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HomeMy WebLinkAbout2036 CORTE QUINTA MAR; ; CB031639; Permit06-13-2003 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Electrical Permit Permit No CB031639 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 2036 CORTE QUINTA MAR CBAD St TP ELEC 2151601000 Lot# LA COSTA RESORT TEMP POWER POLE FOR BALLROOM Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 06/13/2003 MDP 06/13/2003 06/13/2003 7456 06/13/03 0$P6i 02 20-00 Applicant NATIONAL CONSTRUCTION 14551 ANDELDR 92335 909574-1400 Owner KSL LA COSTA I L L C C/O KSL RECREASTION CORP 50-905 AVENIDA BERMUDA LA QUINTA CA 92253 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 $1000 $000 $000 $000 $000 $000 $1000 $000 $000 $000 $2000 Total Fees $2000 Total Payments To Date $000 Balance Due $2000 Inspector FINAL APPROVAL 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 lees/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 FOR OFFICE USE ONLY PLAN CHECK EST VAL Plan Ck Deposit Validated By Date Address (include Bldg/Suite #)Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total tt of units Assessor's Parcel tt Existing Use Proposed Use Description "of Work SO. FT #of Stories tt of Bedrooms tt of Bathrooms Name State/Zip Telephone tt Fax ttAddress -':'[3~Qwrw '-•'• Si"-- rfiflVr.cn I..I. VJ»» i»*.n --•/cr-^ &&*£: Name Address City State/Zip Telephone X (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 far a permit subjects the applicant taa civil npnalty of not more than five hundred dollars ($5001) lame State License # Address License Class City State/Zip City Business License tt Telephone # Designer Name State License tt Address City State/Zip Telephone Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations n 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 JS 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 /SC&£/£?4?J^d!*<^7 »• Policy No ^xTfc/^f'Oyvir^yttc^^r Expiration Date ,^^~^~~ OI'S^ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) O 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, andsljall subjectan employer to criminal penalties and civil fines up to one hundred thousand dollars ($100 000) in addttien-te-the cost of^pmrjerjsaMBn, darnac^*=g!p»»»id>*'f6Tin Section 3706 of the Laborcpdejnterest«rTd attorney s fees SIGNATURE /^ ^^^^^^^^^tZ^^ DATE ^' ^ 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) D 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) t~l 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 C] YES dMO 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 COMrjliETE THIS SECTION FOR WOrV-flE^CTTMi HjlLDING. PERM^ r:',.J'' "--^'"••y^TO ^J ••"'.''; ; "•«•>. --;f-^^^ •••"r^ct ^_ 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? d YES O 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 fj 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 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 buildinopfHClaSjjnder the provisions of this Code srmJJ^Xpire by limitation and become null and void if the building or work authorized by such permit is not commenced witljtrf 180 dayd from the dat&of sucjvjjgrmit orjj^feibujl<Jlng or work authorized by such permit is suspended or abandoned at any tin- '-rer the work is commenced for a/ffenod of/fi^iays (Seeti^JJ36^^ri|fp^jf'BujJ^i#rgCode) ~ APPLICA SIGNATURE DATE WHITE File YELLOW Applicant PINK Finance City of Carlsbad Bldg Inspection Request For 06/18/2003 Permit* CB031639 Title LA COSTA RESORT Description TEMP POWER POLE FOR BALLROOM Inspector Assignment RB 2036 CORTE QUINTA MAR TP Lot 0 