HomeMy WebLinkAbout1631 FARADAY AVE; ; CB993559; Permit.,City of Carlsbad09/27/1999 Electrical Permit Permit No:CB993559Building Inspection Request Line (760) 438-3101Job Address:1631 FARADAY AV CBADPermit Type:ELEC Status:ISSUEDParcel No:Lot #:0 Applied:09/27/1999Entered By:MDPReference #:Plan Approved:09/27/1999Issued:09/27/1999Project Title:TEMP. POWER POLE Inspect Area:Applicant:Owner:
TEMP UTILITY SERVICES
1167 LAW ST
SAN MARCOS, CA 92069
619-471 -5494
Total Fees:$20.00 Total Payments To Date:$0.00 Balance Due:$20.00
Electric Issue Fee $10.00
Single Phase per AMP 0 $0.00
Three Phase per AMP 0 $0.00
Three Phase 480 Per AMP 0 $0.00
Remodel/Alteration per AMP 0 $0.00
Remodel Fee $0.00
Temporary Service Fee $10.00
Test Meter Fee $0.00
Other Electrical Fees $0.00
TOTAL PERMIT FEES $20.00ri
ditiPIRED PERMITV
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FINAL APPROVAL
Inspector: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 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
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.
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161
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FOR OFFICE USE ONLY
PERMIT APPLICATION •0c.-Aori....•PLAN CHECK NO.efg-3
CITY OF CARLSBAD BUILDING DEPARTMENT v fit`r 0 EST. VAL.
2075 Las Palmas Dr., Carlsbad CA 92009 Plan Ck. Deposit-
(760) 438-1161 '9c/F-cya0 Validated By
Date
1.pkoiEctINFORIVIAtoNIrar .77-7:.7.7.7r7MaillUMPTATitrinrrrWNWF:3/f4r4o14 vAddress (include Bldp/Suitpfrf Business Name (at this address)
C drif '.ler('Q7
Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Total # of units
Assessor's Parcel #Existing se Proposed Use
-En 7/a Teill,a r(4.¢r /ow
Description of Work SQ. FT.lot Stories # of Bedrooms # of Bathrooms
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Name Address 'City State/Zip Telephone #Fax #
3.APPLICANT .••7:•
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in 09,0 Lk GA1-79'2/6 7 2 -23 -?0/6
Name Address City State/Zip Telephone #•
4.-'-...PROPERTrOWNER.:.•!..,•-
Re_se Ass-o /34.71,e/Cre/e Of---?a/
Name Address City Telephone #
5LHH:HiCONTRAcToil.COMPANt NAME.j!iiE.r;17i.l.:165.44;;_::.--VE::7;;.]:14Z:..--•"'"
(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
ewption.Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil gena)y of not morl than five hundred dollars ($5001).
Vavver Pius'5‘36 /V,Q Gs.i. ce C./979202s-83 y Py,w
Name Address City State/Zip Telephone #
State License I .5-235-94.License Class "1/City Business License #
Designer Name Address City State/Zip Telephone
State License #
S.WORKERS'. COMPENSATION .
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Workers' Compensation Declaration:I hereby affirm under penalty of perjury one of the following declarations:
O 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 the performance of the work for which this permit is
issued.My worker's compensation ins rance carrier and polictiniubar are:
Insurance Company 749`7.
-ale.Policy No./ 5-
--S-457/0 F y-Expiration Date °0
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS)
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'm ion coverage is unlawful. and shall subject an employer to criminal penalties and civil fines up to one hundred
thousand dollars 00). in add o cost of compensation. damages as provided for in Section 3706 of the Lille code. interrAtAnd attorney's fees.
SIGNATURE DATE7 yy
7.•OWNER-BUILDER DECLARATION •.•••..•••-•"•.•••
I hereby affirm that I am exempt from th Contractor's License Law for the following reason:
El 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).
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 /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-RESIDEN77.4t .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?0 YES 0 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 0 NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?0 YES 0 NO
IF ANY OF THE ANSWERS ARE YES. A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPUCANT HAS MET OR IS MEETING THE
REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
8..CONSTAUCTICiN 'LENDING*3610.•
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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
119..1.•APPLICANT CERTIFICATION !:72;:::::7Z.4 :••••
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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 Cit$ 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 rovisions of this Code shall expire by limitation and become null and void if the building or
work authorized by such permit is not commenced within 365 da m the date of such permit or if the building or work authorized by such permit is suspended
or abandoned at any time after the i co enced for ri 180 days (Section 108.4.4 Uniform Building Code).
APPLICANT'S SIGNATURE DATE rio9 7 -207
WHIT :File YELLOW: Applicant PINK: Finance
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