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1265 LAUREL TREE LN; ; CB060450; Permit
02-22-2006 X City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Electrical Permit Permit No CB060450 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 1265 LAUREL TREE LN CBAD St T P ELEC 2120402500 Lot* BILTMORE PACIFICATEMP POWER Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 02/22/2006 SB 02/22/2006 02/22/2006 Applicant LUSARDI CONSTRUCTION COMPANY 1570 LINDA VISTA DRIVE SAN MARCOS, CA 92069 619-744-3133 Owner ASCENT BILTMORE CARLSBAD L L C 111 WMONROEST #1111 PHOENIX AZ 85003 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 0 0 0 0 $1000 $000 $000 $000 $000 $000 $1000 $000 $000 $000 $2000 Total Fees $20 00 Total Payments To Date $20 00 Balance Due $000 Inspector FINAL ARPROAL Date Oy //Clearance NOTICE Please take NOTICErthat 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 nght 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 fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired PERMIT APPLICATION CITY'OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 FOR OFFICE USE PLAN CHECK NO. EST VAL Plan Ck Deposit. Validated By Date Address (include Bldg/Suite tf)Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total # of units Assessor's Parcel #Existing Use Proposed Use Description of Work SQ FT #of Stories # of Bedrooms # of Bathrooms (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 [$500]) Name Address State License # ^fiv^?/ License Class r* / 1 -y? 'Designer Name p^-P S ' Address State License tt "" City State/Zip Telephone # ZZ> City Business License # City State/Zip Telephone Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations Q 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 JS[ 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 /V^*"f^- iffifs ^^ flf* r/ "f~"f£ . f/\- Policy No yVc^ /^> v /{/ / Expiration Date J/~^/~ & / (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) Q CERTIFICATE OF EXEMPTION I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California WARNING Failure to secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollarsj$JOO,000), In/tiBdltiorUp the cosvpf compensation, damages as provided for In Section 3706 of the Labor coda, interest and attorney's fees SIGNATURE ^) /") /( I<^—r?[/£%^7\-. DATE £--''?- I hereby affirm that I am exempt from the Contractor's License Law for the following reason Q 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^sfele 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 ojjmprove for the purpose of sale) Q I, as owner of the property, am exclusively contracting with licensed contractors to construct-ffieiproject (Sec 7044, Business and Professions Code The Contractor's License Law does not apply to an owner of property who builds or improyesfnereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law) n I am exempt under Section Business and Professiops-Coda for this reason 1 I personally plan to provide the major labor and materials-for construction of the proposed property improvement Q YES QNO 2 I (have / have not) signed an application for ab,uiMing 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 ! of work) f the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type PROPERTY OWNER SIGNATURE DATE NO 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 Q NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or afr quality management district? Q YES Q Is the facility to be constructed within 1 ,000 feet of the outer boundary of a school site? Q YES Q 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 I hereby affirm that there is a constructionJendinjragency for the performance of the work for which this permit is issued (Sec 30970) Civil Code) LENDER'S ADDRESSLENDER'S NAME ( >l!i^A*^:i5K;:>iSfe'.:::;^;:'.i:Vi;SVA;' ijS^4\.