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HomeMy WebLinkAbout2704 LOKER AV WEST; ; CB061870; Permit06-29-2006 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Electrical Permit Permit No: CB061870 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: Project Title: 2704 LOKER AV WEST CBAD St: TP ELEC 0000000000 Lot #: TEMP POWER POLE - BANK OF AMER Status: ISSUED Applied: 06/29/2006 RMA 06/29/2006 06/29/2006 Entered By: Plan Approved: Issued: Inspect Area: Applicant: NATIONAL CONSTRUCTION Owner: 14551 ANDEL DR 92335 909574-1400 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 TOTAL PERMIT FEES $10.00 $0.00 $0.00 $0.00 $0.00 $0.00 $10.00 $0.00 $0.00 $0.00 $20.00 Total Fees:$20.00 Total Payments To Date:$20.00 Balance Due:$0.00 Inspector:(2-FINA1, 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 tp FOR OFFICE USE ONLY 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 # of units Assessor's Parcel #Existing Use Proposed Use Description of Work SQ.FT.#of Stories # of Bediooms of Bathrooms Name Address City islisslSiS^ fZ-' " " State/Zip Telephone # Fax # Address City State/Zip Telephone # Name Address City State/Zip Telephone # (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 Cede] or that he is exempt therefrom, and the basis for the alleged applicant to^a civilypenalty of not mojjay Address License Class £M>-City State/Zip City Business License # Telephone^* -04^5 Address City State/Zip Telephone Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: O ' 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. 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 worker's compensation insurance carrier and policy/lutj Insurance Company TfflV&L#fr'£ Y^P (J&UJ {"l^l L7U ~NL Policy No. I TSUUtTfT-IC/i? ^JXftti Expiration Date {THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS4E0R ONE HUNDRED DOLLARS [$1001 OR LESS) O CERTIFICATE OF EXEMPTION: 1 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; Pollute to secure wothets' compensation coverage is unlawful, end shall subject an emploVei to criminal penaltie* and civil fines up to on* hundred tbdusand doHsnTt+4pO^BCH, DVg^dttiSn to the cost of compensation, damages as provided for In Secti6TT^706 of the jLabor code,Jnter«st and attorney's fees. ^/SIGNATURE, I hereby affirm that I am exempt from the Contractor's License Law for the following reason: LJ 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). 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(s) licensed pursuant to the Contractor's License Law). CI 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, fj 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, 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 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? C] 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 KOT BE ISSUED UNLESS THE APPLICANT HAS MET OH IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. siiltiti^ :'>Y^^;;;:v:<r^ H-^y-r 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 I certify that 1 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 AMD 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'buiiuThx) 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 commerfced withirt 180 days from the date ot such permit or il the building or work authorized by such permit is suspended or abandoned at any time after the wotie^ssafa^p^Sppr^BSnod of 180 days (Section 106.4.4 Uniform Building Code). ] , DATE &APPLICANT'S SIGN WHITE; File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 06/30/2006 Permit* CB061870 Title: TEMP POWER POLE - BANK OF AMER Description: Inspector Assignment: 2704 LOKERAVWEST TP Lot 0 Type: ELEC Sub Type: Job Address: Suite: Location: APPLICANT NATIONAL CONSTRUCTION Owner: Remarks: Phone: 7605741400 Inspector: Total Time: CD Description Act Comment 32 Const. Service/Agricultural Comments/Notices/Hold Associated PCRs/CVs Original PC# Requested By: NA Entered By: CHRISTINE Inspection History Date Description Act Insp Comments -03; 2 ENERGV i7so 436 o§s LUui1U siF °U a sz 33 Oo&iUl 3 as u UJJu 8 -if o •« S VI 2 u. )e >*S a o 5 ,S £f3ojs.§ = ! " C4 * » ^ I"IS2 2"o S Ja»- . "55°ls|1at *- _ '^ ^ 5» 2 ^*S uu .2li^ajl f-S-S 3« g .— o M a> v 3egg"^s s ™ s^^ §K =£.?»7; = Q « g a 5s I -g s - l g « 5 = 5 5 S. Efeetit, ACORDm CERTIFICATE OF LIABILITY INSURANCE Page i .f 2 PRODUCER 87?_945_7378 Willia North America, Inc. - Regional Cart Center 26 Century Blvd. P. 0. Box 305191 Nashville, TN 372305191 INSURED National Construction Rentals, Inc. 15319 Chatsworth Straet Mission Hills, CA 91345 1 DATE 05/02/2006 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; Travelers Property Casualty Company of Am INSURER B: INSURER C: INSURER D: INSURERS: NAIC# 25674-006 COVERAGES 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. INSRLTR A A UHJ'INSRD TYPE OF INSURANCE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY 1 CLAIMS MADE [ ] OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS OARAGE LIABILITY _ ] ANY AUTO EXCESS LIABILITY j OCCUR j j CLAIMS MADE n DEDUCTIBLE RETENTION S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY ANY PROPRIETOR/PARTNER/EXECUTIVE OFFICER/MEMBER EXCLUDED? If yet, describe undw SPECIAL PROVISIONS below OTHER POLICY NUMBER TC2JUB419J201706 TRJUB419J522806 POLICY EFFECTIVEDATE<MM/DD/YY1 5/1/2006 5/1/2006 POLICY EXPIRATIONDATEfMM/DD/YYl 5/1/2007 5/1/2007 UMfTS EACH OCCURRENCE DAMAGETO RENTEDPREMISES (Ea occurence) MED EXP (Any on* pereon) PERSONAL &ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG COMBINED SINGLE LIMIT (Eaacddent) BODILY INJURY(Per pereon) BODILY INJURY (Per accident) PROPERTY DAMAGE(Per accident) AUTO ONLY - EA ACCIDENT AUTO ONLY:AGG EACH OCCURRENCE AGGREGATE X TO^?[{MIITS|°E$ E.L. EACH ACCIDENT E.L. DISEASE • EA EMPLOYEE E.L. DISEASE - POLICY LIMIT S S $ S S $ $ S $ $ S S S S S $ $ S S 1,000.000 S 1,000.000 S 1.000.000 - DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS CERTIFICATE HOLDER CANCELLATION Evidence SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30 DAys WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO DO SO SHALL IMPOSE' NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE INSURER, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE^2X<^ — — ACORD 25 (2001/08)Coll:1616095 Tpl:490259 Cert:7239588 ©ACORD CORPORATION 1988