HomeMy WebLinkAbout1945 CAMINO VIDA ROBLE; A; CB970450; PermitBUILDING PERMIT
03/05/97 11:50
Page 1 of 1
Job Address: 1945 CAMINO VIDA ROBLE
Permit Type: ELECTRICAL
Parcel No: 212-092-17-00 Lot#:
Valuation: 0
Occupancy Group: Reference*:
Description: ADD 100 AMP SUB PANEL
Appl/Ownr
***
SAFEWAY ELECTRIC
300 ENTERPRISE ST
ESCONDIDC- CA 92029
Fees Required ***
Permit No: CB970450
Project No: A9700610
Development No:
Suite: A
3066 03/05/97 0001 01 02
C-PRMT 60-Construction Type: NEW
Status: ISSUED
Applied: 03/05/97
Apr/Issue: 03/05/97
Entered By: RMA
619 745-7554
Collected & Credits
Fees :
Adjustments:
Total Fees:
Fee description
Enter "Y" for Electr
Three Phase Per AM
* ELECTRICAL TOTAL
6 0 , 0 a
***
. 00
.00
60.00
Ext fee Data
10.00 Y
50.00
60.00
CrTYOFCWB-SBAD
2075 Las Paimas 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 ONLY
PLAN CHECK
EST. VAL. ___
Plan Ck. Deposit
Validated By
Date
- ^(AOA
Address (include Bldg/Suite *}Business Name (it thii address)
Legal Description Lot No.Subdivision Name/Number Unit No.Phase No. Total # of units
Assessor's Parcel #Existing Use Proposed Us*
Description of Work SQ. FT.#of Stories # of Bedrooms * of Bathrooms
Name Address City State/Zip Telephone #Fax *
(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 Codel 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 [$500)).
Name ^^ Address
State License # 5t> 2 * S 1 License Class *-~ 1
City State/Zip Telephone *
^ City Business License #
Designer Name Address
State License #
City State/Zip Telephone
. :_^A>& 'a.;S5ja«.!! V?-. :-~tl*~**Z!CUii:-f.
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.
Q 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 JJAPtM^bOL. Aj/rTHAjfifi^' Policy No. /U*/AI Vfl/7/7/7' Expiration Date
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100] OR LESS)
Q CERTIFICATE OF EXEMPTION: 1 certify that in the performance of the work for which this permit-is issued, 1 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 is unlawful, and shall subject an employer to criminal penalties and dvH fines up to one hundred
thousand dollar* 1*100,000), in addition to tha cost of compensation, damages as provided for In Section 3706 of the Labor coda, interest and attorney's fees.
SIGNATURE _ rf/la^. I*-* Je£f DATE _ _Z~
7 OWNER-BUILDER DECLARATION •.
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, and who does
such work himself or through his own employees, provided that such improvements are not intended or offered for sale. M, however, tha 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 tha purpose of sale).
Q 1, as owner of the property, em exclusively contracting with licensed contractors to construct tha project (Sac. 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 aueh projects with contraetorta) 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. 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 I address / phone
number / contractors license number): _ ; _ _
5. I will provide some of the work, but 1 have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type
of work): ___ _ ___ ___ _ _
PROPERTY OWNER SIGNATURE _ DATE _
^MMjreTHKSECTioM-mBJiflMU^^
Is the spplicsnt or future building occupant required to submit a bu*ine&* pian, acutely hazardous materials registration form or risk management and prevention
program under Sections 25505, 2S533 or 26534 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? Q YES Q NO
Is the facility to be constructed within 1 ,000 feet of the outer boundary of a school site? D 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.
fcj?3&eiwrnwCT /••^
I hereby affirm that there is s 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
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 alt
City ordinances and State laws relating to building construction. I hereby authorize representatives of tha 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 requited 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 sucti 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 i$ commenced for a period of 180 days (Section 106.4.4 Uniform Building Coda).
