The URL can be used to link to this page

Home My WebLink About2667 CAZADERO DR; ; CB992089; Permit06/02/1999 City of Carlsbad Electrical Permit Permit No:CB992089 Building Inspection Request Line (760) 438-3101 Job Address: Permit Type: Parcel No: Reference #: Project Title: 2671 CAZADERO DR CBAD ELEC STEVENS RESIDENCE TEMP. POWER POLE Lot#: Status: ISSUED Applied: 06/02/1999 Entered By: MDP Plan Approved: 06/02/1999 Issued: 06/02/1999 Inspect Area: Applicant: TEMP UTILITY SERVICES 1167LAWST SAN MARCOS, CA 92069 619-471-5494 |*£ <•#.««'#• Electric Issue Fee K 5 ***.!' Single Phase per AMP |:::;*Z^:: 0 •* -" , :~ ' Three Phase per AMP .£vir*-v»Z -^*-« - • & • ' " " * • ' Three Phase 480 Per AMP^;~^,j* t st^tt'0 . - ,,!»"' '• Remodel/Alteration per AM W* * 2 » * I - * - € - - ......,-»**. t * i, * « . » « » - •• -Remodel Fee ", 7 ,„._„„. - - Temporary Service Fee - *« f - **'* ' «*>!*' Test Meter Fee " « * ' "-;*•«*' ™ ^^^ ^ rf * * *f_ * ; Other Electrical Fees ":: :-:l. £*j±%to^*r<;V -V. - » *• - - — w'w_» §" "**o.oo 0.00 * "; ft^vS^o.oo;;;7:rt:t$o.ooi't*r!t"$o.oo • ""• -" -'* $0.00 » — v* • $10 00, *:z* $0.00.:t:' $0.00«h.^n «|MI Mti TOTAL PERMIT FEES $20.00 Inspector: FINAL APPROVAL 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 feej/exactigris 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 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760)438-1161 1. :, PROJECT INFORMATION FOR OFFICE USE ONLY PLAN CHECK NO.. EST. VAL. Plan Ck. Deposit Validated By Date Address {include Btdg/Suite *» #7/ CaxoTw Business Name tit this address) Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Total * of units Assessor's Parcel *Existing Us*Proposad Use Description of Work *of Storiei * of Bedroomsh*T*n tey/w1-"- ~:r.*'J r^M--r!^t-r--r:-.«ir^-*fc:-l|>*i«]Fl™^ 'iS^T ' M^'M"«]"-"" ''"I ""7 '" '•rantffi^iapiafclnia 9 of Bathrooms Address City State/Zip Telephone fName !S,;':. CONTRACTOR - tM^PAIiiyiiN/iiMSiiir^*^^ (See. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, attar, improve, demolish or repair any structure, prior to its issuance, also require* 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 Eolation of Section 70J81.5 by any applicant for a permi1^sub}ects the aop)icant,to-a civil penajry of not more^thsn five hund/ed dollars 1*5001).. Name State License 9 Address License Class City State/Zip City Business License f Telephone * Designer Nsme Address City State/Zip Telephone State License # 8. 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 ia Issued. J&* 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 came/ and policy number are: __ * Insurance Company -T 'f'Qf*, F U *i c/ Policy No. A* J^ // O " ?J Expiration Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1*100) OR LESS) Q CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is Issued, I shall not employ any parson in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage fa unlawful, «nd aha! subject an employer to criminal penaMM ami ctvH fines up to one hundred 1 compensation, damage* as provided for In Section 3706 of the Labor cod*. Interest and attorney's feu. DATE thousand dollars (jMOOXFDM, hi addition to thajcosty SIGNATURE /^ Jfbrvtsf ~—£ 7. OWNER-BUILDER DECLARATION // ' ~ ~ - - . , . . :„ . '.....•' :' ; I hereby affirm that I am exempt from the Contractor's License Law for the following reason: O I. " 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, th« building or improvement is sold within one y**r of completion, the owner-builder will have the burden of proving thit 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!*} 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 (heve / have not) signed an application for a bunding permit for the proposed work. 3. t have contracted with the following person (firm) to provide the proposed construction (include name / addra*s / phone number / contractors license number): 4. I plan to provide portions of the work, but I have hired the fallowing person to coordinate, supervise and provide the major work (include ntme / address / phone number / contractors license number): . 5. I wilt provide some of the work, but I have contracted (hired) the following parsons to provide the work indicated (include name / address / phone number / type of work): .__. _ PROPERTY OWNER SIGNATURE DATE COMPETE THIS SECTION FOR AfOA'-«Sro£V7I4iBUu^lNQ PERMITS ONLY , ,r : :^: , 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 Q 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 D NO Is the facility to be constructed within 1 ,000 fact of the outer boundary of • school site? D 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. a. ::.;ipit*niuCTioMi«bto :r: -^':':- .- '•.'- -' ': • I hereby affirm that there ia 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^ 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 lawa relating to building construction. I hereby authorize representative* of the Citt 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 i* required for excavations over 5'0" deep and demolition or construction of structure* over 3 stories in height. EXPIRATION: Every permit issued by the Building Official under tin provisions of this Coda shall expire by limitation and become null and void if the building or work authorized by such permit is not commenced within 385 daya from the date of such permit or if the building or work authorized by such permit is suspended or abandoned « any time after thvpotijt is commence*) for A/period of 180 daya (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE /HITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Inspection Request For: 6/3/99 Permit* CB992089 Title: STEVENS RESIDENCE Description: TEMP. POWER POLE Inspector Assignment: Type: ELEC Sub Type: Job Address: 2671 CAZADERO DR Suite: Lot 0 Location: APPLICANT TEMP UTILITY SERVICES Owner: K.F. STEPHENS, INC-NEWSFD Remarks: Phone: 7608399430 Inspector:4/r Total Time: CD Description 32 Const. Service/Agricultural Act Comments /_. Requested By: MECHELE Entered By: CHRISTINE Inspection History Date Description Act Insp Comments *r«ctp«*«Ts«o* Dogsr Or- Dm- fHUHKHJ ft HOM PAMR. nWM TO JT ITMMCN GtfM Q SMTBIIBI Dagur Jresr » haa nuauftf» HWD •tlON Tfl FAOLt CUWKNT j!.L STTlcf COMPENSATION INSURANCE P.O. BOX 420807, SAN FRANCISCO, CA 94142-0807 PU N D CERTIFICATE OF WORKERS' COMPENSATION INSURANCE MARCH 31, 1999 POLICY NUMBER: CERTIFICATE EXPIRES:1555110 3-31-00 - 99 r CITY OF CARLSBAD BUILDING & SAFETY DEPARTMENT 1200 ELM CARLSBAD, CA 92008 JOB: ALL OPERATIONS L_ This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon ten days' advance written notice to the employer. We will also give you TEN days' advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document with respect to which this certificate of insurance 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. AUTHORIZED REPRESENTATIVE PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,000 PER OCCURRENCE. EMPLOYER r S. R. BRAY CORPORATION DBA: POWER PLUS! TEMPORARY UTILITY SERVICES 1281 EAST SUNSHINE WAY ANAHEIM CA 92B06 SCIF 10262 (RCV 3-