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Home My WebLink About2565 DAVIS AVE; ; CB041483; PermitV 05-04-2004 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Electrical Permit Permit No: CB041483 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #; Project Title: 2565 DAVIS AV CBAD St: TP ELEC 1552510900 Lot#: BAILEY RES TEMP POWER POLE Status: ISSUED Applied: 05/04/2004 Entered By: SB Plan Approved: 05/04/2004 Issued: 05/04/2004 Inspect Area: Applicant: BAILEY MICHAEL C 2565 DAVIS AVE CARLSBAD CA 92008 Owner: BAILEY MICHAEL C 2565 DAVIS AVE CARLSBAD CA 92008 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 $10.00 $0.00 $0.00 $0.00 $0.00 $0.00 $10.00 $0.00 $0.00 $0.00 $20.00 Total Fees:$20.00 Total Payments To Date:$0.00 Balance Due:$20.00 OATirf'/M CLEARANCEM SIGNATURE PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 FOR OFFICE USE Q PLAN CHECK NO. EST. VAL. 83 Plan Ck. Deposit Validate^ By. Dat Address (include Bldg/Suite #)Business Name tat this address) Legal Description Assessor's Parcel # . » A/J /&£>A»<i, y Description of Work / 2. CONTACT PERSON (if differ Lot No. Subdivision Name/Number Existing Use ~&& #i£&f*if'y G./fc.'f/tfCit &G-/^W<:"&* ' ' SO. FT. #of Stones Unit No. Proposed Phase No. Use # of Bedrooms Total it of units # of Bathrooms Name Address State/Zip Telephone #Fax* (Sec. 7031.5 Business and Professions Code: Any City or County which requites a permit to construct, altar, 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 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]). Name State License # Address License Class City State/Zip City Business License # Telephone # Address City State/Zip 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. Q 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 worker's 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 [SI001 OR LESS) Q 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: Failure to secure worker*' compensation coverage is unlawful, and «haH subject an employer to criminal penalties and civil fines up to one hundred thousand dollar* ($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. i SIGNATURED _j.. _J.. _^_ , DATE / \l hereby affirm that I am exempt from the Contractor's License Law for the following reason: / H 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 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 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). / 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(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 QNO 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 / address / phone number / type \ /f work): PROPERTY OWNER SIGNATURE 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? Q 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 Q NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Q YES Q 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. IMSltl^^ VU^'.;;;,-. ,-:.:-..' :; ... . ,'• .\. .."^'•V. I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(1) Civil Code). LENDER'S NAME LENDER'S ADDRESS 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 for excavations over 5'0" deep and demolition or construction of structures over 3 stones 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 1 80 days from the date of suchpermit or if the building or work authorized by such permit is suspended or abandoned at/any time after the work is commenced for aperiod of 180 dayjjJSectiori 1063(TJniform Building Code). 'PLICANT'S SIGNATURE DATE WHITE: File YELk0W: Applicant PINK: Finance T CITY OF CARLSBAD ELECTRIC AND GAS METER CLEARANCE INTER-DEPARTMENT ADDRESS: S.E.O. Service Equipment Only YES NO Reason, If Denied: ELECTRIC METER: COMMERCIAL RESIDENCE NEW SERVICE YES RELOCATE NO T.S.P.B. TEMP. P/P UP-GRADE TEST METER IRR. PEDESTAL GAS METER: COMMERCIAL YES RESIDENCE METER Building Inspector Signature Date ' Time £tO -S""*"OH Called In By Date Time Called In To City of Carlsbad Bldg Inspection Request For: 05/06/2004 Permit# CB041483 Title: BAILEY RES TEMP POWER POLE Description: Type: ELEC Sub Type: Job Address: 2565 DAVIS AV Suite: TP Lot 0 Location: APPLICANT BAILEY MICHAEL C Owner: BAILEY MICHAEL C Remarks: P. Total Time: CD Description Act Comment 32 Const. Service/Agricultural Inspector Assignment: Phone: Inspector: Requested By: NA Entered By: CHRISTINE Associated PCRs/CVs Inspection History Date Description Act Insp Comments CityofCARLSBA BUILDING DEP