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Home My WebLink About1950 SILVERLEAF CIR; ; CB031360; Permit\\ 05-08-2003 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Electrical Permit Permit No: CB031360 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: Project Title: 1950 SILVERLEAF CR CBAD ELEC 2550121600 Lot#: LA COSTA GLEN COMMONS ELEC FOR SUMP-PUMP AT POND Applicant: PRIMARY GENERAL STEI 5345TIMKENST91942 619698-7751 Status: ISSUED Applied: 05/08/2003 Entered By: SB Plan Approved: 05/08/2003 Issued: 05/08/2003 Inspect Area: 4703 05/08/03 0002 01 02 CGP 20-00 COMMUNITIES LLC ENNER 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 Total Fees:$20.00 Totaf Payments To Date:$0.00 $20.00 FINA PPROVAL 5'-Z-Q CLEARANCE. PERMIT APPLICATIONCtTY OF CARLSBAD BUILDING DEPARTMENT1635 Faraday Ave., Carlsbad, CA 92008 FOR OFFICE USE ONLYPLAN CHECKEST. VALPlan Ck. DepositValidated By,DateBusiness Name (at this address)Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Total * of unitsAssessor's Parcel #Existing Use Proposed Use (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 end Professions Code! or that he Is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by sny applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($5001). Name S State Ucense * C^k ^^ $ Address License Class t City State/Zip ^-£*"» • <9vtnj> City Business License # /2-' Telephone #•'Vf osr Designer Name State Ucense # 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. 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 jed. My worker's compensation insurance carrier and policy number are: insurance Company ^TTfr-TOT fit CL£> ^/"/^^-t^tf^^J^^-, Policy No. IZ*?-&& 2-J &Bfy~c> 'L~~ Expiration Date /// /ptf (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, j shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. ING:- Failure to ••cure workers' compensation coverage Is unlawful, and shafl subject an employer to criminal penalties and civil fines up to one hundred ausand dollars {* 101X000), In addftkm to the cost of compensation, damages es provided for hi Section 3706 of the Labor code. Interest and attorney's fees. SIGNATURE ^V£. Sfcrffc DAT6 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). 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). 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 / 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 25605, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? Q YES C 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? ' 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. I hereby affirm that there Is a construction lending agency for the performance of the work for which this permit is issued (Sec. 30971!) 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 CUV 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 IT the building or work juthorized by such permit is not commenced within 180 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned sit any fine after the work Is commencedfor a period of 180 days (Section 106.4.4 Uniform Building Code). APPLIC/> JT'S SIGNATURE DATE WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bl'dg Inspection Request For: 05/16/2003 Permit* CB031360 Title: LA COSTA GLEN COMMONS Description: ELEC FOR SUMP-PUMP AT POND Sub Type: 1950 SILVERLEAFCR Lot 0 Type: ELEC Job Address: Suite: Location: APPLICANT PRIMARY GENERAL Owner: CONTINUING LIFE COMMUNITIES LLC Remarks: REQUSTED ELEC INSPECTION Inspector Assignment: PS