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Home My WebLink About1905 CASSIA RD; BLDG 3; CB042123; Permit06-0'1-2004 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Electrical Permit Permit No: CB042123 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: Project Title: 1905 CASSIA RD CBAD St: TP ELEC 2150201300 Lot#: MANZANITA APARTS- 3 200 AMP TEMP POWER POLES (TP, A & B) & 3 SUB POLES Status: ISSUED Applied: 06/01/2004 Entered By: RMA Plan Approved: 06/01/2004 Issued: 06/01/2004 Inspect Area: Applicant: NATIONAL CONSTRUCTION 14551 ANDELDR 92335 909 574-1400 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 1100 0 0 0 $10.00 $275.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $285.00 Total Fees:$285.00 Total Payments To Date:$0.00 Balance Due:$285.00 3389 06/01/04 0002 01 02 COP 285-00 IQVAL SIGNATURE PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 FOR OFFICE USE ONLY PLAN CHECK NO. EST. VAL. Plan Ck. Deposit Validated By. Date Business Name (arthis address) Legal Description Lot No.Subdivision Name/Number Unit No.Phase No. Total * of units Assessor's Parcel *Existing Use Proposed Use D Owner ' -fZFACHMtt foHJwner »* . - .S03P V/iCET^y /i/1. (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5.by any applicant lor a permit subjects the applicant to a civil penalty of not more than five hundred doll" Name State License t * . \0 O 1 1 V$ 0 Address License Class City State/Zi City Business License # Designer Name State License * Address City State/Zip Telephone c s permt s / / f //10\ Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 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 trmwoftc for which this permit is issued. OB"! have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which ^his permit is issued. My worker's compensation insurance carrier and policy number are: / Insurance Company ~~W-AV EJL£fL$ I}^-0 - Policv No. T/2J UB*rV972fl/ 7&J Expiration Date_ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$1001 OR LESS) Q CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shell not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure |9 secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($Uro.fiOO). In addition to #jrfce«t of compensation, damages as provided for In Section 3706 of the Labor/code./nterest and attorney's fees. SIGNATURE --V C^n^I "|A_^ DATE (p / / f D *T~ IgUwpft^ -fi&ff'e-k v . . i'j?^;* *V*dWiWr$*S.i, **"*kO!(0ll8tfl 1 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, 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 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 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 2S50S, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? Q 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? l~l YES I"] Is the facility to be~£»nstructed within 1,000 feet of the outer boundary of a school site? D YES O 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. NO 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 ADDRESSLENDER'S NAME i»^trHiaAfm<«RfW&ii^N**'' -•**•, T.A> -*-• 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 by limitation and become null and void If the building or work authorized by such permit is not coyfmtenced within 180 daft from the date of such permit or if the building or work authorized by such permit it suspended or abandoned at any time after the work is comrr&rced for a period of IwXdayK. (Section 106.4.4 Uniform Building Code). F I I J> APPLICANT'S SIGNATURE ^\ S^/^~ /X—/ DATE VJ // / t? T~ WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 06/22/2004 Permit* CB042123 Title: MANZANITA APARTS- 3 200 AMP Inspector Assignment: RB Description: TEMP POWER POLES (TP, A & B) & 