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HomeMy WebLinkAbout1901 CASSIA RD; ; CB032971; Permit10-29-2003 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Electrical Permit Permit No: CB032971 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: Project Title: 1901 CASSIA RD CBAD St: TP1 ELEC 2150201300 MANZANITA APARTMENTS 200 AMP POWER POLE Lot#: Applicant: NATIONAL CONSTRUCTION 14551 ANDELDR 92335 909 574-1400 Status: ISSUED Applied: 10/29/2003 Entered By: MDP Plan Approved: 10/29/2003 Issued: 10/29/2003 Inspect Area: Owner: MANZANITA PARTNERS L L C ATTN: KIM ROTH 1764 SAN DIEGO AVE SAN DIEGO CA 92110 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 Additional Fees TOTAL PERMIT FEES 0 0 0 0 $10.00 $0.00 $0.00 $0.00 $0.00 $0.00 $10.00 $0.00 $0.00 $0.00 $20.00 Total Fees:$20.00 Total Payments To Date:$0.00 Balance Due:$20.00 AL APPROVAL 7545 10/29/03 0002 01 02 CGP 20-00 CLI 4- SIGNATURE PERMIT APPLICATION 'CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 Address (include Bldg/Sulte «} FOR OFFICE USE ONLY PLAN CHECK EST. VAL. Plan Ck. Deposit Validated By Date Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No.Phase No.Total # of units Assessor's Parcel #Existing Use Proposed Use State/Zip A 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 Any_^iqlatfc>n of Section 703,1.5 by anyppplicant for a, permi_,subjactsjtbe applicant tp a civil penajty ofjiot more than five hundred dollars ($5001). tfi Name State License * Address License Class ty State/Zip City Business License < Designer Name State License » Address City State/Zip 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. 2 1 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 led. My worker's compensation insurancpaarrier and policy number are: / ' j _*9--»_. ~^fr Insurance Company [fl££/3p£'t& Policy No. [ftjifftS 7frsjPO//%5 Expiration Date_^ (THIS SECTION NEED NOT 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' i subject an employer to criminal penalties and civil for in Section 3706 of the Laboc c is up to one hundred attorney's fees. WARNING: Failure to secure thousand dollars ($100,000). SIGNATURE 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 en 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). Q 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). D 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 number / contractors license number): 5. I will provide some of the work, but t have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type of work): .„ PROPERTY OWNER SIGNATURE DATE 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 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 D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES D 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. 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, 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 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 byJjflSSSion and become null and void if the building or work authorized by such permit is not commencetjjwitnnvt BOD&ys from the date of such permit oriph« buildigsSefwork authorized by such permit is suspendedpr abandoned at any time after the work is commencejHfir a period otlK. days (Section 1 oa^$Jrfn1®m^iiflaingja(we). " ^^APPLICANT'S SIGNATURE DATE WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 03/22/2004 Permit* CB032971 Title: MANZANITA APARTMENTS Description: 200 AMP POWER POLE Inspector Assignment: PD 1901 CASSIA RD TP1 Lot Type: ELEC Sub Type: Job Address: Suite: Location: APPLICANT NATIONAL CONSTRUCTION Owner: Remarks: Phone: 909: Inspect Total Time: CD Description 32 Const. Service/Agricultural Requested By: CARL A Entered By: ROBIN Commenth*/*-£t^ Associated PCRs/CVs Inspection History Date Description Act Insp Comments 11/19/2003 32 Const. Service/Agricultural CO PD NO CONNECTED WIRING 11/14/2003 32 Const. Service/Agricultural NS PD 10/30/2003 32 Const. Service/Agricultural CO PD NOT GROUNDED, ADDRESSED OR CONNECTED TO ANYTHING ACORD, CERTIFICATE OF LIABILITY INSURANCE™ « >ROOUCiJR » . The Dougherty Company, Inc. P.O. Box 7277 Long Beach CA 90807 Phone:562-424-1621 Fax:562-490-0432 INSURED national Business Group, Inc.National Construction RentalsNational Rent A Fence Co.National Fence Company15319 Chatsworth St.Mission Hills CA 91345 1 DATE(MWXyYY) 04/28/03 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 INSURER A: Travelers Indemnity Co. of II, INSURER B: National Union Fire Ins.Co. INSURER ft INSURER D: INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INS IRPn MAMFCt ABO ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RES MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TC POLICIES. AGGREGATE UMTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. ^m A A B A A TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY | CLAIMS MADE | X | OCCUR GENT. AGGREGATE LIMIT APPLIES PER: xlpoucvl ISIcr 1 ILOC AUTOMOBILE LIABILITY X ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS X HIRED AUTOS X NON-OWNED AUTOS GARAGE LIABILITY ANY AUTO EXCESS LIABILITY X~| OCCUR | | CLAIMS MADE DEDUCTIBLE RETENTION t WORKERS COMPENSATION AND EMPLOYERS1 LIABILITY OTHER AZ, MA, OR, HI i/E FOR THE POLICY PERIOD INDICATED. NOTWITH! iPECT TO WHICH THIS CERTIFICATE MAY BE ISSUEI > ALL THE TERMS. EXCLUSIONS AND CONDITIONS C POLICY NUMBER | DATEWM/DOnrn6 1 ^WHWDDTw" 1 '"• UMITS TC2JGLSA419J663-1-02 810507D0187 CAV507D0187 (XBCftS ONLY) BE7230381 TRJUB4197201-7-03 TRJUB419J5228-03 10/01/02 10/01/02 10/01/02 10/01/02 05/01/03 05/01/03 10/01/03 10/01/03 10/01/03 e * • 10/01/03 05/01/04 05/01/04 EACH OCCURRENCE FIRE DAMAGE (Any en* fira) MED EXP (Any on* pvnonj PERSONAL • AOV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG COMBINED SINGLE UMIT(EaceeMmq BODILY INJURY(Pwpwson) BODILY INJURY{PeoceidmQ PROPERTY DAMAGE(P*r MOcklvfiQ AUTO ONLY - EA ACCIDENT OTHER THAN EAACC AUTO ONLY: AOQ EACH OCCURRENCE AGGREGATE X| TORY LIMITS 1 I ER E.LEACHACCDENT EL. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT 3TANDWO 5 OR IF SUCH / s 1,000, 000 s 100 , 006 / s 10, ado ( si, 000, 000 \ *2,yboo,ooo \ • i. 000,000 000,000 s $ s 10 10 ,000,000 ,000,000 si, 000, 000 si, 000, 000 si, 000, 000 See Limit 1,000,000 Above DESCRIPTION OF OPERATIONSA.OCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS All operations of the named insured. 10 days notice of cancellation for nonpayment of premium. CERTIFICATE HOLDER N ADDITIONAL INSURED; INSURER LETTER: CANCELLATION CONTR-2 SHOULD ANY OF THE ABOVE DESCRIE DATE THEREOF, THE ISSUING INSURE] NOTICE TO THE CERTIFICATE HOLDER Contractors State ..__t..™ License Board P.O. Box 26000 Sacramento CA 95826 i JlEPRCSOITWTTreS. •> ED POLICIES BE CANCELLED 13EFORE THE EXPIRATIOd iO__ DAYS WRITTEN ^ AUTHORIZED REPRESENTATIVE |A 1 1 X*""tr"N Joe Castro IJ . V KStyff ACORD 25-S (7/97)©ACORD CORPORATION 1988