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HomeMy WebLinkAbout2704 GATEWAY RD; TP; CB110514; Permit03-14-2011 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Electrical Permit Permit No: CB110514 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: 2704 GATEWAY RD CBAD St: TP ELEC 2132630900 Lot#: REPLACE METER BOX ON PREVIOUS PERMITTED TEMP POWER POLE Status: ISSUED Applied: 03/14/2011 Entered By: JMA Plan Approved: 03/14/2011 Issued: 03/14/2011 Inspect Area: Applicant: RCH CONSTRUCTION, INC. 26170 ENTERPRISE WAY STE.100 LAKE FOREST 92630 949-916-7663 Owner: L J R L L C ; P6 BOX 743 RANCHQ SANTA FE CA 92067 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 $10.00 $0.00 $0.00 $0.00 $0.00 $10.00 $0.00 $0.00 $0.00 $0.00 TOTAL PERMIT FEES $20.00 Total Fees:$20.00 Total Payments To Date:$20.00 Balance Due:$0.00 Inspector: FINAL APPROVAL Date: ?//7///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. >~ > T V O F Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718 / 2719 Fax: 760-602-8558 wvvw..ca rlsbadca.gov Plan Check No. Est. Value Plan Ck. Deposit SWPP CT/PROJ6CT#ufrr # OF UNITS I # BEDROOMS SUITE#/SPACE#/UNIT# # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) pe. j*° fl H* EXISTING USE PROPOSED USE GARAGE (SF)PATIOS (SF)DECKS (SF)FIREPLACE YES D #NO D AIR CONDITIONING YES D NO D FIRE__SPRINKLERS YES n NO D CONTACT NAME (If Different Fom Applicant)APPLICANT NAME ADDRESS fr-A CITY STATE ZIP STATE ZIP PHONE FAX PHONE FAX EMAIL EMAIL PROPERTYOWNERNAMEOPERTYOC6 CONTRACTOR BUS. NAME ADDRESS ADDRESS /&£> CIT*-, J.nft'tf STATE ZIP CITY STATE ZIP PHONE FAX PHONE EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS STATE LIC. # B CITY BUS. LIC.# (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 theapplicant 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 theBusiness 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 acivil penalty of not more than five hundred dollars ($500)). Workers' Compensation Declaration: / hereby affirm under penalty at perjury one of the following declarations: n I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued, d I have and will maintain workers' compensation, as reauired by Section 3700 of the Labor Code, for the performance of the work for which Ihispermil is issued. My workers' compensation insurance carrier and policy number are: Insurance Co. C^Wraa/- /\fe**«a>/ J-n$v*c**t* <<g. Policy No. y&&£>€>® 3 tS//O / Expiration Date 8/'/&>f/ This section need not be completed if the permit is for one hundred dollars ($100) or less. O 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 subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), in addition to the cost of compensation, damages as>orovided for infection 3706 of the Labor code, interest and attorney's fees. / ^CONTRACTORSIGNATURE ^-^7^-t*^T *" '^W&SENT DATE (3/'/ / hereby affirni that I am exempt from Contractor's License Law for the following reason: D 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). D 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 . 1 personally plan to provide the major labor and materials for construction of the proposed property improvement. D Yes n No 2. 1 (have / have not) signed an application for a building permit for the proposed work. 3. 1 have contracted with the following person (firm) to provide the proposed construction (include name address / phone / contractors' license number): 4. 1 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 / contractors' license number): 5. 1 will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone / type of work): pROPERTY OWNER SIGNATURE DAGENT DATE 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? DYes O No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? O Yes d No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? n Yes a No IF ANY OF THE ANSWERS ARE YES, / EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address 5 relating to building construction. I hereby authorize representative 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 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 is not commenced within 1 80 days from the date of such permit or if the building or workaujborized byapch permit is suspended or abandoned at any time after the work is commenced for a^period of J80 days (Section 1 06.4.4 Uniform Building Code). APPLICANT'S SIGNATURE City of Carlsbad Bldg Inspection Request For: 03/15/2011 Permit* CB110514 Title: REPLACE METER BOX ON PREVIOUS Description: PERMITTED TEMP POWER POLE Inspector Assignment: 2704 GATEWAY RD TP Lot: Type: ELEC Sub Type: Job Address: Suite: Location: APPLICANT RCH CONSTRUCTION, INC. Owner: L J R L L C Remarks: Phone. 6195615119 Inspector: ; Total Time:Requested By: JACKIE Entered By: CHRISTINE CD Description 32 Const. Service/Agricultural Act Comments/? /?' Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# Inspection History Date Description Act Insp Comments