HomeMy WebLinkAbout2505 OCEAN ST; ; CB044519; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
12-15-2004 Electrical Permit Permit No: CB044519
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Reference #:
_,si,5
:.W:,.OCEAN ST CBAD
ELEC
0000000000
Status:
Lot#: 0 Applied:
Entered By:
Plan Approved:
Issued:
Project Title: ARMY-NAVY ACAD REPLACE 200AMP
METER AND 3 PANELS AT BOOKSTORE
Inspect Area:
ppl' ··--.
SERVICE ELECTRIC INC
STE H
~m-lel'J'T'i=ERRIPRISE ST 92029
760-291-1302
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
0
0
0
200
Owner:
ARMY&NAVY ACADEMY
PO BOX3000
CARLSBAD CA 92018
ISSUED
12/15/2004
KG
12/15/2004
12/15/2004
$10.00
$0.00
$0.00
$0.00
$50.00
$0.00
$0.00
$0.00
$0.00
$0.00
$60.00
Total Fees: $60.00 Total Payments To Date: $0.00 Balance Due: $60.00
7709 12/15/04 0002 01
CGF"
---;;J_
Inspector: :t';/,
FINAL APPROVAL
'(,,/ Date: Clearance:
NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, rese1Vations, or other exactions hereafter collectively
referred to as "fees/exactions." You have 90 days from the date this pennit 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
/x in fwh'h TE i ilr owhihh fli ion h
·-···-·-----------
02
,50,,00
PERMIT APPLICATION
CITY OF .CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
FOR OFFICE USE ONLY
PLAN CHECK Ncf.:_,6oLJt./sJ9
EST. VAL. _________ _
Validated Bv ~~ c::::::
Plan Ck. Deposit ~
.)5f>~ Date I 2-1 ':2--f>l.{
~ _:_~_d,_:_?_:_~_:_~_:_~_0_1:_gR_/:_"A_~_:•_:_~-----~--•·------~---~--/Jc-i,.l_l:)_B_u_,t-.1._;,_.,_~_N_~_~_,_1_,_'~-h-;,_,_d_d_~_'~_l __ v _____________ _
Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units
Proposed Use
#of Stories II of Bedrooms # of Bathrooms
PE~nt from applicant}
Addrtiss City State/Zip
i,\I -t,3o2..-2-"I \ -I 3c:q
Telephone # Fax II
D Agent for Co~oh ..... i;:::! Owner O f\9Bnt f
• ~ l!).j I QC.l"IQSt:_ • "i.Tiil. t\ ' Ibo Q!.-.~~-~1 __ Z1~1_-_13o_~ __
4, I\ ~OPE~T:,OWNER
,.,.._M,\j ~ IJw.l'J
Address
5. CONTRACTOR~ COMPANY NAME .
State/Zip Telephone#
Telephone#
/
Name Address City State/Zip
(Sec. 7031 5 Business and Professmns Code: Any City or County which requires~ permit to construct, alter, improve, demo!rsh or repair any structure, pnor to 1ts
1ssuan,;e, also requires the appltcant for such perrrnt to file a siyntid statement that he 1s licensed pursuant to the prov1s1om; of the Contractor s License law
[Chapter 9, commending with Section 7000 of Division 3 of th8 Business and Professions Code] or that he 1s exempt therefrom, and the basis for the alleged
exemµtio;l\t~ vio~ Se,cf r 7031 .5 by un~ica~iessu~Tt: t appli lt to a WJIOOlty ~ot mb.1 th· 1 five l#Orod utars_l $(!cZ-
Name Address City State/Zip Telepho #
State License # f,}~l 14'=> Lictinse Class C-\ D City Business License # ____N__e..,,,...,J
Designer Name Address Citv State/Zip Telephone
State License II _________ _
WOR~~RS' COMPENSATION
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: !·□·
J have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of thu Labor Code, for the performance
of the work for which this permit is issued.