Phone: 6197265722 Inspector: Total Time: CD Description A 31 Underground/Conduit-Wiring mment Requested By: CHRIS Entered By: CHRISTINE Associated PCRs/CVs Inspection History Date Description Act Insp Comments 05/13/2003 31 Underground/Conduit-Wiring CO PS CONDUIT NOT 18 IN DEEP o tin H-J < U PH O w SCD 1 •8JSro .'l2.2 '£ ffi 0-S S w O g IM $€ fj' *^O 6 2 ^ \i K J^h CD CDOJ oo 4 (X ,c ACQBD, CERTIFICATE OF LIABILITY INSURANCE PROOUCSR Emerald Insurance Agency 4950 Waring Road, Suite 9 San Diego, CA 92120 """M* PRIMARY GENERAL P.O. BOX TIMKEN ST.f STE. I LA MESA, CA 91944 i DATEdriWfKVYI 02/10/03 THIS CERTIFICATE tS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFIC/TE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELC W. INSURERS AFFORDING COVERAGE wsuRCTABURLINGTON INS. CO. INSURER B: H4SURERC: INSURER Di ; N8URCRE: I COVERAQES ANY REQUIREMENT. TERM OR CONDITION OP ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED' OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 18 SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF Sl!lCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. BIP A TWI W INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL UABIUTY ^_\ CLA1MSMAOE [ J OCCUR GENI AGGREGATE LIMIT APPUCS PER XIroucYnS&r riioc AUTOUOBHJEUAMUTY ANY AUTO «JL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NCHOWNEO AUTOS OARAQe LIABILITY AMY AUTO EXCESS UAMUTY | OCCUR [~"1 CLAIMS MADE DEDUCTIBLE RETENTION 1 WOfUOftS COHnNMTION A EMPLOYCTT LIABILITY NO OTHER •^••??l!?Pf?frH.1.«.liV^^ 262B000019 01/24/03 01/24/04 EACH OCCURRENCE RRE OAMAOe CAny on* fi>« MED EXP (Any om p»rwn) PERSONAL 1. ADV M JURY GENERAL AGGREGATE PRODUCTS- COMP/OP AGG COMBINED SINGLE UMfT(EaKckrtrt) BODILY INJURY(P*rp*f4on) BOQwYNJURY^tfaeddwl) PROPERTY DAMAGE (P^KOtdWt) AUTO ONLY- EAACOOENT OTHER THAN ^* *^-ALnDONtY; ^^ EACH OCCURRENCE AOGflEGATE fiS^affifei rap- E.LEACHACCtOENT &L DISEASE - EA EMPLOYEE ELDtSEASE-POLCYUMT ! sl,000f C'OO * 100, COO « 5, (00 si, 000, 000 si, 000, C'OO si, 000, C'OO s s : s s S i s s. s s s * * s s : % OEBCmmON Or OMMTIOfU/LOCATIOttVVEHICLfWEXCUISIOm ADMD BY iMOOMiMCNT/WtCIAL nWVNKNW TYPE OF FACILITY: RETIREMENT COMMUNITY INTERIOR REMODELING CERTIFICATE HOLDER X ADDITIONAL INSURED; msuRm LETTER A CANCELLATION : LA COSTA GLEN 1950 SILVERLEAF CIRCLE CARLSBAD, CA 92009 _ 1 _ _ . _ _^_ •MOULD AMY Of THf ABOVE DEKRIBEO POUCI£» BE CANCELLED S£FORB THE EXH; UT1«I DATE THEWOf, THE WCWNO USURER WILL ENDEAVOR TO MAIL 10 DAW WWTTEM NOTICE TO THE CERTtnCATE HOLDER NAMED TO TW LWT. WIT FAB.UW TO DO *j SHALL IMPOSE NO OWLJOATION OR LIABILITY OF ANY KWD UPON THE INSURER, ITS A« ITS OR REPRESENTATIVES. . AUTWJWZEOlrtnWl^ATlWy.jffi$Wfff/& i G ACORD CORPORATION IBM COMPENSATION I MSUWAMCB FUND HOMI QfflCl I27B MAWCIT STIET SAr pflANCIICO. CA Ml03 WORKERS' COMPENSATION INSURANCE NOTICE OF CANCELLATION/CONVERSION Data January 23, 2003 PRIMARY MECHANICAL INC PO BOX 1077 LA MESA, CA 91944 Policy No* 229-0021884-02 Pariod 01/01/02-01/01/03 INSURANCE CANCELLED/CONVERTED EFFECTIVE 01/01/03 t 12*01 A.M. Raason t Policy conversion. Effective 01/01/03 your worker*f compensation insurance has baan converted to policy nunber 046-0012733-03. Tour policy nvnbar 229-0021884-02 was cancelled 01/01/03. Your covaraga under tha new policy 046-0012733-03 begins 01/01/03. If you hava any questions, contact our San Diego District otfica during normal business hours at (858) 552-7000 By CustosMr Services Unit State Costpensation Insurance Fund