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Home My WebLink About1860 CASSIA RD; ; CB973637; PermitBUILDINGPERMIT 11/26/97 13:19 Page 1 of 1 Job Address: 1860 CASSIA RD Suite: Permit Type: ELECTRICAL Parcel No: - Lot#: Valuation: 0 Occupancy Group: Reference*: Description: TEMP. POWER POLE FOR WESTERN : PACIFIC Permit No: CB973637 Project No: A9704713 Development No: Appl/Ownr *** POWER PLUS 1167 LAW STREET SAN MARCOS, CA. Fees Required *** Construction Type: VN 1839 U/26/ffritetoSfa ISSUED App^ij^jf 11/2 6,^9 Apr/Issue: ll/26/§ Entered By: MDP 760 471-5494 ***Fees Collected & Credits *** Fees: 20.00 Adjustments: ,00 Total Fees: 20,00 Fee description Total, Cr*dits: Total Payments: Balance' Due: Units F«e/Onit .00 .00 20.00 Ext fee Data Enter "Y" for Electric Issue Fee > Enter "Y" for Temporary Service > * ELECTRICAL TOTAL 10.00 Y 10.00 Y 20. 00 PROW 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 (619)438-1161 FOR OFFICE USE OI^LY PLAN CHECK NO.. 77 EST. VAL. Plan Ck. Deposit Validated By Date Business Neme (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total * of units Assessor's Parcel t Proposed Use Description of Work r PERSON (ifdifferent from SO. FT.*of Stories * of Bedrooms # of Bathrooms -,* ** Nama Address City State/Zip Telephone * Fax * st-,< P Name Telephone # Name Address City State/Zip Telephone * (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 K500D. ft* Name Address State License * O<3- 3 5~j( License Class £, City State/Zip Telephone * £ 1 City Business License » Designer Name Address State License » City State/Zip Telephone &&g^Il^^3^^^ •-.:.,-;. v. , 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. 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 d. My worker's compensation insurance carrier and policy number are: Insurance Company C^r-C- A-#)-ft C*. Policy No. COO6 JT/ ft Q f Expiration Date l^l"Tff (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1*100) OR LESS) Q CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shell 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 ($100,0001, in addition to the cost of compensation, damages as provided for in Section 3706 of the Lobe/ code. Interest end attorney's fees. SIGNATURE DATE ffc-ttbWNEH-BUIUJEHDECUUlATION^^ ^M^r:i!^!:"&MS^^^&^^^^^^^^^^M^S^^'i£:^f " I hereby affirm that I 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, end who does such work himself or through his own employees, provided that such improvements are not intended or offered for aala. 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 tale). Q ' 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 en owner Of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Lew). D I •"! 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 / 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 Is tto applicant or future building occupant iequU«d to tuumit a busineu plan, acutely hazardous materials registration term or risk management and prevention program under Sections 25505, 25533 or 26634 of the Presley-Tanner Hazardous Substance Account Act? Q YES D NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? D YES Q NO Is the facility to be constructed within 1,000 feat 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. ilsSfeorar^^ ' I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(1) Civil Code). LENDER'S NAME LENDER'S ADDRESS fe^L APPLICANT CERTIFICATION .:.^m^j^iJ^l^^Sfi^ JWt!*5^ t;. 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 egrea 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 S'O* 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 366 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 tha^worfcyia commencedjW a^eriod of 180 days (Section 106.4.4 Uniform Building Code). ^^M^ ; DATE 11 ~ J.S" ^\ VWITE: File YELLOWr Anr.lir.mt PIM*. Ci...