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Home My WebLink About1978 DEERGRASS WAY; 116; CB022144; Permit07-22-2002 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Electrical Permit Permit No CB022144 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 1978 DEERGRASS WY CBAD ELEC 2550121600 Lot# 0 HENSHAW RES- OUTLETS & LIGHTS Status ISSUED Applied 07/22/2002 RMA 07/22/2002 07/22/2002 Entered By Plan Approved Issued Inspect Area Applicant POLMEX CONSTRUCTION PMB 104 14871 POMERADO RD 92064 858 565-7789 Owner ,,_., , CONTINUING LIFE COMMUNITIES LU C/O RICHARD ASCHENBRENNER 800 MORNINGSIDE DR FULLERTON CA 92835 1J?7 07/22/02 0002 01 02_u Total Fees $2000 Total Payments To Date $000 Balance Due $2000 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 $1000 $000 $000 $000 $000 $1000 SO 00 $000 $000 $000 $2000 Jnspector FINAL APPROVAL Date Clearance NOTICE Please take NOTICEfhat approval of your project 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 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 fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 1."; PROJECT INFORMATION Q _U2o. FOR OFFICE USE ONLY PLAN CHECK NO EST VAL _ Plan Ck Deposit _ Validated By Date ~ / Address (include Bldg/Suitfl tt)Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total # of units Assessor's Parcel #Existing Use Proposed Use Description of Work SQ FT •tpNTAQT.PERSON.df.diffarent.frdm applicant) C <>w« 4vuxc Uo*\ #of Stories ** t tt of Bedrooms tt of Bathrooms C A Name Address City 3 .APPLICANT .. flff.Contractor Q Agent for Contractor^jlAn Owner; Q Agent for Owner, „ State/Zip Telephone tt Fax* Name 4"/PROPERTY OWNER M /*A Nam "6r;.": "coNTrMcfbR ^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 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 ($5001) Name State License tt 3St 2 I "7 Address ^ License Class D City • State/Zip City Business License tt Designer Name Address City State/Zip Telephone State License tt C LWORKERS' COMPENSATION " >,•--• •—*• •-,-:•. -,, ^pT*rr -.••• --: .-.--* -« ~ .~:F>. ,^:p,,™,,,:,, .,,,„-,,, _..,,-,,,,„.,.,.,, . ,^ ;. v,,,,^ ;? Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations S 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 l~l 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 «j|^jfc^ -fft-^m Policy No / 2&(J It ff —Q ( Expiration Date &/O 2- (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100] OR LESS) f~l 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' CompensajaSE-Lajvs of California WARNING Failuia-t6~s^cure workers'compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand doJtafs($1pOfOOO), in addmofi to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees SIGNATURE V ^) <^ <4 / _ ' 17 •'"•' OWNER-BUILDER DECLARATION .:; .' .' "" :...•/ •• '- •_ " . '.'-: ,'' j-.J.I*"^',:-,: l;'" '' '-"- -" "'. :'• \ \,.. * ^' ..' ../••. ^ *' A'.! ''" V".-,"\:. ,,/i:' :'^\ -'";. '' 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) (~l 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) f~1 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 ,—-., n:., ,Tf •, ::=...,^ .^--'-^ -.^ •*--,.. ^.. . -,. ..,-,- ~^. ^ 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 [H 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 D 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 8..1. CONSTRUCTION LENDING AGENCY."-: >.:^K i; • 1. ' V ^.P:.- ;• ' ,i;,i: X""'"' i . ' : ... ' J? '•. -ur '.. ; '",, '"". ,,'""'' 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 i9. iMPPLICANT CERTIFICATION ;J: I. ^l j.^ '' ? • ,.' ;^ ,„.,.".. ,.,.,_.^^.^:.... , .. , ... > _________ ,, ..... ,..,,.; ...... .: „.. _ • ....„.,.. „.-„, - .. 