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Home My WebLink About1700 OLIVENHAIN RD; ; CB973190; PermitB U I L D I N G P E R M I T Permit No: CB973190 Project No: A9704094 Development No: 10/23/97 14 :01 Page 1 of 1 Job Address: 1700 OLIVENHAIN RD Suite: Permit Type: ELECTRICAL Parcel No: Lot#: Valuation: 0 Occupancy Group: Reference#: Description: TEMPORARY POWER POLE- Appl/Ownr : POWER PLUS 1167 LAW ST SAN MARCOS CA **" Fees Required *** Fees: Adjustments: Total Fees: Fee description 92069~-~~ Enter "Y" for Electric Issue Fee Enter "Y" for Temporary Service: * ELECTRICAL TOTAL 760 CITY OF CARLSBAD 0620 10/23/97 0001 01 C-PRMT Construction 1ype: Status : Applied: Apr/Issue: Entered By: 471-5494 02 20-00 NEW ISSUED 10/23/97 10/23/97 RMA * 7' * .00 .uo 20.00 Ext fee Data 10.00 Y 10.00 Y 20.00 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NO. en 3l 1n "CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (619) 438-1161 EST. VAL. _________ _ Plan Ck. Deposit f Validated BY...-,,,.....__,r----1-1-=-=----- Date f D \ ?-..-? / 1 C Address (include Bldg/Suite I) Business Name (at this address) Legal D1$ctiption Lot No. Subdivision Name/Number Unit No. Phase No. Total II of units Assessor's Parcel I Existing Use Proposed Use Name City State/Zip Telephone I ~ . ~l#'Jii~"''f"'"''°"'·'~•j,,:;,~.i'~:'>;, ... ,....,;~---------·~~~♦"-:tn.,,, I ... ~ .,.;..,•• •• Name City State/Zip Telephone II ~a>~COMW _,,;r,~~\ii", (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, co_mmending 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 then five hundred dollars 1$5001). Name Address City State/Zip Telephone I State License I _________ _ License Class _________ _ City Business License I _______ _ Designer Name Address City State/Zip Telephone State License I _________ _ ~i:tt .wQBKEAS~·.coMPENSA nofu':•~~.:~~Ji;~~~:::i ~!!):!1·::x;j,~r,,~~~~ .. i .. • ... 4~ .. :~.~.1{~~:.:\; .:·~~ :; !:~.~~:':~L. ~;..aJr.-ft~•~~~JJ.e'-m~~a t~~~i-i1-l:., t~~-: .. l==~~) .. · : . :. · .. , .. I:; .. .. ,1 Workers' Compensation Declaration: I hereby affirm under penalty of perjury_ one of the following declarations: Jg(' I hive 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 end will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work ·tor ·which this permit is issued. My worker's compensation insuran • carrier •~d policy number are: , C O /JO .!)-/ // () I J-/ _ 'lf Insurance Company ~ C Policy No.____________ Expiration Date. _______ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1$100) OR LESS) 0 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: Flilure to aecure•workers' compensation overage la unlawful, and shall subject en employer to criminal penalti11 and civil finea up to one hundred thousand dollars ($10 01 in addition to th\9Pst compensation, damages II provided for in Section 3706 of the~ code, in~r1 and attorney's feu. SIGNATURE. __ -6,.,L.~::::::::+---.._,,;-~~::...::::! -~'t,,-L•~~~-----------:------::-. DATE f l} -). J J t7.r.it~~.OWNER•BUILDER DECLARATION;•i"~i·t'~ .. /j,-J:r··. ,.:, '/ f; ./t~t:~~t~~~~~~~~~i:~ .. (!:.J~iilrt$.'1Ji~F~~ll.~,F:}(;~:~i~:t;r:-' .,;':.:~ .. -- 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason: 0 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 •!• not Intended or offered for aele. If, however, the building or improvement is sold within one y11r of completion, the owner-builder will have the burden of proving that he did not build or Improve for the pwpoae of 1111)._ 0 · I, aa.owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Profeaslons Code: The Contractor's License I.aw doea not apply to an owner of proparty who builda or improves tharaon, and contracts for auch projacts with contractor(s) licenaed pursuant to the Contractor's License I.aw). 0 I am exempl under Section ______ Business and Professions Coda 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 parson (firm) to provide the proposed construction lincluda neme / address / phone number / contractors license numberi: 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 parsons to provide the work indicated lincluda name/ address / phone number / type of work):. ________________________________________________________ _ PROPERTY OWNER SIGNATURE______________________ DATE ________ _ ll;olAPJ.~IUttlSiSECTIOttf.Qlf_NPN:RE.s/Q~JIU!LD.IN();RJ;lll,Ul.$JU!l~Y;<:{~ij1i)~~~•~;;r,n1.uri:fflnml!WmE.l.!fll;~lla~l[~l1':~!.E'.':•'.;;.;:1;It~:~::,. Is th, a;:plic::nt or future buildinw cc:cuparit req.,;rad to ""limit • businea,:, 11lan, acutely hazardou, material• registration lorm or risk management end prevention pr09ram under Sections 26605, 25533 or 26534 of the PrHley-Tanner Hazardous Subatance Account Act7 0 YES O NO ' . Is the applicant or futwa building occupant required to obtein a permit from the air pollution control district or air quality management district? 0 YES O NO i. the facility to be constructed within 1,000 fHt of the outer boundary of a school site 7 0 YES O 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 P0UUTION CONTROL DISTRICT. i.~Tt:~.rttrfwcnor,i LEND.1Nt.'~aENcv-~1'111•~t~~"i~~1~~ .. c'~?;i:~;~rr~~tlr1:::.:;~~~'.:~7;-~w·~.,.1.~?'~~~E£-t~1§;;r,f;:~•:'~;;": ... : w:~ :, I hereby affirm that there is a construction lending agency for the performance of the work for which thi1 permit i1 i■suad (Sec. 3097(i) Civil Codel. LENDER'S NAME ______________ _ I certify that I have read the application and state thet the above information is correct and that the information on the plans is accurate. I agree to comply with ~II City ordinsncea 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, cos-rs AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit la required for excavations over 5'0" deep and demolition or construction of 1tructures over 3 stories in height. EXPIRATION: Every permit issued by the Building Official under the provisions of this Code shall expire by limitation end become null and void if the building or WOl"k authorized by such permit is not commenced within 365 days from the date of such permit or if the building or work authorized by such permit is suspended or ebandoned It anytime after the wor ' o menced for a B7'io f 180 days (Section 106.4.4 Uniform Building Code). APPLJCAN_T'SSIGNATURE ------'---'----...l....--'-'.=..:::r:L'-#------------DATE /t' -,:Z,),,. 9 7 WHITE: File YELLOW: Aoolic•n~IIIK· ~-,,.~ • f I j i I , i j r-?---------------1 I I . f O' ~ l $: l e> ~ t \} T, ..... ..., I ~ .. j ' -c I , VC. Th ---<. -" i ( t-> .....j -~ "' C • I ._ ~ li'ld9e'9 L66l-80-E