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Home My WebLink About2193 CAMINO ROBLEDO; ; CB981632; PermitT\ Permit No: CB981632 Project No: A9802173 Development No: * BUILDINGPERMIT 05/28/96 Otf:37 Page 1 of 1 Job Address: 2193 CAMINO ROBLEDO Suite: Permit Type: ELECTRICAL Parcel No: Lot#: Valuation: 0 Construction Type: NEW Occupancy Group: Referenced: Status: ISSUED Description: TEMPORARY POWER POLE Applied: 05/28/98 : LA COSTA VALLEY/STANDARD PACIFIC „,,„ ABt/l£5Ufi: 05/28/98/HO (.-OS/of/ 9s uufil 01 0 Appl/Ownr : POWER PLUS 839-9430 C-^ffT 436 N QUINCE ST ESCONDIDO CA 92025 *** Fees Required *** ^tfHIHBHBfi^^Collected & Credits *** 20-00 Fees : Adjustments: Total Fees: Fee description Enter "Y" for Elect Enter "Y" for Tempo 20 . 00 . 00 20.00 Ext fee Data 10.DO Y 10.00 Y FINALAPPROVAL INSP. OLcAHANCE CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION CJTY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760)438-1161 1. PROJECT INFORMATION FOR OFFICE USE ONLY PLAN CHECK N0._ EST. VAL. Plan Ck. Deposit Validated By Date Address (Include BIdg/Suite f}Business Name lit this address) Legs! Description Lot No.Siftolvtolwi Name/Number UnttNo.Phase No.Totil * of unit* Assessor's Parcel *Exteting Use Proposed Use Description of Work 2. CONTACT PttSbNilroWerint from; SQ.FT.fof Stories f of Bedrooms * of Bathrooms Nsms Address i3, APPLICANT D Contractor _^Ap*nt for Contractor Crty State/Zip Tetephone f " ™ ' " fctf) izy-m/4 Fax # Name PROPERTY OWNER Address 7210 City State/Zip Telephone * $0, Address Crty State/Zip Telephone fName S. CONTRACTOR - COMPANY NAME (Sac. 7031.5 Business and Professions Coda: Any City or County which requires a permit to construct, attar, Improve, demolish or repair any structure, prior to Its issuance, also requires the eppllcant for such permit to file a signed statement that ha to licensed pursuant to the provisions of the Contractor's License Law (Chapter 9, commending with Section 7000 of Division 3 of the Business snd Professions Cods) or that ha to exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031 .S by any applicant for a permit subjects the applicant to a, crytt penalty of not more than five hundred dollars (9500I). Mi' Name State License f Address License Class City State/Zip, Cfty Business License f Designer Name Address City State/Zip Telephone State License * 6. WORKERS'COMPENSATION '" '. .""' " "'. "* .""';" "~-~^-'"T~^'"~^~&^-^>w'^™& -• ": '-;*.-' "l!'"'i Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: D I have and will maintain a certificate of consent to self-Insure for workers' compensation a* provided by Section 3700 of the Lebor Code, for the performance of the work for which this permit is issued. Q 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'a compensation Insurance carrier end poNcy number are: Insurance Comoanv f^tffrT*^ 3^US. &r& Policy No. <_ Expiration Dele (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1*100) OR LESS) Q CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which thto permit to issued, I shaft not employ any person In any manner ao aa to become subject to the Workers' Compensation Lews of California. WARNING: Fadure to aeewv workers' compensation enrerage to unlawful, and shall subject an employer to criminal penalties end ctvd fines up to one hundrad thousand ddtora (*10ttWWMkffDdh1an to the Met of&mpanaation, damagea ee provided for hi Section 3700 of the Labor oode^lrrt^t**! and attorney'a foee. SIGNATURE {S°££s*-~Cf ""^C-yT*^^ DATE . f' 7. ' OWNER-BUILDER DECLARATION & '"' """" "' "."*• "."*' ^V'SBfiF^y*?