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Home My WebLink About2684 GATEWAY RD; ; CB061101; PermitJ 05-22-2006 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Electrical Permit Permit No CB061101 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 2684 GATEWAY RD CBAD ELEC 0000000000 Lot# Status ISSUED Applied 04/24/2006 JMA 04/24/2006 04/24/2006 TEMP POWER POLE FOR CONST Entered By Plan Approved Issued Inspect Area BN Applicant NATIONAL CONSTRUCTION Owner 14551 ANDEL DR 92335 909 574-1400 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 0 0 0 0 $1000 $000 $000 $000 $000 $000 $1000 $000 $000 $000 TOTAL PERMIT FEES $2000 Total Fees $20 00 Total Payments To Date $20 00 Balance Due $000 Inspector FINAL APPROVAL Date Clearance NOTICE Please take NOTICE that approval of your project includes the Imposition of fees dedications reservations or other exactions hereafter collectively referred to as fees/exactions You have 90 days from the date this permit was issued to protest imposition of these fees/exactions If you protest them you must follow the protest procedures set forth in Government Code Section 66020(a) and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3 32 030 Failure to timely follow that procedure will bar any subsequent legal action to attack review set aside void or annul their imposition You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes nor planning zoning grading or other similar application processing or service fees in connection with this project NOR DOES IT APPLY to any fees/exactions of which YOU have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 FOR OFFICE USE ONLY PLAN CHECK NO EST VAL Plan Ck Deposit. Validated By Date Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total # of units Assessor s Parcel #Existing Use Proposed Use #of Stories . &/$"/*- «» from applicant) J ft of Bedrooms # of Bathrooms Name aSF AppLicAri Address Contractor 3[ Agent for Contractor OlQwner City Agent foj Owner State/Zip Telephone # Fax # State/Zip "Telephone # City State/Zip Telephone #Name '/ Address 5 .:CCONf'RACTOR - COJVIPANY NAME ;J 4:; (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] 01 that he is exempt therefrom and the basis for the alleged option Any viqj^tijxryf Section, 7031^6"^ any^pphgant for a permit subjects Jjje applicarrtjg a C|vil penalty cjjiot more than five hundred dollars I Address License Class City State/Zip Telephone # City Business License # /% IO *f U?S~ 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 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 is issued US 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 ^f/e0L,(s-£-*&'&& Policy No /f^ vfc^t' ifr/^(flf^^.TKOVV\.va\ Date_ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) D 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 workers compensation coverage is unlawful and shall subjeg>en employer to criminal penalties and civjj. fines up to one hundred thousand dollars ($100 000) in addition to the^atJsTof^ompensatio^^a^gea^prov^tftor in Section 3706 of the Labor^pode inte/^st and attorney s fees SIGNATURE S /^t^C^^^^^^^i-- DATE . 7 .OWNER BUILDER DECLARATION •. L-S—^ *: ^ ~~ TlrfS I hereby affirm that I am exempt from the Contractor s License Law for the following reason 0 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 no>mtended 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 provingjjlat he did not build or improve for the purpose of sale) n I as owner of the property am exclusively contracting with licensed cgtrfractors to construct the project (Sec 7044 Business and Professions Code The Contractor s License Law does not apply to an owner of property who^Jaffilds 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 Pjafessions Code for this reason 1 I personally plan to provide the major labor and mater|afs for construction of the proposed property improvement l~l YES |~|NO 2 I (have / have not) signed an application for a bu^dmg 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/tut 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 i;;,, ... *ist "••• ™, 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 ^ct? d YES Q NO ^^Is the applicant or future building occupant required to obtain a oefffnt from the air pollution control district or air quality management district' Q YES O NO Is the facility to be constructed within 1 000 feet of the oj^r boundary of a school site' O YES O NO IF ANY OF THE ANSWERS ARE YES A FINAL CERJJFff*ATE 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 "r'" *r" :iH» %- " ,. "" _,,. ::": ,„ I hereby affirm that there is a construction lending ao^Bcy for the performance of the work for which this permit is issued (Sec 30970) Civil Code) LENDER S NAME ^^ LENDER S ADDRESS 1"" APPLICANT CERTIFICATION 'KS& JV ' ""'" IT" :' °... ..J^ 1 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 excavationsjwer 5 0 deep and demolition or construction of structures over 3 stories in height EXPIRATION Every permit issued by the buildj authorized by such permit is not commenced at any time after the work is commenced for jf period APPLICANT S SIGNATURE under the provisions of this Code shall expire by limitation and become null and void if the building or work from the date of such permit orjMSe building or work authorized by such permit is suspended or abandoned days (Sectjjxi 10§^r4yniforrj^Buildmg Code; DATE WHITE File YELLOW Applicant PINK Finance City of Carlsbad Bldg Inspection Request For 05/19/2006 Permit* CB061101 Title TEMP POWER POLE FOR CONST Description Sub Type 2684 GATEWAY RD Lot Type ELEC Job Address Suite Location APPLICANT NATIONAL CONSTRUCTION Owner Remarks Inspector Assignment BN Phone 9095741400 Inspector Total Time CD Description Act Comment 32 Const Service/Agricultural Comments/Notices/Hold Requested By DIANA Entered By CHRISTINE Associated PCRs/CVs Original PC# Inspection History Date Description Act Insp Comments 05/02/2006 32 Const Service/Agricultural NR BN nothing in place ff!|lrli It £0 39yd 1SN03 1WNOI1VN 69 30 05/84/2ee'5 16 21 5624990432 DOUGHERTY CO 92 40UB. 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