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Home My WebLink About2383 MERWIN DR; TP; CB993564; Permit• City of Carlsbad 09/27/1999 Electrical Permit Permit No:CB993564 Building Inspection Request Line (760) 438-3101 Job Address: Permit Type: 2383 MERWIN DR CBAD St: TP ELEC Parcel No: 2081621300 Lot #: 0 Reference #: Project Title: TEMP POWER POLE Applicant: TEMP UTILITY SERVICES 1167 LAW ST SAN MARCOS, CA 92069 619-471-5494 Owner: ' Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 09/27/1999 MOP 09/27/1999 09/27/1999 Total Fees: $20.00 .. Total Payments To Date: $0.00 Balence Due: $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 TOTAL PERMIT FEES Inspector: 9A 0 0 0 0 FINAL APPROVAL Date: ) D=-6-o/'7 ' Clearance: $10.00 . $0.00 . $0.00 $0.00 · $0.00 $0.00 $10.00 $0.00 $0.00 $20.00 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 capactiy 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 vou have nreviouslv been niven a NOTICE similar to this or as to which the statute of limitations has nreviouslv otheiwise exnired. CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 ,.r PERMIT APPLICATION FOR OFFICE USE ONLY ,(.;cJ PLAN CHECK NO. qcr-'3 y \ CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 EST. VAL. _________ _ Plan Ck. Deposit ________ _ Validated By __________ _ Date _____________ _ Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total I of units Assessor's Parcel I :fns'.rwr I/ er Proposed UH Description of Work SQ. FT. #of Stories # of Bedrooms I of Bathrooms Name Address • City State/Zip Telephone# Fax# ,-,Z,.,,~·••·2::,;;;);~~~~,0~~4i-~7':,ec.•'~~~~j!;···· Name ~ Address City State/Zip Telephone# Name &. ;'CONTRACT01i:•.;••coMPANY:NAMl'1::;~:,)i'j~~ft::1;:i.t:~iii~::::-::c1,;:;:: tr;·; .. ,,' ,, :"~;::\ ,;;;;:;.;;~~;:;:,~:;~~1;i;r~~;q;;;:;·,*:,;·~:.':,::~~ .. ~:.\:;J:;:~,;,;-:;:'., Designer Name Address City State/Zip Telephone State License # _________ _ 8. WORKERS" COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury.one of the following declarations: 0 I have and will maintain a certificate of consent to ••If-insure for workers' compensation as provided by Section 3700 of the Labor Coda, for the performance of the work for which this permit is issued. ~ I have and will maintain workers' compensation, as reQuirad-by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My worker's compensation~urance ca~d policy nu ber are: -::,, _ > / lnsuranceCompany j"--,_;r-. r.:;;: PollcyNo./S.557/0-P? ExplratlonData.,;, .;y-oo (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS lt1001 OR LESS! 0 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: Falkn to secure workers' compen coverage ll unlawful, and ahaH subject an employer to crlmlnlll penatdea and civil flnn up to one hundrad thousand dollars ($1 0 , In addition to compenution, damagn u provided for In Section 3706 of the~ code, tnt,rat and attorney'• fees. SIGNATURE, __ ~~~~~'.___::~~~!!::!=::::._ ___________ DATE Z::..:.~ '7-7 9' 7. I hereby affirm that I am exempt from the Contractor's Ucense Law for the following reason: 0 I, as owner of the property or my employees wh:h 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 employen, provided that such Improvements are not Intended or offered for sale. If, however, the building or Improvement is sold within one year of completion, th• owner-builder will have the burden of pro.,;ng that he did not build or improve for the 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: The Contractor's License Law don not apply to an owner of property who builds or Improves th•eon, and contracts for such projects with contractorls) licensed pursuant to the Contractor's License Law). 0 I am exemPt under Section ______ Business and Professions Code for this reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property Improvement. 0 YES ONO 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 I 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/ contractor, license number):, ____________________________________________ _ 5. I will provide some of the work, but I have contracted (hired) the following persons to prov;de the work indicated (include name / address / phone number / type of workt: ______________________________________________________ _ PROPERTY OWNeR SIGNATURE---------------------- COMPl.ETE THIS SECTION l'OR NONRSIDBmAL BUILDING PERMITii'ONLY DATE ________ _ Is the applicant or future building occupant reQuirad to submit • business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 26505, 26633 or 25634 of the Presley-Tenner Hazardous Substance Acc6unt Act? 0 YES O NO Is the applicant or future building occupant teQUired to obtain a permit from the air pollution control district o, air quality management district? O YES O NO Is the facility to be constructed within 1,000 fHt of the outer boundary of a school site? 0 YES O NO IF AJIY OF THE ANSWERS ARE YES. A FINAL CERTIFICATE OF OCCUPANCY MAY NOT IE ISSUED UNLESS THE APPLICANT HAS MET OR JS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CO~OL DISTRICT. 8, .:.:. J;ONSTAUCTION LENDINQ:~-~i{J(!~~~f{:it~~:·:~;itJi::~;,_{J'~~~;;~:~~0;f!1::r.ti~':\''.1::;::;:'.'.(':,:i::\\.';.~,',;!:;t I hereby affirm that there is a construction lending agency for the performance of the-work for which this permh: is issued !Sec. 3097(i) Civil Code). LENDER"S NAME_____________ LENOER"S ADDRESS, ______________________ _ 9. APPLICANT CEIITIFICATiOlli• /;'1:?,C;J:;~;;.::,"ii~~,c,:S1,,i(Ji;(c;s~;it~\;J;iI~:1Jl:.d.2.:i,Ltci~'22J::c:.,c:;·2rL,':::.".'ij'jC''···, '. ' I certify that I havfl read the application and state that the above information is correct and that the information on the plans la accurate. I agree to comply with all City ordinances and State law, relating to building construction. I hereby authorize repre1entativu of the Citt 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 ANO EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit la required for excavation, over 6'0"' dnp and demolition or construction of structures over 3 stories In height, EXPIRATION: Every permit isaued 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 c menced ~lthl 385 VS from the date of such permit or If the building or work 1\11:horized by such permit is suspended or abandoned at any time after t commenc r a od of 180 days I Section 108.4.4 Uniform Building Code). ~ APPLICANTS SIGNATURE _C::::::!~~~~_jf_,,_di~~~:::::.___________ DATE _,.z',_~_f;l. _ _:c?_-_r-_, ____ _ YELLOW: Applicant PINK: Finance City of Carlsbad Inspection Request For: 10/7 /99 Permit# CB993564 Title: TEMP POWER POLE Description: Type: ELEC Sub Type: Job Address: 2383 MERWIN DR f't'R_O'jc Suite: TP Lot O 110"7 07 Location: APPLICANT TEMP UTILITY SERVICES Owner: Remarks: Total Time: Act Comments Inspector Assignment: Phone: 7608399430 Inspector: ~ Requested By: MICHELE Entered By: CHRISTINE CD Description 32 Const. Service/Agricultural /Jf_ _____ _ Inspection History Date Description Act lnsp Comments •