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Home My WebLink About2153 SALK AVE; ; CB983620; PermitBUILDING PERMIT 10/21/98 13:52 Page 1 of 1 <^\ $ 3 Job Address: ,bb*y t LHM1 "CT Permit Type: ELECTRICAL Parcel No: Valuation: r 0 Occupancy Group: Description: TEMP POWER POLE Permit No: CB983620 Project No: A9804716 Development No: Suite: Lot#: Reference*: 10/21/98 0001 01 02 2°"°° Appl/Ownr : TEMP POWER SYSTEMS 750 N CITRACADO PRKWY ESCONDIDO CA 92025 _„„. - *** Fees Required *** ^f^" *** Construction Type: NEW Status: ISSUED Applied: 10/21/98 Apr/Issue: 10/21/98 i Entered By: JM 760 439-1999 Fees: Adjustments: Total Fees : Fee description Fees^Collected & Credits _. *** . 00 .00 20.00 Ext fee Data Enter "Y" for Enter "Y" for Rem^de-i-O. 10.00 Y 10.00 Y FINAL APPROVAL INSP.DATE CLEARANCE, CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760)438-1161 1. PROJECT INFORMATI FOR OFFICE USE ONL PLAN CHECK NO. 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. Totnl 9 of units Assessor's Parcel Existing Use Proposed Use Description of Work 2. CONTACT PERSON (If different from appilcent) SO. FT.#of Stories f of Bedrooms # of Bathrooms Name 13. APPLICANT Contractor Address lent for Contractor City 3 Agent for Owner State/Zip Telephone 9 Fax tt Name ;4. PROPER?YOWNER ^ Address City State/Zip & f S^ * >1 Telephone * L& City -s*TI— *"*** State/Zip Telephone fName Address 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 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. ^ijsijViolation erf Section 7031.5 by any aopjicant for a perrnilsubjects the applicant to a civil penalty_pf notmore than JJve hundred dollars ($5001). Name State License t> Address License Class City State/Zip City Business License * Telephone * o e C«rl •^issued. 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: Q 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. 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 cpjnpensationJnsurance carrier and policy number are: Insurance Company C.&HJJJT- \~sV*4ts4(^if~*f C^P Policy No. rC> /7C/Q<O7/S~>^ Expiration Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS l$100] OR LESS) ' * Q 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' confpensation coverage Is unlawful, and shall subject an employer to criminal penalties and civil flnea up to cine hundred thousand dollars (SIOO.OOQJ/lnaddltlpn to/the cost of compensation, damages aa provided for In Section 3706 of the Labor/bde. interesting attorney's fees. SIGNATURE /jj&/^£{S<!Xs&£. .. DATE. 7. OWNER-BUILDER DECLARATION , r - . , 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). Q 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 Lew does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractorls) licensed pursuant to the Contractor's License Law). n 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): or/ode, Interu / 7 4. 1 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 y\KMMWSffle\r7Mi: BUI^^ 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 D 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 Q 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. CONSTRUCTION LENDING AGENCY " '.'-•-•.--.:-- • T« ,--r-.™-t +*r «•„.-*, .-.- .-. .. „ „,- ., .,.^,,;. .,,.., ._......... I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 30970) Civil Code). LENDER'S NAME LENDER'S ADDRESS !9/: 'APPLICANT CERTIFICATION !::" "'•' ""—•': • ?:=: :;raf r f ^TI'"'^ ™S^^ f^ff-a-'-'- •?"•* "•':"! J:'"; '•"'•"•'':"••' '"• -V • - :' 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 witttin 365 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 worXjS corDfne/lceji for a period of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE WHITE: File YELLOW: Applicant PINK: Finance PERMIT* CB983620 DESCRIPTION: TEMP POWER POLE TYPE: ELEC JOB ADDRESS: 2153 SALK AV APPLICANT: TEMP POWER SYSTEMS CONTRACTOR: OWNER: REMARKS: C/BOB/439-1999 SPECIAL INSTRUCT: CITY OF CARLSBAD INSPECTION REQUEST FOR 11/13/98 PHONE: PHONE: PHONE: INSPECTOR AREA PLANCK* CB983620 OCC GRP CONSTR. TYPE NEW STE: LOT: 760 439-1999 INSPECTOR TOTAL TIME: CD LVL DESCRIPTION 32 EL Const. Service/Agricultural ACT COMMENTS DATE DESCRIPTION ***** INSPECTION HISTORY ***** ACT INSP COMMENTS AJQBD- CERTJHCA¥Js OF UABIMTY INSURANCE <&jaijg Dodge Warren & Petera - ORAHOE 765 The City Drive, Suite #300 Orange CA 92868- Glenn L. Bcoan .. 714-748-0464 714-748-0474 Temp Power 8y*t 1111 V. SuBtin AnaheiJi CA 92806 Inc. DATE IMM/OO/YVJ 10/01/98 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. COMPANIES AFFORDING COVERAGE COMPANY A Continental Casualty Company COMPANY B COMPANYc COMPANY D THIS IS TO CERTIFY THAT THE POLICES 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 POLICES DESCRIBED HEREM IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDmONS OF SUCH POLICES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTH FOUCY BHHbCHVC OATEMM/DO/VY) POUCVEXHRATION DATEMWDD/VY)UMTS GENERAL AGGREGATE COMMERCIAL OBIEBAL LIABILITY I CLAIMS MADE | | OCCUR OWNER'S & CONTRACTOR'S PROT PRODUCTS • COMP/OP AGO PERSONAL & AOV INJURY EACH OCCURRENCE FIRE DAMAGE (Any ono fire) MED EXP lAny on* person) AUTOMOBILE LIABILITY AMY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS COMBINED SINGLE LIMIT BODILY INJURY BODILY INJURY (Par «ccidmt) PROPERTY DAMAGE OAfiAaE Luoarrv AUTO ONLY • EA ACCIDENT ANY AUTO OTHER THAN AUTO ONLY: EACH ACCIDENT A6GRE6ATE EXCCU LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM EACH OCCURRENCE AOOREOATE LUBUTY THE PROPRIETOR/ PARTN ERS/EXECUTIVE OFFICERS ARE: IWC STATIC! I TORY LIMITS I IOTH-IER EL EACH ACCIDENT INCL EXCL 1079802954 10/01/98 10/01/99 t1,000,OOP a DISEASE - POLICY LIMIT 11,000,000 a DISEASE • EA EMPLOYEE 1,000,000 *except 10 days notice for non-payment of premium REt Licence HO. 483443 OOHES8T COMTKACTORS 8ZAIK 1.ICKNBE BOAXO P.O. BOX 260OO SACRAMENTO CA 95826 CANCELLATION -, ' SHOULD AW OF THE ABOVE DGtCMBED POLICIES BE CANCELLED •EFORC THE BXraWTION DATE THEREW. THE mtmo COMPANY WALL ENDEAVOR TO MAIL *30 DAYS MMTTBI NOTICE TO TW CEflTVICATE HOLDEA NAMED 1FO THE LEFT. •UT FAILURE TO HMO. BUCK NOTICE SHALL MPOAE NO OBUOATIOM Oil UAMUTY OF ANY HMD UPON THE COMPANY. IT* AOENT* OR REMESENTAHVEIl. AUTHORIZED REPRESENTATIVE Glenn L. Roman .BOULEVARD EX: t4" A.C>. 4