• I hereby affirm that I am exempt from the Contractor's License Lew for the following reason; Q I, as owner of the property or my employees with wages aa their sole compensation, wffl do the work end the structure to not Intended or offered for sale (Sac. 7044. Business and Professions Code: The Contractor's License Law does not apply to an owner of property who buHda or Improves thereon, and who does such work himself or through his own employees, provided that such Improvements era not Intended or offered for sale. If, however, the budding or Improvement to sold within one year of completion, the owner-bunder wffl have the burden of proving that he dW not buHd or Improve for the purpose of aale). D I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Profeasiona Code: The Contractor's License Law does not apply to an owner of property who budda or improves thereon, and contracta for aueh protects with ccntreetor(a) Bcensed pursuant to the Contractor's License Law). Q I am exempt under Section Business and Professions Code for thto reason: 1. I paraonally 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 budding permit for the proposed work. 3. t have contracted with the following person (firm) to provide the proposed construction Dndude 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 / addraas / phone number / contractors license number): 5. I wiN provide some of the work, but I have contracted (hired) the following persons to provide the work fndteated (Include name / address / phone number / type of work);_ • ' •-. . DATEPROPERTY OWNER SIGNATURE 'OTMHiTeTHWSECTMroRrtO^ to the applicant or future budding occupant required to submit a business plan, acutely hazardous materials regtoliaUoH form or risk management and prevention program under Sections 2650S, 2BB33 or 2BS34 of the Presley-Tenner Hezardoua Substance Account Act? D YES Q NO Is the applicant or future budding occupant required to obtain a permit from the air pollution control district or «r quaftty management district? Q 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 Affl POLLUTION CONTROL DISTRICT. IB."" CONSTRUCTION LENWNG AGENCY ^w^r^-;-•>--*?? ^^TITm^TTT1*1^1"^ -rv^r-v--^-- • • •• —-•.-- . - ; •,--. , I hereby affirm that there to a construction lending agency for the performance of the work for which thto permit to issued (Sec. 30870) ClvH Code). LENDER'S ADDHESSLENDER'S NAME »'; 'MpHKAiTcfcrrsncOTl^ I certify that I have read the application and state that the soove Information to correct and that the Information on the plans to accurate. I agree to comply wrth ad City ordinances and State laws relating to budding construction. I hereby authorize representatives of the Ott of Cartobsd to enter upon the above mentioned property for Inspection purposes. I ALSO AGREE TO SAVE. MDCMMFY 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 to required for excavations over S'O" deep and demolition or construction of structures over 3 stories In height. EXPIRATION: Every permit issued by the Budding Official under the provisions of this Code shed expire by dmitatfon and become null and void if the building or work authorized by such permit Is not commenced within 365 days from the date of such permit or if the buHdmg or work authorized by such permit to suspended or abandoned at any time after the wofty commenced for<ft#erV# of 1BO deys (Section 106.4.4 Uniform BuHdtng Code). APPLICANT'S SIGNATURE DATE WHITE: FHe YELLOW: Appdcant PINK: Finance CITY OF CARLSBAD INSPECTION REQUEST PERMIT! CB981632 FOR 06/04/98 DESCRIPTION: TEMPORARY POWER POLE LA COSTA VALLEY/STANDARD PACIFIC TYPE: ELEC JOB ADDRESS: 2193 CAMINO ROBLEDO STE: APPLICANT: POWER PLUS PHONE: 839-9430 CONTRACTOR: PHONE: OWNER: PHONE: REMARKS: C/MICHELE/839-9430 SPECIAL INSTRUCT: TOTAL TIME: CD LVL DESCRIPTION 32 EL Const. Service/Agricultural INSPECTOR INSPECTOR AREA PLANCK* CB981632 OCC GRP CONSTR. TYPE NEW LOT: ACT COMMENTS DATE DESCRIPTION ***** INSPECTION HISTORY ***** ACT INSP COMMENTS P. BE OKIE CRfPCAl HOMTH j**m Q«r«re OKMND CL£WMNGK OR: IMC im LPCATIMI oy CALL MOVE PMOUC t KM IWrasnQH OF TW GQUMffiNT UtlUTltt MMMW eOHTmttmoHTD FWLT TGTflL **.BZ 5-26-1998 1=06PM FROM P. 4. MM Wfflflfitt Ytt SH-l iu.t 5 ft feray Cwportttwi dwtPowcr tility itrviea* SwuMn* tfty , C* fZloe HWI •«*< «mo TOTHC n » fife MMirti't>n»t «m 'tHi Mumc iwap)Oaoflm<»fr <nmnBCT>^gTTOw«oH-*H» •m; •V1M MUOV* ORK»IM»l«Vnai aUMCTIOMi 1MB TCAMI. v»m cum* MX* UMMAt * Ma.CW051H02 1.000,000 <7»D «ppHto to th* cert, Hold«r rH«MCt to Mployew Mrvtf by 4 fnclutfaf on th* payroll «f th« fMM tor t*w Add*l !*>». All opMTBVUHiS of »w Nw*4 Xrtcurwt. 10 rf^y ndt<c* of M In.., but perform* no for TttDMtf4 turlcson tt«c1fle Crmip150!* Cool