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Home My WebLink About1703 DOVE LN; ; CB980279; PermitBUILDING PERMIT 02/0 2/98 10:44 Page 1 of 1 I Job Address: 1703 DOVE LN Suite: I Permit Type: ELECTRICAL Parcel No: Lot#: Valuation: 0 Occupancy Group: Reference*: Description: TEMPORARY POWER POLE-LIBRARY : CONSTRUCTION Permit No: Project No: Development No: Appl/Ownr * * * TEMPORARY POWER SYSTEMS 7 50 N CITRACADO PKWY ESCONDIDO CA 9202 5 Fees Required *** 3608 02/02/98 OOOl 01 C-PRMT Construction Type: Status: Applied: Apr/Issue: Entered By: 760 439-1999 Fees Collected & Credits V • CB980279 A9800 353 02 20-00 NEW ISSUED 02/02/98 02/02/98 RMA * * * Fees : -I . UO Adjustments: .00 Total Fees: 20.0'^ Fee description Toi-al Credit-^ Total Fayment . Balance Due Units Fee/Unit . 00 , 00 20 . 00 Ext fee Data Enter "Y" for Electri>- Issu-; Fee > Enter "Y" for Tem|X)rary Seiviv.-,.- y 10.00 Y 10.00 Y ROVAL CLEARANCE. CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 Ll.. PROJECTirjFI lib .TION FOR OFFICE USE ONLY. PLAN CHECK NO EST. VAL. NLY^ ^ ^ Plan Ck. Deposit Validated^y. Date Addrbss (include BIdg/Suite #) Businass Name (at tills address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total 9 of units iessgils PargflL? "^^^ j. Assessoi Description of Work Existing Use Proposed Use SQ. FT. #of Stories # of Bedrooms 0 of Bathrooms fZf^.'^.CONTACt-reRSON'Of diffarmt4rom.awHraifit0 Address Cohtraotor; Telephone # Fax » Name 4. 'PgpPERTYjpWNER' Address Citv State/Zip Telephone i Name Address City State/Zip Telephone # !B. ?.'a>NTRACTOR ^ COMPANY t^AMS ;rfc:^.?jSf,'?S,^^S^ffl^S^^^^^^»^^^mS|»S^SSgSSS^^' (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 signad statement that he is licensed pursuant to the provisions of the Contractor's License Law IChapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom, end the basis for the alleged exemption. Any«Mation of Se£tion 7031.5 by any applicant for^permit subjects ths^pplicant to^ civilpenaltY of not more than five hundred dollars (ISOO)). Name State Ucense # Address License Class City State/Zip City Business Ucense # Telephone Address City State/Zip Telephone of thp \ Designer Name State Ucense # : .WORKERS?; COMPENSATlONIili Woricers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: Q 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 thp work for which this permit is issued. 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 pecmit is issued. My worker's conlDensation insurance carrier and policy number are: /" J Insuranoe Company ^ y'^<^//i< .JZ^^^'t^^rMJ^^ Policy No./j/(:0^r7'^^ <JL Expiration Date JCy/^/^Q (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [11001 OR LESS) G 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: Faiiure to secure workera' cMipansation coverage is unlawful, and ahaH aubjact an amployar to eiiminal penaitjes an^ivil fines up to one hundred thousand dollara (lipfl^booi^n adjtcon t6 tlie cost of compensation, damagea as provided for in Section 3706 of tha Labor^de, jpftaraat and attomey'a fees. SIGNATURE /"'^§ ^"dX DATE _ J7J-- -OWNER^UILDER^ECLARATiON-^ -^4 ~ •S¥®**^!15*f'^^^S OWNlilDltGiRiiCLARATiONl I hereby affirm that I am exempt from the Contractor's Ucense 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 snd Professions Code: The Contractor's Ucense Law does not apply to an owner of property who builds or improves thereon, and who doea such work himself or through his own employees, provided that such improvements are not intended or offered for sale, tf, however, the building or improvement ia sold within one year of completion, the owner-builder will hava ths burden of proving that he did not build or improve for the purpose of sale). Q I, es owner of the property, em exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Lew 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). • I am exempt under Section Business and Professions Code for this reason: 1. I personally plan to provide the major labor and materiais 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 / 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 tha work indicated (include name / address / phone number / type of work): PROPERTY OWNER SIGNATURE DATE ..,4™ liMiliMiiisicTW is the appiicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention progrem under Sections 25505, 25533 or 25534 of the Presley-Tenner Hazardous Substance Account Act? Q YES Q NO Is ths 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 ths facility to be constructed within 1,000 feet of the outer boundary of a school site? Q YES Q NO IF ANY OF THE ANSWERS ARE YES, A RNAL 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 POUUTION CONTROL DISTRICT. wMmm^mmmmAmwM^m. 