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Home My WebLink About2076 AVENUE OF THE TREES; ; CB022861; Permit09-24-2002 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Building Inspection Request Line (760) 602-2725 Electrical Permit Permit No: CB022861 Job Address: Permit Type: ELEC 2076 AVENUE OF THE TREES CBAD Parcel No: 1562902300 Lot #: 0 Reference #: Project Title: JOHNSON RESIDENCE OUTLETS,LIGHTS REWORK SUBPANEL Status: ISSUED Applied: 09/24/2002 Plan Approved: 09/24/2002 Issued: 09/24/2002 Entered By: MDP lnspectAm W/24/02 0002 01. O;! CGP 20.00 Applicant: CHAMBERS ELECTRIC INC P 0 21 56 92079 760 598-5498 Total Fees: Electric Issue Fee Single Phase per AMP 0 Three Phase per AMP 0 Three Phase 480 Per AMP RemodeVAlteration per AMP 0 Remodel Fee Temporary Service Fee Test Meter Fee Other Electrical Fees Additional Fees TOTAL PERMIT FEES 0 PERMIT 4PPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 Assessor's Parcel # Existing Use Proposed Use FOR OFFICE USE ONLY PLAN CHECK N0.0ZnT86( EST. VAL. Plan Ck. Deposit Validated By Date Description of Work #of Stories # of Bedrooms # of Bathrooms Name Address City SteteEip Telephone # Fax # Name Address City StateEip Telephone I (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, elso requires the applicant for such permit to fila e 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 Codal or that he is exempt therefrom, and the basis for the alleged exemption. Any violetion of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars I55001). Name Address City state/zipa T&pw State ticanse x 7~8 License class C -/D Designer Name Address City Stateltip Telephone State License # Workers' Compensation Declarat of the work for which this permit is issued. 0 issued. My worker's compensation insurance carrier and policy number ere: Insurance Company w fMD Policy NO. /590/33 - 8 L. (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 181001 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: Fdlura to secwe workem' compenaoth coverage is unlawful, md rhdl subjet3 an employer to crimlnd penaltlm and dvil Rnea up to one hundred thousand dollan ($100,000). in addldlon to the cost of compensation, damegr aa provided for h Section 3706 of the Labor code, interest and ettomy's fees. CHflRg&f?5 bzszlij/c, /NC, P,Or Box 2/56 5#H /YHfircT LAL 92C97pr3w > W-Sr7~ City Business License # & ereby affirm under penalty of Gijury 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 I have and will maintain workers' compensation, es required by Section 3700 of the Labor Code, for the performance of the work for which this permit is Expiration Date 7 - / - O-3 DATE I hereby affirm that I am exempt from the Contractor's License Law for the following reason: 0 I, as owner of the property or my employees with wages as their sole compensatlon. will do the work and the structure IS not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's Licensa 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 improverents 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 ot.proving that he did not build or improve for the purpose of sale). 0 I, as owner of the property, em exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business end Professions Code: The Contractor's License Law does not apply to en owner of property who builds or improves thereon, and contracts for such projects with contractor(sI licensed 0 1. 2. 3. 4. number / contractors license number): 5. "k. pursuant to the Contractor's License Law). I- -* Business and Professions Code for this reason: I am exempt under Section I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES ON0 I (have / have not) signed an application for a building permit for the proposed work. I have contractad with the following person (firm) to provide the proposed construction (include name / address / phone number I contractors license number): 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 I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name I 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 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? 