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Home My WebLink About218 PINE AVE; T.P.P; CB031523; Permit06-03-2003 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Electrical Permit Permit No: CB031523 Building inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: Project Title: 218 PINE AV CBAD St T.P.P ELEC 2032501100 Lot#: AYOUB APTS. TEMP POWER POLE Status: Applied: Entered By; Plan Approved: Issued: Inspect Area: ISSUED 06/03/2003 SB 06/03/2003 06/03/2003 Applicant S S A 1988 TRUST 05-31-88 3003 GLENBROOK ST CARLSBAD CA 92008 Owner: S S A1988 TRUST 05-31-88 3003 GLENBROOK ST CAlU'SBAD CA 92008 ,6457 06/03/03 0002 01 02 CGP 20-00 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 $10.00 ■$0.00 $0.00 $0.00 $0.00 $0.00 $10.t)0' . $0.00 $0.00 $0.00 .$20.00 Total Fees:$20.00 Total Payments To Date:$0.00 Balance Due:$20.00 inspector FINAL AR Date:Clearance: NOTICE: Please take NOTICE ttiat appnova! of your project Includes ttie "imposition" of fees, dedications, neservatlons, or ottier exactions hereafter collectivety 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 mustfollow the protest procedures set forth In Government Code Section K020(a), and file the protest and any other requied Information with the City Manager forprocessing 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 ate hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacitychanges, 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 vou have orevlouslY been olven a NOTICE similar to this, or as to which the statute of limitations has DfevlousiY othetwtee exPiied, PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 i oi k PROJECT INFORMATION FOR OFFICE USE ONLY PLAN CHECK NO. EST. VAL. Plan Ck. Deposit ValldatecL Date j late^By. Address (InGliida BIdg/Sulta.#! . ^ j ^ .■Si.^ cy ^Business Name (at this address) Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Total # of units Assessor's Parcel tt Existing Use Proposed Use Description of Work , 2. CONTACT PERSON flf dHferent frojn appUcaniIt from appUcant SQ. FT.#of Stories # of Bedrooms # of Bathrooms l .^ V D rS Name ' Address City :3. APPLICANT □ Comraotof □ Agent for Contractor □ Ownar P Agent for Owner State/Zip Telephone #Fax # ' Name Address City State/Zip Telephone # "3 ig a? ^ ^ -p- ^yS /\ City State/Zip Telephone 9 ® 4. PROPERTY OWNER y9-yP(^S Name Address B. CONTRACTOR - COMPANY NAME (Sec. 7031.5 Business and Professions Code; Any City or County which requires a permit to constnjct, after, improve, demolish or repair any structure, prior to itsIssuance, also requires the applicant for such permit to file a signed statement tfiat he is licensed pursuant to the provisions of the Contractors 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 allegedexemption. 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 (JBOOl). Name State License # Address Licerrse Class City State/Zip City Business License 9 Telephone 9 Designer Name Address City State/Zip Telephone State License 9 6. WORKERS' COMPENSATION 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. □ 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 Policy No. Expiration Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS) □ CERTIFICATE OF EXEMPTION: I certify ttiat 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: FaDure to secure workers' compensation coverage Is unlawful, end shall subject an employer to crfmlnal penalties and dvfl fines up to one hundred thousand dollars (4100,000), In addition to tfie coat of compensation, damages as provided for In Section 3706 of tfta Labor code. Interest and attorney's fees. SIGNATURE_ DATE 7. OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: 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 fo> 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 Wmself or through his own employees, provided that such Improvements are not Intended or offered for sale, if, however, the building or Improvement is sold witWn one year of completion, tlie owner-builder will have the burden of proving that he did not build or Improve for tfie purpose of sale). 0^I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: TheCorrtractor's License Law does not apply to an owner of property who builds or improves tiiereon, and contracts for such projects with contractor(e) licensed pursuant to the Contractor's License Law). I~l I am exempt under Section Business and Professions Code for this reason: □no1. I personally plan to provide the major labor and materials for construction of the proposed property improvement 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 / addre^ / phone number / contractors license number):y: a £> 1 ^ cy> 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); 6. I will provide some of the work, but I have contracted^j^ed) the following persons to provide the work indicated (include name / address / phorw number / type of work): PROPERTY OWNER SIGNATURE DATE J / O COMPLETE THIS SECTION FOR NON-RBStDBTnAL BUILDINQ PERNUTS ONLY 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 25E06, 26533 or 26634 of the Presley-Tanner Hazardous Substance Account Act? □ YES □ NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? □ YES □ NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ YES □ NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIHCATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPUCANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFHCE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. 8. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit Is Issued (Sec. 3097(1) Civil Code). LENDER'S NAME LENDER'S ADDRESS 9. APPUCANT CERTIFICATION i certify that I have read tiie application and state that the above information Is correct and that the information on the plans is accurate, i agree to comply with ail City ordinances snd 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 UABILITIES, 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 6'0' deep and demolition or constiuction of structures over 3 stories in height. EXPIRATION: Every permll Issued by the building OfMai under the provisions of this (3ode shall expire by limitation and become null and void If the building or workauthorized by such permit Is not commerx^d wlthlrt4^^days from the date of such permit or if the building or work authorized by such permit Is suspended or abandoned1 /at any time t 'er the work Is commenced for a^g^nda oj>eo days (Section 106.4.4 Uniform Building (Code).jC^ APPLICANT SIGNATURE^ ^ DATE WHITE: Ria YELLOW: Applicant PINK: Rnance City of Carlsbad BIdg Inspection Request For 06/04/2003 Permit# CB031523 Title: AYOUB APTS. TEMP POWER POLE Description: Inspector Assignment: JM Type: ELEC Sub Type: Job Address: 218 PINEAV Suite: T.P.P Lot 0 Location: APPLICANT 8 8 A1988 TRU8T 05-31 -88 Owner: 8 8 A1988TRU8T05-31-88 Remarks: Phone: 7607225400 Inspector: Total Time:Requested By: MR AYOUB Entered By: CHRI8TINE CD Description 32 Const 8ervlce/AgrIcultural ^t Comment , / Associated PCRs/CVs Inspection History Date [^escrtptlon Act Insp Comments