',! ~ I have and will maintain workers' compensation, as requinid by Stiction 3700 of the Labor Code, for the performance of the work for which this permit is
ued. My worker's compensation ~urance carrier and policy number are:
losurnoce Compaoy :"Sr"ATE ~l> PoHcy No. C()j) ~1c?.-c3 Exp;,a,;o, Date l-Ol -l!>S'
{THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$1001 OR LESS)
D CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not ernpluy 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 µenalties and civil fines up to one hundred
! thousand dollar $1~000bin additiqn ~ the cost of compensation, damages us provided form Section 3706 of the La:~_jlterest and attorney's fees
SIGNATURE •I ' ~ ~ DATE_,)"'2,"-J./-,A~"'J-'~'--'----
7. OWNER.BUILDER DECLARATION
J hereby affirm that I am exempt from the Contractor's License law for the follow11g reason
, D I, as owner of the property or my employees with wages as their sole cornp1msat1on, will do the work and the structl re 1s not mtended or offered for sale
(Sec, 7044, Business and Professions Code: The Contractor's License Law does nqt apply to an owner ot 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, how0ver, 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 pL1rpose of sa!e).
0 I, ris owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, ausiness and Professions Code: The
Contractor's License Law does not apply to an owner of property who builds or 11nproves thereon, and contracts for such projects with contractor(s) licensed
pursuant to the Contractor's License Law).
D I am exempt undtir 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 I 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 l 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 indicatlld (include mime/ address/ phone number/ type
of work):. ___________________________________________________________ _
PROPERTY OWNER SIGNATURE ______________________ _ DATE _________ _
COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY
Is the aj)plicant or future building occupant required to submit a business plan, 1icutely trnzardous materials registration form or risk management and prevention
program under Sections 25505, 25533 or 25534 of thf:l Presley-Tanner Hazardous Substance Account Act? 0 YES O NO
Is the ,applicant or future building occupant required to obtain a pormit from the air pollution control district or air quality managem·mt district? 0 YES D NO
ls the facility to be constructed within l,000 feet of the outer boundary of a school site? D YES O NO
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MA'( 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 whicti this permit is issued (Sec. 3097(i) Civil Code).
LENDER'S NAME _____________ _ LENDER'S ADDrlESS ___________________________ _
9. APPLICANT CERTIFICATION
I certify that I have read the application and state that the above information is correct and that the information on the plans is JCcurnto. l agree to comply with all
City ordinances and State laws relating to building construction. l hereby authorize representatives of the Cit~ ot Carlsbad co enter upon the above montionod
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 AGAIN.ST 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 Ollidal under the provisions of thi5 Code shall expire by limitation and become null and void if the building or work
authonzed by such permit 1s not commenced w1thm 180 days from the date ot such µerm1t or 11 the building or work authorized by such permit 1s suspended or abandoned
vat any time after the work 1s c~menced I nod of 1~0 <f6YS (Section 106 4 4 Uniform Building Code) / _.,/ t .J1 APPLlCANT'S SIGNATURE "2-1 ~-DATE _\~-.L--~"""''l-0--'-'-----
WHITE: File YELLOW: Ap;,licant PINK: Finance
City of Carlsbad Bldg Inspection Request
For: 12/28/2004
Permit# CB044519
Title: ARMY-NAVY ACAD REPLACE 200AMP
Description: METER AND 3 PANELS AT BOOKSTORE
Type: ELEC Sub Type:
Job Address:
Suite:
Location:
OWNER
Owner:
2507 OCEAN ST
Lot
ARMY&NAVY ACADEMY
Remarks: AM PLEASE
Total Time:
CD Description
33 Service Change/Upgrade
0
Act
d!_
Comment
Inspector Assignment: TP ---
Phone: 7608022592
lnspector:J2___
Requested By: DAVID
Entered By: CHRISTINE
a_ ,'(J/1 fVd J(?µt,,f
-3'f__ ,1/7
Associated PCRs/CVs
lnsgection Histoty
Date Description Act lnsp Comments
12/22/2004 39 Final Electrical NR TP SUB PNLS N/COMP.
12/21/2004 33 Service Change/Upgrade PA TP MTR PNL (NEED GRN. ROD)
12/21/2004 34 Rough Electric NR TP N/COMP.