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Home My WebLink About2512 GATEWAY RD; TP; CB071038; Permit04-17-2007' City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Electrical Permit Permit No CB071038 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 2512 GATEWAY RD CBAD St TP ELEC 0000000000 Lot # 200 AMP TEMP POWER POLE Status ISSUED Applied 04/17/2007 MDP 04/17/2007 04/17/2007 Entered By Plan Approved Issued Inspect Area Applicant POWER FABRICATING INC 625 S FEE ANA ST PLACENTIA CA 92870 714223-3600 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 200 0 0 0 $1000 $5000 $000 $000 $000 $000 $000 $000 $000 $000 TOTAL PERMIT FEES $6000 Total Fees $60 00 Total Payments To Date $60 00 Balance Due $000 Inspector FINAL APPROVAL Date Clearance *\-z 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 CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 mmm*...:- '*• : 1 .".."'• 'P.™"?"'".''." . . 1. ^ :.: .^"ijjj^!!;!': • :,j'.^^ Gateway Rrl TP FOR OFFICE USE ONLY PLAN CHECK NO 67' EST VAL Plan Ck Deposit Validated By Date Address (include Bldg/Suite #)Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total # of units Assessor's Parcel # *Temp Power Pole Existing Use Proposed Use Description of Work SQ FT #of Stories # of Bedrooms # of Bathrooms Name Address City &--' :&$5Jji?AMt ^-Q Contractor- SAgem ^Contractor. .'Q "Owner Q Agent for Owner - *Gary Seymour 2438 S.SantaTe Ave. Vista. C A. 92084 Name Address City *San '"Diego1 Contracting f9D8 Friendship Dr. # A R1 Cajnn "c. State/Zip State/Zip A 02020 Telephone # 760-SQ7-2QQ4 Telephone # ~ Fax* Name Address City State/Zip TeTepfTone # (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 p&OA Any violfftQnofjSectipn 7033 5 by anvswplKjant-for a permit subjects the applicant to a cjyil penalty of not more than five hundred dollars [$5001)^PoWef Fabricating Inc 525 S Fee Ana St Placentia, CA 92870 714-223-56QQ Name State License * 6967 1 Designer Name State License # Address •> License Class Address CIO City City Business City State/Zip License # State/Zip Telephone # iZZi ioZ Telephone 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 C] 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 worke^s^compensatiocLinsurance carrier and policy number are o Pol.cy Nol CW50'205301 Expiration Datt 0/0 1 707Insurance Company (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 employ any person in any manner so as to become subject toTRfc^Workers' Compensation Laws of California WARNING Fallute to secVe .\foikers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars RlOO.OOWlUaidition to the cost of compensation, damages as provided for in Section 3706 of the^Lqbor qp4a) Interej] and attorney's fees SIGNATURE 1 Lftpj^ DATE - I hereby affirm thatTam exempt from the Contractor's License Law for the following reason Q 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 Ru>¥sslons 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 througivBis 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 he 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) Q 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 Q YES L"_NO 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 / eddress / phone number / type of work) ^ PROPERTY OWNER SIGNATURE DATE 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 Q 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? CD YES CD 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 iiiss^^ '•'.-•• -. '••..*.:'••'.. '•'....".'-'.'.- ' •'!.--'iSi* •os4'--,., I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 30970) Civil Code) LENDER'S NAME LENDER'S ADDRESS ISAjfip^^^ .:y:.:?ai_^r,_-:-";7-..-..:-;:'.;:.-:^':;;•'.:'•";•; ::;;.»>\.