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Home My WebLink About2634 GATEWAY RD; TP; CB080121; Permit01-16-2008 ' City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Electrical Permit Permit No CB080121 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 2634 GATEWAY RD CBAD St TP ELEC 0000000000 Lot # 200 AMP TEMP POWER POLE Status ISSUED Applied 01/16/2008 KG 01/16/2008 Entered By Plan Approved Issued Inspect Area 01/16/2008 Applicant POWER FABRICATING INC 625 S FEE ANA ST PLACENTIA CA 92870 714223-3600 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 200 0 0 0 $1000 $5000 $000 $000 $000 $000 $000 $000 $000 $000 $6000 Total Fees $60 00 Total Payments To Date $60 00 Balance Due $000 Inspector FINAL APPROVAL J Vi- 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 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 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 FOR OFFICE USE PLAN CHECK N EST VAL Plan Ck Deposit ValidaterJ By_ Date Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total # of units Assessor s Parcel Existing Use Proposed Use *Jemp Power Pole ition of WorkDescription SQ FT #of Stories # of Bedrooms # of Bathrooms CONTACT PERSON (if different from applicant) Name 3... APPLICANT jjj f\ CD Contractor Seymour Address CD Agent for Contractor ' 9.4S8S Santa Fe City CD Owner CD Agent for Owner Ave Vista. CA 07.084 State/Zip Telephone # Fax It 760-SQ7-7Q04 Name Address City State/Zip Telephone # PROPERTY OWNER *Grant CoPt Ave Fnnnas TarkhaH TA Q9008 760-438-7500 Address City State/Zip Telephone #Name !5" CONTRACTOR COMPANY NAME ,-;: :"~ i t (Sec 7031 5 Business and Professions Code Any City or County which requires a permit to construi t 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 apolicant for a permit subjects the applicant to a civil penalty of not more than five hundrexl dollars U 500!)714-223-5600 er ei tion Any violation of Section 7031 5 by any apolicant for a permit subjects the applicant to a civil penalty of not *Power Fabricating Inc 625 S Fee Ana St Placentia, CA 92870 Name State License # *5Q571 3 Address License Class City State/Zip City Business License # Telephone t 1221182 Designer Name Address City State/Zip Telephone State License # 6 ....WORKERS.., COMPENSATION* , Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations CD 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 n 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 Comparfj^Old Republic General Policy NA1 C W49500702 Expiration Datel 0/0 1/08 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) D CERTIFICAIEOF 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 subiect tcNhe WdfkWs Compensation Laws of California WARNING Failure tcljeaule workers compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars <$1u(KMl>\r> addition to the cost of compensation damages as provided for in Section 3706 of the Labor code, interesuip^ttorney s fees SIGNATURE V fftlS^^ ^ DATE fal * I [& ~( 7 OWNER B\mJ>A/t'ECLARATIOr7~ I hereby affirm that I i l~l I as owner of exempt from the Contractor s License Law for the following reason Lroperty 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 ana 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) CD 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 CD YES CDNO 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 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? d YES C] 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 Q NO Is the facility to be constructed within 1 000 feet of the outer boundary of a school site? CD YES CD 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 APPLICANT CERTIFICATION 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 CitV 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 stiuctures over 3 stones in height EXPIRATION Every permit islued lw thi bUding 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 commWidftd iithm 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 colrimenc»J*J period of 180 days (Section 106 4 4 Uniform Building Code) APPLICANT S SIGNATURE DATE ft) \. WHITE File YELLOW Applicant PINK Finance City of Carlsbad Bldg Inspection Request For 01/25/2008 Permit* CB080121 Title 200 AMP TEMP POWER POLE Description 2634 GATEWAY RD TP Lot Type ELEC Sub Type Job Address Suite Location APPLICANT POWER FABRICATING INC Owner Remarks Inspector Assignment Phone 7606446107 Inspector Total Time CD Description 32 Const Service/Agricultural 39 Final Electrical Act Com me a. Comments/Notices/Holds Requested By GARY Entered By CHRISTINE Associated PCRs/CVs Original PC# Inspection History Date Description Act Insp Comments ta Dale (mm/dd/yy) 10/11/2007 Producer Countrywide Insurance Services, Inc PO Box 25317 Santa Ana CA 92799 (949) 222-8500 insurance countrywide com/Commercial/default aspx OC17399 Insured Temp Power Systems Inc 625 Fee Ana Street Placentia,CA 92870 THIS. CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND EXTEND OR ALTERTHE COVERAGE Al FORDED BY THE POLICIES BELOW INSURERS7\FFORDTNGCOVERAGE INSURER A Old Republic General Insurance Corp INSURER B INSURER c INSURER INSURER E '^'a^'.^W^ i';>:^f:^^V;;^»5£^'V^S.x-^.'5-.^-..;••>-:.- .-•:v..».-.."-f ••^•asl^s!«W1:^''"«--'"*r-v\!;-?-,;«?*;" i? •;'• •*•"-, •-• Vi1 -.••,••' ••••'• •&'x-&h.ivfh4"-1 '"• -'''-''-'-'''-'- - ' '- •'•• '•-a'-; THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY ABOVE FOR THE POLICY PERIOD INDICATED DOCUMENT WITH RESPECT TO WHICH THIS DESCRIBED HEREIN IS SUBJECT TO ALL THE HAVE BEEN REDUCED BY PAID CLAIMS NSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE MM/DD/YY POLICY EXPIRATION DATE MM/DD/YY LIMITS iOCCUR ^ENERAL LIABILITY / COMMERCIAL GENERAL LIAB H ^CLAIMS MADE H PEP 10.000 GEN L AGG LIMIT APPLIES PER ~]POLICY [7JPROJECT |~| LOC A1CG49500701 10/1/2007 10/1/2008 EACH OCCURRENCE FIRE DAMAGE (Any one tire) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS-COMP/OP AGG 2.000^00 UTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS '. ... SCHEDULED AUTOS ~7_ HIRED AUTOS / NON OWNED AUTOS A1CA49500702 10/1/2007 10/1/2008 COMBINED SINGLE LIMIT 1,000000 BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE (Per accident) GARAGE LIABILITY ~~ANY AUTO AUTO ONLY EA ACCIDENT OTHER THAN AUTO ONLY EA ACC $ AGG S EXCESS LIABILITYn EACH OCCURRENCE OCCUR CLAIMS MADE AGGREGATE (RETENTION $ WORKERS COMPENSATION & EMPLOYERS LIABILITY A1CW49500702 10/1/2007 10/1/2008 71 STATUTORY LIMIT T PTHER EL EACH ACCIDENT 1.000.00 EL DISEASE EA EMPLOYEE EL DISEASE POLICY LIMIT .OOOTOTJ .000.00' DESCRIPTION OF OPERATIONS/LOCAT ONSA/EHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS Re License #696713 Re License #696713 Contractors State License Board Attn Insurance Department 9821 Business Park Drive Sacramento, SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE CA 95827-1703 LEFT BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY ITS AGENTS OR REPRE SENTATIVES * 10 Days for Non Payment of Premium AUTHORIZED REPRESENTATIVE | Stephen Wood