Type ELEC Sub Type Job Address Suite Location APPLICANT NATIONAL CONSTRUCTION Owner KSL LA COSTA I L L C Remarks Phone 9095741400 Inspector Total Time CD Description Act Comment fif32 Const Service/Agricultural Requested By CARLA Entered By CHRISTINE Associated PCRs/CVs Inspection History Date Description Act Insp Comments 06/16/2003 32 Const Service/Agricultural CO RB SEE NOTICE 06/16/2003 33 Service Change/Upgrade WC RB * City of Carlsbad Bldg Inspection Request For 06/16/2003 Permit* CB031639 Title LA COSTA RESORT Description TEMP POWER POLE FOR BALLROOM Inspector Assignment 2036 CORTE QUINTA MAR TP Lot 0 Type ELEC Sub Type Job Address Suite Location APPLICANT NATIONAL CONSTRUCTION Owner KSL LA COSTA I L L C Remarks Phone 9095743882 Inspector Total Time CD Description 33 Service Change/Upgrade Act Comment C//C- Requested By MARK Entered By ROBIN Associated PCRs/CVs Inspection History Date Description Act Insp Comments CITY OF CARLSBAD BUILDING DEPARTMENT DATE NOTICE (760) 602-2700 1635 FARADAY AVENUE TIME. LOCATION PERMIT NO FOR INSPECTION CALL (760) 602-2725 RE-INSPECTION FEE DUE? FOR FURTHEPfelNFORMATION, CONTACT YES PHONE .UILDING INSPECTOR CODE ENFORCEMENT OFFICER ACORD- . CERTIFICATE OF LIABILITY INSURANCE™ « PRODUCER The Dougherty Company, Znc P.O Box 7277 Long Beach CA 90807 Phone. 562-424-1621 Fax:562-490-0432 INSURED National Business Group, Znc. National Construction RentalsNational Rent A Fence Co. National Fence Company15319 Chatsworth St.Mission Hills CA 91345 1 1 DATE (MM/DD/YY) 04/28/03 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW INSURERS AFFORDING COVERAGE * INSURER A Travelers Indemnity Co of IL INSURER B National Union Fire Ins Co. INSURER C INSURER 0 INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF 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 IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS IKISRLTR A A B A A TYPE OF INSURANCE GENERAL LIABILITY _Xj COMMERCIAL GENERAL LIABILITY | CLAIMS MADE | X | OCCUR GEN1 AGGREGATE LIMIT APPLIES PERTI POLICY ns§§r r>oc AUTOMOBILE LIABILITY X X X ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY ANY AUTO EXCESS LIABILITY jjT] OCCUR [ | CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY OTHER AZ, MA, OR, WI POLICY NUMBER TC2JGLSA419J663-1-02 810507D0187 CAPS07D0187 (TEXAS ONLY) BE7230381 TRJUB4197201-7-03 TRJUB419J5228-03 POLICY EFFECTIVEDATE (MM/DD/YY) 10/01/02 10/01/02 10/01/02 10/01/02 05/01/03 05/01/03 POLICY EXPIRATIONDATE (MM/DD/YY) 10/01/03 10/01/03 10/01/03 10/01/03 05/01/04 05/01/04 LIMITS EACH OCCURRENCE FIRE DAMAGE (Any one fire) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGO COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) AUTO ONLY EA ACCIDENT OTHER THAN EA ACC AUTO ONLY AGG EACH OCCURRENCE AGGREGATE X WCiilAlU 1 JOTH TORY LIMITS I I ER E L EACH ACCIDENT E L DISEASE - EA EMPLOYEE EL DISEASE -POLICY LIMIT $ 1,000,000 I 100, 000 $10,000 $1,000,000 $2,000,000 $2,000,000 $1,000,000 $ $ $ $ $ $ $ 10,000,000 $10,000,000 $ $ $ $ 1,000,000 $ 1,000,000 $1,000,000 See Limit 1,000,000 Above DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS All operations of the named insured. 10 days notice of cancellation nonpayment of premium for CERTIFICATE HOLDER N ADDITIONAL INSURED, INSURER LETTER CONTR-2 Contractors State License Board P O Box 26000 Sacramento CA 95826 i CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLE NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT PUT RCFnCKHTATna AUTHORIZED REPRESENTATIVE f\ f 1 ^\ x. Joe Castro [J 4 V UW&W ED BEFORE THE EXPIRA ACORD 25-S (7/97)©ACORD CORPORATION 19£