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HomeMy WebLinkAbout185 CHESTNUT AVE; MP; CB072732; Permit10-29-2007 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Electrical Permit Permit No CB072732 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 185 CHESTNUT AV CBAD St MP ELEC Lot# AT&T 100 AMP MET PED Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 10/29/2007 JMA 10/29/2007 10/29/2007 Applicant ROBINSON ELECTRIC 8871 TROY ST SPRING VALLEY, CA 91977 619-697-6040 Owner Elecinc 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 100 0 0 0 $1000 $2500 $000 $000 $000 $000 $000 $000 $000 $000 TOTAL PERMIT FEES $3500 Total Fees S35 00 Total Payments To Date $35 00 Balance Due $000 Inspector FINAL APPROVAL Date Clearance NOTICE Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively refe'red 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 capacity 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/exac'.ions 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 PBT VAL Plan Ck Deposit Validated By Date Business Name [at this address) Subdivision Name/Number Unit No Phase No Total tf of units Existing Use Proposed Use ., w, •,•.•»,,-* joiitt. TACT PER! sa FT #of Stories tt of Bedrooms tt of Bathrooms 2•, CONTACT PERSON (If tMferent from applicant) 3. Address PPLlCANT Q Contractor ' 0 .Agent for Contractor City Owner - Q Agent for Owner State/Zip Telephone tf AAddress PROPERlpt OWNER City State/Zip Telephone # Name Bi , CONTRACTOR-COMPANY NAME Address City State/Zip Telephone ff (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 pLrsuant to the prov.sions 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 exejjiRtion Any violation of iSection 7031 5 byjny applicant for a permit subjects theapplicant to a civil penalty ft not more than five hundred dollars [$5001) 0*41177Name State License tt ^^1^5 Designer Name State License tt Address *-> License Class Address C~ib ' Cfty J State/Zip City Business License tt I2j City State/Zip *" ' ' v ' ' **" ' -Telephone tf z\3lt<l- Telephone Workers' 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 the work for which this permit is issued <9 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 "6Aplft55 Ifi^ • Gd? ' Policy No W] Afi'sl '3'2> Expiration Date / DJ f (THIS SECTION NEED No'J BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] 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 tt> 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 additionto'lhe cost of compensation damages as provided for m Section 3706 of the Labpr code, interest and attorney s fees SIGNATURE 'fjl^U \JC//*^ DATE ft)/^^ 7 OWNER-BUILDER DECLARATION I 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 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) fj 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) Q 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 f~l YES l""lNO 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 ruime / 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 the work indicated (include name / address / phone number / type of work) ____^_ — PROPERTY OWNER SIGNATURE DATE COMPLETESTHIS SECTIONIFOR NON-R£SIDENTlAL BUILDINGi PERMITS ONLY > 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? l~l YES l~l NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? t~l YES C3 NO Is the 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 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(i) Civil Codel LENDER'S NAME LENDER'S ADDRESS 9 APPLICANT CERTIFICATION I certify that I have read the application and state that the above information is correct and that the mfoimation 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 