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Home My WebLink About1320 CASSINS ST; ; CB971373; PermitBUILDING PEHMI 05/27/97 10:13 Page 1 of 1 Job Address; 1320 CASSINS ST Suite Permit Type: ELECTRICAL Parcel No: 215-690-39-00 Lot#: Valuation: 0 Occupancy Group: Reference*: Description: 4 110 VOLT LIGHTS Permit No: CB971373 Project No: A9701769 Development No: 5292 05/27/97 0001 01 02 C-PRMT 20-00 Construction Type: NEW Status: ISSUED Applied: 05/27/97 Apr/Issue: 05/27/97 Appl/Ownr * * * ALLSCAPE LANDSCAPE 505 LILAC CT SAN MARCOS, CA 92069 Fees Required *** 760 480-4041 Entered By: JM llected & Credits Fees : Adjustments: Total Fees: ' Fee description Enter "Y" for Elect Enter "Y" for Remo * ELECTRICAL TOTAL 20 ** * .00 .00 20 . 00 Ext fee Data 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 (760)438-1161 1. PROJECT INFORMATION "": ."'":; :" ""'ft I FOR OFFICE USE ON PLAN CHECK NO. Plan Ck. Validated Jy; Date Address (include Bldg/Suite *)Business Nsme 1st this address) Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Totsl * of units Assessor's Parcel *Existing Use Proposed Use Description of Work SQ. FT.*of Stories * of Bedrooms * of Bathrooms Name +SGa,jift4 Address City State/Zip Telephone*-• -Fax* Name Address City State/Zip Telephone* Name Address City State/Zip Telephone* (Sec. 7031 .5 Bualrwss and Professions Coda: Any City or County which requires a permit to construct, alter, improve, demolish or repair sny 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, commanding 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 .6 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars 1*5001). Name State License*Ucer*e daw i-, ~ C 7 CltV State/Zip City Business License * Tejeohpne* 1JU&* Jf*7 Designer Name Address City State/Zip Telephone State License * ____________ i.;vv'wdfiK»r::coM*_NSATioN ". ~ '" ;,"r" """•;. /'::: . ••. -—r-*—^'**^ ^>^ ~-- .,....... Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: J2S I have end 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. D 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: *7 0 ' ^ <*" ") / ") C~ f Insurance Company ^TAJ'£' £*r«fX Policy No. 'j/^^~ I ~~ > ' Expiration Date I ^~~ $ ~ / 7 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS f*100l OR LESS) D CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shell not employ eny person in any manner so es to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shal subject an employer to criminal penalties and dv» fine* up to one hundred thousand doaare 0100,0001, In addition to the coat of compensation, damages as provided for hi Section 3706 of the Labor code, Interest and attorney's fees. SIGNATURE /fev< £ STtdtf DATE 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 (Sac. 7044, Business and Professions Code: The Contractor's License Law does not apply to en owner of property who builds or Improves thereon, end 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 ia 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 Licsnse Law does not apply to an owner of property who builds or improves thereon, end contracts for such projects with contractors) licensed pursuant to the Contractor's License Lew). D I am exempt under Section _ Business and Professions Code for this reason: 1 . I personally plen 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 fore budding 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 / eddreas / 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 Is the applicant or future building occupant required to submit s business plan, acutely hazardous mstorials 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 obtehi a permit from the air pollution control district or air quality management district 7 G YES D NO Is the facility to be constructed within 1,000 feat of the outer boundary of a school site? D 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. »WPS«sf!ipc^^ " 'Tf" T1" I hereby affirm that there is e construction lending agency for the performance of the work for which this permit Is issued (Sec. 3097(1) Civil Code). LENDER'S ADDRESS _ _LENDER'S NAME I certify that I nave read the application and state that the above Information is correct and that the information en the plans is accurate. I agree to comply with all City ordinances and State laws relating to bulking construction. I hereby authorize representatives of the CHy 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. OSHA: An OSHA permit is required for excavations over 5'0* deep and demolition or construction of structure* 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 end void if the building or work authorized by such permit Is not commenced within 385 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 ^.commenced teperiod of 180 days (Section 108.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE PERMIT* CB971373 DESCRIPTION: 4 110 VOLT LIGHTS TYPE: ELEC JOB ADDRESS: 1320 CASSINS ST APPLICANT: ALLSCAPE LANDSCAPE CONTRACTOR: OWNER: REMARKS: R/MARK/480-4041 SPECIAL INSTRUCT: CITY OF CARLSBAD INSPECTION REQUEST FOR 07/01/97 INSPECTOR AREA PD PLANCK* CB971373 OCC GRP CONSTR. TYPE NEW STE: LOT: PHONE: 760 480-4041 PHONE: PHONE: INSPE TOTAL TIME: CD LVL DESCRIPTION 39 EL Final Electrical ACT COMMENTS ***** INSPECTION HISTORY ***** DATE DESCRIPTION ACT INSP 052897 Underground/Conduit-Wiring AP PD COMMENTS CONDUIT ONLY 05/27/97 10:10 FAX 6194718558 ALLSCAPE IMPORTANT - THIS IS NOT A BILL. SEND NO MONEY UNL6SS STATEMENT IS ENCLOSED. 1 STATE COMPENSATION INSURANCEFUND HOME OFFICE SAN FRANCISCO WORKERS' COMPENSATION ENIJORSEMENT CERTIFICATE IN CONSIDERATION OF THE PAYMENT OF THE TOTAL DEPOSIT PREMIUM AND FULL PREMIUM TQ B6 COMPUTE': AS PROVIDEDIN THS CONTINUOUS WORKERS' COMPENSATION POLICY INDICATED HEBEDN. IT IS AGREED fTHAT S-BJECT TO THE PROVISIONS OF SUCH POLICY AND ENDORSEMENTS THERETO, THE EMPLOYER INDICATED HEREON IS HEREBY NAMED AS ADDITIONAL GROUP INSURED EMPLOYER. | THIS INSURANCE IS EFFECTIVE FROM 112:01 A.M., PACIFIC STANDARD TIME 1-01-97 TO 1-01-98 AND SHALL I AUTOMATICALL? RENEW EACH 1-01 UNTIL CANCELLED DECLARATIONS CONTINUOUS POLICY WESTERN REGIONAL MASTER ASSOCIATION ALLSCAPE LANDSCAPE AND DESIGN, INC 905 LILAC CT SAN MARCOSr CALIF 92069 DEPOSIT 229-97 BUILDERS [ITHUM MINIMUM PREMIUM PREMIUM ADJUSTMENT PERIOD NAME OF EMPLOYER- ALLSCAPE LANDSCAPE AND DESIGN, INC (A CORPORATION) TRADE NAMES-ALLSCAPE ISSUED TO 17298 $650.00 $520.00 MONTHLY R SD WORKERS' COMPENSATION INSURANCE - PART ONE OF THIS POLICE APPLIES TO THE WORKERS' COMPENSATION LAWS OF THE STATE OF CALIFORNIA. 2. EMPLOYER'S LIABILITY INSURANCE - PART TWO OF THIS POLIC LIABILITY UNDER THE LAWS OF THE STATE OF CALIFORNIA. LIABILITY INCLUDING DEFENSE COSTS UNDER PART TWO IS, $1,000,000 CODE NO. PRINCIPAL WORK AND RATES EFFECTIVE TO 1-Q1-98 II APPLIES TO LIMIT! OF BASI RATS INTEKIM BILLING RATli* BUILDING CONSTRDCTION-SEE EXTENSION SCHEDULE FORM 10500 5201 CONCRETE OR CEMENT WORK—POURING OR FINISHING OF CONCRETE SIDEWALKS SPLIT RATES APPLY 1-01-97 TO 10-05-97 10-05-97 TO 1-01-98 5201 CONCRETE OR CEMENT WORK—POURING OR FINISHING OF CONCRETE FLOOR SLABS SPLIT RATES APPLY 1-01-97 TO 10-05-97 10-05-97 TO 1-01-98 5205 CONCRETE OR CEMENT WORK—POURING FINISHING OF CONCRETE SIDEWALKS SPLIT RATES APPLY 1-01-97 TO 10-05-97 OR 14. >6 16.13 14.96 16.13 8.67 11.72 12. 64 11.72 12,64 6.79 TOTAL ESTIMATED ANNUAL PREMIUM $2,009 COUNTERSIGNED AND ISSUED AT SAN FRANCISCO MARCH 7, 1997 POLICY FORM L 1