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HomeMy WebLinkAbout1694 DOCENA RD; ; CB002721; Permit07/25/2000 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Electrical Permit Permit No CB002721 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 1694DOCENARDCBAD ELEC 2159103100 Lot# ELEC CIRCUIT FOR FOUNTAIN Status ISSUED Applied 07/25/2000 Entered By JM Plan Approved 07/25/2000 Issued 07/25/2000 Inspect Area Applicant PRO EARTH LANDSCAPE INC STER 2210ENCINITASBLVD ENCINITAS CA 92024 760 633-3120 Owner IKEDA FAMILY REVOCABLE 1998 TRUST 1694DOCENARD CARLSBAD CA 92009 4151 07/25, 00 0001 01 02 C-FRHT 20-00 Total Fees $2000 Total Payments To Date $000 Balance Due $2000 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 TOTAL PERMIT FEES 0 0 0 0 $1000 $000 $000 $000 $000 $1000 $000 $000 $000 $2000 Inspector FINAL APPROVAL Date \ I&JQ1 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 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 FOR OFFICE USE ONLY PLAN CHECK NO EST VAL Plan Ck Deposit ^ Validated By . ) \A/\/ "/ 1 PROJECT INFORMATION usiness Name (at this address)Address (include Bldg/Suite tt) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total tt of units Assessor's Parcel tt Existing Use Proposed Use Description of Work CONTACT PERSON (if different from applicant) SQ FT #of Stones tt of Bedrooms ft of Bathrooms Name 3 APPLICANT Q Contractor Address City Agent for Contractor Q. Owner D Agentjpr Owner State/Zip Telephone # Fax tt Name Address City State/Zip Telephone tt PROPERTY OWNER Address City Itate/Zip TelephoneName "'5 CONTRACTOR -COMPANY NAME ^ - VilSV '.£• 'T; • 7i -., .,°: "" ».^'f" *" ' ',:~? . :'fr""\f (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 ex^jnption 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), Name State License ttState LicensVe\rn AdHress License Class c-an City State/Zip City Business License tt Telephone 31 £0 Designer Name Address ~ City State/Zip Telephone State License tt "7fo&3^?'ft _ 6 WORKERS' COMPENSATION - Si ^, 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 5d 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 . / /||) Cjf^T\<^)CC\C\\ _ Policy No i/Jf,0 1,7^7 £> | | _ Expiration Date_£?/|_5j£>L_Insurance Company (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS) [~1 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^S^IOO-pOOL^n addition to the cgst of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney s fees SIGNATURE X^AA. L, , (_ffiM/44^!uX()5r' DATE 7 OWNER-BUILDER DECLARATION ~,• •:?:„ ^ ~,, ^~... I hereby affirm that I am exempt from the Contractor's License Law for the following reason CD 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) CD 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 contrjctor(s) licensed pursuant to the Contractor's License Law) CD 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 CD YES CDNO 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 / contractor; 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 ;V „ . t; 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? O YES CD NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? (~l YES PJ NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? f~l YES l~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 &."" CONSTRUCTION LENDING AGENCY " V L, "'" ; " ' "". I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 30970) Civil Code) LENDER S NAME LENDER'S ADDRESS 9. APPLICANT CERTIFICATION •••:." •"' ?