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Home My WebLink About156 CHINQUAPIN AVE; ; CB000552; Permit02/15/2000 City of Carlsbad Electrical Permit Permit No CB000552 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 156 CHINQUAPIN AV CBAD St TP ELEC 2060131400 Lot# PALISADES-MOVE EXIST POLE Status ISSUED Applied 02/15/2000 RMA 02/15/2000 02/15/2000 Entered By Plan Approved Issued Inspect Area Applicant TEMP UTILITY SERVICES 1167LAWST SAN MARCOS CA 92069 619-471-5494 Owner _ „ KEYSTONE CARLSBAD L L C 9683 T|ERRA GRA'NDE ST #201 SAN DIEGO.CA . , N 9757 02/15/00 0001 01 02 C-PRMT 20.00 Total Fees $2000 Total Payments To'Da'te*1*^"$000 Balance Due $2000 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 TO TAL PERMIT FEES 0 0 0 0 $1000 $000 $000 $000 $000 $000 $1000 $000 $000 $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 refe rred 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 pro essing 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 fee >/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 1 PROJECT INFORMATION „ T ' FOR OFFICE USE O PLAN CHECK NO EST VAL Plan Ck Deposit Validated By >__. Date Address (include Bldg/Suit Business Name (at this address) Legal De cnption Lot No Subdivision Name/Number Unit No Phase No Total tt of units Assessor s Parcel ft Existing Use Proposed Use Description of Work SQ FT #of Stories 9 of Bedrooms tt of Bathrooms 2. CONTACT PERSON Of different from applicant) Name 3 APPLICANT D Contractor Address |3sAgent for Contractor City "D Owner ^D'Agent-for Owner State/Zip Telephone #Fax tt Name 4 PROPERTY OWNER #& Address City State/Zip Telephone tt /, e 90 Name Address City State/Zip Telephone 9 6 CONTRACTOR-COMPANY NAME - «• - -,„;;„-,-»,«, „_ w_ (Sec 70 11 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 Codel or that he is exempt therefrom and the basis for the alleged exemption Any violating of Section 7031 5 by any applicant for a permit subjects the applicant to a civil penalty of not morejrtan five hundred dollars ($5001) Name State License tf Address License Class City State/Zip City Business License ft Designer Name Address City State/Zip Telephone State License ft 6 WORKERS COMPENSATION Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations Q I ha ye 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 SjL 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 Policy No /5T55~//0 Expiration Date (THIS SEC TION 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 becomi subject to the Workers Compensation Laws of California WARNING Failure ttTsbcure workers compansatwn/coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($160.0001 In addition toxftfe con/if compensation damages as provided for in Section 3706 of the Labor cpde-interesSarvdyattomev s fees S.GNATURE {J&Z^f ^Jt"^ DATE ' ^ ^ 7 he Labor cpde-interesSarvdyatto $' Z> ^ ^ OWNER BUILDER DECLARATION I hereby affirm that I am exempt from the Conctor 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 wort 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) l~1 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 / < ontractors 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; *" ,__ ' *-"•"" •""- 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 - l , „ J "\ 1 ' -•*.**-,# TI I ~ ~ ' 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 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 notcommenced within 365 irfjys fro* 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^cpmmenced for^nefiod^/SO days (Section 1 06 4 4 Uniform Building Code) ^_ ^ - /JAPPLICANT S SIGNATURE WHITE^'FilFile YELLOW Applicant PINK Finance City of Carlsbad Bldg Inspection Request For 2/16/2000 Permit# CB000552 Title PALISADES-MOVE EXIST POLE Description Inspector Assignment 156 CHINQUAPIN AV TP Lot 0 Type ELEC Sub Type Job Address Suite Location APPLICANT TEMP UTILITY SERVICES Owner BEACH KING INC Remarks Phone Inspector Total Time CD Description Act Comments 32 Const Service/Agricultural Requested By MICHELE Entered' By CHRISTINE „ ( Associated PCRs Inspection History Date Description Act Insp Comments FEB-15-2000 07 51 SDG&E 760 739 7494 P 02/02 p COM w u D RESIDENTIAL DATfi OWIOAL ' PJMOHHO «THfJFtaaaiRFACINC Q- EXlsnHOD RISER QUAD TRMISFB> OP qgroct C3 MMTAGHArWt- n JOH IfflCI- ^"ST/^g^S 7^ 5£&t"Q& Yemf PWc$'v£&: ~&B& -€k Dt J a APPBOVHJ BV OAT*FOBEUAH * morma f mm dfltft K*»e IMS oo»lte P 83 From. A curata Ponrtt Co. To MIchelM Scott Dale om/87 TOTM 14 SO S2 Pago / ot i Form jp-~gycy f of o^ Other Permits Pulled far Tht» ffo R*port NO a AEaut Proi«cf fffSw fairfponrcopfc to right at-tayoef^ Any other comments about the project Please senrf-wmraiiy aihlHUmul luCmimtlDn COMPENSATION INSURANCE PO BOX 420807, SAN FRANCISCO CA 94142-0807 F" LJ N D CERTIFICATE OF WORKERS' COMPENSATION INSURANCE MARCH 31, 1999 POLICY NUMBER CERTIFICATE EXPIRES 1555110 - 99 3-31-00 r CITY OF CARLSBAD BUILDING & SAFETY DEPARTMENT L200 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 Insui ance 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 descnbed 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 PLUS! TEMPORARY UTILITY SERVICES 1281 EAST SUNSHINE WAY ANAHEIM CA 92806 L THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND SCIF 102i2 (REV, 3-95)