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Home My WebLink About1950 SILVERLEAF CIR; C311; CB030853; Permit03-24-2003 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Electrical Permit Permit No: CB030853 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: Project Title: 1950 SILVERLEAF CR CBAD St: C-311 ELEC 2550121600 Lot#: LA COSTA GLEN-ADD 2 PLUGS, LOWER 2 PLUGS.CAP 2 PLUGS-UNITS 311&313 Status: ISSUED Applied: 03/24/2003 Entered By: RMA Plan Approved: 03/24/2003 Issued: 03/24/2003 Inspect Area: Applicant: CONTINUING LIFE COMMUNITIES LLC C/O RICHARD ASCHENBRENNER 800 MORNINGSIDE DR FULLERTONCA 92835 Owner: CONTINUING LIFE COMMUNITIES LLC C/O RICHARD ASCHENBRENNER 800 MORNINGSIDE DR FULLERTON CA 92835 1079 03/24/03 0002 01 COP 02 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 Additional Fees TOTAL PERMIT FEES $10.00 $0.00 $0.00 $0.00 $0.00 $10.00 $0.00 $0.00 $0.00 $0.00 $20.00 Total Fees:$20.00 Total Payments To Date:$0.00 Balance Due:$20.00 FINM. APPROVAL -I INSIV1WJ ^ OATF ' ** CLEAfWNCE PERMIT APPLICATIONCiTY OF CARLSBAD BUILDING DEPARTMENT1635 Faraday Ave., Carlsbad, CA 92008 FOR OFFICE USE ONLYPLAN CHECKEST. VALPlan Ck. DepositValidated By^ LADataAddress (include Bldg/Suite Business Name (at this address)Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total $ of unitsAssessor's Parcel #Existing Use Proposed UseDescription of Work SQ. FT.#of StorieS K of Bedrooms # of Bathrooms Name Address 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 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 [$500)}. t. Name State License # ffOfoffa % Address ' License Class _£f City State/Zip City Business License # / *- > Telephone # 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. J3 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 ^TT^yE^ XtVnQ CasvtP. 3f7< Policy No. <PV6* - (X) / 2.7 3j-Q_S Expiration Date / ~ r ~Ot/ (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' 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.!$10JJ,OOOI, In addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, Interest and attorney's fees. SIGNATURE/^-£^7 S^ZttT *fe>&-,7 /*=€>< /%• DATE ~Z/'2- <//,3 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. 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). J0 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). 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. l~l YES QNO 2. t (hava£/"hBvenot) stoned an application for a building permit for the proposed work. 3. I have contractedwith 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 PROPERTY OWNER SIGNATURE 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? 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? O YES Q NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Q 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. 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 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 1 80 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 is commenced jo/ a period of 180 days (Section 1Q6.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 04/21/2003 Permit^ CB030853 Title: LA COSTA GLEN-ADD 2 PLUGS, Description: LOWER 2 PLUGS.CAP 2 PLUGS-UNITS 311&313 Inspector Assignment: PS 1950 SILVERLEAFCR C-311 Lot 0 Type: ELEC Sub Type: Job Address: Suite: Location: APPLICANT CONTINUING LIFE COMMUNITIES LLC Owner: CONTINUING LIFE COMMUNITIES LLC Remarks: Phone: 0000000000 Inspector: Total Time: CD Description 34 Rough Electric Act Comment Requested By: N/A Entered By: ROBIN Associated PCRs/CVs Inspection History Date Description Act Insp Comments CONTINUING LIFE COMMUNITIES LLC March 24, 2003 Mr. Mike Peterson City of Carlsbad - Building Department 1635 Faraday Avenue Carlsbad, CA 92008 Dear Mike: We hereby authorize Primary General to obtain Building Permits to make renovations to the interiors of several Villas and Apartments at La Costa Glen. If you should have any questions please feel free to contact me at 760-704-6252. Sincerely, Gary E. Kutz Vice President - Independent Living Development cc: Darolyn Jorgensen-Kares Kavin Ward 1940 Levante Street-Carlsbad CA 92009 (760) 710-6300 - Fax (760) 710-6262 H sr r I£ 0 VI < * -Xf. 5 n £if $ O ! §" 9 ? 