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Home My WebLink About2250 ALTISMA WAY; MP; CB071969; Permit07-26-2007 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Electrical Permit Permit No: CB071969 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: Project Title: 2250 ALTISMA WY CBAD St: MP ELEC Lot#: AT&T: 100 AMP MET. PED. Status: ISSUED Applied: 07/26/2007 Entered By: JMA Plan Approved: 07/26/2007 Issued: 07/26/2007 Inspect Area: Applicant: ROBINSON ELECTRIC 8871 TROY ST SPRING VALLEY, CA 91977 619-697-6040 Owner: 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 100 0 0 0 $10.00 $25.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $6.00 $0.00 TOTAL PERMIT FEES $35.00 Total Fees:$35.00 Total Payments To Date:$35.00 Balance Due:$0.00 /> Inspector- FINALAPPROVAL 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 capacity 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. PERMIT APPLICATION j CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 ! PROJECT INFORMATIONRMATIONKP 10 FOR OFFICE USE ONLY PLAN CHECK NO. EST, VAL. Plan Ck. Deposit Validated By. Date Address include BIdg/Suite #)/SVr Business Name (at this address) Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Total # of units Existing Use Proposed Use Description of Work . :2.' 'CONTACT PERSON (if different from applicant) SO... FT.!#of Stories # of Bedrooms # of Bathrooms Name Address ; City APPLICANT, > Q Contractor « B Agent,for Contractor Q Owner, jTJ'Agent fof Owner '• State/Zip Telephone # Fax # ,Trou ; INameAddress State/Zip Telephone'* 4, PttOPERtV OWNER 422-1 4t-/2mi Sf.frti/fe f*it\/ ^Name Address City ^ State/Zip B.; 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 exen IIIIIIHI fjeimmea miu I»IVH i the Labor code, interest \ 7/24701 Designer Name Address i . City State/Zip TelephoneiState License 9 • 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. | , Sj 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: ^-A- ^ i A.—? Insurance Company C-UflUgy? "T-VQ' C-D ' P°"CV No. V\}D/n}%l33 Expiration Date lt> " ' ' P"7 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS! [~| 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 ($100,OOOJyfn addition to.the cost ofjcornpeAsEftlork damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. SIGNAT,URE_ ^jftUtttk-Ui <J4^jT^-^ DATE 7," OWNER-BUILDER DECLARATION , /, ' ~* * ''•"<•' I hereby affirm that I am exempt from the Contractor's License Law for the following reason: O 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 ha 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 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). -i r~| | am exempt under Section Business and Professions Code for this reason: 1. | personally plan to provide the major labor and materials for construction of the proposed property improvement. D YES flNO 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): _________^__ I — '• — : : PROPERTY OWNER SIGNATURE DATE COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS 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 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? CD 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? Q YES d 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 . * - ' \ < ,.. - .''' '-." *' ' ' '"' 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, " APPLICANtCERTIFICATION , - ' , „ "• ' ' -r * 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 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 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 trW; 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 witWh 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 for a oeriod oJ 180 days (Section 106.4.