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Home My WebLink About1285 CARLSBAD VILLAGE DR; ; CB951648; PermitBUILDING PERMIT Permit No- CB951648 11/09/95 15 52 Proiect No: A9502408 Page 1 of l Development No: Job Address: 1285 CARLSBAD VILLAGE DR Suite Permit Type. ELECTRICAL Parcel No- Lot#- Valuation: '* 0 Construction Type- NEW Occupancy Group Referenced Status ISSUED Description: TEMPORARY POWER POLE-CHRISTMAS Applied: 11/09/95 TREE LOT Apr/Issue- 11/09/95 Entered By RMA Appl/Ownr : POWER PLUS 619471-5494 1167 LAW ST SAN MARCOS, CA ' 92069 ^>12 li/OP'95 0001 Qi 02 ^ -- * ' '" ~- ^ C-PRHT 20-00 *** Fees Required *** "" A * *,--. , Fe^^^Qpllected & Credits *** r"5 -™- — —s Fees • Adjustments Total Fees: Fee description 00 . 00 20,00 Ext fee Data Enter "Y" for Ele Enter "Y" for * ELECTRICAL TOTAL 10 00 Y 10 00 Y 20 00 CITY OF CARLSBAD 2075 Las Palmas Dr , Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION City of Carlsbad Building Department 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 T PERMIT TYPE From List 1 (see back) give code of Permit-Type For .Residential Proiccts Only From List 2 (see back) give Code of Structure-Type Net Loss/Gain of Dwelling Units PLANCHECKNO. ^J S I V *~\ EST VAL HAN CK DEPOS1 VALID BY DATE 2. PROJECT INFORMAnON FOR OFFICE USE ONLY "Address or Suite No Nearest Cross Slre> TECAl DESCRIPTION Lot No Subdivision Name/ Number Unit No Phase No CF1ECK BELOW IF SUBMITTED D2 Energy Calcs D2 Structural Gales D 2 Soils Report D 1 Addressed Envelope ASSESSOR'S PARCEL EXISTING USE PROPOSED USE DESCRIPTION OF WORK SQ FT # OF STORIES # OF BEDROOMS # OF BATHROOMS 31A-JNIACI FtKJiUN (.it aiiierc.nl irom applicant) NAME (last name first) CITY STATE ADDRESS ZIP CODE DAY TELEPHONE 4 TU'PULANl UUJNIRAC1UK U ACihN I FOR CON I HAL I OH QOWNERLJ. AGENT FOR OWNER NAMF (last name first) ADDRESS CIFY STATE ZIP CODE DAY TELEPHONE ^PROPERTY OWNER NAMF (last name first) STATE 6 A ZIP CODE *? 3OH 1 DAY TELEPHONE ~?S3 ~ V_S£> ' 6 C-ON IKACTO, NAML (last name first) CITY /P \ADDRESS J / £ 7 ZIP CODE9<^0 6 9 DAY TELEPHONE STAIELIC #S'A3'5i?€ LICENSE CLASS C& f CITY BUSINESS L1C #3 MUNhK NAML (last name Iirst)ADDRESS CITY STATE ZIP CODE DAY TELEPHONE STATE LIC # 7 Wt JUKI JUT OOMl'LNSAnON Workers Compensation Declaration 1 hereby afiirm thai 1 have a cenilKdle 65 consent to seU-insure issued by Ihe Director of Industrial Relations, or a cemficate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified by the Director of the insurer thereof filed with the Building Inspection Department (Section 3800, Lab C) INSURANCE COMPANY POLICY EXPIRATION DATE - / - 7 4 Ccrtilicate or Lxemption 1 certify that in the performance ot the work lor 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 SIGNATURE DATE CJWNlJt-BUILDKH. ULCLARAnUN Owner-Builder Declaration T hert-tiy attirm trut I am exempt trom tne contractors License Ldw lor the lollowmg reason n D 1, 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 compleuon, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale ) 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 Ijcense 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) I am exempt under Section Business and Professions Code for this reason (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, commencing 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]) SIGNAITJRE DATE H!Q'MPLETE THIS SECTION FOR NON-RESIDENTIAL 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 25505, 25533 or 25534 of the Presley-Fanner Hazardous Substance Account Act? D YES D NO Is the applicant or future building occupant required to obtain a permit from the air pollution control distnct or air quality management district? D YES n NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES D NO IF ANY OF Tl IE ANSWERS ARE YES, A FINAL ChR nFlCATE OF OCCUPANCY MAY NOT BE ISSUED AF1TR JULY 1, 1989 UNLESS 11 IE APPIJCANT JLAS MET OR IS MEETING THE REQUIREMENTS OF HHE OFFICE OF EMEBGrJICY SERVICES AND THE Am POLLUTION CONTROL DIS1HICT. 9. dDNVntUCTlON