HomeMy WebLinkAbout1958 LA COSTA AVE; "TP"MULTI-PERMIT FILE; CB070751; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
03-20-2007 Electrical Permit Permit No: CB070751
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Reference #:
Project Title:
1958 LA COSTA AV CBAD St: TP
ELEC
0000000000 Lot #:
LA COSTA PLAZA TEMP POWER POLE
0
Applicant: Owner:
POWER PLUS
436 N QUINCE ST
ESCONDIDO CA 92025
760 839-9430
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
0
0
0
0
Total Fees: $20.00 Total Payments To Date:
Inspector: Date:
Status:
Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
ISSUED
03/19/2007
KG
03/20/2007
03/20/2007
$10.00
$0.00
$0.00
$0.00
$0.00
$0.00
$10.00
$0.00
$0.00
$0.00
$20.00
$20 00 Balance Due:
Clearance:
$0.00
NOTICE: Please take NOTICE at app val of your project includes the "lmposi of fees dedications, reservations, or other exactions hereafter collectively
referred to as "fees/exactions." You hav 90 days from the date this permit was issu d to protest imposition of these fees/exactions. If you protest them, you must
follow the protest procedures set forth in Government 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/exactions DOES NOT APPLY to water and sewer connection fees and capacity
changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any
f fwhi I Tl i ii hi r i h h flimi in I
-,,,_-...\ ' '
FOR OFFICE USE ONLY
PLAN CHECK NO. ______ _
PERMIT APPLICATION
EST. VAL. __________ _
Plan Ck. Deposit _________ _
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad CA 92008
Validated By __________ _
Date ____________ _
1. PROJECT INFORMATION
1958 TP La Costa Ave
Address (include Bldg/Suite#)
Legal Description
Assessor's Parcel#
Temporary Power Pole Amp
Description of Wor1<
Bldq G
Lot No
Business Name (at this address)
La Costa Plaza
Subdivision Name/Number Unit No
Existing Use
SQ. FT # of stories
Phase No. Total# of units
Proposed Use
# of Bedrooms # of Bathrooms
2. CONTACT PERSON (ii different from applicant)
Michelle Scott 436 N Quince St. Escondido CA 92025 760-839-9430 760-839-9436
Name Address
3. APPLICANT a Contractor □ Agent for Contractor
leooifer Gale Pa Box 711564
Name Address
4. PROPERTY OWNER
Eleven Western Siders 2863 Executive Pl
Name Address
City
□ Owner
Santee
City
State/Zip Telephone#
Iii Agent for Owner
Ca 92072 619-405-2648
State/Zip Telephone#
Escondido CA 92029 760-796-6346
City State/Zip Telephone#
Fax#
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 pennit 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 cMI penalty of not more than five hundred dollars ($500]).
Power Plus! 436 N. Quince Street Escondido CA 92025 760-839-9430
Name Address City State/Zip Telephone#
State License # _,,5:,2"'3"'5""9'-'6'------License Class C61 C10 D31 City Business License # 01..,2,.,0"6,.2,.,5e,5e__ _____ _
Designer Name City Stata/Zip Telephone#
State License•--------
6. WORKER'S COMPENSATION
Workers· Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
D ! have and will mamtain a certificate of consent to self-insure for wor1<:ers' compensation as provided by Section 3700 of the labor Code, for the perfonnance of the wor1<:
for which this permit is issued [Z] I have and .viii maintain worker's 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 American Home Assurance Policy No. WC7171634 Expiration Date,_0_3_-_3_1_-0_7 ______ _
(THIS SECTION NEED NOT BE COMPLETED IF lHE PERMIT IS FOR ONE HUNDRED DOLLARS [$1001 OR LESS)
D CERTIFICATE OF EXEMPTION: I certify that in the pertormance of the wor1<: for which this pennit is issued, I shall not employ any person in any manner so as to
become subject to the Workers' Compensation Laws a Galifomia
7.
I hereby affir that l exempt from the Contra r's License Law for the following reason
□ /, as r of the property or my employees with waQeG as their sole compensation, will d the 'WOik and the structure is not intended Of offerad for sale (Sec. 7044,
Business and Professions Code: The Contractor's License Law does not apply IC an ONner of property who builds Of improves thereon, and who does such wor1<: himself or
through his own emplo)lees, prowled that such improvements are not intended a offered for sale. If, hcMte\ter, 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 cl sale)
D I, as owner of the property, am excluscvely oontrading with licensed oont:radors to construct the project (Sec. 7044, Business and Prof8$5ions Code: The Contractor's
Ucense Law does not apply to an owner of property ffllO builds or improves thereon, and contracts for such projeCts with contractor(s) licensed pursuant to the Contractor's
license law).
