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HomeMy WebLinkAbout2604 CAZADERO DR; MP; CB070517; Permit02-22-2007 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Electrical Permit Permit No CB070517 Building .Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 2604 CAZADERO DR CBAD St MP ELEC Lot# 100 AMP MET PEDESTAL Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 02/22/2007 JMA 02/22/2007 02/22/2007 Applicant CTI TELCOM CORP 1150 N RICHFIELD RD ANAHEIM 92811 7149935600 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 TOTAL PERMIT FEES 100 0 0 0 $1000 $2500 $000 $000 $000 $000 $000 $000 $000 $000 $3500 Total Fees $35 00 Total Payments To Date $35 00 Balance Due $000 Inspector FINAL APPROVAL Date 3 '"?- 0*1 Clearance 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 ttieir 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 tees/exactions of which you have previously been qiven 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 Address (include Bldg/Suite #) FOR OFFICE USE ONLY PLAN CHECK NO. (2B>&7QS\ 7 EST VAL Plan Ck Deposit Validated By Date Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Totaf # of units Assessor's Parcel #Existing Use Proposed Use Description of Work SQ FT #of Stories # of Bedrooms # of Bathrooms Name Address City V State/Zip Of Telephone #Faxff Name Address City State/Zip Telephone # Name Address City State/Zip Telephone (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 Codel or that he' is exempt therefrom, and the basis for the alleged exemption Any violation of Section 703U5 by any applicant for a permit subjects the applicant to a.civil penalty of not more than five hundred dollars l$500[) ' " *' Tlame State License ft 2>- 'Address /G9/2S?" License Class C/£> C City State/Zip Telephone # ^7 -A City Business License # / -U _^- \2-tf rt*~tsy —^— — - t f ' Designer Name Stats License ft fJ/ ,A, 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 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 ,jed My worker's compensation insurance earner and policy number are Insurance Company Policy No Expiration Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) O 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 workers compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to one hundred jthousand dollars ($1 JIGNATURE )0p), (^addition to the coat of compensation, damages as provided for In Section 3706 of the Labor code, interest and attorney's fees DATE <A> '\ hereby affirm that I am exempt from the Contractor's License Law for the following reason n 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 wilt 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 thq 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) 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 Q YES QNO 2 I (have i have not) signed an application for a building permit for the proposed work 3 I have contracted with tho 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 of work) ~ PROPERTY OWNER SIGNATURE DATE NO 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 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 &;&pJSTRJOT I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(0 Civil Code) LENDER'S NAME LENDER'S ADDRESS _ 9, 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 180 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned |at any time after the work is commencBd/ora-penad Of 180 days (Section 106 4 4 Uniform Building Coda) \^APPLICANT'S SIGNATURE °ATE WHITE File YELLOW Applicant PINK Finance City of Carlsbad Bldg Inspection Request For 03/06/2007 Permit# CB070517 Title 100 AMP MET PEDESTAL Description Inspector Assignment 2604 CAZADERO DR MP Lot 0 Type ELEC Sub Type Job Address Suite Location APPLICANT CTI TELCOM CORP Owner Remarks Phone 7149819195 Total Time CD Description 39 Final Electrical Act Comment Requested By STEVE Entered By CHRISTINE Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act Insp Comments 02/15/2007 07 57 tt852 P 002/003 nun ii-'<-u in win ui i nn i uu uuc SBC FACSIMILE TltANSMITTAL SHEET TO Attention Scott Bums 1 635 Famfey Avenue Oariibftd, CA 92008 PHONSML-MOE^ 760-602-2717 760-602-8558 DATL. 2/16/2006 Mi AddlCSS Request FROM SBC EngjneeoriE Jan Stover 7985 Engineer Rd FMONE HUMBttl '858^68 21 U 858.27e-3S>80 EMAIL ADDRESS TOTAL HO PAGES IHCLUIMNC COVER 2 D URGENT QFOR REVIEW 0 PLEASE COMMENT D REQUESTING AM ADDRESS A!iSlGNMF.hfr.PUF-ASRPROVrDB AM A MPMETER SEHVICE PAR A MP,W SBC CABINET. SERVICE ADMRSS. THE STTE IS ON TH£ HAST STOP. OP rft7ADERQ PR 1 THECENTERIJNEOF ABEDUL ST D APN, 215-29Q-08 FEB 2"07 Crty of CARLSBAD BUILDING DEPT 1 127-G5 LAYOTTTy.NG1MF.ER IZ£6£iil9et- PLEASE CALL, FAX O» EMAIL ADDRf SS TO JIM STOVtR THANK YOU Cl is/at 01 90 I 9 f*Qt(l 02/15/2007 07-57 tt852 P 003/003 © © 0 i( © ® i; \—jo I - s a s- i |ls i i SsS 1 * = Imn « t-^c c s«" S ?sSn WO l-H POLICYHOLDER COPY SP COMPENSATION INSUR'ANCE FUND PO BOX 420807, SAN FRANCISCO,CA 94142-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE 07-24-2006 GROUP 000044 POLICY NUMBER OO23162-2005 CERTIFICATE ID 7 CERTIFICATE EXPIRES 07-24-2O07 07-24-2006/07-24-2007 WORLDCOM INC C 0 WORLDCOM PURCHASING LLC PO BOX 21348 TULSA OK 74121-1348 SP This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to the employer We will also give you JQ days advance notice should this policy be cancelled prior to its normal expiration This certificate of insurance is not an insurance policy and does not amend extend or alter the coverage afforded by the policy listed herein Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions and conditions of such policy JTHOR1ZED REPRESENTATIVE^ \ PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS $1,000,000 PER OCCURRENCE ENDORSEMENT #1600 - OLGA MESEN, SECRETARY TRE - EXCLUDED EMPLOYER CTI TELECOM CORP DBA PO BOX 142 ATWOOD CA 92811 CTI TELECOM CORP SP M0409 (REV 2-05) PRINTED 08-03-2006