HomeMy WebLinkAbout1596 MARTINGALE CT; ; CB032859; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
10-16-2003 Electrical Permit Permit No: CB032859
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
1596 MARTINGALE CT CBAD
ELEC Status:
Parcel No: 2150723300 Lot#: 0 Applied:
ISSUED
10/16/2003
SB
10/16/2003
10/16/2003
Reference #:
Project Title: GATES RES MISC REAR YARD ELEC
OUTLETS
Applicant:
GATES GARY G&ALICIA L
1596 MARTINGALE CT
CARLSBAD CA 92009
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
Additional Fees
TOTAL PERMIT FEES
0
0
0
0
Entered By:
Plan Approved:
Issued:
Inspect Area:
Owner:
GATES GARY G&ALICIA L
1596 MARTINGALE CT
CARLSBAD CA 92009
$10.00
$0.00
$0.00
$0.00
$0.00
$10.00
$0.00
$0.00
$0.00
$0.00
$20.00
Total Fees: $20.00 Total Payments To Date: $0.00 Balance Due: $20.00
Inspector: Date:
6732 .l0/16/03 00()2 •,)1
CGF"
Clearance:
NOTICE: Please take NOTICE that approval of yourprq'ect 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 capacity
changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any
f x ion fw i h hav r vi I N T imil r hi h h I th
02
:20 -00
PERMIT APPLICATION
t
FOR OFFICE USE ONLY
PLAN CHECK No.G~3 'Z~/
EST. VAL. _k__;;a.....--------CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
1. PROJECT INFORMATION
· 1 Address (include Bldg/Suite #) Business Name (at this address)
,,<.r2 C u,~d~c ~Z: Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units
Assessor's Parcel # Existing Use Proposed Use
~e#~~?'~/ ~ ~.v;;;rz.&-~o. FT.
#of Stories # of Bedrooms # of Bathrooms
2 .. CONTACT PERSON (If different from applicant)
Name Address City State/Zip Telephone# Fax#
3. APPLICANT O Contractor O Agent for Contractor O Owner . 0 ~gent for Owner
Address City State/Zip Telephone#
4. PROPERTY OWNER )(
Name
~~--~~:.4-.;:__,co/:;...__;/4z==-,::;....,o:;.,,~"'--Z'-"'Z_~~""""------------------------Name Address City State/Zip Telephone #
6. 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 of 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 [$500]).
Name Address City State/Zip Telephone#
State License # _________ _ License Class _________ _ Cit y Business License # _______ _
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:
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.
0 I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for t he performance of the w ork for which this permit is
issued. My worker's compensation insurance carrier and policy number are:
Insurance Company_____________________ Policy No. ___________ _ Expiration Date _______ _
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS)
O 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 to secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up t o one hundred
thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, Interest end attorney's fees.
SIGNATURE______________________________ DATE t· OWNER-BUILDER DECLARATION --=::;:;;;:::==:--=-:=:::::::::;;::;:::; __
hereby affirm that I am exempt from the Contractor's License Law for the following reason:
~ 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). _,g 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).
O 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 ONO
2. I (have I have not) signed an application for a building permit for the proposed work.
3. I have contracted with the following person (firm) to prov·de the proposed construction (include name / address I phone number I contractors license number):
C. /
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 I address I phone
number I contractors license number): ________ -::;;:,aac-------==-----------------------------
5. I will provide some of the work, but I have contra arsons to provide the work indicated (include name I address I phone number I type
of work): ____________ --,,........,.,,,..--~~;;~~':.';;,-?--------------------:-----------------
PROPERTY OWNER SIGNATURE -"'<,--:>"f--f--~"--~--7'~----------DATE / 6 ~ ?:-!Zt:' ~
COMPLETE THIS SECTION FOR NON-
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 7 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.
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. 3097(i) 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 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 w· · days fro e of such permit or if the building or work authorized by such permit is suspended or abandoned
" /t any time after the work is commenced f peri of 18 s (Se on 106.4.4 Uniform Building Code).
} APPLICANT'S SIGNATURE --,~~_::-~:-½......,...,..._,£..,L-,;;z:;++-------------DATE ,L6 /::) CZ ~.?
YELLOW: Applicant PINK: Finance
City of Carlsbad Bldg Inspection Request
For: 09/20/2004
Permit# CB032859
Title: GATES RES MISC REAR YARD ELEC
Description: OUTLETS
Type: ELEC Sub Type:
Job Address: 1596 MARTINGALE CT
Suite: Lot 0
Location:
APPLICANT GATES GARY G&ALICIA L
Owner: GATES GARY G&ALICIA L
Remarks: PAPERWORK UNDER FRT MAT
Total Time:
CD Description Act Comment
Inspector Assignment: JM ---
Phone: 6195323986
Inspector: ,:::JJ'v\.
Requested By: GARY
Entered By: ROBIN
39 Final Electrical ~--------------
Associated PCRs/CVs
lns12ection Histoiy
Date Description Act lnsp Comments
03/2212004 31 Underground/Conduit-Wiring PA JM CONDUIT ONLY
03/22/2004 39 Final Electrical WC JM