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Home My WebLink About2627 COLIBRI LN; ; CB010323; Permit01/25/2001 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Electrical Permit Permit No CB010323 Building Inspection Request Line (760) 602-2725 Job Address 2627 COLIBRI LN CBAD Permit Type ELEC Status ISSUED Parcel No 2155352300 Lot# 0 Applied 01/25/2001 Entered By RMA Reference # Plan Approved 01/25/2001 Issued 01/25/2001 Project Title ARMSTRONG RES-ADD CIRCUIT, Inspect Area CHANGE PLUGS/LIGHTS-KITCHEN-GAS TO STOVE Applicant MIRABELLA CONSTRUCTION P O 462696 ESCONDIDO CA 92046 760-738-7446 Owner ?°*3 Ol/25/01 5002 01 ARMSTRONG ERIC W&BETH A CQF» 2627 COLIBRI LN CARLSBAD CA 92009 4? Total Fees $4700 Total Payments To Date $000 Balance Due $4700 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 TOTAL PERMIT FEES 0 0 0 0 $1000 $000 $000 $000 $000 $1000 $000 $000 $2700 $4700 Inspecti FINAL Date ¥•*•••/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 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 .A RROJECT INFORMATION FOR OFFICE USE O PLAN CHECK NO EST VAL Plan Ck Deposit _ Validated By Date / H/ ( / ABJdress (include Bldg/Suite tt)Business Name (at this address) Legal Description Subdivision Name/Number /.^" / -T71 I)Assessor s Parcel # / \ ( f CsTl Unit No Phase No Total # of units Proposed Description of Work 2 CONTACT PERSON (if different from applicant) SO FT M Stories # of Bedrooms # of Bathrooms Name 3 APPLICANT Address lontractor Q Agent for:; Contractor City Owner D Agent for Owner State/Zip Telephone # Fax # Name 4 PROPERTY OWNER Address City State/Zip Telephone # Address City State/Zip Telephone #Name 5 ' CONTRACTORS-COMPANY NAME If :3;vi s '":"':i':: '"-' •' "V-A •'••:, , (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 5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500]) Name f State License tt &> / Address ^94^£~3 License Class 6 City State/Zip City Business License # /•*£. Telephone # Designer Name State License # Address City State/Zip Telephone et^ WORKERS COMPENSATION" '"" ... :«" • :,' .. .:,:i-"" .. ..:"" Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations n 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 V2 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 ^T^r^C ^tfl ^ Policy No &¥& -O/ - 0<? <%O ~?% Expiration Date /"~/~GZ~ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) l~l 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 workersfetoropBnsation cpvgrage^-tinlawful and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100 000) in additfcn to_t>ffi cost pfcon SIGNATURE 7 'damages as provided for in Section 3706 of the Labor code interest and attorney s fees _, DATE OWNER BUILDER DECLARATION -yi :7 I 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 will have the burden of proving that he did not build or improve for the purpose of sale) l~l 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) l~l 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~lNO 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 of work) PROPERTY OWNER SIGNATURE DATE COMPLETE ^THIS SECTION FOR NON RESIDENTIAL BUILDING PERMITS ^ ONLY ;£ 1 v; 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? C] YES [H NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? l~l YES l~l 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 8. CONSTRUCTION LENDING AGENCY -s; h i , ' / .,>•••- >, 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 _ _____ 9,, 1 1 APPLICANT CERTIFICATION :Y '•"""" , ..'-*":- '" '" :-"i .. •"" ,., ..... "'"" ^ ^W 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 stories in height EXPIRATION Every permit issued by the ^uilding^SlftcH^li under the pro>tsiops ofthis'Codeshall expire by limitation and become null and void if the building or work authorized by such permit is not commenced wttj^liiijspday^ffom the-date>of syeh permtTor if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced for a aenod^Tn<nia^3eftton^(lo4^IJiK>fm Building Code) APPLICANT S SIGNATURE DATE WHITE File YELLOW Applicant PINK Finance City of Carlsbad Bldg Inspection Request For 03/30/2001 Permit# CB010323 '1 Title ARMSTRONG RES-ADD CIRCUIT, Description CHANGE PLUGS/LIGHTS-KITCHEN-GAS TO STOVE Inspector Assignment PD 2627 COLIBRI LN Lot Type ELEC Sub Type Job Address Suite Location APPLICANT MIRABELLA CONSTRUCTION Owner ARMSTRONG ERIC W&BETH A Remarks AM PLEASE Phone 6195205015 Inspecto Total Time CD Description 19 Final Structural 29 Final Plumbing 39 Final Electrical 49 Final Mechanical Requested By JOHN Entered By CHRISTINE Act Comments Associated PCRs Inspection History Date Description Act Insp Comments 02/05/2001 17 Interior Lath/Drywall AP PD NO CARD 02/01/2001 24 Rough/Topout AP PD 02/01/2001 33 Service Change/Upgrade AP PD 02/01/2001 34 Rough Electric AP PD City of Carlsbad Bldg Inspection Request For 02/01/2001 Permit# CB010323 J Title ARMSTRONG RES-ADD CIRCUIT, Description CHANGE PLUGS/LIGHTS-KITCHEN-GAS TO STOVE Inspector Assignment 2627 COLIBRI LN Lot Type ELEC Sub Type Job Address Suite Location APPLICANT MIRABELLA CONSTRUCTION Owner PEARSON BETH A Remarks Phone 6195205015 Inspector Total Time CD Description 24 Rough/Topout 33 Service Change/Upgrade 34 Rough Electric Act Comments Requested By ARMSTRONG RES /JOHN Entered By CHRISTINE Associated PCRs Inspection History Date Description Act Insp Comments TERMS OF PARTICIPATION IN A DESIGNATED REP 09 PREFERRED PROVIDER FACILITY 046-01- 008073 _ RENEWAL COMPENSATION SD '•ISURANCE 2-35-19-14 FUND PAGE 1 HOME OFFICE ENDORSEMENT AGREEMENT .SAN FRANCISCO EFFECTIVE JANUARY 1, 2001 AT 12.01 A.M. ALI, EFFECTIVE DATES ARE AT! 12 01 AM PACIFIC STANDARD TIME OR THE TIME INDICATED AT PACIFIC STANDARD TIME MIRABELLA CONSTRUCTION, INC. P.O. BOX 462696 ESCONDIDO, CA 92046 ANY CONTRADICTION BETWEEN THE POLICY AND THIS ENDORSEMENT WILL BE CONTROLLED BY THIS ENDORSEMENT IT IS AGREED THAT THE POLICYHOLDER SHALL REFER ALL WORK RELATED INJURIES OR DISEASE TO AN AGREED DESIGNATED PREFERRED PROVIDER FACILITY AT THE TIME OF A WORK RELATED INJURY OR UPON KNOWLEDGE OF A WORK RELATED INJURY OR DISEASE IT IS FURTHER AGREED THAT PARTICIPATION IN THIS PROGRAM IS VOLUNTARY AND IS EFFECTIVE FOR THIS POLICY PERIOD ONLY RENEWAL OF THIS PROGRAM IS OPTIONAL FOR THE POLICYHOLDER AND THE INSURER AND MAY BE DEPENDENT UPON POLICYHOLDER COOPERATION IN THE REFERRAL OF INJURED WORKERS TO THE DESIGNATED PREFERRED PROVIDER. IT MAY ALSO BE DEPENDENT UPON POLICYHOLDER COOPERATION IN EARLY RETURN TO WORK AND MODIFIED WORK PROGRAMS. IT IS FURTHER AGREED THAT THIS ENDORSEMENT IN NO WAY AFFECTS THE RIGHT OF AN INJURED WORKER TO PREDESIGNATE A PHYSICIAN OR TO SELECT HIS OR HER OWN PHYSICIAN 30 DAYS AFTER THE DATE OF INJURY. IT IS FURTHER AGREED THAT ANY PREMIUM DISCOUNT GIVEN FOR PARTICIPATION IN THIS PROGRAM WILL BE RESCINDED IF YOU ARE NO LONGER ELIGIBLE FOR PARTICIPATION. NOTHING IN THIS ENDORSEMENT CONTAINED SHALL BE HELD TO VARY, ALTER, WAIVE _fL THJ!. TERMS, CONDITIONS, AGREEMENTS, OR LIMITATIONS OF THIS~ ~POLICY OTHER THAN AS STATED NOTHING ELSEWHERE IN TWS POLICY SHALL BE "' HELD TO VARY, ALTER, WAIVE OR LIMIT THE TERMS, CONDITIONS, AGREEMENTS OR *" ' LIMITATIONS OF THIS ENDORSEMENT COUNTERSIGNED AND ISSUED AT SAN FRANCISCO " DECEMBERS?, 2000'' : 2430 ssf ,. ... ,. ._, AUTHORIZED REPRESENTATIVE ' PRESIDENT