^iii^V:'>iH'SI/:t'5"3ft;!fefeS 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 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 this 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 the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced for a period-of l8J)Jays (Sectjcn,106 4 4 Uniform Building Code) "" WHITE File YELLOW Applicant PINK Finance APPLICANT'S SIGNATURE City of Carlsbad Bldg Inspection Request For 03/15/2006 Permit* CB060450 Title BILTMORE PACIFICA TEMP POWER Description Sub Type 1265 LAUREL TREE LN T P Lot 0 Type ELEC Job Address Suite Location APPLICANT LUSARDI CONSTRUCTION COMPANY Owner Remarks Inspector Assignment Phone 7608025133 Inspector Total Time CD Description Act Comment 32 Const Service/Agricultural Requested By JOHN Entered By CHRISTINE Comments/Notices/Hold Associated PCRs/CVs Original PC# Inspection History Date Description Act Insp Comments CITY OF CARLSBAD ELECTRIC AND GAS METER CLEARANCE INTER-DEPARTMENT ADDRESS: S E O Service Equipment Only Reason, If Denied ELECTRIC METER GAS METER COMMERCIAL RESIDENCE NEW SERVICE RELOCATE TSPB TEMP P/P UP-GRADE TEST METER IRR PEDESTAL COMMERCIAL RESIDENCE ETER Building Ij^sp YES NO YES V NO YES NO Called In By Date Time Called In To /AI^UKU UhK 1 IhlUA 1 b Uh LIABILI 1 Y IN5UKAIMUt 12/28/2005' PRODUCE (8585642-0010 FAX (858)642-0888 G A Pearson and Associates License #OA91092 6225 Lusk Boulevard, Suite B Diego, CA 92121 INSURED Lusardi Construction Co 1570 Linda Vista Dr San Marcos, CA 92078 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW INSURERS AFFORDING COVERAGE INSURERA American Int'l Specialty Lines It INSURERS National Union Fire Ins Co. of F INSURER c American Home Assurance Company INSURER D INSURER E NAIC# IS Co 'itt , PA COVERAGES — , THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS NSRLTR A B ADDLNSRC TYPE OF INSURANCE GENERAL LIABILITY X T COMMERCIAL GENERAL LIABILITY | CLAIMS MADE [ X | OCCUR $10,000 SIR GEN L AGGREGATE LIMIT APPLIES PER | POLICY [T~j SECT | | ioc AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS GARAGE LIABILITY ANY AUTO • EXCESS/UMBRELLA LIABILITY | OCCUR | | CLAIMS MADE DEDUCTIBLE RETENTION S WORKERS COMPENSATION AND EMPLOYERS LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes describe under SPECIAL PROVISIONS below OTHER POLICY NUMBER GL 1757118 CA 8262244 INSURER B WC 1359707 (CA) INSURER C WC 1359708 (AOS) POLICY EFFECTIVEDATE IMM/DD/YY) 01/01/2006 01/01/2006 01/01/2006 01/01/2006 POLICY EXPIRATIONDATE IMM/DD/YYI 01/01/2007 01/01/2007 01/01/2007 01/01/2007 LIMITS EACH OCCURRENCE DAMAGE TO RENTEDPRFMISFR (Fa nr.nirBnrR) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY(Per accident) PROPERTY DAMAGE (Per accident) AUTO ONLY - EA ACCIDENT OTHER THAN' EAACC AUTO ONLY AGG EACH OCCURRENCE AGGREGATE v WC STATU OTHA TORY 1 1MITS ER E L EACH ACCIDENT EL DISEASE EA EMPLOYEE E L DISEASE POLICY LIMIT s 2,000,000 * 100,000 i 5,000 $ 2,000,000 s 4,000,000 $ 4,000,000 $ 1,000,000 $ s $ s $ $ s s $ $ s s 1,000,000 $ 1,000,000 s 1,000,000 E All Operations he City of Carlsbad, its officers, employees, and volunteers are named as dditional Insureds per attached Form CG2010 0704 10 Day Notice of Cancellation in the event of non-payment of premium CERTIFICATE HOLDER CANCELLATION City of Carlsbad 1635 Faraday Ave Carlsbad, CA 92008-7314 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON JHjfNSURER ITS AGENTS OR,REPRESENTATIVES 5.CORD 25 (2001/08)©ACORD CORPORATION 1988 IMPORTANT If the certificate holder is an ADDITIONAL INSURED, the poiicy(ies) must be endorsed A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s) If SUBROGATION IS WAIVED, subject to the terms and conditions of the policy, certain policies may require an endorsement A statement on this certificate does not confer rights to the certificate holder in lieu of such endorsement(s) DISCLAIMER The Certificate of Insurance on the reverse side of this form does not constitute a contract between the issuing insurer(s), authorized representative or producer, and the certificate holder, nor does it affirmatively or negatively amend, extend or alter the coverage afforded by the policies listed thereon .CORD 25 (2001/08)