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Home My WebLink About187 CHERRY AVE; ; CB994017; Permit10/26/1999 City of Carlsbad Electrical Permit Permit No:CB994017 Building Inspection Request Line (760) 438-3101 Job Address: Permit Type: Parcel No: Reference #: Project Title: 187 CHERRY AVCBAD ELEC 2042320100 REPLACING SUB PANEL Lot#: Status: ISSUED Applied: 10/26/1999 Entered By: GMF Plan Approved: 10/26/1999 Issued: 10/26/1999 Inspect Area: Applicant: DUFFETT CONSTRUCTION 7413ELCAJONBLVD LA MESA, CA 91941 619-442-8706 _^ VILLAVICENCIO-DENNIS R' CARLSBAD/GA'92008 5509 10/26/99 0001 01 02 C-PRHT 20.00 Total Fees:$20.00 / / ATcStal Payments f o//D'ater>$0.00\ V^Balance Due: $20.00 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 $10.00 $0.00 ,$0.00 /$0.00 ,$10.00 $0.00 $0.00 $0.00 $0.00 $20.00 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 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. CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760)438-1161 fl/ Csj 1. PROJECT INFORMATION 4JIII < FOR OFFICE USE ONLY PLAN CHECK NO. EST. VAL. Plan Ck. Deposit Validated By Date ipji Address (inclJde Bldg/Suite *)Business Name lat this address) Legal Description - 222-0 I Lot No.Subdivision Name/Number .Unit No.Phase No.Total # of units £=.lec. Meier Existing Use Proposed Use Description'of Work SQ.FT.0of Stories » of Bedrooms * of Bathrooms ONTACT PERSON (H different from applicant) Name ' Address 3. APPLICANT ^TContractor D Agent for Contractor~. ~7}vJ F ' City wner Q Agent: for Owner State/Zip Telephone *x « / . . F B TT Name Address City State/Zip Telephone i PROPERTY OWNER > ft.n ' ~7 ? o- 7 JZ 6 Name Address City State/Zip Telephone i •5. CONTRACTOR-COMPANY'NAME -'" "; ' . ':;':'.: ' -" ' :v:r v:"'..":::,'/ -"—• i'7.-- ..^-'"-:: ;:- :v : • : •• (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 ($5001). Name State License » £>3.S3C>?_ Address License Class JO City State/Zip City Business License # Telephone # Designer Name State License # Address City State/Zip Telephone 6. WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: [~J 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 issuea. My worker's compensation insurance carrier and policy number are. f-x/Vv CA _ Policy No. ) 3 fc> *S~S> ^ ~ 9 f Expiration Date Gy — / fe~ &Insurance Company (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) C| 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 n unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100.000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE _ DATE _ 7. OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: d 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). f/J 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). l~l 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. 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 nurnber / contractors license number): 5. of work): 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 >rk): PROPERTY OWNER SIGNATURE DATE COMPLETE THIS SECTION FOR NON-A£S/D£NTJM BUILDING 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? D YES Q NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? O YES O 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. 30970) 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 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 365 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^s commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). IT'S SIGNATURE DATE City of Carlsbad Inspection Request For: 11/15/99 Permit# CB994017 Title: REPLACING SUB PANEL Description: Inspector Assignment: DM 187 CHERRY AV Lot Type: ELEC Sub Type: Job Address: Suite: Location: APPLICANT DUFFETT CONSTRUCTION Owner: VILLAVICENCIO DENNIS R Remarks: Phone: 6198385725 Inspector: Total Time:Requested By: RENEE Entered By: CHRISTINE CD Description 39 Final Electrical Act Comments Af. Inspection History Date Description Act Insp Comments 11/5/99 31 Underground/Conduit-Wiring AP DM 11/5/99 33 Service Change/Upgrade AP DM 11/3/99 33 Service Change/Upgrade CO DM City of Carlsbad Inspection Request For: 11/5/99 Permit# CB994017 Title: REPLACING SUB PANEL Description: Sub Type: 187 CHERRY AV Lot Type: ELEC Job Address: Suite: Location: APPLICANT DUFFETT CONSTRUCTION Owner: VILLAVICENCIO DENNIS R Remarks: AM REQUESTED Inspector Assignment: DM Phone: 6198385725 Inspector: Total Time: CD Description Act Comments 31 Underground/Conduit-Wiring Requested By: CHERRY Entered By: CHRISTINE Inspection History Date Description Act Insp Comments 11/3/99 33 Service Change/Upgrade CO DM COMPENSATION INSURANCE FUND P.O. BOX 420807, SAN FRANCISCO, CA 94142-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE SEPTEMBER 13, 1999 r WALT BOCHENEK 5873 MADRA AVENUE SAN DIEGO CA 9£1£0 POLICY NUMBER: 1305811 CERTIFICATE EXPIRES: 6-16-0® JOB: ALL OPERATIONS - 99 L -: ; . " . • . • This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated;' "- >.''.,"- This policy is not subject to cancellation by the Fund except upon ten days' advance written notice to the employer. We will also give you TEN days' advance notice should this policy be cancelled prior to jts normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement,: term, or condition of any contract or other document with respect to which this certificate of insurance may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions and conditions of such policies. • • • AUTHORIZED REPRESENTATIVE ' ' PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: *1,000,000 PER OCCURRENCE. EMPLOYER r RANDALL L. DL'FFETT CONSTRUCTION P.O. BOX £311 LA MESA CA 91943 NR SCIF 10262 (REV. 3-95)