^ UrTifofm Building Code). APPLICANT'S SIGNATURE (M?U)/lk\ ^IfJ^TT^-^ DATE City of Carlsbad Bldg Inspection Request For: 08/06/2007 Permit# CB071969 Title: AT&T: 100 AMP MET. PED. Description: Type:ELEC Sub Type: Job Address: 2250 ALTISMA WY Suite: MP Lot 0 Location: APPLICANT ROBINSON ELECTRIC Owner: Remarks: Inspector Assignment: Phone: 619 Inspec Total Time: CD Description 39 Final Electrical Act „ Comment Requested By: KIM Entered By: JANE AN Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act Insp Comments ** gftg. City of CARLSBAD BUILDING DEPT •,''•»';''. >•-;•#''7.V£V^• i "X t'l'Si';. v y •'•;>»!<•,'|C3iS'. •t"V»'Vwis '";^:;i'i:i:y:;;'''v/^;'.'.-,'.-;, ' A'.'.V-, ,s / * ',' ,'•; .<{&{( <. , •i'*i: ,;-'^AR-01-2007 THU 05:11 Pf) CITY OF CftRSLBAD ' '''FflX NO, • 760 602 8558 2.23'07 10'Se/ST. 10:5«/W>. 484975840(1 P ' City of Carlsbad •• Attention: From; AT4T / SBC Construction Jim Srover 7985 Engineer Rd., 2nd Floor SanWeoo. pftone numbdf:asa.26g.2i3 Carlsbad. CA 92008 Phone number: » number _ 760-602-8558 856-276.3980 local no pa0tt induce wvflr Pleas* Comment ^ APN Layout EngiBAer ; ,;/:•>• 'SBC Construction C0'd ^^^B-Oi-2007 THU 05:12 PN CITY OF CfiRSLBAD' m NO, 760 602 8558K r ROM P, 36 P 2 'S0M. $\#p.^Jjjp£i '.... " •"''-~7 #/. /* ,'—-., -/ / * / i >'s^<:- f 17 PI ' H j r -in r CERTIFICATE OF LIABILITY INSURANCE OP ID KS ROBIN-1 09/29/0 PRODUCER ';'•..... Ranctto Mesa Insurance Agency 1810 Gillespie Way, Suite 108 ^1 Cajon CA 92020 'hone: 619-937-0164 Pax:619-937-0168 M «m.T mo cuwt-tris NO HTGHT5 UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAIC# INSURED INSURER A: Cypress Insurance Company INSURER B: Robinson Electric 8871 Troy Street Spring Valley CA 91977 INSURER C:, INSURER D: INSURER E: COVERAGES THE POLICIES 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 OH MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. . IMSM LTH A AUU'LMSB!TYPE OF INSURANCE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY ~ | CLAIMS MADE | | OCCUR GEN'L AGGREGATE LIMIT APPLIES PER:n POLICY nss n<-oc AUTOMOBILE LIABILITY .ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY ANY AUTO EXCESS/UMBRELLA LIABILITY ~~~] OCCUR j ..' [ -CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPHIETOFWARTNEH/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yes, describe under SPECIAL PROVISIONS below OTHER POLICY NUMBER <• ' • ' '•'.••• W6A08133 POLICY EFFECTIVE DATE (MWDD/YYL ,' • -'..•-• .)•••'• • .:._,.:-.. -- . 10/01/06 POLICY EXPIRATIONDATE f MWDD/YY) -'-—-' -.-:;- .10/01/07 UMITS EACH OCCURRENCE UAMAUb lUHbNIhU PREMISES (Ea occurence) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) AUTO ONLY - EA ACCIDENT rvmt=iJTH4N EAACC AUTO ONLY: AGG EACH OCCURRENCE AGGREGATE _ Wt^TArO- UTH-X TORY LIMITS ER E.L EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE- POLICY LIMIT $ . ' •-$ ' • ' $ .$ . '. <; •$'. • s . - • .$ . •*..... " * ••"•'. $ • $ $ • ' • $. . $ $ ". ' • '- • * ': .$.'.. $ 5 1000000 $1000000 $1000000 ESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS IE: ALL OPERATIONS *10 DAY NOTICE FOR NONPAYMENT OF PREMIUM ERTIFICATE HOLDER CANCELLATION CITYCHO" CITY OF CHDTA VISTA 276 FOURTH AVE., BLDG. CHTJLA VISTA CA 92010 DEPT. SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL *30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, 9UT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OH LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. ' ' • '_ AtTTHORgED REPRESEjjyATflfr.) f^~ ~ o. 73rnrnH en'-ore ;5Eo §f> f—I —m. O c O' ^D • p5 10"Z0"^^3c^frj •-rSR^n 5H °2; U3^\kD\ J