~ ... ::'vL , : . "'€. ". , • A,'f""' , ' •• ''' , .. , -': 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 City 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 within 180 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced for aceriod of 180 days (Section 106 4 4 Uniform Building Code) , * tir- DATE "7/95to WHITE File YELLOW Applicant PINK Finance APPLICANT'S SIGNATURE City of Carlsbad Bldg Inspection Request For 1/5/2001 Permit# CB002721 Title ELEC CIRCUIT FOR FOUNTAIN Description Inspector Assignment SR 1694 DOCENARD Lot Type ELEC Sub Type Job Address Suite Location APPLICANT PRO EARTH LANDSCAPE INC Owner IKEDA FAMILY REVOCABLE 1998 TRUST Remarks Phone 7606333120 Inspector Total Time CD Description 39 Final Electrical Act Comments Requested By LAURIE Entered By ROBIN Associated PCRs Inspection History Date Description Act Insp Comments 7/27/2000 31 Underground/Conduit-Wiring AP SR OK TO BURY 7/27/2000 34 Rough Electric WC SR i 1 >JU I IHfl- I*-UB1H«HL.L_ l-UI III 1(0 T i?blj bJO OUi AWfc CERTIFICATE OF LIABILITY INSURANCE "'"";«.,;«" PHOOUCES TH|. AU. COMMERCIAL INSURANCE SERVICES LLC OMl 6790 TOP GUN STREET *3 H0l SAN DIEGO CA 92121 ALT PHONE 854/642-0200 FAX 858/642-0205 COMPA Agency Lie* QC64S52 A INSUPEC COMPA PRO EARTH LANDSCAPE VHRHINC OBA B 2210 ENCWITAS BLVO * f? "cOMPAl ENCINTTAS CA 92024 ci — COMPA 0 > CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION .Y AND CONFERS NO RIGHTS UPON THE CERTIFICATE DER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ER THE COVERAGE AFFORDED BV THE POLICIES BELOW COMPANIES AFFORDING COVERAGE MY UNfTED CAPITAL W MY VILLANOVA INSURANCE >JY WILLIAMSBURG NATIONAL COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED A80i/E FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER OOCUVENT WITH RESPECT TO WHICH THIS CERTIfiCATE. MAY BE ISSUED Ofi WAV PERTAIN TM£ INSURANCE APPQHOEO BY THE POLICIES DESCRIED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN_ReOLJCED_ 8Y PAID CLAIMS _ L"' TYPt OF WSURAWCf POLICY NUMBER f04TS(w!owv" "^trf (Suoonri* U"™* i GENE HAL UA8ll.fTY , GLAC1300393 I OC1 X COMMERCIAL GENERAL LIABILITY CLAIMS MADE * | OCCU" A OWNER'S & CONTRACTORS PHOT ' 1 AUTOMOBILE LIABILITY TBA JUN X »NT AUTO c^ _ SOSOULEOAU Co nineo AUTOS ! NON OvvsEC AUTOS GARAGE LIABILITY < ANY ALJTO ' | EKCSSS LIABILITY UVBH£LLA PQRv OTHER THAN UM8fi6LL\ POHM '999 OCT900 GENERAL SGGRfeGATE S 1,000,000 PSOOLCTS-COMP/OP »C6_ !} _ ^000,000 PERSONAL 4 »OV INJURY * 1,000,000 £/>CH OCCURRENCE i 1 000,000 FiPt DAMAGE (Any One f<n) J 50,000 MCO EXP (Any One Per .an] S 5000 2600 | JLJN2501 COMBINED SINGLE UVIT « 500,000 ' BOOilY INJORV (Por pi'40^1 * 80D(l.V INJURY 1 ' i AUTO ONLY 5» ACCIDENT S | OTHER THAN Al/TO ONLY EACH ACCIDENT $ AGGREGATE J AGGREGATE i 5 WORKERS COMPENSATION ANU WC01 27611 MAY 15 00 MAY 15 01 ro^lUSe ST EMPLOYERS UABILfTY EAC»ACOO£«? "i 1,000,000 OFFICERS Afl£~ EXCL 'oiSEASE EACH EWPLOVCE i 1000,000 ' OTHER DESCRIPTION OP OPERATIONS/LOCATlONSA/EHICLES/SPEClAL ITEMS FOR YOUR INFORMATION ONLY _CERTIFlCATEHgLDER___ FOR INFORMATIONAL PURPOSES ONLY Attention ACORD 25-S (1/95) Certificate tf 7070 CAJNCELLAT1ON _ . . _ . . SHOULD ANY OF THE ABOVE DESCRIPEO POLICIES ee CANCELLED BCFOOETHE EXPIRATION DATt ThEREOf THE ISSUING COMPANt nnx eivOE'VCP TO i**'L '0 OAV5 wBiTTPw NOTlCf TO THE CERTIFICATE MOLOE" NAMED TO THE LfcFT OUT FAILURE TO MAIL SUCK NOTICE SMALL IMPOSE NO OBUGAllON OR LIABILITYOC ANY KINO UPON TH£ COWPAMY iT$ AOEMTS OS RfPliESENTATlvFS /rftsi /£ jf^£~'^ "WA"RK"RUBIN 0822037