CitV 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 wrthm 180 days trom the date of such permit or it the building or work authorized by such permit is suspended or abandoned at any time after the work is commencedoor a period of 180 days (Saction 106 4 4 Uniform Building Code) ^/'//l/'vJ III M*^*lJ^s l^li^y/lt/ APPLICANT'S SIGNATURE A t///L ^JLTrj ^ DATE IvU^ll/ ( City of Carlsbad March 2-1 :U08 ROBINSON 11 I-CIRIC 8871 I ROY SI SPRINCi VAI 1 IT C.A 91977 2 51008 Building Department Pcimil Number CB072732 Issue Date 10/29/2007 UK. HMLDINC; PKKMIT KXPIRA I ION PKRMH TYPE EL EC ADDRESS 185 CHESTNUT AV #MP PLKASE CALL FOR AN INSPECTION IF WORK IS COMPLETE Oui iccouls indicate that your building peimit will expire by limitation of time on 04/26/2008 I he pioviMons of IJBC Section 10644 as amended by the Carlsbad Municipal Code stale "EXPIRATION I \eiy peimit issued by the Building Official undei the provisions ol 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 ol such peimil (unless issued pnoi lo 7/1/99 which is one year from date of permit), or if the building or \\oik aulhon/ed by such permit is slopped at an\ time after the work is commenced fora period of 180 days or if the building or work authon/ed b\ such pumil exceeds three calendar years from the issuance date of permit Woik shall be picsumed to have commenced if the permittee has obtained a icquired inspection approval ol woik aulhon/ed by (he peimil by (lie Building Official within 180 days of the dale of permit issuance Work shall be picsumed to be stopped it the permittee has not obtained a required inspection approval of work by the Building Olflual within each 180 day period upon the initial commencement ol work authon/ed by such permit Beloic such woik can be iccommenccd. a new peimil shall be obtained to do so. and the fee, therefore, shall be one-hall the amount icquired lor a ne\\ permit for such woik. and provided that no changes have been made or \\ill be made in the original plans and specifications for such woik, and provided furthei that such suspension or abandonmcnt'has not exceeded one yeai In order lo renew action on a permit alter expnation. the pcimittee shall pa\ a nc\\ peimil lee Am person holding an unexpiicd peimil may apply for an extension ol the lime within which work may commence undei that permit when the permittee is unable lo commence work within the time period requned by this section loi good and satisfactoiy icasons I he Building Official may extend the time for action by the permittee loi a period not exceeding 180 da_\s on written request by the permittee showing that circumstances beyond the control of the permittee have prevented action from being taken No permit shall be extended more than once Please check below indicating vom intentions and return mis letter 10 us ^^ Piojcct abandoned A new permit will be obtained pnoi lo commencing work ^ No lee extension requested tor 180 clays (attach a letlei of explanation) _ Renewal permit requested II the pioiect has been completed and only a final inspection is needed, please call the inspection request line at (760)602-2725 II sou have any questions please contact the Building Inspection Department at (760) 602-2700 V Christine Wiiuschek Olfice Specialist ' . . .,. l&ltf* 7."3: -h ii 1635 Faraday Avenue • Carlsbad, CA 92008-7314 • (760) 602-2700 • FAX (760) 602-8560 City of Carlsbad Mdich 2-4. 2008 A 'I & 'I" 4220 ARIZONA ST SAN DIIIGOCA 92104 Building Department Permit Number CB072732 Issue Date 10/29/2007 RE BUILDING PERMIT EXPIRATION PERMIT TYPE: ELEC ADDRESS. 