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Home My WebLink About1587 MARTINGALE CT; TP; CB001056; Permit&\v-• City of Carlsbad 03/23/2000 Electrical Permit Permit No:CB001056 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 1587 MARTINGALE CT CBAD St: TP ELEC Parcel No: Reference #: Project Title: TEMP POWER POLE Applicant: TEMP UTILITY SERVICES 1167 LAW ST SAN MARCOS, CA 92069 619-4 71-5494 Lot#: 0 Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 03/23/2000 GMF 03/23/2000 03/23/2000 2205 ()l/23/00 0001 01 C-f'RtfT Total Fees: $20.00 , ';· ·::'!'~.Payments To Date: j , t ~ ' $0.00 ' ·~lance Due: $20.00 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 TOTAL PERMIT FEES Inspector: L- 0 0 0 0 FINA 1 Lr,rzr0VAL Date: 0IC) Clearance: :110.00 $0.00 $0.00 $0.00 $0.00 $0.00 $10.00 $0.00 $0.00 $20.00 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 1T APPLY to any fees/exactions of which vou have oreviouslv been oiven a NOTICE similar to this or as to which the statute of limitations has orevious1v otheiwise exc ired. CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 02 20.00 FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NO. c..80O 105ep CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST. VAL. _________ _ Plan Ck. Deposit ________ _ Validated By___;;;.-t)'-""-Z....__ ______ _ Date 3{ .2S { ll'cJ 1. PROJECT INFORMATION I :5 7 -r, /1ar r 'n /e. Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total II of units Assessor's Parcel II Z:n 5-re:r/l ct Existing Use Pole Proposed Use Description of Work SQ. FT. #of Stories II of Bedrooms # of Bathrooms 2. CONTACT PERSON (If different from applicant) Name 3. APPLICANT Em Name 4. 6. CONTRACTOR • COMPANY NAME City 0 Agent for Owner ;:;;o . City State/Zip Telephone# Fax II (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 of the Business and Professions Code) or that he is exempt therefrom, and the basis for the alleged exemption. Any vi~tion of Section 7031.5 by any ap licant for a ,Permit subjects the applicant to a civil pen ty of not mo a than five hundred ollars ($5001). w e(' /-'. lA 5' }b a <. e ?T, -✓, " C 9 2.0'2.S-?60 :?9-7 ',?C) Name Address / -C:, / City State/Zip Telepho e II State License # __ J___;2=c.....::.}......,7'--'9,'--'ba...-_ License Class __ <--________ City Business License II _______ _ Designer Name Address City State/Zip Telephone State License # _________ _ 6. WOR!(E_FIS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 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. J3-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 num rare: Insurance Company __ .z.:..L.~t:,(._,C:__ __ L::.::....i!:J.~z..s:;~----Policy No. / 75"~//C}-79' Expiration Date 3 -;?/-00 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) 0 CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure t..--ae,::u,j11 w 11 unlawful, and shall subject an employer to criminal peneltiaa and civil fines up to one hundred thousand dollars ($ OOf, aatlo ages as provided for In Section 3706 oft Labo;.,cod:,, lnte!.es.qand attorney's fees. SIGNATURE __ ..._..::::;__._.c.-<...:.-"-'4 ___ _,_r--'-'-7''+--'----------------DATE ,-,:,I.. .5 ,_. O"fl 7. OWNER-BUILDER DECLARA Tl N 0 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). 0 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. 0 YES O NO 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 PER"11TS 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? 0 YES O NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES O 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. B. 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. 3097(1) Civil Code). LENDER'S NAME _____________ _ LENDER'S ADDRESS ________________________ _ 9. APPLICANT CERTIFICATION 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 authorize representatives of the Citt 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 stories in height. EXPIRATION: Every permit issued by the building Official under the provisio s of this Code shall expire by limitation and become null and void If the building or work aulhorized by such permil is nol comm wit · 180 days fr~-~ 1 t~e uch permit or if the building or work authorized by such permit is suspendE\d or abandoned at any time after the work is comma e r riod of 180 da7j 6.4.4 Uniform Building Code). :} -cJ-. Y _ ~ Cl APPLICANT'S SIGNATURE __ _,_=--"'"------'------iZ-------------DATE WHITE: File PINK: Finance UNSCHEDULED BUILDING INSPECTION DATE _tf_f_5-+-/o_o __ 1 I PERMIT# CG (X) ( 05'(;, JOB ADDRESS /5''6] MM,TIN<eA</i_ er DEscRIPTioN Tmr tovJf ~ '\bu.., INSPECTOR T(.___ ___, ___ _ . PLAN CHECK# ___ _ CODE DESCRIPTION Coo~r, ~«vie£ /~l I ACT COMMENTS