HomeMy WebLinkAbout1314 DAYLILY DR; TP; CB993437; Permit09/16/1999
City of Carlsbad
Electrical Permit Permit No CB993437
Building Inspection Request Line (760) 438-3101
Job Address
Permit Type
Parcel No
Reference #
Project Title
1314 DAYLILY DR CBAD St TP
ELEC
Lot#
TEMP POWER POLE
Status ISSUED
Applied 09/16/1999
Entered By RMA
Plan Approved 09/16/1999
Issuea1 °8$1«fl&9H>01 01 02
Inspect Area C-PRMT 20.00
Applicant
TEMP UTILITY SERVICES
1167LAWST
SAN MARCOS, CA 92069
619-471-5494
.Owner-
Total Fees $2000 / /\ Total payments To'Date'j^ $0 00 \ XT r Balance Due $2000
: " \ •-•-.-.- ^ -.-«•- ./ | •••• _ 1
! ("( n 1 V '^\ ^ ,%\\ i '<• — ^ 1Electric Issue Fee ; \^—y j ^X,^ jy S A/Il \>--'V$1'000
Single Phase per AMP j " i cx^ /TlO1 \ l^i
Three Phase per AMP \ \ c:>! •-{ };Ch_ \ ; j'"
Three Phase 480 Per AMP\ \ x^ v 1Q^> \ ^
Remodel/Alteration per AMPX \ " ]> 0\.±,\KJ
-/ ./^\e/i $000
// ^ /'^ \jy / $0 00II ^ 1&-?JJ/ ! $o oo
>j y ^^' , /$ooo
Remodel Fee \ \ / / Wll " '" " / / $0 00
Temporary Service Fee \ /p:\) \ INCORPORATED / (> -, /$1000
Test Meter Fee \ ••^-; /' ; ""-- ,. IT
Other Electrical Fees \. '';--^ / /? ri ,~ ~"~
,.. - ,-,\\ -;r / $000•-'•";..., c:v\\\u / $000
TOTAL PERMIT FEES
\ v -)
$2000
Inspector
FINAL APPROVAL
Date 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 you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired
CITY OF CARLSBAD
2075 Las Palmas Dr, Carlsbad, CA 92009 (760) 438-1161
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
2075 Las Palmas Dr, Carlsbad CA 92009
(760)438-1161
PROJECT ;- ~ •>»• .. -r; -• - •*-«•_.._£•* *' •* (l^-Ci-*.** b '
FOR OFFICE USE O
PLAN CHECK NO
EST VAL
Plan Ck Deposit.
Validated
Date ^77
t ("7/T
Address (include Brag/Suits'*)Business Name (at this address)
Legal Description Lot No Subdivision Name/Number Unit No Phase No Total # of units
Assessor s Parcel #Use Proposed Use
Description of Work
2 CONTACT PERSON (if different from applicant)
SQ FT #of Stories 9 of Bedrooms # of Bathrooms
Name Address City
3 APPLICANT D Contractor JB-Agenrfor Contractor"1 "D'Owner U'Agent'for Owner
State/Zip Telephone »Fax #
Name '
4 PROPE1
Address City State/Zip Telephone 9
PERTY OWNER
Of*/er foe,A
Address City S>ote/Zip Telephone ffName
5 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
(Chapter 9 commending with Section 7000 of Division 3 o' 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 ($5001)
Name
State License #
Address
License Class
City State/Zip
City Business License 9
Telephone
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
l~1 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
Q 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 compejisatiorunsurance-eamer and policy number are / ._ ._ . QQ
Insurance Company i_)~7ttl*ts / frvtw* Policy No /_? & .? 11 v / Expiration Date
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS I$100J OR LESS)
f~] CERTIFICATE OF EXEMPTION I certify that in the performance of the work for which this permit is issued I shall not employ any person in any manner so as
to become subject to the Workers Compensation Laws of California
WARNING Failure Jlojsecure workers compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to one hundred
thousand dollars ($£p(M>i&) in additiog/o th/cost of compensation damages as provided for in Section 3706 of the Labor code. Interest and attorney a fees^^& L~JIs 11••/ is f^* /s* ^%^*\
SIGNATURE ( ^\Sfrl£/ (7 ^/H-»V»v— DATE X"Vfe " //
7 OWNER BUILDER DECLARATION
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 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)
Q 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 Code 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 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-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 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 air quality management district? Q YES Q NO
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
8 CONSTRUCTION LENDING AGENCY. • ' " ___ " 1"i"
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 30970) Civil Code)
LENDER S NAME _ LENDER S ADDRESS _ ^_____ _
9 APPLICANT CERTIFICATION J^V7" " , , " . ,,„,. ,,, ,'* ~ ~/\ ~ ~_ - ^ ' '
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 authonze representatives of the CitV 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 6'0" 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 365TJays from the date of such permit or if the building or work authorized by such permit is suspended
or abandoned at any time after tjjejp&los commenceafor aAenod of 1 80 days (Section 1 06 4 4 Uniform Building Code)
APPLICANT S SIGNATURE DATE
HITE File YELLOW Applicant PINK Finance
City of Carlsbad Inspection Request
For 9/22/99
Permit# CB993437
Title TEMP POWER POLE
Description
Inspector Assignment
1314 DAYLILYDR
TP Lot
Type ELEC Sub Type
Job Address
Suite
Location
APPLICANT TEMP UTILITY SERVICES
Owner
Remarks
Phone 7608399430
Inspector
Total Time
CD Description
32 Const Service/Agricultural
Comments
Requested By MICHELE
Entered By CHRISTINE
Inspection History
Date Description Act Insp Comments
From Accurate Perm,, Co To Fax*1-7<HM38-0894 Date 9/16/99 T,me 09 04 06
9-15-1999 9 47AM FROM POWER PLUS 7B0 839 Page 4 of 10
P 9
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IB \ Iflfr t(4JM tttftK MOA P.02
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COMPENSATION
INSURANCE
PO BOX 420807, SAN FRANCISCO, CA 94142-0807
FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
HARCH 31, 1999 POLICY NUMBER
CERTIFICATE EXPIRES 1555110 - 99
3-31-00
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CITY OF CARLSBAD
BUILDING & SAFETY DEPARTMENT
1200 ELM
CARLSBAD, CA 92008 JOB: ALL OPERATIONS
L
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California
Insurance Commissioner to the employer named below for the policy period indicated
This policy is not subject to cancellation by the Fund except upon ten days' advance written notice to the employer
We will also give you TEN days' advance notice should this policy be cancelled prior to its normal expiration
This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the
policies listed herein Notwithstanding any requirement, term, or condition of any contract or other document.with
respect to which this certificate of insurance 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
AUTHORIZED REPRESENTATIVE PRESIDENT
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE.
EMPLOYER
r
S.R. BRAY CORPORATION
DBA. POWER PLUS1 TEMPORARY UTILITY SERVICES
1281 EAST SUNSHINE WAY
ANAHEIM CA 92806
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THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND SCIF102S2 (REV. 3-95)