0 YES 0 NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality menagement district? 0 YES 0 NO 1s the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES 0 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). LENDERS NAME LENDERS ADDRESS i certify that I have reed 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 thb building or work authorized 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 at any time after the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE & ' WHITE: File YELLOW: Applicant PINK: Finance , City of Carlsbad Bldg Inspection Request For: 12/03/2002 Permit# CBO22861 Inspector Assignment: RF Title: JOHNSON RESIDENCE Description: OUTLETS,LIGHTS REWORK SUBPANEL Type: ELEC Sub Type: Job Address: Location: 2076 AVENUE OF THE TREES Suite: Lot 0 APPLICANT CHAMBERS ELECTRIC INC Owner: JOHNSON DAVID PAUL&EASTON JADE Remarks: EARLY INSPECTN - IST OF THE DAY IF POSSl Phone: 7605985498 Inspector: AF Total Time: Requested By: JACK CD Description Act Comments Entered By: CHRISTINE 39 Final Electrical AP Associated PCRsICVs , InsDection History Date Description Act lnsp Comments 11/15/2002 39 Final Electrical AP RF 10/28/2002 17 Interior Lath/Drywall AP RF 10/18/2002 34 Rough Electric AP RF 09/30/2002 34 Rough Electric PA RF ROUGH OUTSIDE NOT COMPLETE STATE FUN D CERTIFICATE Of WURKERS' CQMPENSATtON INSURANCE PotlCV NUMQER: P.O. BQX 420807, SAN FRANCISCO, CA 941424807 COMPENSATLON INSUWANOE I"yd'13:4 - 02 .iiJ '[ i % .to< 2 CERTIFICATE EXPIRES; 7' i'bos r CITY %- CkPCI.ShAl) lh13 -:BRADAY AVF. CARL SBhD CA $2000 imr; )I CIL, Lhl :.FORNltl L This IS to certify that we have issued a vatid Workers' CBppensatioFt inwpnce peticy in$ fprm applOIle Insurance Cornm'esroner toithe mpfoyer named bekiw fur the policy period indicllted. This policy is not subject to cancetlahon by the Fund except upon ten days' advance written notice to the mployer. respect to which this described herein is sub ani irvuni newe rnnv ISSUE DATE (MMIDDNY) bo A GENERALLIABILITY TYPE OF INSURANCE .m ROWER INSURANCE AGENCY .O. BOX 729 SCONDIDO CA 92033 POLICY NUMBER ACP7820661049 CONFERS NO RIGHTS UPON THE CERTIFICAk HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE COMPANY AALLIED GROUP INSURANCE PROPERTY DAMAGE EACHOCCURRENCE AGGREGATE __ LETTER COMPANY B INSURED LETTrR ZHAMBERS ELECTRIC, INC . COMPANY s s s .O. BOX 2156 MARCOS, CA 92079 - LmER COMPANY D - LEllER I I E COMPANY I THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR ME POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR THER DOCUMENT WITH RESPECT TO WHICH MIS CERTlFlCAtE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DES8RIBED HEREIN IS SUEUECT TO ALL ME TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POUdES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. I ANY AUTO ALL OWNED AUTOS HIRED AUTOS NOKOWNED AUTOS WAGE LIABILITY ACP7820661049 ' EXCESS UABILIW UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKER'S COMPENSATlON AND EMPLOYERS' LlABlUTY OTHECONTR LIC BOND 7900594304 I XlCY EFFECTIVE W (MmW) 6/23/02 6/23/02 6/01/00 WCY EXPIRATION A= (MMIMXW) 6/23/03 GENERALAGGREGATE $ 2,000,000 UMrrS PROWCTSCOMPIQPAQQ. $ 2,000,OO PERSONAL&AoV.lNJURY S 1,000 00 EACHOCCURRENCE 5 1,000,000 50, OOC FIRE DAMAGE (Any me Hre) MED.MP. (Any one person) $ 5,OOC 5 (Per accident) EACH ACCIDENT DISEASE-F'OLICY UMlT IS IDISEASE-EACH EMPLOYEE Is I 5/01/02 $7500 CITY OF CARLSBAD 1635 FARADAY Am. CARLSBAD CA 92008 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUINQ COMPANY WlLL ENDEAVOR TO MAIL In DAYS WRllTEN NOTICE TO THE CERTIFICATE HOLDER NAMEO TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPR