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Home My WebLink About2313 CAMINO HILLS DR; ; CB951393; PermitBUILDING 10/03/95 13:00 Page 1 of 1 Job Address: 2313 CAMINO HILLS DR Permit Type: ELECTRICAL Parcel No: Valuation: 0 Occupancy Group: Reference*: Description: TEMPORARY POWER POLE-SHEA HOME Appl/Ownr : PERFORMANCE POWER 9279 CABOT DR, STE F SAN DIEGO, CA 92126 *** Fees Required *** PERMIT Suite: Lot# : Permit No: Project No: Development No: CB951393 A9502032 Construction $- Status: Applied: Apr/Issue: Entered By: NEW 20*00 ISSUED 10/03/95 10/03/95 RMA 689-4092 Collected & Credits * ** Fees : Adjustments: Total Fees: Fee description Enter "Y" for Ele Enter "Y" for Tern * ELECTRICAL TOTA . 00 .00 20.00 Ext fee Data 10. 00 Y 10.00 Y 20. 00 FINAL APPROVAL _ DATE FRANCE CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION City of Carlsbad Building Department 2075 Las Pal«fl Dr., Carlsbad, CA 92009 (619) 438-1161 1. PhHMirTtPE From List 1 (see back) give code of Permit-Type: For Residential Projects Only: From List 2 (see back) give Code of Structure-Type: Net Loss/Gain of Dwelling Units 2. PROJECT INFORMATION PLANCHECKNO. EST.VAt PLAN CK DEPOSIT VALID. BY DATE FOR OFFICE USE ONLY Address Nearest Cross Street LEGAL DESCRIPTION'Lot No.subdivision Name/Number Unit No.Phase No. CHECK BELOW IF SUBMITTED: D 2 Energy Calcs D 2 Structural Calcs D 2 Soils Report D1 Addressed Envelope ASSESSOR'S PARCEL EXISTING USE PROPOSED USE DESCRIPTION OF WORK SQ. FT.# OF STORIES # OF BEDROOMS # OF BATHROOMSTJUPf I «JT rEJttUN (ii aiiierent irom-appiicantj NAME (last name firs!) A/^//x J CITY\^\ 11 (_ APPLICANT STA ADDRESS ZIP CODE DAYTELEPHONE 4. APPLICANT LJCQNTRACluR NAME (last name first) CITY TJW STATE FOR CONTRACTOR Q OWN ^V, ADDRESS ^y ZIP CODE LfACibNl FOR.UWN DAY TELEPHONE 5. PROPERTY OWNER NAME (last name CITY ^'0 STATE ZIP CODE n ADDRESS / f--S)(* <J f DAYTELEPHONE 6. NAME (last name first) c™£.0 DESIGNER NAME (last name lirstj __- ADDRESS 7*7 DAYTELEPHONE STATE UC. »J2&&^7 LICENSE CLASS d CITY BUSINESS UC. */ 7 C? CITY 7. WORKERS' COMPENSATION STATE ZIP CODE DAY TELEPHONE STATE UC. # Workers' Compensation Declaration: I hereby at firm that I have a certificate or consent to self-insure issued by ineDirector of maustnal Relations, or a certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified by the Director of the insurer thereof filed with the Building Inspection Department (Section 3800, Lab. C), INSURANCE COMPANY Od, POLICY NO. -- EXPIRATION DATE Certificate ot Exemption: I certify that m th# perrormance or the work tor whicnthis permit is issued, I shall not employ any person m any manner so as to become subject to the Workers' Compensation Lawn of California. SIGNATURE,L/DATE 5. OWNER-BinUJER meTr-Buiiaer Declaration: T nereoy attirm that ram exempt trom me uintractors License Law tor tne loiiowing reason: I, Downer of the property or my employees with wages as their sole compensation, will do die 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 mat 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.). 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). D I am exempt under Section _ Business and Professions Code for this reason: (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 die provisions of the Contractor's License Law (Chapter 9, commencing 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. 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 [$500]), SIGNATURE DATE CMPLETE l SECTION fOR N ON -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? D YES D NO Is the applicant or future building occupant required to obtain a permit from die air pollution control district or air quality management district? D YES D NO Is the facility to be constructed within 1 ,000 feet of the outer boundary of a school site? D YES D NO IF ANY OP THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED ARER JULY lt 1989 imi£SS THE APPLICANT 11X5 MCT °R J^.