51 O O?m (^ (7T» <$>£ i.h o ^X ^x ^_rf V\l s ^ "V e Ir1^ [s -t 0 1 >V* E Cfry Ill^ £ 8£ ->:=ip* « ID£ K> 3 lito> o f«0-c * e fi.5 § D,2 « 20-2 fi p « ac — 4* ftic •£ •£ffl » *•"a 3 0- unis um .5 - t5 OPfO C 8 '^ £|i*• C V•o "OCIII 3•1 =,( *11 * ACORD, CERTIFICATE OF LIABILI rnooucM Emerald Insurance Agency 4950 Waring Road, Suite 9 San Dieqo, CA 92120 JNBUNED PRIMARY GENERAL P.O. BOX TIMKEN ST., STE . I LA MESA, CA 91944 i TY INSURANCE DATE <MIM>0/ ' •) 02/10/03 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CEJTOFIC'TEHOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND DR ALTER THE COVERAGE AFFORDED BY THE POLICIES BEL<)W. INSURERS AFFORDING COVERAGE wsuflERABURLINGTON INS. CO. INSURERS: INSURER C: INSURER O-. INSURER E: COVERAGES THE POLICIES Of INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCV PERIOD INOtCATCD. NQTWITHSTWH ><NG ANY REQUIREMENT. TERM OR CONDITION Of ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUEf > OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN tS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF S . <CH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INBRLTH A TYPBOFMBUfUNCI ae JL MEftAL LIABILITY COMMERCIAL GENERAL LIABILITY I CLAIMS UAOe | | OCCUR QENV AQOReOATE UMIT APPLIES P£R AUTOMOEVUr LUBMJTV ANY AUTO ALL OWNED Auroe SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS OAKAOBUABIUTY ANY AUTO EXCW LIABILITY | OCCUR L] CLAIMS MADE DEDUCTIBLE RETENTION S WOHKBAB COUPtNBATIOII AND •UPLOVBM1 LIABILITY OTKCT POLICY NUMBER [ *Qj!£n!uij£9vS? 1 'T&T^jfiffiBwS?* 262B000019 01/24/03 ii 01/24/04 UMITB EACH OCCURRENCE FIRE DAMAQE (Anyon»fir»> MEO EXP (Any cm* pcrton) PERSONAL ft AOV INJURY GENERAL AGGREGATE PftOOUCTS • COMP/OP AGO COMBINED StNOLE LJMITCEtKOkMnQ BODILY INJURY BODti.Y INJURY <P*rucldinO PROPERTY DAMAGE AUTO ONLY • EA ACCIDENT AUTO ONLY: ^an EACH OCCURRENCE AGGREGATE T&futiMk \ i°prR" EL EACH ACCIDENT £.L DISEASE - EA EMPLOYE! E.l_ OtSEASE • POLCY LJMT •1,000, 00 » 100, 00" * 5, 00 •1, 000, 00 •1,000, •: oo *1L000, 00 S . . * DCBCRIPTION OP OPVUTIOHfAOCATKMC/VBHICLEt/CXClUBtaifB ADDED BY BUDOffBeMfMT/BPECM. PMWIWONB TYPE OF FACILITY: RETIREMENT COMMUNITY INTERIOR REMODELING CERTIFICATE HOLDER 1 X ! ADDITIONAL INWREO; WBOMR LITTW: A CANCELLATION LA COSTA GLEN 1950 SILVERLEAF CIRCLE CARLSBAD, CA 92009 SHOULD ANY OF THE ABOVE DEBOfllBCD POLICIES BE CANCELLED BEFORE THf DC* UTKMI DATE THEREOF, THE ISBIMHQ (NBUMEfl WILL CNDBAVOH TO MAIL 10 DAVB V *TTW HOTICI TO THE CWTWCATE HOLDER MAUED TO THE UVT, BUT FAILURE TO DO »> BMAU MPOBE NO OBUOATION OH UABIUTY OF ANY KMD UPON THE IMtURCR, »t» AO1 IT» OM REPMBENTATfVH. , wffiffiffi?f$SilK^ 1 .-.~~~«« L~«*i . - CACORD CORPORATION! B*B POLICYHOLDER COPY P.O. BOX 420807, SAN FRANCISCO, CA 94142-0807 COMPHNSATfON INSURANCE FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE FEBRUARY 11, 2003 GROUP: 000046POLICY NUMBER: 12733-2003 CERTIFICATE ID: iCERTIFICATE EXPIRES: 01-01-2004 01-01-2003/01-01-2004 CITY OF CARLSBAD 1635 FARADAY AVE CARLSBAD CA 92008 This is to certify that we have issued a valid Worker's 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 10 days advance written notice to the employer. We will also give you 10 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by thepolicies listed herein. Motwith stand ing any requirement, term or condition of any contract or other document withrespect to which this certificate of insurance may be issued or may pertain, the insurance afforded by the policiesdescribed herein is subject to all the terms, exclusions, and conditions, of such policies. c. AUTHORIZED REPRESENTATIVE PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE EMPLOYER PRIMARY MECHANICAL, INC. FAYE, ROBERT HOWARD FAYE, LORI DBA: PRIMARY GENERAL PO BOX 1077 LA MESA CA 91944 SCIF10265 fEPF-UI:Sn