HomeMy WebLinkAbout2610 PIRINEOS WAY; TP; CB020678; Permit5%
^^|:.03-04-2002
M,
'i^N;;{j6lD Address:
w'^Psrmit Type:
ijvc-'iiParcel No:
'fe'''; n
w-x-Reference #:
-v
'>,?> Project Title:
Applicant:
DARRYLCLUBB
City of Carlsbad ic£>
1635 Faraday Av Carlsbad, OA 92008
Electrical Permit Permit No: CB020678
Building Inspection Request Line (760) 602-2725
2610PIRINEOSWYCBAD Tf
ELEC
Lot #: 0
PIRINEOS PT-TEMP POWER POLE
Owner
Status: ISSUED
Applied: 03/04/2002
Entereid By: RMA
Plan Approved: 03/04/2002
Issued: 03/04/2002
Inspect Area:
2174 03/04/02 0002 01 02
CGP 20.00
,;;5v ;858 689-8911
' Total Fees:
X'-"'
'■iV'iV.x Electric Issu
$20.00 Total Payments To Date:$0.00..Balance Due:$20.00
ft: V'V
e Fee
Single Phase per /VMR'
Three Phase per /VMP
Three Phase 480 Per /\MP ■
Remodel/ZMteration 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$10.06.',^.00,
$0.60'
$0.00
$20.00
IsSx
'\{i
-fV
iOV''v
inspector:
FINAL APPROVAL
Date; j Clearance:
■■ '.Tl-F
t.V'
NOTICE: Please take NOTICE that approval of your project includes the Imposition" of fees, dedications, reservations, or other exactions hereafter coBectlvely
referred to as fees/exactions." You have 90 days from the ctete this permit was Issued to protest Imposition of these fees/exactions. If you protest them, you mustfollow the protest procedures set forth In Qovemment Code Section 68020(a), and ffle the protest arxl any other required Information with the City Manager for
processing In accordance with Carlstiad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any sutisequent legal adion to attack,
review, set aside, void, or annul their Imposition.
You are hereby FURTHER NOTIRED that your right to protest the specified feealexactlons 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 fT APPLY to any
fees/exactkms of which vou have oreviouslv been given a NOTICE simitar to this, or as to which the statute of Bmltatlons has orevlouslv otherwise expired.
PERMit APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
1. PROJECT INFORMATION
Address (Include BIdg/Sulte #) '
FOR OFFICE USE ONLY
PLAN CHECK N0._
EST. VAL.
Plan Ck. Deposit.
Validated By
Date 2 /
Business Name (at this address)
Legai Description Lot No.Subdivision Name/Number Unit No.Phase No.Totai # of units
Assassor's Parcei #Existing Use Proposed Use
SQ. FT.#of Stories # of Bedrooms 9 of Bathroomsueschption or work ,—
'11^^P. ..
2. CONTACT PERSON (H dHorent from applicant) " , „ . ^ x - , - ^ .
ne / Address City State/Zip Telephone 9 Fax 9Name / Address ' City Telephone 9 Fax 9
3. APPLICANT □ Contractor Q Agent for Contractor □ Owner □ Agent for Owner
\
Name
4. PROPERTY OWNER
Address City State/Zip Telephone 9
Name Address City State/Zip Telephone 9
B. 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, aiso requires the applicant for such permit to file a signed statement that ho 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 allegedexemption. Any violation of Section 7031.6 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$600]).
Name
State License 9
Address
License Class
City State/Zip
City Business License 9
Telephone #
Designer Name Address City State/Zip Telephone
State License 9
6. WORKERS' COMPENSATION
Workers' Compensation Dedaration: i hereby affirm under penalty of perjury one of the following declarations;
□ 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 wtiich 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 tfiis 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)
□ CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for wWch 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.
WARNMQ: Failure to sacure workers' compensation coverage Is unlawful, and shall subject an employar to criminal penalties and civil fines up to one hundred
thousand doUara ($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 DATE
7. OWNER-BUILDER DECLARATION
I hereby affirm that i am exempt from the Contractor's Licensa Law for the following reason:
n I, as owner of the property or my employees with wages as tfteir 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 doss not apply to an owner of property who builds or improves thereon, and who does
such work himseff or through his own employees, provided that such improvements are not intended or offered for sale, if, however, the building or improvemerrt is
sold witfrin one year of completion, the owner-builder will have the burden of proving ttrat he did not build or improve for the purpose of sale).
"^0—I, as owner of the property, am exduslvaiy contracting with iicertsed 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).
□ i am exempt under Section Business and Professions Code for this reason:
1.
2.
3.
i personally plan to provide the major labor and materials for construction of the proposed property improvement, d YES ^^[(nO
i have not) signed an application for a building permit for the proposed work.
i have contracted with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors license number):ving pe
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): / A7
DATE__3ryj^Z=PROPERTY OWNER SIGNATURE
COMPLETE THIS SECTION FOR NOli-SESOBfnAL BUILD»IQ P^lfS ONLY
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and preverrdon
program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? □ YES □ NO
is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? □ YES □ NO
is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ YES □ NO
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPUCANT 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(1) Civil Code).
LENDER'S NAME LENDER'S ADDRESS
9. APPUCANT CERIIFICATION
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 ail
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 A(3AINST ALL UABIUTIES,
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 S'O" 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 workauthorized by such permit is not cornmenced within 180 days from t^date of such permit or if the building or work authorized by such permit is suspended or abandonedat any time after the work is cemnwiced lor a oBriod of 180 UrjHoijzi Building Code).
HITE: Rie YELLOW: Applicant PINK: Finance
APPLICANT'S SIGNATURE DATE