-1v: ^^Q^^^M&S&SSA^^^&SK^A 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 City 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 ftr excavations over S'O" deep and demolition or construction of structures over 3 stories in height EXPIRATION Every permif issued bl (he building Official under the provisions of this Code shall expire by limitation and become null and void if the building or wo* authorized by such permit islnot commeflWdWhin 180 days from the date of such permit or if the build'ng or work authorized by such permit is suspended or abandoned at any time after the work iscommeacellMr aj period of 180 days (Section 106 4 4 Uniform Building Code) APPLICANT'S SIGNATURE ^-X_L*\ V| —•— DATE WHITE File YELLOW Applicant PINK Finance City of Carlsbad Bldg Inspection Request For 04/30/2007 Permit* CB071038 Title 200 AMP TEMP POWER POLE Description Inspector Assignment 2512 GATEWAY RD TP Lot 0 Type ELEC Sub Type Job Address Suite Location APPLICANT POWER FABRICATING INC Owner Remarks Phone 7606446107 Inspector Total Time CD Description 39 Final Electrical Act Comments Comments/Notices/Holds Requested By GARY Entered By JANEAN Associated PCRs/CVs Original PC# Inspection History Date Description Act Insp Comments cr JL r Client*. 57867 POWERFAB ACORD« CERTIFICATE OF LIABILITY INSURANCE PBUOUCBB > OWP/US1 of Southern California 'Jc# OE61S29^{949)790-9339 Suzan ,d A Technology Drive Irvine, CA 92618 INSURED Power Fabricating, Inc. & Temp Power Systems, Inc 625 S. Fee Ana Street Placenta, CA 92870 DATE (MWOO/Wn 09/28/05 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AMD CONFERS NO RIGHTS UPON THE CERTIFICATE HOLOSR. TW$ CERTIFICATE DOES NOT AMEND, EXTENOOB ALTER THE COVERAGE AFFORDED 8V THE POLICIES BELOW ,;.-.,, INSURERS AFFORDING COVERAGE iNsuncnA. Liberty Surplus Insurance Company INSURERS Virginia Surety Company INSURER c: Hartford Fire Insurance Co, INSUWftO- INSURER c *io day notice for nonpay NAIC* COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE POft THg POLICY PERIOD INDICATED NOTWITHSTANDING POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMSwsn A B B c KH TYPeOPIHSOnAMCE OeNeNAL UASWTY X COMMERCIAL GENERAL UABIlfTY (CLAIMS MADE I xlocctjH X W/PD Ded-10000 X OCP CEffL A30REQATE LIMIT APPUfcS K-H 1 POLICY r~ljPECT !X]LOC AUTOMOBILE UAJBILTTY X ANY AUTO ALL OWNED AUTOS SCHEDULED AUTO-i X nOn OwMtO AUTOS -GAflACE UABIUTY ANY AUTO EXCESS/UMBRELLA UABIUrv ,__J OCCUR I I CLAIMS MoQE _] DCOUCTIBLE WOKKEK& COMPtNSAirKM AND EMPLOYERS LIABILITY UHHCtH/MhMBtFl txCLUGtD* H yes dcocr'&c un£cr o™01 Comm Prop Leased/Rented •BiT^'*WpT^iMiilfc t' ' '" JU I 't " Ji^Mi1i^iMi»PT^iMilBi»iii»il DOLB02001 52033 1CA501 05200 1CW5020S300 72UUMTR0128 10/01/05 10/01/05 10/01/05 10/01/05 IOflOl/06 1 EAC.H occwHFtSNce I $1,000,000 8SS9&e%:^S^».i 1*50.000 10/01/06 10/01/06 12/01/06 MEO EXf (Any one INIKKI) PERSONAL. JADV INJURY GENERAL AQQREQATE PROOUCTS - COMP/OP AOG COMBINED SINGLE UNIT lEaacooenO BODILY INJURY BOOILV INJURY (PorottkttnO pnOPEFTTY DAMASE ALTTOONLY EAAOCWeNT SB ERTHAN fcAACC OOMLY AGO EACHOCCUHHENCe AttflEOATE X WCSTATU- ITrtnvnUfTsl 0Ffl' tLL.£AChACOOENT E L DISEASE - EA €UPLQVEE ELOlSEASfi PCHJCY LIMIT $ J1 ,000.000 s2.000.000 $2,000,000 — *1, 000,000 * S $ $ S S S $ S 9 $ *1, 000,000 $1,000,000 $1,000,000 $100,000 Max Limit $2,5000«<l. Oe$CRimON OF OPERATIONS / lOOAtttHfi 1 VEHtCLES ( eXeUJSKiMfi A&DEB BY ENOOMSEUEMT > SPECIAL PROVISIONS "Except 10 day notice of cancellation for non-payment of premium. Re- License #483433 and License #656713 CERTIFICATE HOLDER CANCELLATION Contractors State License Board PO Box 26000 Sacramento,, CA 95926 ACORD 25 (2001/08) 1 OT 2 SHOULO ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXHAATtON DATE THEREOF THE ISSUING INSURER WlkLBBBflOBDlKMAK. *3fl OAVS WRfTTEN NOTICE TO THE CEHTIFWATe HOLOfifl NAMED TO THE LEFT #M316595 SMZ O ACORD CORPORATION 1980 I d ON/ic H 1S/88.H S002 > 100(3,11)