~.. APPLICANT'S SIGNATURE CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB973637 FOR 12/05/97 INSPECTOR AREA PS DESCRIPTION: TEMP. POWER POLE FOR WESTERN PLANCK# CB973637 PACIFIC OCC GRP TYPE: ELEC CONSTR. TYPE VN JOB ADDRESS: 1860 CASSIA RD STE: LOT: APPLICANT: POWER PLUS PHONE: 760 471-5494 CONTRACTOR: PHONE: OWNER: PHONE: f^ REMARKS: C/MICHELE/471-5494 INSPECTOR SPECIAL INSTRUCT: THE TEMP POLESITS UP IN THE PARKING LOT' OF THE APT. COMPLEX SUB POLES § THE TRAILER TOTAL TIME: CD LVL DESCRIPTION 32 EL Const. Service/Agricultural ACT COMMENTS DATE DESCRIPTION 120297 Const. Service/Agricultural ***** INSPECTION HISTORY ***** COMMENTSACT INSP NR PS CITY OF CARLSBAD BUILDING DEPARTMENT DATE. NOTICE 438-3550 2075 LAS PALMAS DRIVE LQCAT.ON PERMIT NO T / | jFOR INSPECTION CALL 438-3101, RE-INSPECTION FEE DUE? YES URTHEFUfclFORMATION, CONTACT, V RTHEgJN J ryii'—BUILDING INSPKTOR PHONE CODE ENFORCEMENT OFFICER I'd "Midi »CCBl*n QftEMMXIUl arm "TCwATTACMMBMrXm T AH^QB MCTtH LOCATIOIt ito T^«a STO^TMHCN O MOM *JU W5EWQUMJ MQVKW MINIMUM BHPUMI •HffBCtlflM Dt THi Mu<PMENT rn Ir S'd Hd00:I A66L-9S-1L TICE, SftLTER 8. flLGER ID=3106989637 ACORDii 'fia^!!^K^!!!^^J^ix^^&iy3aiiiSSSS^ilS\PROOUOBR (310)698-9631 FAX (310)698-9637 nca, Salter, Alger & Bullock T . 0. BOX 471 ! ' :1 trier, CA 90608 Jfl'N 02'97 lea^N^Oll P.O ~~ MMM™m*-*!*a*.. Qi/02/19 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. Attn: Kris Archer V- * C^MPAWIEBAFFORDlNOCOyERAOE. COMPANY 'Car'«^merica'CofflpensaHon A IMURBO S R Bray Corporation dba:Power PTusI' 'Temporary Utility Services I 1281 Sunshine Way Anaheim, CA 92806 COMPANY B COMPANYc WDJCATED, NOTWITHSTANWNO ANY REQUIREMENT, TERM OR CONDITION OP ANY CONTRACT Oft OTHER DOCUMENT WITH RESPECT TO WHICH THJS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, 6XCLU3IONB AND CONDITIONS OF SUCH POLICIES. LMT0 SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYPS OF INSURANCE : POLICY EFFECTIVE : POUOV CX« RATION ; iMNERALUAMUTY ! . 1 COMMfRCIAl GENERAL LIABILITY ! i I OENeRALAOOREOATE 1 PROOUCTB . COMP/OP AOO ! CLAIMS MADE OCCUR 1 PERSONAL 4AOV INJURY j OWNER'S « CONTRACTOflrt PROT.J6AOH OCCURRENCE ! PWE DAMAGE (Any«n» Arc) j AUtOMOaaAUAWUTYI'M|»t* I ] ANY AUTO ( •"] ALL OWNED AUTOB j ...... | •CKBOULEOAUTOa CD ! NON-OWNEOAUTDa j COMftweDWNOLE LIMITn i i i BODILY INJURY| (Pwotnon) i BODILY INJURYI (P«r«ecMwil) i PROPERTY DAMAOE OAKAOaUAMUlY ANY AUTO II LAH9 ?!W.:$* t?®?®*1 I OTNKR THAN AUTO ONLY: I EACHACODENT AOOREOATE I|MMMUA«UTY '"* UMBREOAFORM OTHBR THAN UMBRELLA FORM j GAOH OCCURRENCE i AOOREOATEi" 1 WORKBMOOMPtNMTIONANO j •MHOVWUAWUTY iTHEPROPRIETOft/ ! ...... } : gARTNERBCXEOmVE I ..... J JEXCL C0005il01v .01/01/1997 | 01/01/1998 |let. EACH ACOIOENT ! EL0»6A9g.EAEMPLOYEE 11 JUP$i'.ppt 'v'bor iOTHW t-t s agreed t^at fu,c^ -rnsurancf! af Tf iffBfdft( i?Y ^h1s policy also 4Bc?1iQi to the Certificate Hold is an additional Insured, but only wlth'respect to employees hi rod by and Included on the payroll o :he Named Insured while performing workt'for* the Additional Insured. City of San Diego Building & Inspection Department 1222 First Ave. HS 301 San Diego, CA 92101 SHOULD AMY OF THC ABOVE M«CftUU£0 MUCIES H CANCPOBD WORE TKB EXPIRATIOM OAtt THtHBOF, THE IUUWW COMPANY WX.L BNDKAVOR TO MAIL 10 QAVft WMItBN NOTICE TO THI OERTmCATK HOLDER NAMED TO THE L& BUT PAlLUM TO MAM. MICH MOTlCl ftHALL IMPOU NO OBLKUTION OR LIABILITY OF ANY KIMO UPON THE COMPANY. ITt AaiHTB OR RMPRBMNTATIVB8. AUTHORI