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 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 notcommenced within 180 davs^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 workj^-wSmrnenpetJ for a period of/#5o days (Jjeetreo 106 4 4 Uniform Building Code) APPLICANT'S SIGNATi DATE WHITE File YELLOW Applicant PINK Finance City of Carlsbad Bldg Inspection Request For 11/15/2002 Permit# CB022144 Title HENSHAW RES- OUTLETS & LIGHTS Description Type ELEC^v V s Sub Type Job Address 1#78 DEERGRASS WY Suite Lot 0 Location APPLICANT POLMEX CONSTRUCTION Owner Remarks Inspector Assignment PS Phone 6197198894 Inspector Total Time CD Description 39 Final Electrical Requested By JOE, PALMEX CONSTRUCTI Entered By CHRISTINE Act Comments Associated PCRs/CVs Inspection History Date Description Act Insp Comments 08/23/2002 39 Final Electrical CO PS NO ONE HOME 08/07/2002 89 Final Combo NR PS NO FIXTURES 08/01/2002 34 Rough Electric CO PS NO SUPER ON SITE 07/25/2002 34 Rough Electric AP PS VillaS 3 Bodroom'l liath Outlets tb added Cable, Computer or Phone ^; Ceiling lights BY JUL 2 2 2002 City of CARLSBAD BUILDfNG DEPT. \; La Costa Glein 920001 Ber ->m 2 12' .4'-0- Patio 16 S-x8'-0' Living 16' 8"xl3M<T Dining l2'-0"x9--8" Maste' '-droom 16' 2 <" REMOVE LIGHT G- ie 17-.L /-O" 02/01 Continuing Life Communities reserves the right to change product design options pncex and terms without prior notice. Continuing Life Communities LLC dba La Costa Glen Carlsbad^ has filed a licensing application with and has been tssuea a permit to sell Deposit Subscription Agreements by the State erf California, Department of Social Services Continuing Care Branch. '•BUS NUMBER .^,^"1214006 ,,,-••''' ,4y PATE ISSUED' -• ' .,' 06/27/200? ',;'.';" ,910 CODE;;'-; />^*'-ci^ •- ,/•'.,-"' BUSINESS REGISTRATION CERTIFICATE: " x> . ;->' ._y\- ;•'^''Xv^ ..:Y ^'^ . '-I'' The peiscn firm or'coiporation named -Wow is'granted tils busness certnrate pureiant to the provisions* ot the City jSusinesslicense'Ordnances toengagen cartyonorccnductthebusriess trade cdhng profession,eKrtbilonoroccupaaondsscrtoedbebw Issuanceollhe,: certificate Is not an endorsement nor certification of 'compliance wth other ordinances or laws. This license B issued without verifcatbn thatv the Icensee Is sitiject, to or exempt from licensing by the State cfCdifomla ; .:,' ••' -,'•;• •::• .:.:-' •,>• /•> . ,•-'>- .•>:•'-• . .•P •••" ,::" -•'"'' .:" ,> .'/•' ....-." :••.•'" ..,•" ,-.-" BUSINESS LOGATIONr-^" ^v ^.V'^r•' " "' " ,v. .f;\:../:';{:;;;';.;;/'i2oicREELMANiCN';^;y ,;^y., neral'Buildihg;Contrac,,:EXPlRAT.iON PATE r%; ^/'''^ °^SIC DESCRIPTION .'-••:• V /Building C9nstruction-General .v-: .^ .<j .c-^srai/Moa:':•.-: OWNER FIRM OR-• ... '^CORPORATION NAME MILINGADDRESS, • j'V- yiLLARREAL, RUDY . ,y^ ,v^^.^'c"j,V" :' ;:,POLMEX:CONSTRUCTION ;:; " lif •,',' •:i"^M4781 POMERADO RD..# 104;; ^''^-^*;;.- POWAY, CA so COMPENSATION INSURANCE PO BOX 807, SAN FRANCISCO,CA 94101-0807 F~LJND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE 08-01-01 POLICY NUMBER. 1284119 - 01 CERTIFICATE EXPIRES 08-01-02 CONTRACTORS STATE LICENSE BOARD ATTN: WORKERS1 COMP. UNIT BOX 26000 SACRAMENTO CA 95826 JOB LIC #351217 INCEPTION DATE- 08-01-01 D.O.: SAN DIEGO This is to certify that we have issued a valid Workers' 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 30 days' advance written notice to the employer. We will also give you 30 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 the policies listed herein Notwithstanding any requirement, term, or condition of any contract or other document with respect to which this certificate of insurance may be issued or may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions and conditions of such policies PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000.00 PER OCCURRENCE. STANDARD EXCLUSION INDIVIDUAL EMPLOYERS AND HUSBAND AND WIFE EMPLOYERS ARE NOT ELIGIBLE FOR BENEFITS AS EMPLOYEES UNDER THIS POLICY. ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 08/01/01 IS ATTACHED TO AND FORMS A PART OF THIS POLICY. EMPLOYER LEGAL NAME 'POLMEX CONSTRUCTION PMB #104 H781 POMERADO RD # POWAY CA 92064 VILLARREAL, RUDY L. PRINTED 07-18-01 P0409