3 SUB POLES W/75 KVA TRANSFORMER Type: ELEC Sub Type: Job Address: 1905 CASSIA RD Suite: TP Lot 0 Location: APPLICANT NATIONAL CONSTRUCTION Owner: Remarks: Phone: 9095741400 Inspector: Total Time:Requested By: CARLA Entered By: CHRISTINE Act CommentCD Description 32 Const. Service/Agricuftural Associated PCRs/CVs Inspection History Date Description Act Insp Comments 06/10/2004 32 Const. Service/Agricultural NS RB 06/03/2004 32 Const. Service/Agricultural NR RB City of Carlsbad Bldg Inspection Request For: 06/10/2004 Permit* CB042123 Title: MANZANITA APARTS- 3 200 AMP Inspector Assignment: RB Description: TEMP POWER POLES (TP, A & B) & 3 SUB POLES W/75 KVA TRANSFORMER Type: ELEC Sub Type: Job Address: 1905 CASSIA RD Suite: TP Lot 0 Location: APPLICANT NATIONAL CONSTRUCTION Owner: Remarks: Total Time: Phone: 9095741400 Inspector: CD Description Act Comment 32 Const. Service/Agricultural Requested By: CARLA Entered By: CHRISTINE Associated PCRs/CVs Inspection History Date Description Act Insp Comments 06/03/2004 32 Const. Service/Agricultural NR RB tr • • • CITY OF CARLSBAD BUILDING DEPARTMENT DATE NOTICE (760) 602-2700 1635 FARADAY AVENUE TIME LOCATION PERMIT NO. T- i± 7~ l FOR INSPECTION CALL (760) 602-2725. RE-INSPECTION FEE DUE? FOR FURTHER INFORMATION, CONTACT YES PHONE CODE ENFORCEMENT OFFICER -Gl V : i-o-aa-s City of CARLSBAD BUILDING DEPT. g-cl oIlO 510 frO LS ^W ' BBE:SO frO 82 Rew Mas 03 04 09:23a May 03 04 09:28a p.l p.2 ACORD. CERTIFICATE OF LIABILITY INSURANCE^™ « The Dougherty Coajpaay, Zap. *.O. Box 7277 Long Beach CX 90807 Phone: 562-424-1621 Fax: 562-450-0432 WWREB Mional Constructiontal». Inc.Western Fabricator* , Inc.19 Chatawor-Sh St.•Ion Hills CA 91345 BAteiMiuocvm 04/29/04 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERT-FtCATE HOLDER. THIS CERTIFICATE DOCS NOT AMEND, EXTEND OR AtTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDWO COVERAGE USURER* Travelers Indemnity Co. of II, IWUREKSC »9UR34a iMunstft INSURER? COVERAGES THE* ANYRMAYPPOL<O if?" X OUCIES OF INSURANCE USTSDSOUWeWNT. TERM OR COND ERTMN, THE MSURANCE AFFOImS. AOORCOATC UMTS SHOWl TYM OP INSURANCE OHlOULtUaWTT COM YWOAt OeNERAUJAWUTV j CLAIMS MAOE | | OCCUR eon. AOOREBATE UMir APPLES PER: - «M AJ. OWMEOAUT3S scueouten AUTOS MKED AUTOS MONJ3WNED AUTOS ANVMJTD excess UABNJIV ' OCCUR j | CLAIMS MADE ^IsexcneLe WORKER* CCMPENCAT10H AMD BELOW HAVE BEEN ISSUED TO THE MSrON CF ANY CONTRACT OR OTHER OO Y MAY HAVE BEEN RESUCeO BY PAffl CL MUCyWUWBM TOJTJB419720 1-7-04 OTHER , UMO NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANCMOCUk/ENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR EIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONOfflONS OF SUCHAIMS. ^A^LKeW^ 05/01/04 'StrlT^^r OS/01/05 UMTS EACH OCCURRENCE FWEDAMAOe VMftnt 1(4 MED EXP (Any one p«Mn| PERSONAL kAOVKJUftr CSNERAI. AOORCOATi PRODUCTS . COMWOP AM ssaasr"0" IBOLYIMMtY BSOILYNIWV tP" 9(CMfVfl|] ^*f 4QEWWMQ AUTooM.v.CAAcaeEKr OTHER THAN »ACO i 3 J 1 J t AUTOONLV: AOQ EACH OCCURRENCE AGSKESATE X I To^vlMiTs 1 TER" EL EACHACCBENT E.L. D8CA5E • EA EJ*IOYS5 E.L09EA9E-POUCVUMIT $1000000 * 1000000 t 10COOOO oeicwnoNor owRA¥iot«an.ocATicNSivcHieu»«XGLUSKms ADDED BT CNDOMCMCNTAFCCIAL WKWISON* lioense f6971€0 National Construction Rentals, Ino. 10 days notice af cancellation for nonpayment of premium. CERTIFICATE HOLDER | jr | AOWTIOMAI WSUREO; wsu* w LErrgR: CANCELLATION COStR-2 Contractors State License Board P.O. Box 26000 Sacramento CA 95826 W-OULB Mf Of THF ABOVE 3E4CRIB MTE THEKEOF, THE ItSUMO IMSUUSK NOTICE TOTHECMTinCATEH01.DSIl nLmEttaj»A»iM ED POUCKS BE CANCELLED eeRME TNI exPHUTKUll AJTNORiZea REPRESENTATIVE Joe Castro | \ 1^ 'i, .1 ^M) ACORD2S-SIW7)IACORD CORPORATION 1118