, t»s&i&k MSS, 'Ufi~iM KU*w '?!&!£ rifflt^ v%WJji>j>,& 4 t'ijfti"*™ &S '-' « ^C-ljSl.«^ ,- 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 CitV 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 stones in height EXPIRATION Every permit issued by the budding Official under the provisions of this Code shall expire by limitation and become null and void if the building or work authorized hv such permit is not commenced within 180 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned atiany tin • ler the work is commented for a-pariod of 180 days (Section 106 4 4 Uniform Building Code) / y(pPLICA SIGNATURE ^VWll ftM(^~ ' DATE 7/ 8/O3 •A WHITE File YELLOW Applicant PINK Finance City of Carlsbad Bldg Inspection Request For 07/15/2003 Permit# CB031830 Title CITY HALL COUNCIL CHAMBER Description CHANGE OUT ELEC PANEL Inspector Assignmen 1200 CARLSBAD VILLAGE DR Lot 0 Type ELEC Sub Type Job Address Suite Location APPLICANT CITY OF CARLSBAD Owner Remarks AM PLEASE Phone 7608025756 Inspector Total Time CD Description 39 Final Electrical Comment Requested By ROBERT RICHARDSON Entered By CHRISTINE Associated PCRs/CVs Inspection History Date Description Act Insp Comments