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Home My WebLink About1598 TRITON ST; ; CB052298; Permity M 06-21-2005 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Electrical Permit Permit No CB052298 Building Inspection Request Line (760) 602-2725 Job Address 1598 TRITON ST CBAD St TP Permit Type ELEC Parcel No 0000000000 Reference* CT03 13 Project Title BLACK RAIL RIDGE TEMP POWER POLE Lot* Status ISSUED Applied 06/21/2005 Entered By MDP Plan Approved 06/21/2005 Issued 06/21/2005 Inspect Area \ Applicant \NATIONAL CONSTRUCTION Owner 14551 ANDELDR 9; 909574-1400 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 0 0 0 0 $1000 $000 $000 $000 $000 $000 $1000 $000 $000 $000 TOTAL PERMIT FEES $2000 Total Fees $20 00 Total Payments To Date $0 00 Balance Due $2000 > ''21/05 000.2 OJ CGP 02 20. 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 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 fees/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 PERMIT APPLICATION 1 PROJECT INFORMATION CARLSBAD BUILDING DEPARTMENT B35 Faraday Ave , Carlsbad, CA 92008 FOR OFFICE USE ONLY PLAN CHECK NO EST VAL Plan Ck Deposit. Validated By Date Address (include Bldg/Suite tt)Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total # of units Assessor s Parcel tt Existing Use Proposed Use Descriptionion ofoWork / _ -^SQ-i-r*»p pew* p&te fj ) 2 CONTACT PERSON (if different from applicant) FT #of Stories # of Bedrooms tt of Bathrooms Name 3 APPLICANT Contractor Address City for Contractor Q Owner O Agent for Owner State/Zip Telephone tt Fax ff Name 4 PROPERTY O City 'State/Zip Telephone # Address City State/Zip Telephone #Name 5 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 uiolatwjn of Secttsn 7031 JLb^armjjBRlicant fgO permit subjects the applicaoLtg. a civil penalty of-not roere than fin hunrlrrrl dollars 1A50Q Name State License tt £27/60 Address License Class City State/Zip City Business License # Telephone # Designer Name Address City State/Zip Telephone State License it 6 WORKERS COMPENSATION Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations l~1 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 Jhe work for which this permit is issued M 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 ipsbed My worker s compensation insurance carrier and policy number are Insurance Company \7\^/\AJ~CjJJ^\. J^s Policy No (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) f~l 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 to one hundred thousand dollars ($100 OOOJJjp-«rildigonw> the cost of compensation damages as provided for in Section 3706 of the Labor, code interest andajterney s fees SIGNATURE \^ \ i _J(/ DATE f^> "~C-~] ~ ^ 7 OWNER BUILDER DECLA^TION I hereby affirm that I am exemptTrom the Contractor s License Law for the following reason f~l 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) [3 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~l 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 l~l YES I~|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 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' O YES Q] NO Is the facility to be constructed within 1 000 feet of the outer boundary of a school site? O YES l~) 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 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 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 commenceAwtiHfrreO dais from the date of such permit or if the building or work authorized by such permit is suspeng^fSrabandoned at any tim* after the work is commenced frjM^pyio/ofjtfc days (Ssction 106 4 4 Uniform Building Code) APPLICAN S SIGNATURE ^\ \ I /7U DATE HITE File YELLOW Applicant PINK Finance DATE UNSCHEDULED BUILDING INSPECTION - 1*1-0$ INSPECTOR PERMIT # QSii^q. PLAN CHECK # JOB ADDRESS DESCRIPTION CODE DESCRIPTION ACT COMMENTS City of Carlsbad Bldg Inspection Request For 06/23/2005 Permit* CB052298 Title BLACK RAIL RIDGE Description TEMP POWER POLE 1598 TRITON ST TP Lot Type ELEC Sub Type Job Address Suite Location APPLICANT NATIONAL CONSTRUCTION Owner Remarks Inspector Assignment^ Phone 9093226700 Inspector Total Time CD Description 39 Final Electrical Act ^Comment Requested By CAR LA Entered By CHRISTI Associated PCRs/CVs Inspection History Date Description Act Insp Comments 0b/19/2005 06 33 707528766? Jun QQ OS Qg.19a PERMIT SERVICES INC PAGE 14 vacff/^31 rtefna r -se-ss s 26/2034 08 49 -?075287&63 ib U4 08'57a Play 03 04 OS PERMIT SERVICES INC PARE 36 p,8 CERTIFICATE OF LIABILITY INSURANCE » O Boot 727 Lonff Beach CA 90807 Shocte. THtS( ONLY CeRTlPK-4T«'ls"jSSUBD AC A MAfVwlOf Ji*-^ ONLY AMD CONFERS NO RIGHTS UPON THE CERIfflCAT TTcST HOLCER. THIS CERTIFICATE DOE* NOT AMEND, BXTEMD OR ALT8R THE COVE^ABg APFOROaa BY THE POLICIES BEtftff INSURERS Af FOaOttJG COV6RACE a.tJ.enAL Construction ptai», *n—_ , j_ffesiam ?abiic«k,tor 1* CSitssr*irt£ St „ls CA 91.343 c» af II. ! I\SUKEH £ COVERAQCS THE POLICIES <y»48«WAe«uB--aoBeLow HAVE Jeew ssufBTi3-TfENsu«EOi*u«io^*iwrfc5^ _ ANY SISuREWWr TBW OR CONOCTON OF ANV CONTRACT GR CTMSS DO«SW*WT WITH RESPECT TO WKtfHTMieWWOiTBMWaSBSUEO ORMAT PERTJurTn* wsiNMNCe VPOdcee gv WE cAidie OESCRIBUO HEUBW is SUBJECT TO A. t THE TSK**, sastuoona AND ccwimw* OP CUCH i__J ocaR cei«n/< Mm XMOAUTW x± I iMVAUTB FACKCCOMTOKCE [H occgn (^[3 CUVM5 SWCE 3wnwnau t 05/01/04 05/01/05 1 tX MCMhVT£<l » toooooo i innoooo ;100QOOO OTHgB aUehiftia*' La.o«m« IS871SO Rational Ccnuttwoeion 10 d«ys rotie* of CSHTlfCATE HOLDER i^ H4BU ISO CA^7ELUTIl5Nr Contractors ar.ate Li can SB Board 6 aox »finnn CA 95325 ACOflO«-S(»i7[ WOULD W OF Tht/£IWC 3«eiV»BPl7.ie(U K C »S-0«TOTMEpt>lT\;leATeholtSHNIiMgaTDTt(«LErr »U»ni»(