185 CHESTNUT AV #MP PLEASE CALL FOR AN INSPECTION IF WORK IS COMPLETE GUI records indicate that your building permit will expire by limitation of time on 04/26/2008 I he provisions of UBC Section 10644 as amended by the Cailsbad Municipal Code state "EXPIRATION I veiv permit issued bv the Building Official under the provisions of this code shall expire by limitation and become null and void if the building 01 work authon/.ed by such permit is not commenced within 180 days from (he date of such permit (unless issued prior to 7/1/99 which is one year from date of permit), or if the building or work authorized by such permit is stopped at any time after the work is commenced for a period of 180 days or if the building or woik authored by such permit exceeds three calendai years from the issuance date of permit Woik shalfbe presumed to have commenced if the permittee has obtained a required inspection approval of woik authoii/ed by the permit by the Building Official within 180 days of the date of permit issuance Work shall be piesumed to be stopped if the permittee has not obtained a required inspection approval of work by the Building Official within each 180 day period upon the initial commencement of work authorized by such permit Bcfoie such woik can be recommenced, a new permit shall be obtained to do so, and the fee, therefore, shall be one-hall" the amount required for a new permit for such work, and provided that no changes have been made or will be made in the ongmal plans and specifications for such work, and provided further that such suspension or abandonment has not exceeded one year In ordei to renew action on a permit after expiration, the permittee shall pav a new permit fee Any peison holding an unexpired permit may apply for an extension of the time within which work may commence under that permit when the permittee is unable to commence work within the time period required by this section for good and satisfactory reasons The Building Official may extend the time for action by the pcimittcc for a period not exceeding 180 days on written request by the permittee showing that circumstances beyond the control of the permittee have prevented action from being taken No permit shall be extended more than once Please check below indicating youi intentions and return this letter to us Project abandoned A new permit will be obtained prior to commencing work No tee extension requested for 180 days (attach a letter of explanation) Renewal permit lequested If the piojecl has been completed and only a final inspection is needed, please call the inspection request line at (760)602-2725 II \ou have any questions please contact the Building Inspection Department at (760) 602-2700 Christine Wauschck Office Specialist 1635 Faraday Avenue • Carlsbad, CA 92008-7314 • (760) 602-2700 • FAX (760) 502-8560 10/^9/07 FRI 07 19 FAX 760 744 3188 IRISH CONSTRUCTION i)002 ft3s rv *r\% ®< 2J. °a^ Ho — ^—6* £££A ELECTRIC UNDERGROUNt saa*- Ct/sf A £tr SernpiM Energy umiy Wanted Date ON INSPECTION SeraceType UG Service New Project No 734537 Job No 270 Project Title AT&T LIGHTSPEED -NORTHCOAST project Address i'tp'S CL^v^fVYX-w^J" OU/€ $— 12 Project Crty CARLSBAD | Customer Phone # 858-268-2113 Contact JIM STOVER [ Contact Phone* 858-268-2113 PI Trafrc Control Permit Required Excavaoon/encraachmenl Perrni's Required By Customer Service Attachment Poimano/cr Meter Locaton Locate 100-amp meter panel Oft AT&T 52B cabinet. Customer is to prov/de all excavation, trench, 2-inch conduit, backfill, compaction, poly-pull rope in conduit and surface repair from po!e#P22798 to new meter panel. Take conduit within 7 1/2 inches of North/East quadrant of Cable pofe or within distance instructed by SDG&E inspector. Address #158- WP must