HomeMy WebLinkAbout2605 CARLSBAD BLVD; ; CB993128; Permitv l^^l City of Carlsbad
08/18/1999 Electrical Permit Permit No:CB993128
Building Inspection Request Line (760)438-3101
Job Address: 2605 CARLSBAD BL CBAD
Permit Type: ELEC Status: ISSUED
Parcel No: Lot#: 0 Applied: 08/18/1999
Entered By: DT
Reference #: Plan Approved: 08/18/1999
Issued: 08/18/1999
Project Title: ARMY NAVY ACADEMY LIBRARY BLDG Inspect Area:
ELEC SVC UPGRADE 125AMPS TO 200AMPS 3103 08/18/99 0001 01 02
C--PRMT 26.75Applicant: Qwoer:
AMERICAN EAGLE ELECTRIC , - - '
319 FESTIVAL DR
OCEANSIDECA 92057
760-754-1194
Total Fees: $28.75 Total Payments To Date: $0.00 Balance Due: $28.75
Electric Issue Fee $J 0.00
Single Phase per AMP 75 , $18.75
Three Phase per AMP 0 pO.OO
Three Phase 480 Per AMP 0 f$0.00
Remodel/Alteration per AMP 0 $0.00
Remodel Fee $0.00
Temporary Service Fee $0.00
Test Meter Fee $0.00
Other Electrical Fees $0.00
TOTAL PERMIT FEES $28.75
FINAL APPROVAL
f7Inspector: fr Date: 1o f7 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 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 capactiy
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.
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161
Z
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
2075 Las Palmas Dr., Carlsbad CA 92009
(760)438-1161
1. PROJECT INFORMATIO
FOR OFFICE USE ONLY
PLAN CHECK
EST. VAL.
Plan Ck. Deposji
Validated By
Date
Address (include Bldg/Suite #)
Legal Description Lot No.Subdivision Name/Number Unit No. Phase No. Total # of units
Description of Work
2. CONTACT PERSON (If different from applicant)
# of "Bedrooms # of Bathrooms
Name
3. APPLICANT Contractor
Address
Agent for Contractor
City
Owner D Agent for Owner
State/Zip Telephone # Fax #
Name
4. PROPERTY OWNER
Address City State/Zip Telephone #
Name Address City State/Zip Telephone #
S. CONTRACTOR - COMPANY NAME
(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
exemption. Any violation of Section 7031 .W»y anyjpplw*it fora permit subjects the applicant to a civil genalty of not roc-re than five
Name „rState License If 5
.. _, C~nM Address ,.
/ ^ ^ License Class V: ID -- 26- City State/Zip
City Business License 9 t^d
Telephone #
" V '
Designer Name
State License #
Address City State/Zip Telephone
6. WORKERS' COMPENSATION
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 [$100] OR LESS)
'RJ 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
*6Sbecome 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
thousand dollars ($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.
SIGNATURE ,/L\^ //^\ DATE
7.
I hereby affirm that I am exempt from the Contractor's License Law for the following reason:
Q I, as owner of the procerty 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).
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).
D 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. ! 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 prdvide 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
COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY
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 D 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? fj] 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.
8. CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued {Sec. 3097(i) Civil Code).
LENDER'S NAME LENDER'S ADDRESS
9, APPLICANT CERTIFICATION
1 certify that 1 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 5fG" deep and demolition or construction of structures over 3 stories 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 nat commenced witKin 365 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/Cork is commencap TBNa period of 180 days (Section 106.4.4 Uniform Building Code).
•'LICANT'S SIGNATURE DATE
YELLOW: Applicant PINK: Finance
UNSCHEDULED BUILDING INSPECTION
DATE
PERMIT #
JOB ADDRESS _i
DESCRIPTION _
CODE DESCRIPTION
INSPECTOR
PLAN CHECK #
ACT COMMENTS