LENDING AGENCY I hereby afhrm that there is a construction lending agency tor the performance of trie work tor which this permit is issued (Sec 3097(i) Civil Code) LENDER'S NAME LENDER'S ADDRESS TOAPI'lJLAN 1 I ccrtiry that 1 have read the application dnd state that the above information is correct T agree to comply with all City ordinances and Stale 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 EXPENSE WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUliNCE OF THE GRANTING OF THIS PIJIMIT 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 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 nmcommenced within 365 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned at anwtfmeailer the work is commenced for a penod of 180 days (Section 303(d) Uniform Building Code) APPLICANTS SIGNATUREy^^X /) / ^ U//7 ,„ , * An DATE , Fil<* /YELLOW: Applicant PINK: Finance f~~* V- CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB951648 FOR 11/28/95 DESCRIPTION: TEMPORARY POWER POLE-CHRISTMAS TREE LOT TYPE: ELEC JOB ADDRESS: 1285 CARLSBAD VILLAGE DR APPLICANT: POWER PLUS PHONE: CONTRACTOR: PHONE: OWNER: , PHONE: INSPECTOR AREA PY PLANCK* CB951648 OCC GRP CONSTR. TYPE NEW STE: LOT: 619471-5494 REMARKS: MW/MICHELLE SPECIAL INSTRUCT: INSPECTOR TOTAL TIME: —RELATED PERMITS—PERMIT# TYPE CD 32 CB951584 ELEC LVL DESCRIPTION EL Const. Service/Agricultural STATUS ISSUED ACT COMMENTS W &IL. INSPECTION HISTORY ***** DATE DESCRIPTION ACT INSP 112095 Const. Service/Agricultural CO PY 111495 Const. Service/Agricultural CO PY COMMENTS SAME CORK AS 11/14 BELOW NDS CONDUIT AND GFI OUTLET v City of Carlsbad Building Department WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self-insure for A. workers' compensation as provided by section 3700 of the Labor Code, for the performance of the work for which this permit is issued. /" •• B. \ 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 workers' compensation insurance carrier and policy number arep INSURANCE COMPANY POLICY NO EXPIRATION DATE: (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) 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 ™ C. workers compensation laws of California. Signature /Date If- Warning: Failure to secure workers' compensation coverage is unlawful, and shall be subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, Interest and attorney's fees. March 3, 1995 2O75 Las Palmas Dr - Carlsbad, CA 92009-1576 • (619) 438-1161 • FAX (619) 438-O894 * ?;" ^ f^ojw^h^^tws1, # ^V:?',-"1' :^:" ;A^f | lfyi -", ••/« " » ," '^ J ^ Hf. >,«* * ' "* *iK*i, „ ,? ' ** ' \ M*sifi^ J " ,. vs*^ ' ' * ' ^ j. ' -"-/ x i *>!«/< ( - - ' ' •* -- -!.^' ?$*£-*- ~~' '* J ''^ - ^'^'% ^1<^<l;1 ' -i^"*5" V-*'' ' ^^-y;'!^ > ',^^,";//' ^ --^ ^^ >"" r < f*^ ^?^ ^^ - -';-, '/" < ^^^^^^f^J^O^^^tt^^^^i^-f' --"^^i "*^ /-,-' (;,is, \ '^j1( ,';C s *t1JK ' \**o ^_^ -' -v * ^'^'"* " "" , ', '-:,^.^ -1 _ - ' , , ~ J- - -- L >, ! ^ k s ' - < - Th.is islo-certify tt>at-we have issued^a ^ajjcl Workers' Compensation insurance policy wra form appr6vect by tft^ Caltforofa -,.._,< JnsBranceCommissloner-to the employer rtaraed be'lo^for the policy period indicate1:*", f ' '' . ~ - - <' '''" " ''" '- 'r ',.; . '-"" i' " , '.,:' - 1 . , ..'-,'.'" -X - ,-' v , , ',• ,*-*' »' -s * '.i.^i ^ ji,J' '^^ T'V - "" '-'<•-.'•' _ f • - ' ' U •> ' > ,•- , We wfflvgiSD give you TEN days advance ootice should tnte)x>ltcy ba cancelled, pnor to.ite normal expiration, , ^ /"-V--^-* ^ '-'•-'> - " - " v ' > > / , " - • "'1 L' v -, '^/(fis_uet^uv<*w w tfistwaoc** is ;"Ot dn^'nsuia^rcrB ptw&y afio ao^s n^^afneni?, «xi^?uvor ^HW f«e covwrage ajjofoeu.-wy tneJ^.J-f^pficies;|isted;;rhfere{p( Nolwrttratanding any requlreimnt^tertji, or cond^lon,of «f»ycontract^or other'-document'Wth f .'/^^^^r^'^^hCsfeerttficat^-ofImst^ance jf^,.bfi! ^su«cr er^ayiyert&tCthe if^wg&jtfte&f^fy'tf&, poWd^s ' „.'V *r_ ' .^ -^j*.AJt«^J^^j. hAd^^^u.. J':ii£-i:i*i A>*i j^« nii jJ-'^^i.^:-,*-.-. >..-.,.—.*..—.! ii—L. 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