D I am exempt under Section ________ Business and Professions Code for the& reasm:
"I \ pereona\\y p\anto prD'lide the major labor and material$ for oonstruction dthe proposed property improvement. □ YES □ NO
2. I (have/have not) signed an application for a building permit for the proposed 'MXk
3. I have contracted with the following pen.on (firm) to provide the proposed oonstrudion (include name I address/ phone number/ contractors license number):
4. I plan to provide portions d the work. but I have hired the folkMing person to coordinate, supervise and provide the major work (include name/ address/ phone number/
/ontractors license number): --------------------------------------------5. \ wffl prOVIOe &m'le o'i ttiework, but I have contracted (hired) the following persons to provide the work indicated (include name I address I phone number I type of wor1<:)
PROPERTY OWNER SIGNATURE ___________________________ DATE __________ _
WHITE: File YELLOW': Applicant PINK: Finance
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave .• Carlsbad CA 92008
Page 2 of 2
COMPLETE THIS SEC110N FOR NON-RESIDENTIAL BUILblNG PERMITS ONLY
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration for or risk management and prevention program under
Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Acco.mt Act? O 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? D YES □ NO
Is the facility to be constructed 'Mthin 1,00Jfeetcltheouterboundaryof a school site? D YES □ NO
IF ANY OF TIE ANSWERS ARE YES. A RtAL CERl'FICA'II: OF OCCUPANCY MAY NOT IE ISSUED I.N.ESS DIE APPUCANT HAS MET OR IS MEETING THE
REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES ANO TI-IE AIR POU.UTION CONTROL DISTRICT.
8. CONSTRUCTlON LENDING AGENCY
I hereby affirm that there is a construction lendmg agency for the performance of the work for Wich 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 W'ith au City
ordinances and State laws relating to building construction. I hereby authorize representatives of the City of Gar1sbad to enter upon the aboVe mentioned property for inspection
purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS TIE CITY OF CARLSBAD AGAINST ALL UABLITES, JUDGEMENTS, COSTS AND
EXPENSES WHICH MAY It ANYWAY ACCRUE AO.UrlSTSADaTY It CQIISEQIIENCE OF TtE GRANTING OFlHIS PERMIT.
OSHA: An OSHA permit is_ required for excavations of 5'CT deep and demolition orcoostruction of structures m,er 3 stones in height
EXPIRATION: Every permit issued by the building Ofooial under the provisions o( this Code shall expire by limitation and become null and void if the building or work authorized
by such permit ls not commenced within BO da.)6 from the dated such penni °' if the building or'M>fk authorized by such permit iS suspended or abandoned at any time after
the work is commenced for a period cl 1 days (Section 106.4.4 Uniform ~ Code)
APPLICANT'S SIGNATURE',.--""=----+~LLjLl.4.~L\➔i::;:.--"'""'~,.,:_]L<S....-------DATE --s3=· ,.,___-~l_iL·_·-_{)~J-1 _7~-----
WHITE: FIie YELLOW: APl>lica~ PINK: Finance
,
;
•
City of Carlsbad Bldg Inspection Request
For: 04/05/2007
Permit# CB070751
Title: LA COST A PLAZA TEMP POWER POLE
Description:
Type: ELEC Sub Type:
Job Address: 1958 LACOSTAAV
Suite: TP
Location:
APPLICANT POWER PLUS
Owner:
Remarks:
Total Time:
Description
Lot
CD
32 Const. Service/Agricultural
0
Comments/Notices/Holds
Associated PCRs/CVs Original PC#
Inspection History
Date Description Act lnsp Comments
Inspector Assignment:
Phone: 7608399430
Inspector: -----
Requested By: MICHELE
Entered By: CHRISTINE
I
! . I( City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008 .........
