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Home My WebLink About2100 COSTA DEL MAR RD; ; CB000294; Permit01/31/2000 City of Carlsbad Electrical Permit Permit No CB000294 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 2100 COSTA DEL MAR RD CBAD ELEC Lot# LA COSTA GOLF EVENT ELEC UTILIZING SHORE POWER Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 01/31/2000 JM 01/31/2000 01/31/2000 Applicant EDLEN ELECTRICAL 1844 IMPERIAL AVENUE SAN DIEGO CA 921 02 619-696-7762 / Total Fees $40 00 //j/ IElectric Issue Fee i 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 Owner— -_ ,-.-'"'/,--J r\/' <C, iv /Q\ / /--•*. '<•' ^'J(s~> \/ if MY> ~ - / v>-:// ^ ' x"^-, -,-i\ / ^2^.. ;\- A., Total Payments To Dale"' \x i-^r / ^-^^^S:i n ; x °yy\:---/ i M/V ^^- ^\ ^-, rjip i IPi T\^ --;_/^p_ \ rf ii \ \x " &oC> \gx-f f \ ""^ /0N-"i. \^='JI (-3'. \ / __/ O-/> y /;.^~-<N \" INCORF.JRAT^D '\ / i' "•"" '^-. "9'F2\ ->> .•;•"; "---.-... w_.--\x ^ <} 1 ,~. •• — • — \ '""x' / // /'/--, „-.,. (-:; ""--.. _ "^-s»V^ \ /VM \ //^// \ \\ / / s~^ \v! / . \ \.. \:),, i (xj \^X \^>)^. \-^ \ ~~y"^o] N $0 00\ V^:/j3alahce Due $40 00 '^..f^^/ \ ^~\v} \^ •--/' \ // \ /^ //?; ' r" ; S .....-< :-^i' ] i '^-8795 ^^§?/00 0001 01 02 /W\T-n $000 C-PRMT 40-00( / .oW v / ,$o oo >> -g^ i /$Q OQ >'^' / / $0 00 / /$1000 /' (^ / $000 •""' rA.Vy" / $000 x"'^ W ' / $2000 TOTAL PERMIT FEES PERMIT PERMIT HAS EXPREDW ACCORDANCE WITH U.B.C. $4000 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 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 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 you have previously been given a NOTICE similar to this or as to which the statute of limitations has previously otherwise expired CITY OF CARLSBAD 2075 Las PalmasDr, Carlsbad, CA 92009 (760)438-1161 PERMIT APPLICATION ., » CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 PjtOJECf INFORMATION FOR OFFICE USE ON PLAN CHECK NO EST VAL Plan Ck Deposit Validated Date ^~TA/V Address (include Bldg/Su/te .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' 12\ "' CONfACT PERSON (if different from applicant) SQ FT #of Stories tt of Bedrooms tt of Bathrooms Name.. .,3 :. APPLICANT OiContractor CltY _>i <£>i State/Zip^^/j^reJephone tt Fax , ft' '^AgehOor'Owner1'"::"r *" *"'*"! " "f; ' ': ,, ^&/K?,.6f9& ~ " " '"- 7/£ Name 4 PROPERTY OWNER :! Address City State/Zip Telephone i Address City State/Zip Telephone #Name B. ..CONTRACTOR ..... COMPANY NAME i« ;:i. , ..... I.. ^ :£f V'"" :'l \ ", "" *" rffi[ ....... '- " ":: 2S5 :- f..: * >J-'i '"" 4 ... .,":?' .. (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 applicanOo a civil penalty of not more than five hundred dollars [$500]) Name State License tt Address License Class C-/D City ^ State/Zip City Business License tt TelephoneDesigner Name Address City State/Zip State License tt 6: "WORKERS COMPENSATION >•..••" ""••'' >, .fc-{ ": A.J:^ ,'3 ,JP:::....JhL ..,.?.- „>. '•., J ^ ..> -^ ..." . -i., • ...'".:; Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations ^f 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 /ofthe work for which this permit is issued D 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 JS/r/9/~€- C^bffl/X'AjSftnQ^J "&(& H/WQ po|lcy No Q(^S~~O^ Expiration Date Of—Q/^O/ (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 secure workers compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($106 000) in addition to the cost of compensation damages as provided for in Section 3706 of the Labor code interest and attorney s fees 7 ' OWNER BUILDER DECLARATION' '""' ; \j; ' • ••- ,? ; «i: : : •*... f 1 hereby affirm that I am exempt from the Contractor s License Law for the following reason l~l 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) CD 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) CD 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 CD YES CDNO 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 /?fS/p£/y77X>i BUILDING PERMlfSlQNliY/ :!"Z....I.. iiU, " * "' i!.':' i , ~ 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 CD NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? CD YES CD NO Is the facility to be constructed within 1 000 feet of the outer boundary of a school site? [] YES CD 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 I8.;.s CONSTRUCTION LENDING AGENCY :, ' ,,;•..,:..,, , "A „,.....it 2Esi'Jl ••''., ';5iil,,. ... "^:?3" JT .. ''• ''<•' L "., ?;.„•£':: •' '" 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 9 APPLICANT CERTIFICATION ... :.,,. J:rt: * ""I - :,.^'\ ,., ... • .,,"", A,.sS- ......<.i:..,,i ... ,*. ,:,,,,..,,:, ...„•.,., ,.:; X, •; " ° 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 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 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^fbr a period of 180 days (Saction 106 4 4 Uniform Building Code) APPLICANT S SIGNATURE XJLW-X?/S^-lV /,~ 'X^£*-C£> DATE WHITE File YELLOW Applicant PINK Finance 01/31/00 MON7 11 25 FAX 702 385 1810 EDLEN LAS VEGAS EDLEN SAN DIEGO 0001 NA COMPENSATION INSURANCE FUND PO BOX 807 SAN FRANCISCO CA 94101-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE 01-01-00 SAN DIEGO UNIFIED PORT DISTRICTC 0 SAN DIEGO CONVENTION CTR CORP 111 W HARBOR DRIVE SAN DIE'GO, CA 92101-7899 'POLICY NUMBER 04&-00 UNIT 0007089 CERTIFICATE EMPIRES 01-01-01 This is to certify that we have issued a valid Workers Compensation insurance policy in a from approved by the California Insurance Commissioner to the employer named below for the policy period indicated This pohcv 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 COSTSi $1,000,000 00 PEA OCCURRENCE ENDORSEMENT #2085 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE O1/O1/OO IS ATTACHED TO AND FORMS A PART OF THIS POLICY EMPLOYER LEGAL NAME EDLEN ELECTRICAL EXHIBITION 5ERVOF CALIFORNIA, INC3010 BUILDERS AVE LAS VEGAS MV 891OT EOLEN ELECTRICAL EXHIBITION SERV OF CA PRINTED 12-18-9S P0410