HomeMy WebLinkAbout1953 DOVE LN; ; CB041195; Permit04-07-2004
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Electrical Permit PermitNo: CB041195
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Reference #:
Project Title:
Applicant:
POWER PLUS
1953 DOVE LN CBAD St: TP
ELEC
Lot #:
LA COSTA GREEN APTS-TEMP POWER
POLE
Owner:
Status:
Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
ISSUED
04/07/2004
RMA
04/07/2004
04/07/2004
436 N QUINCE ST
ESCONDIDO CA 92025
760 839-9430
Electric Issue Fee $10.00
Single Phase per AMP 0 $0.00
Three Phase per AMP 0 $0.00
Three Phase 480 Per AMP 0 $0.00
Remodel/Alteration per AMP 0 $0.00
Remodel Fee $0.00
Temporary Service Fee $10.00
Test Meter Fee $0.00
Other Electrical Fees $0.00
Additional Fees $0.00
TOTAL PERMIT FEES $20.00
Total Fees: $20.00 Total Payments To Date: $0.00 Balance Due: $20.00
9^98 04/07/04 gg^,. 02
20.00
Inspector:
FINAL
Date: Clearance:
NOTICE: Please take NOTICE that approval of your project includes the "Imposition' of fees, dedications, reservations, or other exactions hereafter collectively
referred to as "fees/exactlons." You have 90 days from the date this permit was Issued to protest Imposition of these fees/exactions. If you protest them, you must
follow the protest procedures set forth in Govemment Code Section 66020(a), and file the protest and any other required Information with the City Manager for
processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack,
review, set aside, void, or annul their Imposition.
You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactlons DOES NOT APPLY to water and sewer connection fees and capacity
changes, nor planning, zoning, grading or other similar application processing or sen/ice fees in connection with this project. NOR DOES IT APPLY to any
fees/exactlons of which vou have previously been given a NOTICE similar to this, or as to which the statute of limitations has oreviouslv otheiwise expired.
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
1. PROJECT INFORMATI
FOR OFFICE USE O
PLAN CHECK NO.
EST. VAL.
09//9S
Plan Ck. Deposit
Validated B
Date
sposit M ,
Address (Include BIdg/Sulte #) _
^QiTf A=A/7tl. Subdivision Name/I
g^usiness Name (at this address)
^1 /hm Legal Description Lot No. lame/Number Unit No. Phase No. Total # of units
Assessor's Parcel # *y^mA Aiu/§^ fi/S
•k S
Existing Use Proposed Use
Description of Worl so. FT. #of Stories # of Bedrooms # of Bathrooms
^WTP^ON (If nmj^^ft^^ppl^cantl
Name Address
3. APPLICANT • Contractor 5^*9*"' *0' Contrartor • Owner
City
• Agent for Owner
State/Zip Telephone # Fax #
Name Address City State/Zip Telephone #
PROPERTY OWNER
A/tJL6//i^ <o<?r'A^/ZPA H/k2/f/^S 5/'^g> /^/h^C^4/f/? A^A
7f-oV9A^f Name Address City State/Zip Telephone #
5. CONTRACTOR - COMPANY NAME
(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
exemptioiL Any violatioa<^f Section 7031.5 by any applicant for a permit subiects the applicant to a civil penalty of not more than five hundred dolors [$500]).
Aiu/0^ y/os </-^^/t< ^u/^/6/f ^A ^zt- 7^//h^9A(/9o Name
State License # ^7, ^
Address
License Class
City State/Zip
City Business License #
p Telephone #
A2P^lK^
Designer Name Address City State/Zip Telephone
State License #
6. WORKERS' COMPENSATION
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
|~| 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
issued. My worker's compensation insurance carrier and policy number are: j y
Insurance Company S A^ ^7)^'^^ Policy No.^*-^,^^5^ t A Expiration Date "^A^/^
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR OME HUNDRED DOLLARS [$1001 OR LESS) / ^
• 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'cpmpensation coverage is unlawful, and shaii subject an employer to criminai penalties and civil fines up to one hundred
thousand doiiars ($100,000). in additio/to tne mst of compensation, damages as provided for in Section 3706 of the Labor codeyihtejpst and attorney's fees.
SIGNATURE AAACA (_J ^ DATE "^A^y/^//
7. OWNER-BUILDER DECLARATION
I hereby affirm that I am exempt from the Contractor's License Law for the following reason:
• 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).
• 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).
• 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. • YES DNO
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
COMPLETE THIS SECTION FOR NON-RESIDemW. BUILDING PERMtTS ONIY
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? • YES • 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
REOUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DiSTRiCT.
8. CONSTRUCTION LENDING AGENCY
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 NAME LENDER'S ADDRESS
9. 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 all
City ordinances and State laws relating to building construction. I hereby authorize representatives of the CitV 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'C 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 IflCLdays from the date of such permit or If the building or work authorized by suoh permit is suspended or abandoned
at any time after the work Is commenced^r a perlqpof/80 days (Section 106.4.4 Uniform Building Code).
CM APPLICANT'S SIGNATURE DATE
WHITE: File YELLOW: Applicant PINK: Finance
City of Carlsbad BIdg Inspection Request
For: 04/13/2004
Permit* CB041195
Title: LA COSTA GREEN APTS-TEMP POWER
Description: POLE
Inspector Assignment:
Type: ELEC Sub Type:
Job Address: 1953 DOVE LN
Suite: TP Lot (
Location:
APPLICANT POWER PLUS
Owner:
Remarks:
Phone: 7608399430
Inspect
Total Time:
CD Description Act Comment
32 Const. Service/Agricultural
Associated PCRs/CVs
Requested By: STEPHANIE
Entered By: ROBIN
Inspection Historv
Date Description Act Insp Comments