^^0.™ .REQUmEMENTS °F ™E OFFtCE O* EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. 9. UUNSiHUlllUN LENDING AGENCY i hereby attirm that tnere is a construction lending agency tor tne performance or the work lor which tnts permit is issued (Sec 3O97UJ uvii uxiej. LENDER'S NAME LENDER'S ADDRESS 1O. AFFLIUVNI I certify that I nave read tne application and state tnatthe above information is correct. 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 OTY OF CARLSBAD AGAINST AU 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 within 365 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned atany rime after the work is commenced for a period of 180 days (Section 303(d) Uniform Building CodeK APPLICANTS SIGNATURE/ Ilia /Y) ~T}/9n, ' DATE: / " " // <1_A-"--O ' / ' ' ^^ LA- ~ /WHITE: File YELLOW: Applicant PINK: Finance CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB951393 FOR 10/05/95 DESCRIPTION: TEMPORARY POWER POLE-SHEA HOME TYPE: ELEC JOB ADDRESS: 2313 CAMINO HILLS DR APPLICANT: PERFORMANCE POWER CONTRACTOR: OWNER: REMARKS: MW/JULIE SPECIAL INSTRUCT: STE: PHONE: 689-4092 PHONE: PHONE: INSPECTOR INSPECTOR AREA PLANCK* CB951393 OCC GRP CONSTR. TYPE NEW LOT: TOTAL TIME: CD LVL DESCRIPTION 32 EL Const. Service/ Agricultural ACT COMMENTS DATE DESCRIPTION ***** INSPECTION HISTORY ***** ACT INSP COMMENTS City of Carlsbad Building Department WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self-insure for A. workers7 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 B. of the Labor Code, for the performance of the work for which this permit is issued. My workers' 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 ($100) OR LESS) 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 • C. workers compensation laws of California. Signature Date Warning: Failure to secure workers' compensation coverage is unlawful, and shall be subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, Interest and attorney's fees. March 3, 1995 2O75 Las Palmas Dr. • Carlsbad, CA 92OO9-1576 • (619) 438-1161 • FAX (619) 438-O894 ISSUE DATE {MWDD/rr) ytstl"\ 09/22/95 HALLMARK ASSOC INS SERVICE SANOLIN & ASSOG INS AGENCY P.O. BOX 769 DOWNEY. CA 90241-0769 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. PERFORMANCE POWER SYSTEMS, INC. 1326 E.FRANCIS ONTARIO, CA 91761 CCMPAIIV COUPAHV LETTER COMPANIES AFFORDING COVERAGE RELIANCE INSURANCE CO, (WA.) 80LDEN EAGLE INSURANCE CO. COMPANYimw COMPANY LfTTM- .- COMPANYintw E THIS IS TO CERTIFY THAT THE POLICIES OP INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIRE WENT, TEfiM 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 POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. OCCLUSIONS AND CONOfTIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS, nrEBFtHIUAANCE roucr EFFECTIVE tpouor BCPUUTIQH DATE (MM/DDJVY) DATl (MWOO/YY)UMITS CE«£ML UA*HITY COMMERCIAL MN ERA L LIABILITY ]CLAIM»KAOII f X i owiitt-s & CONTRACTOR''* P«OT. BLKTCONTRACTL. SJ2672151 09/11/95 09/11/96 PERSONAL I ADV. IMJURV EACH OCCURRCHCK BROAD FORM PD .JiMftWO. I«ML 50,000., AUTOMOBILE LIAItLlTY ANVAUTO SCHEDULED AinOS tflREO AUTOS CCP329420 09/11/95 09/11;% COMBINEDIIWLE {Pir pin on) 1,000,000 GAMQE LIABILITY PROPERTY DAMAGE EXCESS lUIIUIY EACH OCCURENCE T» AGGREGATS OTHER DUN UMBRELLA FOAM WORXfR'KCOMPEHUTION AND NWC322705 02 00/11/96 X I STATuToftV UUtTX CACHACCIDINT if DI6EASE-POUCVLJWT lSEASE-EACH EUPLDVEE j 1 1,00,0,000 I^MJXJO1,000.000" OTHER fit AND PD LIAB.09/11/95 09/11/96 DEDUCTIBLE PER CLAIM 2,500 ^ INSURED WffH RESPECTTO LIABILITYARISING OUT OF INSURED'S OPERATIONS; PER ATTACHED FORM CS 2010 TEN (10) DAY NOTICE OF CANCELLATION DUE TO NON-PAYMENT OF PREMIUM. SHOULD ANY OP THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL MAIL -3Q^ DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE CITY OF CARLSBAD 2075 LAS PALMAS DRIVE CARLSBAD. CA. 92008 S89 GTS WW OT3M