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Home My WebLink About2213 CAMINO ROBLEDO; ; CB981170; PermitBUILDING PERMI 04/22/98 12:32 Page 1 of 1 Job Address: 2213 CAMINO ROBLEDO Suite Permit Type: ELECTRICAL Parcel No: Lot#: Valuation: 0 Occupancy Group: Reference*: Description: TEMPORARY POWER POLE-VILLAGE : P-KAUFMAN & BROAD T Permit No: CB981170 Project No: A9801542 Development No: 6321 04/22/98 0001 01 02 C-PRMT 20-00 Construction Type: NEW Status: ISSUED Applied: 04/22/98 Apr/Issue: 04/22/98 Entered By: RMA Appl/Ownr : TEMPORARY POWER SYSTEMS 750 N CITRACADO PKWY ESCONDIDO CA 92025 *** Fees Required *** 760 439-1999 Collected & Credits Fees : Adjustments: Total Fees: Fee description 20 Enter "Y" for Elect Enter "Y" for Tempo * * A FINAL/APPROVAL INSP: .00 . 00 20.00 Ext fee Data 10.00 Y 10.00 Y 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 'SA/0 FOR OFFICE USE ONLY PLAN CHECK NO. °(& i\~] O EST. VAL. Plan Ck. Deposit Validated B Date Address (include Bldg/Suite #}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 Work SO. FT.#of Stories # of Bedrooms t of Bathrooms Name Address City State/Zip Telephone # '^5*atox^>^cT'''' Fax* Name Address City State/Zip Telephone # Name Address City State/Zip Telephone # (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 issusnce, 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 Coda) or that he is exempt therefrom, and the basis for the alleged exemption. Anyjoojation of Section 7031.5 by any applicant^or/jpermit subjects t^applicant to a civil penalty of not morejhen fiyj hundred o>!ars,[*5QOJl •>*£bfbo Name State License # Address License Class -. /& City State/Zip City Business License * Telephone # Designer Name State License # 8. WORKERS'COMPENSATION Address Crty State/Zip Telephone 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. Js^**! 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 (^^T"C^f'-J^-t^ftP^A^X/'fr~y_ Policy No. ^ftyOrj^ ^ff*^^~ Expiration Date_ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [»100I 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' ^compensation coverage la unlawful, and shafl subject an employer to criminal penalties and dvfl fine* up to one hundred thousand dollars (tlOBJbOOjJn addrtioA to the cost of compensation, damage* aa provided for hi Section 3706 of the Ls£o/code, jrtterwt and attorney's fees. SIGNATURE sl£0f~ &CskLfts£ DATE _ 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 aale (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 heve the burden of proving that he did not build or improve for the purpose of sale). D 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^ licensed pursuant to the Contractor's License Law). Q I am exempt under Section Business end 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. t (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 neme / address / phone number / type of work): _ _ PROPERTY OWNER SIGNATURE DATE .bttfeHJIafttli^^ 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 26534 of the Presley-Tanner Hazardous Substance Account Act? Q YES Q NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality 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 G 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(11 Civil Code). LENDER'S NAME _^__^_ LENDER'S ADDRESS 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, t agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the Crty 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 end 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 36ff days from the date of such permit or if the building or work authorize/*by such^formit is suspended or abandoned at any time after the woj^JKjojp^Anced/or a period of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE WHITE: File YELLOW: Applicant PINK: Finance CITY OF CARLSBAD INSPECTION REQUEST PERMIT! CB981170 FOR 04/23/98 INSPECTOR AREA DESCRIPTION: TEMPORARY POWER POLE-VILLAGE PLANCK* CB981170 P-KAUFMAN & BROAD OCC GRP TYPE: ELEC CONSTR. TYPE NEW JOB ADDRESS: 2213 CAMINO ROBLEDO STE: LOT: APPLICANT: TEMPORARY POWER SYSTEMS PHONE: 760 439-1999 CONTRACTOR: PHONE: OWNER: PHONE: REMARKS: C/BOB/439-1999 SPECIAL INSTRUCT: TOTAL TIME: CD LVL DESCRIPTION 32 EL Const. Service/Agricultural INSPECTOR COMMENTS DATE DESCRIPTION ***** INSPECTION HISTORY ***** ACT INSP COMMENTS is IMP »AS Mffim fat AsasMHi BUMP air. xomitmaAaiaFaiMACcuutry Mnuncm Aataars mm* my MM com an loan smuyigai« wooucra Milestone Insuranci 8 Corporate Park, < Irvine, CA 92714-5: {714)852-0909 PaxC •MUMD Temp Power Systems 1111 N. Tustin Avei Anaheim, CA 92807 THIS CERTIFICATE K CONFERS NO RIGHTe Agency DOES NOT AMEND, |X30 POLICIES BELOW. 1 ISSUED AS A HATTER OF INFORMATION ONLY AND S UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE EXTEND OR ALTER THE COVERAGE AFFORDED BY THE LOS COMPANIES AFFORDING COVERAGE 714)852-1131 : fjfSf* A California Indemnity Ins. COM! LETT PANY Qm ° me .' COMPANY nLETTER u COMPANY c LETTER c Co. THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WTTH RESPECT TO WHICH THIS CERTIFICATE 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR A TIM. of •wufUNca QOflPttL UAWUTY COMMERCIAL GENERAL UABUTY '"• ::;;- ! CLAIMS MADE 1 : OCCUR. OWNER'S « CONTRACTOR'S PROT. AUTOMOMJI UAMUTY ] ANY AUTO } ALL OWNED AUTOS ! SCHEDULED AUTOS I HIRED AUTOS j MOH-QVWED AUTOS j GARAGE UABUTY j UMBRELLA FORM ! OTHER THAN UMBRELLA FORM AND EMMOVBtS' UABUTY OTHBI RE: License 4834 *10-dav notice oi $\ POLICY NUMBER N 6044720C POUCY tVHLIIVE DATE {MMDOffV) 10/01/97 KUCV EXHRATION DATE(MM/DOffY) 10/01/98 » GENERAL AGGREGATE PRODUCT&COMP/OP AQ3, PERSONAL ft ADV. MJURY EACH OCCURRENCE PTC DAMAGE {Any one to) MED. EXPENSE (Any om ptrwn) COMBMEDSMQLE UMtT BOM.Y INJURY (Ptf pmon) BOOLY INJURY (Ptf KCUWlQ PROPERTY DAMAGE EACH OCCURRENCE AGGREGATE 3J 1 STATUTORY UMTTS EACH ACCIDENT DISEASE - POUCY LJMTT DISEASE - EACH EMPLOYEE s i ft $ s » $ s s s s s s 1,000,000 $ 1,666,006 s 1,000,000 &CMKCUL mm 143 : CANCELLATION in the event of non-roavment of roremium fg^^ffeft-^fe:<tiJi!ftiiNiltf4iiw:^^ Contractors State L: P.O. Box 26000 Sacramento, CA 9582( ^^^^^^^^^^^^^^^^^^^^^^^^^^^^ S SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE II EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO j| MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE .cense Board |i LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR |j LIABILITY OF ANY WHO UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. ' J!|AUTHORIZED REMCMHTATIVE ^ u^^<^ j^j^B^i^i^i^P