APPLICANT'S SIGNATURE DATE
'WHITE: File YELLOW: Applicant PINK: Finance
CITY OF CARLSBAD
INSPECTION REQUEST
PERMIT! CB970450 FOR 04/15/97
DESCRIPTION: ADD 100 AMP SUB PANEL
TYPE: ELEC
JOB ADDRESS: 1945 CAMINO VIDA ROBLE
APPLICANT: SAFEWAY ELECTRIC
CONTRACTOR:
OWNER:
REMARKS: MW/MARK
INSPECTOR AREA PY
PLANCKtf CB970450
OCC GRP
CONSTR. TYPE NEW
STE: A LOT:
PHONE: 619 745-7554
PHONE:
PHONE:
INSPECTOR
SPECIAL INSTRUCT: WILL CALL IN AM TO MAKE ARRANGEMENTS TO
PER HIS CONVERSATION W/PAT KELLEY
ELEC RM OPEN
TOTAL TIME:
CD LVL DESCRIPTION
39 EL Final Electrical
ACT COMMENTS
***** INSPECTION HISTORY *****
DATE DESCRIPTION
032497 Final Electrical
032197 Final Electrical
031897 Final Electrical
030697 Final Electrical
ACT INSP
NR PY
NS PY
PA PY
CO PY
COMMENTS
NO ONE THERE
NEED ACCESS TO ELECT ROOM
NO ONE THERE/ELEC RM LOCKED
*
I
• m
ti
+L
-4J
r§
i*
5ts^
on
v>
i R
. 0
Z
••«
4
UJaua
E<
UJa
•H
*
•€
Kl
>
o
0
-
a:
1
iZ2
•4Q
0O
ffs
UJ
QC
UJ
Q.r<
^
L
3
U.
UJ
h-
C
1
0-
oe
LU
ci I• ^m
LJ irf
MPERE!4
O
(ft
-1
H-
O
UJ
CO
X&
_J
t-
=>
O
(ftUJttu
Q.r
t--J
S
u M
>-
Ue
CQ
•e
-e
MPT IONU
(OUJ
uUJ
QC
U
.
tr
C
QC
CQ
O
CO
•C
Of
cc
(O
r
H
UUJoe
DESCRIPTIONu
•e
CO
•e
•e
^
f^i
1
r\
c-
#
a
Or
0
7
r!r-cr
*~
^
0
or
*
o-
*
rJ
r-CT
Kl
UD
3
0
o-
*
^
_
«
—
1
5
in
CO
So-
4
C^
OE
N
•*
S
Q
*s
^
Ci
|
^
a
S
5
-*
\
«^\
*
<
S
-
S
a.
M
r
s
$
9u•
*
o
|
o
«-
*•
*
^?
lO
*
in
CO
Kl
^
o
*
?:
*
(SI
*
53
\o
*
inISl
CO
*
r-
o
*
CM
M
*
«
*
*
S
jfl
#
in
CO
*
r-
o
*
ONm
rj
*
^
Q
Ji
**O
<?•
t
^
h-O
h-
QQ
t?
1
0
Vfr(
CC
ri
a
•e
o
H
0
-4
3-
H
EH
DC
U
H
Q
EH
H
J
EH
DO
e
2K-
E-CT
h-
&-
E-
C
CL
2
^C
C
t^a.c
S
ftc
t
U
C
Ccr
LCL ADDER0
00
•S
f
(
f
(
1
1ttt
(
•e
HOHs
r-
V^
V)
5
ai<
Xo
T
ZH
-»
/3
-(
J
£
DH
DJ
*
J
d
<1
Sjqz
O^
a
C
UJ
Z
3
?
rir
to
N
CJ
21
uJo2;
Mw
u
CO
w
EH
EL|
i>y r«f*r«nce to th« iaaa »xt»nt BE if
>«ntry.
.lara •* r*qulrad.
jn: R-B aound batt insulation where
R-ll and R-19 batt insulation wherp
BBSS
(pnlldlnf B) : Hollow eera
rclal 'C' s«rl«> (black). Door*10 »lnut« fir* rating wh»r« required.
>ffic«.
TM714 4-1/1x4-1/3 «32 McKlnn.y
DIM OLV «!8 Schlaq*
T«OOM (WI BI9
1130 IT' Brovn
W30IT 830
TJ714 4-1/2X4-1/3woe OLT «:«
•JOJT «301337A army
Dona
Quality
Combo
scni««*
Quality
Quality
T3714 4-1/3X4-1/3 «53
OlOt OLT 627
W02T 130UJ7A Or*y Quality
provld* 1/4" el«ar taBp*r*d gla«a In
la (black) .
ing and Cyp*u» Board: 39 -jauij* »«til:•• Indicated on drawina*. furringon drawlnga. 5/SB qyp«u» dry wall,
-il« Cmilingm:
iomf (Building A) : Arutronq "Sacond
,8" X 1/4-, lay-in calling (vhlta) .
