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Home My WebLink About1238 MARIPOSA RD; ; CB011615; Permit------··-··--·------ City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 05/02/2001 Electrical Permit Permit No:CB011615 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 1238 MARIPOSA RD CBAD ELEC Status: Parcel No: 2122202500 Lot#: 0 Applied: ISSUED 05/02/2001 JM 05/02/2001 05/02/2001 Reference #: Entered By: Plan Approved: Issued: Project Title: BAN NA -ELEC LINE TO LIGHTS Inspect Area: Applicant: BAN NA SABAH B&ILHAM N 1238 MARIPOSA RD CARLSBAD CA 92009 Total Fees: $20.00 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 lnspectot:2L Owner: BAN NA SABAH B&ILHAM N B20l 05/02/0l 1238 MARIPOSA RD CARLSBAD CA 92009 Total Payments To Date: $0.00 0 0 0 0 Balance Due: $10.00 $0.00 $0.00 $0.00 $0.00 $10.00 $0.00 $0.00 $0.00 $0.00 $20.00 0002 01 CGP $20.00 FINAL APPROVAL Date: /,:J -z 7 -0/ Clearance: _____ _ NOTICE: Please take NOTICE that approval of your project 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 changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project NOR DOES IT APPLY to any fees/exactions of which vou have nrevlousl11 been n iven a NOTICE similar to this or as to which the statute of limitations has nreviousJv otherwise exr ired. 02 20-00 \ PERMIT APPLICATION FOR OFFICE USE OY\~ . PLAN CHECK NO. ~/)/(60 CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST. VAL. _________ _ 1) Total # of units Assessor's Parcel # Existing Use Proposed)Jf: ... J ~Si~Cf J _ Da~ ... ~iption .of. W. o. ,k . / . , . . . _i. ✓ .... X C ,~ef-n'c.,a .. lt¢,f;r;v .. ;i;,., ,CONTACT Pl;QSON lfli'tt,iNiot.from:•0p:,,Jli:aotl ; ' c~ : of Bed,ooms . ( l/) of Bath,ooms Name Address ;3'. _ -\4,PPLJCANt □-c:qbtr;C't9r,_ 0 :Ag1;mffo~Corjini'i¾tor Name Address ;4. . P80PE~TT QWJ'IE8 '.: "· Name Address cE,. ' CONTMCJ'O~:,'COl\!PANY•IIAfllE City □ o.wnor. Jr□. 41/inffbh'C!wnei '' City City State/Zip Telephone# 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 {$600]). Name Address City State/Zip Telephone# State License # _________ _ license Class _________ _ City Business License # _______ _ Designer Name Address City State/Zip Telephone State License # _________ _ ij. . :WOR~ER$' CONIPEI\ISATION 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. O J have and will maintain workers' compensation, as required by Section 3700 of the labor Cade, 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 Na. ____________ _ Expiration Date _______ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS) O 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 penaldea and civil fines up to one hundred thousand dollars 1$100,000), in addition to the cast of compensation, damages as provided for in Section 3706 of the Labor code, Interest and attorney's fees. IGNATURE ______________________________ DATE.,-,--,-,--,---- 7;/'('[0W~;j(iJIDERDtC1;ARATION'0 · "''":"!.,. e;:,'"l l hereby affirm that l am exempt from the Contractor's license law for the fallowing reason: '&r! 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). O 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 Cade for this reason: 1. I personally plan ta provide the major labor and materials for construction of tha proposed property improvement~YES ONO 2. I (have/ have not) signed an application for a building permit for the proposed work. 3. I have d construction (include name / address / phone number / contractors license number): 4. J 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 fallowing persons to provide the work indicated (include name/ address/ phone number/ type of work): --4---l'l--tf AOPERTY OWNER SIGNATURE~~ d'-~ DATE _ __i _ _,=<-._ __ .....,'-/- COl\!)!l;~Tl!cflJl$i $~CJi(.li.iFOR' k,,,.,-'/IESJbE!i'1At,IIQ11:i1iNil PERMIT$ Ol'l~Y½I'.' ,[:;'lit< ·.· 1 f i! ;':. . . ; , 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 25534 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 quality management district? D 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 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. '¢0NSTRIICTION ·L£t1l;>ING'AGENCY 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,. <iAPPllCI\Nl'.:CE~TIFICATION . l 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 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 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 aver 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 this Code shall expire by limitation and become null and void if the building or work authorized by such permit is not com need ithin 1 0 days from the date of such permit or if the building or work authorized by such ermit is suspended or abandoned at any time after the work is comme d fo peri of 1 day (Section 106.4.4 Uniform Building Code). ~PPUCANT'S SIGNATURE "'---- WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 05/07/2001 Permit# CB011615 Title: BANNA -ELEC LINE TO LIGHTS Description: Type:ELEC Sub Type: Job Address: 1238 MARIPOSA RD Suite: Loi 0 Location: APPLICANT BANNA SABAH B&ILHAM N Owner: BAN NA SABAH B&ILHAM N Remarks: Total Time: CD Description Act Comments Inspector Assignment: PD --- Phone: 7604315660 Inspector:~ Requested By: SAM Entered By: CHRISTINE 34 _R_o_u_g_h_E_le_c_tr-ic------~--------------------- Associated PCRs Inspection History Date Description 05/03/2001 31 Underground/Conduit-Wiring Act lnsp Comments AP PD CONDUIT