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HomeMy WebLinkAbout1684 FISHERMAN DR; TP; CB044410; Permitf'Y7 , 1 City of Carlsbad (.y/, /~o ~635 Faraday Av Carlsbad, CA 92008 12;08-200~ ( q , Electrical Permit Permit No: CB044410 Building I spection Request Line (760) 602-2725 Job Address: Permit Type: 1684 FISHERMAN DR CBAD St: Ip ELEC Status: Parcel No: 2150810100 Lot#: 0 Applied: Reference #: Project Title: LA SUVERA-TEMP POWER POLE Applicant: CRAFTSMAN CARLSBAD I L L C 1195 LINDA VISTA DR #G SAN MARCOS CA 92078 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: CRAFTSMAN CARLSBAD I L L C 1195 LINDA VISTA DR#G SAN MARCOS CA 92078 ISSUED 12/08/2004 RMA 12/08/2004 12/08/2004 $10.00 $0.00 $0.00 $0.00 $0.00 $0.00 $10.00 $0.00 $0.00 $0.00 $20.00 Total Fees: $20.00 Total Payments To Date: $0.00 Balance Due: $20.00 7076 12/08/04 0002 01 CGP· Inspector: Date:/ Clearance: t 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 peITTlit 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 1T APPLY to any f hi h h n iv n N Tl E imil whi h h f limi i n h I h 02 20 .. 00 PERMIT APPLICATION Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. :2t '£-,::;J>v -:z.2-,t.t? r 13v,<-P1111tr w,r Total # of units Assessor's Parcel # Existing Use Proposed Use -5 ,-... cJwtf/l Description of SQ. FT. #of Stories # of Bedrooms # of Bathrooms 2. CO_NTACT·PERSON (If dlffl;1rent from applicant) Gt . .tL,ytv' clJ/-5~n' Name Address 3. APPLICANT O Contractor O Agent for Contractor Name Address 4. PROPERTY OWNER c fl.. II r u ff'& N' /Jt;,t,., Name 5. CONTRACTOR ~ COMPANY NAMI;: D Owner / City l] Agent for Owner City City State/Zip Telephone# Fax# State/Zip Telephone# State/Zip Telephone # (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----------City Business License # -------- Designer Name Address City State/Zip Telephone State License # ---------- 8. WO.RKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: D 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. D 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 ___________ ----------Policy No. ____________ _ Expiration Date _______ _ (THIS SECTION NEED NOT BE COMPLETED IF THI': PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS) D CERTIFICATE OF EXEMPTION: l 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 ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE·------------------------------DATE ________ ~ 7. OWNER•BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law tor the following reason: D 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 tor the purpose of sale). D 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). D I am exempt under Section ------Business and Professions Code for this reason: 1. I personally plan to provide the major labor and materials tor construction of the proposed property improvement .• i:;:l' YES ONO 2. I (have I have not) signed an application for a building permit for the proposed work. 3. l have contracted with the following person (firm) to provide the proposed construction (include name I address I phone number I contractors license number): 4. I plan to provide portions of the work, but t have hired the following person to coordinate, supervise and provide the major work (include name I address I phone number I contractors license number): _________ -;,,,-----------------------·--------------- ) the following persons to provide the work indicated (include name I address I phone number I type Is the applicant or future building occupan 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 D 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 D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES D 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 tor the performance of the work tor which this permit is issued {Sec. 3097(i) Civil Code). LENDER'S NAME-------------~ LENDER'S ADDRESS __________________________ _ 9. APPLICANT CERTIFICATION I certify that 1 have read the application and state that the above information is correct and that the information on the plans is accurate. J 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 ANO 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 buildin•J Offi ial under the provisions of this Code shall expire by limitation and become null and void if the building or work authorize· I by such permit is not commenced within days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any tir ,ifter the work is commenc of 180 days (Section 106.4.4 Uniform Building Code). APPLICP DATE , 1../u/c,'I-I t WHITE: File YELLOW: Applicant PINK: Finance • ' City of Carlsbad Bldg Inspection Request For: 12/17/2004 Permit# CB044410 Title: LA SUVERA-TEMP POWER POLE Description: Type: ELEC Sub Type: Job Address: 1684 FISHERMAN DR Suite: tp Lot 0 Location: APPLICANT CRAFTSMAN CARLSBAD I L L C Owner: CRAFTSMAN CARLSBAD I L L C Remarks: Total Time: Inspector Assignment: Phone: 7606442533 Inspector: ---- Requested By: GLEN Entered By: CW £¢Commen~ CD Description 32 Const. Service/Agricultural Associated PCRs/CVs Inspection History Date Description Act lnsp Comments