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Home My WebLink About1218 MARIPOSA RD; TP; CB002625; Permit' City of Carlsbad 07/14/2000 Electrical Permit Permit No:CB002625 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 1218 MARIPOSA RD CBAD St: TP ELEC Status: ISSUED 07/14/2000 MDP 07/14/2000 07/14/2000 Parcel No: 212221 0400 Lot #: 0 Reference #: Project Title: MARIANO TEMP POWER POLE Applicant: TEMP UTILITY SERVICES 1167 LAW ST SAN MARCOS, CA 92069 619-471-5494 Total Fees: $20.00 Electric Issue Fee Single Phase per AMP Three Phase per AMP Three Phase 480 Per AMP Remodel/Alteration per AM Remodel Fee Temporary Service Fee Test Meter Fee Other Electrical Fees TOTAL PERMIT FEES ... "': ,.'.•,." "'. " . .. • % FINAL APPROVAL Date?·Z) • /)7) Applied: Entered By: Plan Approved: Issued: Inspect Area: 07 /l"f./00 J001 01 Clearance: 0.00 0.00 0.00 ,$0.00 +'$0.00 ,' $0.00 $10.00 $0.00 $0.00 $20.00 C--P~:MT $20.00 NOTICE: Please take NOTICE that approval of your prq'ect includes the "Imposition' 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 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 capactiy charges, nor planning, zoning, grading or other similar application processing or service fees in connection with this project NOR DOES 1T APPLY to any fees/exactions of which ou have reviousl been iven a NOTICE similar to this or as to which the statute of limitations has reviousl otherwise ex ired. CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 20,,00 FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NO. (:f3--2G ~ CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 EST. VA~. ________ _ Plan Ck. Deposit ________ _ Validated By __________ _ 1./ 2Ris:CT{f;;~~;;~;~ ,. r·~~;./, "' Date, _____________ _ Address (include Bldg/Suite I) i Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel I I .,. Proposed Use I of Bedrooms I of Bathrooms 2. CONTACT·PERSON '(ff dtffareni,froni ■ppllcentJ Name 3. 'APPLICANT O contractor · £✓--er Crfa-t..., Name Name Address 'S499nt'f0(c"ontractor . , ~:o 'owner et:2, Bax-Z..6:~ 2. Address •,t; ",! Address 6. CONTRACTOR -COMPANY NAME City D I\Qent'toi 0wne, ~Cl- City ";,:,•,,, .... ,,. State/Zip Telephone# Fax II (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 tor such permit to tile 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 at the Business and Professions Code] or that he is exempt therefrom, and the basis for the alleged ;•~x=•~mlpjt~;o~n~,!:[r!n~y-v-;0Ll:at~i1i[n!,!0~$~S-•_•_b_o_n_7_0_3~1~,J5~b~y~~~•~nyfla~p~p~lic_•,n~tlt,ot,~•~~~•~•m~e~i~~•=u-b_j•_'~$°~•~t7';~h•'.",•~P-P~e:~~~n~t~t!o~•~•.,;~¼/,~;1ep~•~o~•l~ty7'"0,t~n~o~t~m;o,:J.e~tlh~•a~n~tz~;v~a~h~u~n~~J•~::".;dd"~o~ll~•!l~$~5~0ZO~J~:J.~Z:,>'/ City State/Zip T elephon I State license # _.,$'c..,Z,:.,J<..,:<-Lf._.'_,£...__ license Class _C. __ -~~~~/_· ___ _ 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: D 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. _pt--1 have and will maintain workers' compensation, as reciuired_ .by Section 3700 of the labor Code, for the performance of the work tor which this permit is issued. My worker's compensation insurance carrier and policy n'!J"ber are: _ Insurance Company f> ;fe-..zle F Wn~ Po>;ey No. / 5 5"5" //'~ -0 Oxp;ration Date 3 ~/-O I (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 alifotnia. WARNING: Fallur workers' c~m n 10n rage la unlawful, and shall subject an employer to criminal penaltlaa and civil fin"8 up to one hundred In eddition o t oat mpen■ation, damage• a■ provided for In Section 3706 of the ~co~yi!>'_!tf •,.,-attorney'■ fee■. SIGNATURE_.S:,~~~~~(_ __ .J;'Lc:::'.'~~"Zlt.C:_::'.:.____________ DATE _ _,_/_~_cf':_,:. ''7_ • __ _ 7, OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contr or'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 wilt have the burden of proving that he did not build or improve for the purpose of sale). D 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(&) licenaed pursuant to the Contractor's license law). D 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 at the proposed property improvement. 0 YES ONO 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-RESJDEN71AL 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 26505, 25533 or 25634 of the Presley.Tanner Hazardous Substance Account Act? D YES O NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air ciuality management district? 0 YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES O NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIF1CATE 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 LENDINGtAGENCY. ,,,, .,.,.,.,,,.,,,.,. ,.,,.,," 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 _____________ _ ·9, APPLICANT CERTIFICATION I certify that I hav~ 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 conatruction. I hereby authorize repreaentatives of the Citt 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 ANO 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 structure, over 3 stories in height. EXPIRATION: Every permit issued by the Building Official und the provisions of this Code shall expire by limitation and become null and void if the building or work authorized by such permit · n enced .. 11!!7," 36 i:1 vs from the date of such permit or If the bull ding or work authorized by such permit is suspended or abandoned at any time after h w comma~ for a 10d of 180 vs (Section 108.4.4 Uniform Building Code). ~-/Y,; {11 c)' APPLICANT'S SIGNATURE _:::::::_ ___ ..£. __ __,,,.,z__:_.:_:____________ DATE _ _cr __ c__/ __ · _____ _ YELLOW: Applicant PINK: Finance ~ w City of Carlsbad Bldg Inspection Request Permit# CB002625 Title: MARIANO Description: TEMP POWER POLE For: 7/24/2000 Type:ELEC Sub Type: Job Address: 1218 MARIPOSA RD Suite: TP Lot Location: APPLICANT TEMP UTILITY SERVICES Owner: Remarks: Total Time: CD Description 0 Act Comments Inspector Assignment: Phone: 7608399431 lnspectorfiL___ Requested By: ANDREA Entered By: CHRISTINE 32 Const. Service/Agricultural ¥----- Associated PCRs Inspection History Date Description Act lnsp Comments