be permanently marked on cabinet. Call SDG&E Trench Desk at 760- 432-5805 to schedule the SDG&E trench inspector and to confirm the SDG&E crew schedule. IS SDG4E Application Required - Call. 1 -800-41 1 *7343 Municipal Inspection Required By City of Carlsbad Meier height -40' mm. - 6 3' max. From finish grade to wrtfertina of meter base Meters am required lo be readiiy accessible 24 Hours per flay Meiers rnusl be tocaieo in a safe area froe oi any potentially mjz^rrfovs at dangerous coodilio/t Provide 34 X 3 ft. Minimum clca; snd level working spCce in front o: rnclw Where peier rgom i£ prooosaj, contac! Iho planner a( the nearest SOGiE Mgltf tescs anrf meter service disconnect must bt loca'.DO at or immsdia^iir adjacent to each o(h$r ant! be irfsaliM vnlh address end vn( nurnber il serves PROCEDURE FOR JMStALUflON 1 PHONE DIG Al£RT 1-800-227-2SOO AT LEAST TWO DAYS PRIOR TO TRENCHING FOR LOCATION OF UNDERGROUND UTILITIES 2 Phone SDG&E at 750-480-7723 for the following 3 wwfcing days pnorto trenching to arrange pre-meetwit)i inspector and innate trenchirrg process • After excavation of trench, installation of conduit and service entrance equipment at meter location, CALL FOR INSPECTION Do not cover conduit without inspector's wnften approval to backfill Yi'hen trench is backfilled and compacted. CALL FOR INSPECTION. If service entrance equipment is installed after faacfcSH, CALL FOR INSPECTION OF THE EQUIPMENT 3, Meter cannot be set untit inspector has approved instafla&on, including service equipment, and receipt of city/county/state inspection clearance. Power Source STA 781-407 j Structure Number P22798 Joint Trench with Electric Only Handhole Installed br Standards Page if Handhole Lid Shaff Read Ladder Arms Required | Stop Trench 7 1/2" from pole RsserQuad Northeast Bend installed by Customer Type Cable Pole 2" SO Deg 36"R SCH80 Conduit Installed by. Customer Conduit Size 1-082" Service Panel Rafing 100 Numfier/Sae of Mam Swricn 1@100-AMP Voltage. 120^240 ft of Wires 3 Phass Single Utilities Maximum Contnbution to Fault Current 42000 Amps Metering Self-Contarned, Test Bypass Facilities Rqrd Meter Clips- 4 Temp Service Change Due on R$t B'H S ) ft Oft i i i 1 i 10/19/07 FRI 07 19 FAX 760 744 3188 IRISH CONSTRUCTION 121003 /JETER & SERVICE LOCATION Copy Customer Type Comm&rciai T.B. 1106-D6 Dale Prepared 04/25/2007 Additional Infoimafon. Q Rigfii-of-way Required Assessors Parcei Number Please call your Operations Assistant Robert Howell at 760-4SO-7723 with questions about inspection, construction installation and to schedule a crew. fla^ fesponstbfity la teaxm antfar dean up if tezardtxis of loifc nwlmal pnorto SDGiE coittnisng consmclian SOGSE «hsB feve no CaflilrfyoroWjadon whaisOftww te clean up retime or remj^iwt anj1 hazardous «r gut mWfirafa disajveretf dyflnj Ihc cowss o( conanKJofl note* r( 15 ihrcujti negSgeflce ot SDGiE Ccrtcnw-Qwned ladifiw (9 ftcawe etectrfcai StrvCE at stibied to all applicable loc^ and state of CaSfonira repeclofl atrthwiiy r^iicaicntE BuJding aMnss a«!iw mttet b«s musl.be postea pnor fa mete set WcmatiM <m tfts ste« 1$ v»d alto six |6) morths fr&m Cale Kee? IW «Ase wilh huildinj P'anner MICHELE M UJEUNESSB ADY Tefep^ne 760480-7651 10/19/07 FRI 07 20 FAX 760 744 3188 IHU OS: 16 Ptl CITY OF CfiRSLBfiD IRISH CONSTRUCTION @1004 FAX NO 760 602 8558 cm,') 2 iS'07 9 49/ST 9 4B/HO 4B637SB777 P. 45 facsimile transmrttal sheet To City of Carlsbad Attention Janet 1553 Fairday Ave Carlsbad CA 92008 phone number. 