HomeMy WebLinkAbout156 CHINQUAPIN AVE; ; CB994529; Permit12-08-1999
City of Carlsbad
Electrical Permit Permit No CB994529
Building Inspection Request Line (760) 438-3101
Job Address
Permit Type
Parcel No
Reference #
Project Title
156 CHINQUAPIN AV CBAD St TP
ELEC
2060131400 Lot#
TEMP POWER POLE-PALISADES
Applicant
TEMP UTILITY SERVICES
1167 LAW ST
SAN MARCOS CA 92069
619-471-5494
Status ISSUED
Applied 12/08/1999
RMA
12/08/1999
12/08/1999
Entered By
Plan Approved
Issued
Inspect Area
6951 12/08/99 0001 01
Owner-^ C-PRMT
'***" KEYSTONE CARLSBAD L L C
9683 TIERRA GRANDE ST #201
SAN DIEGO CA
92126
02
20-00
Total Fees $2000 I, Tdtal Payments To Date $000 Balance Due $2000
Electric Issue Fee | J
Single Phase per AMP f *-
Three Phase per AMP
Three Phase 480 Per AMP*.
Remodel/Alteration per AMPC
Remodel Fee
Temporary Service Fee
Test Meter Fee
Other Electrical Fees
TO TAL PERMIT FEES
$1000
"$000
$000
*$ooo
'^$000
1 $000
$1000
$000
$000
$2000
Inspector
FINAL APPROVAL
Date /-Z->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
pro essmg m 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 ""* ~~ ~!, '"I* _ ""Jr"* u
Address (include Bldg
FOR OFFICE USE ONLY
PLAN CHECK NO
EST VAL
Plan Ck Deposit.
Validated By
Date / 0 .
Business Name (at this address)
Legal De cnption
Assessor s Parcel #
Descnption of Work
Lot No Subdivision Name/Number
~-p Existing Use
i^> ( \o\.*s&^ rol •&.
' SO FT *>of Stones
Unit No Phase No
Proposed Use
* of Bedrooms
Total tt of units
n of Bathrooms
2. CONTACT-PERSON Of different from applicant)
Name Address City
3 APPLICANT D Contractor SAgenMor Contractor^ D Owner XPAgerrffor Owner
State/Zip Telephone #Fax
Name '
4 PROPERTY OWNER '
got* -f-ti /#*£/ C etn w >
Address City
l/V/o"
State/Zip 'Telephone *
Name Address _/ City^ State/Zip Telephone 9
S CONTRACTOR COMPANY NAME '"_.•-- "- " *-«?•• f*.~-~- — _ -«~* C-
(Sec 7001 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 cjyil penalty of not rrjore than five hundred dollars ($500))
/7^>
Name
State License tt ^2. ? ~*
Address /
»^ License Class £-~~ & /
City State/Zip
City Business License tt
Telephone *
Designer Name
State License tt
Address City State/Zip Telephone
6 WORKERS COMPENSATION
Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations
G 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
T2^ 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 ^/e?7^£?- /-- Cfsy&f Policy No / ^^? 5 f/CJr~ ss Expiration Date ^ ~^/ ~^O
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS)
G CER riFICATE 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 worken^compenaation coverage UMinlawful and (hall aubjact an employer to criminal penalties and civil fines up to one hundred
thousand dollars ($100 000) irf'a|Uttfm/to the cost of campensMJon damages aa provided for hi Section 3706 of the Labor code interest and attorney a fees
SIGNATURE d-3=:CX^-4>'' *~~r1^fw/H/l'~^ DATE /J- *~ Q* " f ?
7 OWNER BUILDER DECLARATION J
I hereby affirm that I am exempt from the Contractor s License Law for the following reason
G 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)
G I am exempt under Section Business and Professions Code for this reason
1 I per onally plan to provide the major labor and materials for construction of the proposed property improvement Q YES QNO
2 I (hav e / have not) signed an application for a building permit for the proposed work
3 I havs 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-RESIDENTTAL 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? l~l YES l~l 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 * \ „ „- -^ *-^f - ->™>~
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(0 Civil Code)
LENDER S NAME _ LENDER S ADDRESS _ ___ _
9 APPLICANT CERTIFICATION . l „ „ J/V* - > , •>"''" „„,.„ „_ 1 ""
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 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
JUDGMENT S 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 notcpmmenced within 365 days frpm the date of such permit or if the building or work authorized by such permit is suspended
or abandoned at any time after the vy6rk V/pmmenced for t&anoa/^f 1 80 days (Section 1 06 4 4 Uniform Building Code)
APPLICANT S SIGNATURE
WHITE Tile YELLOW Applicant PINK Finance
DATE
f> a
1 7
City of Carlsbad Bldg Inspection Request
For 1/25/2000
Inspector Assignment DMPerrniW CB994529
Title TEMP POWER POLE-PALISADES
Desc nption
Sub Type
156 CHINQUAPIN AV
TP Lot 0
Type ELEC
Job Address
Suite
Location
APPLICANT TEMP UTILITY SERVICES
Owner BEACH KING INC
Remarks
Total Time
Phone 7608399430
Inspector
Requested By MICHELE
Entered By CHRISTINE
CD Description
32 Const Service/Agricultural
Act Comments
Associated PCRs
Inspection History
Date Description Act Insp Comments
12/23/1999 32 Const Service/Agricultural CA DM RED TAG NOT LIFTED
12/14/1999 32 Const Service/Agricultural CA DM
12/9/1999 32 Const Service/Agricultural CA DM DUE TO RED TAG
Panasonic Ffix SYSTEM PHONE NO 619 442 6957
€LECTRtG METER 5 SERVICE LOCATtOtT
Nov 12 1399 01 12PM P2
D JT MEg HEQj^ aCQMM t_
JiiOHATORIUM EFFECT AGENC
TYP6
ST PCga Fg^MfTS.gEQ P DCUST
GEBVtceATTACHMENT POINT
KSPBC BEO B PRIOaTO S£F
(Pmln fy m*t, from finis
_locatca In a safe ««» ffao of *n^ potentiai/ha*wdeuS or dpngsKKIS
Ft at prt-"> olatrai-trfnant
Fr ovar artveway or parktna area
F1 at outer limit o
Fr
L UtEeLIGA6l.g QUQT AP
1utnr»finf|ri<»/pprlni'trtfg?if!hInBtn arrange
Q DAySPRlQB TQ TBEMCM
FOfMMsPECTJOM Do not cover conduit
mtnl u IH JUHgU »*>» LiMHtiH C*bt. ABOVE PI KM»E » FOt)
FTHE"EDUIWrERT
iirbe set after Inspector nas approved tnstallatian 1ncrutitngj«rvice
ctre TORIES DstXifcG B1Z6
RAEiUS SCH 80 StZB
ifi)uiiitMia«>fflHft4immi|
aw UManiouo or ttstie nmgrtire ifecovcreg uuitny ttw course of conatrueti=<rt(rrtBS»ft
- PIaww GBtB-C.t Ord»F
COMPENSATION
INSURANCE
PO BOX 420807 SAN FRANCISCO CA 94142-0807
F-U 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
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 i
This policy is not subject to cancellation by the Fund except upon ten days' advance written notice to the employer
1 »
We will also give you TEN days' advance notice should this policy be cancelled pnor to its normal expiration* *• «
This certificate of insurance is not an insurance policy and doesJ not amend extend or alter the coverage afforded by the
policies listecl 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 condrtions 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 PLUSI TEMPORARY UTILITY SERVICES
1281 EAST SUNSHINE WAY
ANAHEIM CA 92806
L
THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND SCIF 10262 (REV. 3-95)