12/05/2000 Electrical Permit Permit No:CB004591
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Reference #:
1958 LA COSTA BLVD CBAD
ELEC
Lot#: 0
Project Title: TEMP POWER POLE-ALBERTSONS
Applicant:
TEMP UTILITY SERVICES
1167 LAW ST
SAN MARCOS, CA 92069
619-471-5494
Owner:
Status:
Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
ISSUED
12/05/2000
RMA
12/05/2000
12/05/2000
5917 12105/(J
Total Fees: $20.00 Total Payments To Date: $0.00 Balance Due: ~jlO
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
TOTAL PERMIT FEES
Inspector: ,d~ ·;
0
0
0
0
FINAL APPROVAL
Date: /-0'7-N Clearance:
$10.00
$0.00
$0.00
$0.00
$0.00
$0.00
$10.00
$0.00
$0.00
$20.00
NOTICE: Please take NOTICE that approval of your prq'ect includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively
referred to as "fees/exactions." 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 Government Code Section 66020(a), and file the protest and any other required information with the City Manager for
processing in accordance with Cartsbad 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/exactions DOES NOT APPLY to water and sewer connection fees and capactiy
changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any
fees/exactions of which vou have nreviouslv been civen a NOTICE similar to this, or as to which ttie statute of limitations has oreviouslv otherwise exoired
() "
FOR OFFICE USE ONLY
PERMIT APPLICATION PLAN CHECK NO. ____ _
CITY OF CARLSBAD BUILDING DEPARTMENT
2075 Las Palmas Dr., Carlsbad CA 92009
(760) 438-1161
EST. VAL. _________ _
Plan Ck. Deposit ------7'1Hf--
1. PRo.iECT INFORMATION
Address (include Bldg/Suite #) / 'f S B Business Name (at this address)
Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units
Assessor's Parcel II Proposed Use
Description of Work #of Stories II of Bedrooms # of Bathrooms
2. CONTACT PERSON (It dlfferont irom eppllcani)
Name Address
3. APPLIFi,,., ;1,,.comre(:lt7!Ag;~;m1°' Downer
Name Address
4.
Address
6. CONTRACTOR • COMPANY NAME
City
0'Agent'for Owner 5'l>
City
State/Zip Telephone# Fax#
State/Zip Telephone#
State/Zip Telephone#
(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 nt the Business and Professions Code) or that he is exempt therefrom, and the basis for the alleged
exemption. ny violation of Se tio 7031 . 5 by any applica tor a Jlllrmit subjects ~e applicant to a civil P/nflty of not more than five hundre9... dollars I$ 5001). WV s Ol,t11~ <-.Yf c1,d1 l)f 7(0-ZS-3 -<j' :JI
State Ucense # S) J 5' 7'( License Class _,u....,'f'c...l _____ _ City Business License # _______ _
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:
0 I have and will maintain II 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. OJ"" I have and will maintain workers' compensation, as require~ .by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued. My worker's compensation ins,!!.t'nce c1rrier and policy number are: g .-3 f ... 4 f
Insurance Company .,S fq]r,, r(/';1,,(/ Policy No. / .j.J3°'/ / CJ -Q CJ Expiration Date _______ _
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS)
0 CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as
to become subject to the Workers' Compensation Laws of California.
WARNING: Failure to ■ecure workert' compe aflon coverage I■ unlawful. and ■hall ■ubject an employer to criminal penattles and civll flne■ up to one hundred
thou■and dollar■ I$ 00 ), in addition oat of compen■atlon, damage■ a■ provided for In Section 3706 of the Labor code, Interest and attomey'■ fee■.
SIGNATURE,_t,.:.:&::!::::~~~~~~~-------------DATE /;7.-/-o-<J
7,
ntractor's License Law for the following reason:
0 I, as ow er 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. 704 , usiness and Professions COde: The Contractor's License law does not apply to an owner of property who builds or improves thereon, and who does
k himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or Improvement is
ithin one year of completion, the owner-builder will have the burden of proving that he did not build or improve tor 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(sl licensed
pursuant to the Contractor's License Law).
0 J am exempt under Section ______ Business and Professions Code for this reason:
1. t personally plan to provide the major labor and materials for construction of the proposed property improvement, 0 YES ONO
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 tha major work (include name / address / phone
number/ contractors license number): ________________________________________________ _
5. I wlll 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-RESIDENTIAL BUILDING PERMITS .ONLY
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? 0 YES O NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air Qualitv management district? D YES D NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 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.
8. CONSTRUCTION LENDING AGENCY ,'
I hereby affirm that there is • 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 __ -,-_____________________ _
9. APPLICANT CERTIFICATION
I certify that I havl!l 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 Citt 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 36 ays from the date of such permit or if the building or work authorized by such permit is suspended
or abandoned at any time atter the commenced riod of 180 days (Section 106.4.4 Uniform Building Code). .l I).~ I -ot7 APPLICANT'S SIGNATURE _ _j~~:::Z~t..-.s/.~~::21~~------------DATE
YELLOW: Applicant PINK: Finance