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 » • T . .. I certify that I have read ths application and stats that tha 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 Cartsbad to enter upon the above mentioned property for inspection purposes, I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AQAINST ALL LIABIUTIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CrTY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavations over S'O" deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the Building Official undsr 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 coirfhienced witbin 365 days from the date of such permit or if the building or work authorized bf sucUpermit is suspended or abandoned at any time after the wojIQ; cggii^ricja foya period of 180 days (Section 106.4.4 Uniform Building Code). ^ DATE ^^y^^pTy-fi WHITE: File YELLOW: Applleent PINK: Finence APPLICANT'S SIGNATURE CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB980101 FOR 02/11/98 DESCRIPTION: TEPORARY POWER POLE-LIBRARY TYPE: ELEC JOB ADDRESS: 1701 DOVE LN APPLICANT: TEMPORARY POWER SYSTEMS CONTRACTOR: OWNER: REMARKS: C/BOB/439-1999 SPECIAL INSTRUCT: INSPECTOR AREA PLANCK* CB980101 OCC GRP CONSTR. TYPE NEW STE: LOT: PHONE: 760 439-1999 PHONE: PHONE: INSPECTOR TOTAL TIME: CD LVL DESCRIPTION 32 EL Const. Service/Agricultural ACT COMMENTS yi7. DATE DESCRIPTION ***** INSPECTION HISTORY ***** ACT INSP lAIMNSII. CEHTlFiCATE OF INSURANCE BSUE DATE (MM/OD/YY) PRODUCER Milestone Insuramce Agency A " 9/29/1997 THIS CERTIRCATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIQHTS UPON THE CERTIFICATE HOLDER. THIS CER'HFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. Irvine, CA 92714-5105 (714)852-0909 Pax(714)852-1131 COMPANIES AFFORDING COVERAGE Irvine, CA 92714-5105 (714)852-0909 Pax(714)852-1131 : COMPANY 1 LbllbH A Califomia Indemnity Ins. Co. i COMPANY B MSURED : LETTER B Temp Power Systems, Inc. llll N. Tustin Avenue ; COMPANY •• LbllbH 0 Anaheim, CA 92807 i COMPANY ; LETTER D COMPANY c LETira ^ THIS IS TO CERHFY THAT THE POUCtES OF INSURANCE USTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMEO ABOVE FOR THE POUCY PERIOO INOICATEO, NOTWrrHSTANDING ANY REQUIREMBrr. TERM OR CONOmON OF ANY CONTRACT OR (3THER DOCUMENT WITH RESPECT TO WHICH THtS CERTIRCATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFOROEO BY THE POUCIES DESCRIBED HEREIN IS SUBJECT TO AU THE TERMS. EXCLUSIONS AND CONDfTIONS OF SUCH POUCIES. UMTTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLMMS. CO : Ln; TYPE 0I< MSURANCE POUCY HUMBBI : POUCY EFPecnvE *ouer EXPMTION I DATE (MM/DO/YY) : IMTE(MMO0/yy) uHns i OENERAL UABUTY GENERAL AOOREQATE ; C0MMB1CIAL GQ4ERAL LIABLITY i PHO0UCTS4XMP/OP AGO. is i CIAIMS MADE i j OCCUR j ; PERSONAL & AOV. HMRY |s i OWNBTS & C0N1RACKKS PROT. [FIRE DAMAGE (Any on • Ike) is 1 MEO. ElPBtSE CAny a iAUTOMOBHE UABUTY i ANYAUTO 1 COMBMED SMGLE i LMIT i$ : Aa OWNED AUTOS i SCHEDULED AUTOS i BODLY MJURY j (Pal penon) is j HIRED AUTOS j NON-OWNEO AUTOS j BOOLY INJURY 1 (Per acddMiO is i OARAOE UABUTY i PROPERTY DAMAGE is jEXCESS UABUTY : EACH OCCURRENCE * i UMBRBLA FORM : AGGREGATE s : OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION N 6044720C EHPLOVERS' UABtiTY STATUTORY LMITS ilO/01/97 \ 10/01/981^.^!!^ i.» ...If.P. P. P P [oisEASE - POUCY LMIT is 1,660,000 I DISEASE - EACH EMPLOYEE iS 1,666,660 : OTHER DESCRmON OF OPBUTIONSfljOCATIONSraEHICUSnPCCIAL nEMS RE: License 483443 Contractors State License Board P.O. Box 26000 Sacramento, CA 95826 SHOULD ANY OF THE ABOVE DESCRIBEO POUCtES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING COMPANY WIU ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIHCATE HOIDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTTCE SHAU IMPOSE NO OBUOATION OR UABtUTY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED RmtESENTATIVE y./\ +6978499 TftYLOR BOLL 515 P02 JflN 13 '98 11:23