HomeMy WebLinkAbout2636 GATEWAY RD; ; CB080120; Permit01-16-2008
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Electrical Permit Permit No CB080120
Building Inspection Request Line (760) 602-2725
Job Address
Permit Type
Parcel No
Reference #
Project Title
2636 GATEWAY RD CBAD
ELEC
0000000000
BRESSI RANCH
200 AMP POWER POLE
Lot#
Status
Applied
Entered By
Plan Approved
Issued
Inspect Area
Applicant
POWER FABRICATING INC
625 S FEE ANA ST
PLACENTIA CA 92870
714223-3600
Owner
ISSUED .
01/16/2008
MDP
01/16/2008
01/16/2008
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
200
0
0
0
$1000
$5000
$000
$000
$000
$000
$000
$000
$000
$000
TOTAL PERMIT FEES $6000
Total Fees $60 00 Total Payments To Date $60 00 Balance Due $000
Inspector
FINAL APPROVAL
Date Clearance V"*g
NOTICE Please take NOTICEthat 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 APPL> 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 NO
EST VAL
Plan Ck Deposit.
Validated By
Date
Address (include Bldg/Suite #)Business Name (at this address)
Legal Description Lot No Subdivision Name/Number Unit No Phase No Total tt of units
Asselessors, Parcel t^Temp Power Pole Existing Use Proposed Use
Description of Work SQ FT #of Stones # of Bedrooms tt of Bathrooms
.." ' ':, "Wt*
Name Address City
nt'torCorrtraqiqr : Q Owner ^D'Agem for C^JJL . "."
> Santa Fe Ave Vista, CA 92084
State/Zip Telephone # Fax tt
760-597-2904
Name Address City State/Zip Telephone tt
Tahf General Corit 55t)t Ave^ Encihas^Sle 100 Carlsbad. 92008 "'" 760-4lS-7snn
City State/Zip Telephone ttName Address
iRPPWliil^S:CSpp/iN^aM.E?:•' ''•'.: f ;'••.
(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 end the basis for the alleged
more than
Name
State License 0*696713
Address
License Class
City State/Zip Telephone tt
City Business License # 1221 1 82
Designer Name
State License #
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 prodded 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 wortot&cQ]n||ansation|inGurane« carrier and policy number are ,>-,,, , ..-^^^ ~ —
insurance ComprnPJ?^P™i^£^ _ Policy &1 CW49S00702 Exp.rat.on DatLO/01/08
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS)
D CERTIFICAHhQF 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 tbe Wo/i<tirs Compensation Laws of California
WARNING Failure to ncoVl vlorkers compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to one hundred
i ($100 JMMWn/addrtion to the cost of compensation damages as provided for In Section 3706 of the Lalj
— -^ DATE
attorney a fees
..
I hereby affirm that I am kkempt from the Contractor s License Law for the following reason
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 at 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)
n 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 contractors) licensed
pursuant to the Contractor s License Law)
n 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 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 supeivise 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
iiBECjKJlFN^ •>.%.:•..;•-..'• • •:. • i;:.'^:;v..:^»-,.i..:.;.;:-^..;s:.= .,-.;- 1-iKk^1^
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? O 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? Q YES Q 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
iiHfiiMNWsiPf^v:•:;';•"'.:.'•..li.-,.,."''.'•..".-.^1L;,.•: '.'•...-^ '. -.1 •" -,..:", :',';•'...,.-•' •.' .-.' :::: t?
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
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 [0qTlrred for excavations over 5 0" deep and demolition or construction of structures over 3 stones in height
EXPIRATION Every permit issued DM tjm 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 li not comoVfcea 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\commert0\for\a period of 180 days (Section 106 4 4 Uniform Building Code)
APPLICANT S SIGNATURE DATE
WHITE File YELLOW Applicant PINK I mance
City of Carlsbad Bldg Inspection Request
For 01/25/2008
Permit* CB080120
Title BRESSI RANCH
Description 200 AMP POWER POLE
Inspector Assignment J
Type ELEC Sub Type
Job Address 2636 GATEWAY RD
Suite Lot C
Location
APPLICANT POWER FABRICATING INC
Owner
Remarks
Phone 7606446107
Inspector
Total Time
CD Description
32 Const Service/Agricultural
39 Final Electrical
Act Comments
Requested By GARY
Entered By CHRISTINE
Comments/Notices/Holds
Associated PCRs/CVs Original PC#
Inspection History
Date Description Act Insp Comments
Date (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 ALTER THE
COVERAGE AFFORDED BY THE POLICIES BELOW
INSURERS AFFORDING COVERAGE
INSURER
A
Old Republic General Insurance Corp
INSURER
B
INSURER
D
INSURER
E
THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED
NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS
CERTIFICATE MAY BE ISSUED OR MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE
TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY 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
^ENERAL LIABILITY
TlcOMMERCIAL GENERAL LIAB A1CG49500701 10/1/2007 10/1/2008
EACH OCCURRENCE
FIRE DAMAGE (Any one fire)
CLAIMS MADE OCCUR MED EXP (Any one person)
PERSONAL & ADV INJURY
PEP 10.000
GEN L AGG LIMIT APPLIES PER
GENERAL AGGREGATE
[TlpROJECT [~| LOC
PRODUCTS COMP/OP AGG 2.000.000
AUTOMOBILE LIABILITY
T^ANY AUTO
ALL OWNED AUTOS .
SCHEDULED AUTOS
71 hiRED AUTOS
7" 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 $
EXCESS LIABILITY
| |
EACH OCCURRENCE
CLAIMS MADE AGGREGATE
DEDUCTIBLE
"| RETENTION 3
WORKERS COMPENSATION &
EMPLOYERS LIABILITY A1CW49500702 10/1/2007 10/1/2008 /| STATUTORY LIMIT
EL EACH ACCIDENT 1.000.00
EL DISEASE EA EMPLOYEE
EL DISEASE POLICY LIMIT
[00
I.OOO
DESCRIPTION OF OPERATIONS/LOCAT ONS/VEHICLES/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
LEFT BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION
OR LIABILITY 01 ANY KIND UPON THE COMPANY ITS AGENTS OR REPRE
SENTATIVES * 10 Days for Non Payment of Premium
CA 95827-1703 AUTHORIZED
REPRESENTATIVE
Stephen Wood
.-...