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Home My WebLink About2417 MICA RD; TP; CB100456; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 03-16-2010 Electrical Permit Permit No: CB100456 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 2417 MICA RD CBAD St: TP ELEC Status: Parcel No: 2132701400 Lot#: 0 Applied: Reference #: PC#: Project Title: LA COSTA GREENS :200 AMP TEMP POWER POLE Applicant: BOLD ELECTRIC INC 2760 PROSPECT ST 92881 909 340-3573 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 TOTAL PERMIT FEES 200 0 0 0 Entered By: Plan Approved: Issued: Inspect Area: Owner: REGENT LAND INVESTMENT L L C 11990 SAN VICENTE BLVD #200 BRENTWOOD CA 90049 ISSUED 03/16/2010 KG 03/16/2010 03/16/2010 $10.00 $50.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $60.00 Total Fees: $60.00 Total Payments To Date: $60.00 Balance Due: Inspector. Clearance: \ •4, '' ~' D $0.00 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 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 ·n nivnNTIEiilrhi iinh I --«1'» ~ G:ITY OF CARLSBAD Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718 / 2719 Fax: 760-602-8558 www.carlsbadca.gov JOB ADDRESS \""\\CA SUITE#/SPACE#/UNIT# CT/PROJECT# LOT# PHASE# #BEDROOMS #BATHR OMS DESCRIPTION OF WORK: Include Squa,. Feet of Affected AIM(s)--r-:; ,c"' ,on...r- Plan Check NoC 1 Est. Value Plan Ck. Deposit Date EXISTING USE GARAGE (SF) PATIOS (SF) DECKS (SF) AIR CONDITIONING FlRE SPRINKLERS YES □ NOD YES □ NO □ CONTACT NAME (" Different Fam App/leant) APPLICANT NAME ADDRESSJ 7 ~ ADDRESS d. l {:n CITY O("GI\ A. ~ IP8'd-I Cl(DftnA CA-ZIP(y.~~/ PHONE C\-S\-1i,<:::. sSl~ FAX PHONE FAX EMAIL EMAIL PROPERTY OWNER NAME CONTRACTOR BUS. NAME ADDRESS L\ l...\ c., (:, ADDRESS ~7 60 PHON~-PHON EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS STATE LIC. # (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 exem9.t 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}). WORKERS" COMPENSATION Workers' Comptnutlon Declamion: I hereby affirm under penalty of perjury ooe of the following declsrations: D I hive and wil maintain I ctrtificat• of cons.nt to stlf-lnsure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this perm fl is issued. ~ have and will maintain worlu.~s ~ bv..~ 3700 of the Labor Code, for the _performanceAlh'?!--fq ~ h~,· i-:dAY ~pensation insurance carrier and policy number are: Insurance Co. ~~ rV"t--' PohcyNo. -~U-~-=1--=-,_~·1'----<:=:/..--<'--~--~~~\::)= e4ira!Jn Date _________ _ This section need not be completed if Iha permit is for one hundred dollars ($100) or less. D C.rtlf1eate of Exemption: I certify that in the performance of the work for which this pennil is issued, I shall not employ any person in any manner so as to become subject to the WOfbra'CCNT1pensation laws of California. WARNING: Failure to sKure workers' compensaHon covera lawful, and shall subject an employer lo criminal penalties and civil fines up to ooe ~':~red thousand dol6ars (&100,000), in ddltlonto the cost of compan ... .., ... "'1fl's as provided for In Sect 3706of Labor code, In and attorney"s fees. J-'(...-w AS CONTRACTOR SIGNATURE □ AGENT DATE OWNER-BUIL0ER DECLARATION I h81'flby affirm that I am axempt from Contrac!Or's Ucense Law for the following reason: O I, as owner of the property or my employees wilh wages as their sole compensation, will do the work and the structure is ool intended or offered for sale {Sec. 7044, Business and Professions Code: The Conlraclor's License Law does ool apply to an owner of property who bu~ds 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 ci proving that he did not build or Improve for the pllfl)ose of sate). O I, as ownM of the property, am exclusively contracting with licensed contractors to construct the p-ojecl (Sec. 7044, Business and Professions Code: The Conlraclor'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). O I am exempt under Section _____ ,Business and Professions Code for this reason: 1. I pen;onally plan lo provide the major labor and materials for conslruclion of the proposed property improvement. 0 Yes O No 2. I (have/ hava not) signed an appHcalion for a building permit for the proposed work. 3. I have contracted with the following person (finn) to provide the proposed construction (include name address/ phone/ contractors' license number): 4. I plan lo provide portions of the work, but 1 have hired the following person to coordinate, supervise and provide the major WOO( (include name/ address/ phone/ conlrac!Drs' license number): 5. I will provide some of the WOO:, but I have contracted (hired) the following persons to provide the work indicated (include name/ address/ phone I type of work): AS PROPERTY OWNER SIGNATURE □AGENT DATE City of Carlsbad Bldg Inspection Request For 03/24/2010 Permit# CB100456 Title: LA COSTA GREENS :200 AMP TEMP Description: POWER POLE Type: ELEC Job Address: Suite: Location: 2417 MICA RD TP Sub Type: Lot: 0 OWNER REGENT LAND INVESTMENT L L C Owner: REGENT LAND INVESTMENT LL C Remarks: Total Time: Inspector Assignment: Phone:~31681 lnspectd L Requested By: DAN Entered By: CHRISTINE CD Description 32 Const. Service/Agricultural itCom~-nt_s __ Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act lnsp Comments