I B) : Amtrong "cortaga" J4" X *•" X
Ing (wtiit*) .
1 Donn DX calling Grid, J4" X 4S",
••f»a«lF *0»viBf>^» .H-T- fcay.
B) : B*ntl*y 'Covln^ton II",
?luB-do«n application.
;Bulldlng B Tollat ROO»B) : An
"Briqantin*", «6)BO, wfiitn.
J 1*100, Black («") .
> - Building B) NhlCa.
Llding A Lobby and Corridor):
Trad«wlnd», Vartlcal Pattarn.
03/04/1987 09:02 6197419308 BROUWER INSURANCE PAGE 01
PRODUCER
JROUWER INSURANCE AGENCY
?.0. BOX 729
SSCONDIDO CA 92033
SAFEWAY ELECTRICAL
:ONTRACTORS, INC.
300 ENTERPRISE STREET
SUITE "0"
ESCONDIDO, CA 92029
03/04/97
THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLYAND
CONFER3 NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE
DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE
POLICIES BELOW.
COMPANIES AFFORDING COVERAGE
LETTER
A SUPERIOR NATIONAL INSURANCE CO.
COMPANY
LETTER B
COMPANY
LETTER
COMPANY
LETTER
COMPANY
LETTER
^ig^slts^
BBMKP"5™"1""*sBMfwD MAY HAVE SEEN REDUCED BY PAID CLAIMS.
:o
,TB
\
TYPE OP INSURANCE
OENKHAL LIABILITY
boMMSRCIAL OENBNAL L1ABIUTYXt.pf.f—' -i .....-— .
^ilTIs buWMBMAOE 1 JOCCUR.
OWNER'S & CONTRACTOR'S PROT,
f UTOMOBOC UABILJTV
ANY AUTO
ALLOWNCDAUT09
aOHOXILEOALTOB
HIRED AUTOB
NON-OWNSO AUTOS
OARAGE UABLTTY
EXCEttLUBIUTY
UMBBtLLAFCflM
OTHEATHAN UMWELUA POHM
WOHKCirS COMPfMSATIOH
AND
DJPLOYCM' LIABILITY
OTHER
POLICY NUMBER
WDN38897A
POLICY CFFECTIVE
»TB (MM/OD/YY)
06/24/96
DCSCMPTION OF OPCRATtOwa/LOCATTOWVWICUS/SPeCIAL. )TtM»
\LL OPERATIONS
3AFEWAY FAX: 745-2838
•BE!snipGftjii^^
CITY OF CARLSBAD if
1200 ELM AVENUE i-f
CARLSBAD CA 92008 Mi
POLICY EXPIRATION
DATE (MM/OO/YY)
06/24/97
LIMITS
GENERAL AdOAEOATE
PRODUCTS-COMP/OP AGQ.
PERSONAL ft ADV. INJURY
EACH OCCURRENCE
FIRE DAMAQE (Anx on* flra)
MIO.EXP. (Any on* ptrton)
COMBINED SINGLE
LIMIT
BODILY INJURY
[P«p»r»on)
5ODU.Y INJURY
PROPERTY DAMAGE
EACH OCCUBRtNCE
AG6RCQATE
"% ftTATUTOHYUMtTS
EACHACdOeNT
DiSEASe-POUCYUMrT
DISEASE-EACH EMPLOYEE
s
s
t
*
*1
*
I
1
s
t
I
44444W4£W;'K>:-:-H4«44W^^:>-»«> *\
9
t ;
E
SHOULD ANY OF THE ABOVE DESCRIBED POUCIES BE CANCELLED BEFORE THE
EXPIRATION DATS THeoeOP. THE ISSUING COMPANY WILL KND6AVOR TO
MAIL ^ DAYS WRFTTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR
LIABILITY OF ANY KIND UPON THE COMPANY, ITS AOENT3 OR REPRESENTATIVES.
AUTHORtZfD REPBtSFlWATlV^ ^. ^