760JJ02-2717 fax number 760-602-8558 DATE 2/15/2007 Re Address """ Request Urgent REQUEST FO X For Review From AT&T /SBC Construction Jim Stover 798S EngmearRd , 2nd Floor SanOiego, Ca92in phone number J5&268 211.3 _ _______ f»x numl>or, 853 273 3380 email address total no pages Including cover 2 Please Comment Please Reply Requesting an addre&s assignrnerit Please provide an address for a 100 amp meter service for a ne* ATT Cabinet Trite new meter/cabinet will be located on Ihe _ WEST SIDE OF CHESTNUT AVE , 38' NORTH DF GARFlELP ST. APN 204-234-01 layout Engineer ROLSETH TGM Number 1106-E6 Job Number 619614.1 ThsnK you for your assistance w/th th»s project Cordially Jim Stover SBC Construction 8582682113 (THU) J :5 07 9 4863758277 P 2 ~- 91? 'd s S S I .'•<; ?\ ^Bg ll Kafa2 Si ll V ^ISn ^^1!i el i !B !J ml 111 P! 81'!SS 1 . t lilil!;p!|;j f ilh iiUl 8SS8 eos 091 'ON xyj jo AIIO wa 9U20 ma ;nn?-in-> nr /n H 2 SORICE00 00 £So 10/02/2007 13 22 6194532577 ROBINSON ELECT From Peggy Rlnefiart At. Raneho Mesa Insurance Services Fax!D (619)-937-0168 Ts Donna PAGE 01/81 D«e 10/2/07 02 06PM Page 2 of 2 ACQRDn CERTIFICATE OF LIABILITY INSURANCE sogff-i1* PRODUCER Rancho Mesa insurance Agency 1810 Oxiiespie Way, Suite 1G8 El Cajon CA 92020 Pftone 619-937-0164 Fax 619-937-0168 INSURED Robinson Electric 8871 Trqy Street spring Valley CA, 91977 DATE IMMffiWWY] 10/02/07 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW INSURERS AFFORDING COVERAGE USURER A cypress insurance Company INSURER B INSURER C INSURFff D INSURER E NAIC# COVERAGES WE POLICIES OF INSUR/WE LFTE3 3ELOW HAVE BEEN ISSUED Tn THE IN5I KEC NAMED AHOVE Fi"iR THE PO! ICY PERIOD INDICATED NHTWITi ICTANDINn AN" *EOL'«CMENT T=KM 09 COND.TKW or AW CONTRACT OR OTHER DOCI VENT wm i RESPECT TO WICH mis CDPIHCAT ^v DC ISSUED CR WAY PERTAIN Tl 1C INSURANCE AiTnunEn BY THE POLICIES DESCRIBED HEREIN IS SUBJECT Tl ALL THt TERMS EXCI LS;ON< ANP CON!DITirjN5 n= SJC! i OOLICIE1! ASGRECATE i MlTS SHOWN V«V HAVE RrEN BCD1 CEP flV PAID CLAIMS LTR A TlSRD1 TYPE OP INSURANCE POLICY NUMBER GFNfiRAL LIABIirTY 1 COMMERCIAL 5ENCRAL LiABiLlTV | | r 1 KIMS MAra- j^ j OCn F 1 GEN1!. AGG^fcATC LIMIT APPLIES PCP L — i 1 ! DRQ. I1 '1^TOUCY| jJgT | JLOC AUTOMOBILE LIABILITY ANY AUTO AJLLOWNE&AUTCS SCHEDULED Al nOS |hlHJtL'ALTOp 1 NON OWNED AllTOS OARAGE LIABILITY ANY AUTO 6XCESS/UM9RELLA LIABILITY j OCIUO i | CLAIMS MADE I DEDltTlBLC RETENTION < WORKERS COMPENSATION AND EMPLOYERS LIABILrtY ANY PROPSICrowPARTNCR/EXccirtlVC AsrlCFWME«*CTEJ(CI UPEOT 1! ji»3 fiwcrlbo Lirvlur SFtClAJ. PROVISIONS tnKV OTHER W7A08133 PULItT tzhhcCTlVbBATE |MM»DWi 1D/03./07 | FLJLIGY E \flKA M^"1*DATE (MM/DD/YY) lo/oi/oe Liwrrs CACH OCCURRENCE PREMISES Ico «<sjftnr«i MtaCXPfAnyonopciwn! FERiniMAL 5 ADV INJURY 5SNERAL AtlBRSeATE FROOU~'-, COMP/OPA61 ooweiKSi sivri e i IMT li=n -isciC»ntl *f *$ f ? f B03ILY INJLH" 1 1 (?»r parson! i * BCDiLY :NARY |P»r«cclinrt| PROPERTY OAMACE (Pur (icntlMll) AUTO OM» - EA ACCIDENT mHSS THAN >AACC AUTO ONLY A6fi EACH OCCURRENCE ACGREr-ATS » 1 W'^ 1 1 A i ii | LI i n- X|WRY(JKIT5 ! CP SL CACi-IACClBENfr EL DISEASE CAEM'LOYFE EL DISEASE POLICY LIMIT f I H J t $ f 1 5 t 11,000,000 51,000,000 f 1,000,000 PEBCRIPTION OF OPERATIONS I LOCATIONS I VEHICLES 1 EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PRQVigiDME KK ALL OPERA-TIOHS *10 DAY NOTICE FOR NONPAYMENT OF PREMIUM CERTIFICATE HOLDER CANCELLATION COUNTY! COUNT! OF SAN J5IEOO DEPT OF ELAHNXHS & LAND USB ^?A1""PTTTrWTW BAXn flTTTTW— n SAN DIEQO CA. 32123 ACORD 25 (2DOV08) SHOULD ANY OF THE ABCVE PeaCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL *30 DAYS WRITTEN NOTICE TO THE CERTIFICflTE HOLDER NAMED TO THi L6PT BUT FAILURE TO DC SO SHALL IMPOSE NO OBLIGATION OR LIABILITY Of ANY KIND UPON THE INSURER IT» AQENTB OR REPHEBENTATIVES AUTHORlflp REPREBErOTTiye — J—ff ^J/A^^CCU ££ ^ ©ACORD CORPORATION 1988