HomeMy WebLinkAbout1691 CONOSA WAY; ; CB990013; Permit01/04/1999
City of Carlsbad
Electrical Permit Permit No CB990013
Building Inspection Request Line (760)438-3101
Job Address
Permit Type
Parcel No
Reference #
Project Title
1691 CONOSAWYCBAD
ELEC
SERENATA METER PED
Lot#
Status
Applied
Entered By
Plan Approved
Issued
Inspect Area
ISSUED
12/31/1998
MDP
12/31/1998
Applicant
WIPPER JENNIFER
2835 CAMINO DEL RIO SOUTH 92109
6192937090
Owner
/ (
Total Fees /
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
\ ! ' .. V • •' . ' - . \
$35 00;..-.... Total Payments To Date $35 00
•V '••••-• ,.;-::•-• '-::;: "':-r>' '' \ ^/' $'1000
100 -> " -/ .,-) '/'-•-• , $2500
."o-. ^"^ . *' />y \',. ,; $000
/•po "'v ' .,,/ r' /-,:*;'•;'/• " ' ^00°
'-./I/O :<'• '/ / '.\N\."'y / $000
"'i'N,-. !- ,:' '' ?-: ;-x / '$000. • / \/; ./'••:,.. • s-' ; $000
\ / ,• Y •'-••• '-• "" -' .•• $000
\ V'" :-!COP:' .VPIATF-'. r_, ' r- . - $000
TOTAL PERMIT FEES $3500
APPROVAL
Inspector
Date
Clearance
NOTICE Please take NOTICE that approval of your project includes the Imposition of fees dedications reservations or other exactions hereafter collectively
referred to as fees/exactions You have 90 days from the date this permit was issued to protest imposition of these fees/exactions If you protest them you must
follow the protest procedures set forth in Government Code Section 66020(a) and file the protest and any other required information with the City Manager for
processing in accordance with Carlsbad Municipal Code Section 3 32 030 Failure to timely follow that procedure will bar any subsequent legal action to attack
review set aside void or annul their imposition
You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capactiy
changes nor planning zoning grading or other similar application processing or service fees in connection with this project NOR DOES IT APPLY to any
fees/exactions of which you have previously been given a NOTICE gjT14aCi|0fttlls' giLjgjQ^lwA^Statute of limitations has previously otherwise expired
2075 Las PalmasDr, Carlsbad, CA 92009 (760)438-1161
PERMIT fAPPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
2075 Las Patmas Dr, Carlsbad CA 92009
(760)438-1161
1 PROJECT INFORMATION
\lo<\\ CorNQS^v
FOR OFFICE USE ONLY
PLAN CHECK NO
EST VAL
Plan Ck Deposit
Validated By
Date
Lf
Address (include Bldg/Suite 0)Business Name (at this address)
Legal Description Lot No Subdivision Name/Number Unit No Phase No Total * of units
Assessor s Parcel #Existing Use 0001 01 02
Tiption of Work ~^. X, y / SQ^fiT /' /' /»of Storms^ ~ * of/fiedroortis/J^ fltefa* &d<$fcl_. jKr .CIA. J/?£f--
CONTACT PERSON (If drff«r«nt from applicant) " " , " ^^ / /^ J7
3-c.^fr^- vv^fp^ jy>s-r».*..*..^*-'S *» c^» ^'^
e ~ *^ Address City State/Zip Tel
U-rWlBathrooms35 » 00Description of Work
2
Name
3 APPLICANT Q'Cqntraetor D Agent for Contractor D Owner Q Agent for Owner
Telephone #Fax'*
Name
4 PROPERTY OWNER
Address City State/Zip Telephone #
Address City State/Zip Telephone #Name
S 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 ($5001)
O/" «_ Uv <v-,
Name
State License » &" ? °
Address
License Class
City State/Zip
City Business License 9
Telephone *
0-S Lt V
Designer Name Address City State/Zip Telephone
State License #
6 WORKERS COMPENSATION " ~ " ~T~"
Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations
n 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 compensetion msurence 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 ($1001 OR LESS)
Q 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 la unlawful and ahall subject an employer to criminal penalties and civil fines up to one hundred
thousand dollars |S1p6-OOuT)ln addition to the cost of compensation damages as provided tor hi Section 3706 of the Labor code Interest and attorney a fees
SIGNATURE /*_ ^ ^' ^ ""~IX " DATE ' ."*'/** *
' 7 OWNER BTJ^fRliECLARATIQN^^'^ " ' **'f •>'''* ' Tr~
1 hereby affirm that! am exempt from the Contractor s License Law for the following reason
Q 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 aale If however, the building or Improvement Is
sold WHthln one year of completion the owner builder will have the burden of proving that he did not build or Improve for the purpose of aale)
JEgf I as owner of the property am exclusively contracting with licensed contractors to construct the project (Sec 7044 Business and Professions Coda The
Contractor s License Law does not apply to an owner of property who builds or improves thereon and contracts for such projects with contractors) licensed
pursuant to the Contractor s License Law)
0 ' *m 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 Q YES QNO
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 / phona number / contractors license numbed
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) ___^__^________^___________^_________^_____^___________^___^__ii_^^______
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) ^ N
-—•PROPERTY OWNER SIGNATURE
COMPLETE THIS SECTION FOR
^~-~ju
TKuWlLDING PEI
DATE /I ,/ S f
ILDING PERMITS ONLY"
Is the applicant or future building occupant required to submit a business plan acutely hazardous matanala registration form or riak management and prevention
program under Sections 25505 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? D 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? Q YES Q NO
Is the facility to be constructed within 1 000 feet of the outer boundary of a school site? D 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 for the performance of the work for which this permit Is issued (Sec 3097(0 Civil Code)
LENDER S NAME LENDER S ADDRESS
9 APPLICANT CERTIFICATION " ~ *—,™ --.-,,- -.-,_.»„,-™rt - —,Tr,_,,I,
I certify that I have read the application and state that the above information is con-act 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 authonze representatives of the CrtV 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 notjammenced within 365 days from the date of such permit or if the building or work authorized by such permit is suspended
or abandoned at any time afterjlWwork is corjiiirja'nced for a period of 180 days (Section 106 4 4 Uniform Building Code)
.PPLICANT S SIGNATURE DATE
'HITE File YELLOW Applicant PINK Finance
City of Carlsbad Inspection Request
For 01/06/1999
Permit# CB990013
Description THIS IS A TEST
TO SEE IF THIS WILL
DDIMT
Type ELEC Sub Type
Job Address 1691 CONOSAWY
Suite Lot I
Location
APPLICANT WIPPER JENNIFER
Owner
Remarks
Inspector Assignmen
Phone (760)930-8980
Inspector
Total Time Requested By RON
Entered By CHRISTINE
CD Description
32 Const Service/agricultural
Act Comments
12A3 0/98 15 38 FAX 619 234 0349 PROJECT DESIGN CONS
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