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Home My WebLink About1265 CARLSBAD VILLAGE DR; ; CB050160; PermitOt-18-2005 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 ! Electrical Permit Permit No CB050160 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 1265 CARLSBAD VILLAGE DR CBAD St T P ELEC 1561802100 Lot# 0 CARLSBAD VILL OFFICE TEMP PWR Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 01/18/2005 KG 01/18/2005 01/18/2005 Applicant (NATIONAL CONSTRUCTION 14551 ANDELDR 92335 909574-14 Owner CARLSBAD VILLAGE DRIVE INVESTORS L L C C/O FRANK VIOLl 1241 CARLSBAD VILLAGE DR #100 CARLSBAD CA 92008 Electric Issue Fee Single Phase per AMP f 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 $1000 $000 $000 $000 $000 $000 $1000 $000 $000 $000 $2000 Total Fees $20 00 Total Payments To Date $0 00 Balance Due $2000 Oi/IB/05 0002 Oi 02 Inspector A FINAL APPROVAL !_.*• Clearance NOTICE Please take NOTICE that approval of your prefect includes the Imposition" of tees dedications, reservations, or other exactions hereafter collectively referred to as lees/exactions ' You have 90 days from the date this permit was issued to protest imposition of these fees/exactions !f 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 PERMIT APPLICATION CFTY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 PROJECTJNFOWVIftTIQJECTJ .&) FOR OFFICE USE ONLY PLAN CHECK N EST VAL Plan Ck Deposit Validated By Date Address (include Bldg/Suite Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total tt of units Assessor's Parcel Existing Use Proposed Use Description of Work 21, SQ FT ttai Stories # of Bedrooms of Bathrooms T PERSON (if different from applicant) O /f *"*>» l Name 3 * APPLICANT Q Contractor Address ("Agent for Contractor Fax tt Address City State/Zip Telephone tt Address City State/Zip Telephone ftName B" CONTRACTOR- COMPANY NAME. ,?'-.<-,'.''' , « •* (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 IChapter 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 S«ction^p31 5 by any-aaplicant for a-permit sub|ects the applicant to a civil penalty ofjiot more than five hundred dollars NamS State License #O Address License Class City State/Zip City Business License ff Telephone # Designer Name Address City State/Zip Telephone State License # 6, ".yyOBKERS"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 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 and policy number are Insurance Company /^2?-^<±!fe^^7 Policy No"^STr7^/^)y^>j|2c9/x^7^xpiration Date B /issi (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) n 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' CornpeneatTOTTtaws of California WARNING Failure to secure worfers carnpensaUtfn coverage (^wnlawfyf^a^sh^sOSJeet an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,OOQ)rfn addition totbj^04fit oicompep«^tejj^^^§«S^S^^flded for in Section 3706 of the Labor code, intrrnTgnrl Btltinuy'ii fees SIGNATURE / .'^^^^^^^ ^~1— DAJE " ~ 7 * OWNERiBUILDER 'OECy I 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) 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(s) licensed pursuant to the Contractor's License Law) Q 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 of the proposed-property improvement f~l YES [~|NO 2 I (have / have not) signed an application for a building permit for the proposed WOTK 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-RESIDENTIAL BUILDING PERMITS ONLY ; , • - "„„ t •<••<<••, 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? Q YES d NO Is the applicant or future building occupant required to obtain a permit from ttja-alr pollution control district or air quality management district? Q YES D Is the facility to be constructed within 1,000 feet of the outer boundaryof a school site? Q YES Q NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATEOTOCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE NO REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICE'S AND THE AIR POLLUTION CONTROL DISTRICT 'JK "CONSTRUCTION LENDING AGENCY * > s^ * • ' . ,"' • * - *- 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 _ _jr LENDER'S ADDRESS 9 'MAPPUCANT 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 City 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 MAYJN-ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT OSHA An OSHA permit is required for excavations over 5'C" deep and demolition or construction ofstructures over 3 stories in height EXPIRATION Every permil issued by the JJuildmg Official/nder the provisioris^this Code shalJ-sSi^pire by limitation and become null and void if the building or work authorized by such permit is not commenofed within 180 days from the dateo^gupKWwitfo'rifttte'bijilding or work authorized by such permit is suspended or abandon, at any time after the work is commence^ for a period of^ft^D day^^cJi«rMp^^^^rjjforn>^8tldmg Code) APPLICAr-rS SIGNATURE / ^ ' /^ ^ S^ /^ ^-~7 DATE WHITE File YELLOW Applicant PINK Finance City of Carlsbad Bldg Inspection Request For 02/10/2005 Permit^ CB050160 Title CARLSBAD VILL OFFICE TEMP PWR Description 1265 CARLSBAD VILLAGE DR T.P Lot 0 Inspector Assignment Type ELEC Sub Type Job Address Suite Location APPLICANT NATIONAL CONSTRUCTION Owner CARLSBAD VILLAGE DRIVE INVESTORS L L C Remarks Phone 9093229866 Inspector Total Time Requested By MARIE Entered By CHRISTINE CD Description 39 Final Electrical Act Comment Associated PCRs/CVs Inspection History Date Description Act Insp Comments »\^ •&•^.% SO L\