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HomeMy WebLinkAbout2772 JEFFERSON ST; MULTI-PERMIT FILE; CB012482; Permit' City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 07/24/2001 Electrical Permit Permit No:CB012482 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 2772 JEFFERSON ST CBAD St: TP ELEC Status: Parcel No: 2032010300 Lot#: 0 Applied: Reference #: Project Title: Applicant: CITY STORM DRAIN PROJECT TEMP POWER POLE TEMP POWER SYSTEMS 750 N. CITRACADO PKWY. ESCONDIDO CA 92025 760 439-1999 Entered By: Plan Approved: Issued: Inspect Area: Owner: BURKE DANIE;L V&SUSAN B 2755 JEFFERSON ST #100 CARLSBAD CA 92008 ISSUED 07/24/2001 MOP 07/24/2001 07/24/2001 Total Fees: $20.00 Total Payments To Date: $0.00 Balance Due: $20.00 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 0 0 0 0 FINALAPPiAL Date: 2_/CJ o I l l $10.00 $0.00 $0.00 $0.00 $0.00 $0.00 $10.00 $0.00 $0.00 $0.00 $20.00 Clearance: ------ NOTICE: Please take NOTICE that approval of your project includes the "Imposition' of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions.' You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capactiy changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any lees/exactions of which ou have reviousl been iven a NOTICE similar to this or as to which the statute of limitations has reviousl otherwise ex ired. FOR OFFICE USE ONL V PERMIT APPLICATION PLAN CHECK NO. ____ _ CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST.VAL.~~~~~~~~~~ Plan Ck. Deposit---------- Validated By __________ _ Date ______________ ~ 1. ~~~NF~,A.TION J;__l-1~ , Y JEEEe.CdSC)Ll Address (include Bldg/Suite #I Business Name (at this addressl Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # Existing Use Proposed Use so. FA .. ~ ........ #of Stories # of Bedrooms # of Bathrooms f}rv,:::,ct...- Name Address City State/Zip Telephone # Fax# ~gent for Contractor O Owner O Agent for Owner A.<.OCJ~ :2.~ S. S'AAJTit. #re AvtE c.$'il\ Name Address City Telephone# 4. PROPERTY OWNER Name Address City State/Zip Telephone# 6. CONTRACTOR • COMPANY NAME (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, and the basis for the alleged exe ption. Any lation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($5001). EM-P . '5",tNT)\ F£ tvtr ll ~ m ,u,0." q ., ¥ Name State License # _Lf...a...cB=-3C-.-'l.f....,:3""_3"'----- Address City State/Zip Telephone # License Class (!._ f Q City Business License # /,';J,O /"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: 0 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. ~ 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 s~ 'Fu fJ() Policy No. \S8:i"19~-oo Expiration Date ,o •Ol ·O I (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS) 0 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 subje the Workers' Compensation Laws of California. WARNING: Fa ure o ecure rkers' compensation coverage is unlawful, and shell subject en employer to criminal penalties end civil fines up to one hundred n ddltion to the cost of compensation, damages as provided for In Section 3706 of he L r code, interest and attorney's fees. SIGNATURE_~c=J-1,!~~~...., ......... ~~=====~....,....._----------~ 7. exempt from the Contractor's License Law for the following reason: 0 roperty 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 a 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). 0 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(sl licensed pursuant to the Contractor's License Law). 0 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. 0 YES ONO 2. I (have I have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firml to provide the proposed construction (include name I address I phone number I 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 I 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 I address I phone number I type of work):. __________________________________________________________ _ PROPERTY OWNER SIGNATURE ______________________ _ DATE _________ _ COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY 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? 0 YES 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? 0 YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site 7 0 YES O 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. 8. CONSTRUCTION LENDING AGENCY 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~-----------------------~ 9. APPLICANT CERTIFICATION 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 Cit\' of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY ANO 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 su 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 ot co enced ·thin 1 80 days from the date of such permit or if the building or work authorized b such permit is suspended or abandoned at any time after the work is f eriod of 180 days (Section 106.4.4 Uniform Building Code). City of Carlsbad Bldg Inspection Request For: 08/09/2001 Permit# CB012482 Title: CITY STORM DRAIN PROJECT Description: TEMP POWER POLE Type:ELEC Sub Type: Job Address: 2772 JEFFERSON ST Suite: TP Lot 0 Inspector Assignment: PY --- Phone: 7607998703 Location: Inspector: OWNER BURKE DANIEL V&SUSAN B Owner: BURKE DANIEL V&SUSAN B Remarks: Total Time: CD Description Act Comments ---- Requested By: GARY Entered By: CHRISTINE 39 Final Electrical I)(" fi 1:!:: rJI ,..... 0 ,/~---fflY \-,....-/<,-w --- Associated PCRs Inspection History Date Description Act lnsp Comments 08/03/2001 39 Final Electrical CO PY REPLACE BREAKERS WHERE AMPERAGE CANNOT BE READ • 11 / 17 17 PLUMBING PERMIT APPLICATION City of CARLSBAD, CALIFORNIA 92008 Applicant to complete numbered spaces only Phone 729-1181 Permit No JOI ADD,. CSS . ---s~ t C 5,. 1i LOT NO. rLK I TOACT LEGAL I 1 OCSCO, OWN£,. MAIL A.00,.ESS ZIP PHONE 2 W'<., ue {~ l I\ 1M ; CON T,.AC TOfll: " .... V\,\\'h'J MAIL AD0A£S5 PHON t STATE LIC. NO. 3 h. \'..),().-. "1 I '1 I ~I cl -- AfllCHITECT OR 0£S1CNE,. MAtL AOD,.[5.S PHON C LIC£NSC NO, 4 CNC.INEE,. MAIL AOOfll[SS PHON[ LICENSE NO, 5 ~ '!/_.- CGMl"EN!U•TIO,.. (N6:,C,ARRIER.~.--MAIL AOOIIIIESS " ;; IIIIIANCM 6 USE or BUILDING 7 8 Class of work: 0 NEW 0 ADDITION 0 ALTERATION 0 REPAIR 9 Describe work: l ~J, rJ~1 ;/..!,.{ f u ~" ._..t ,,_Jc..,i: ~ J.,J.~-~ ( c(P;-) " . PERMIT FEES No. Type of Fixture or Item SPECIAL CONDITIONS: WATER CLOSET (TOILET) BATHTUB LAVATORY (WASH BASIN) SHOWER KITCHEN SINK & OISP DISHWASHER ~-APPLICATION ACCEPTED BY PLANS CHE CKE OBY APPROVE O FOR ISSUANCE BY LAUNDRY TRAY i'i CLOTHES WASHER .t [ D ATE I WATER HEATER . ..JI' 'T NOTICE URINAL THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC DRINKING FOUNTAIN'.:.~ TION AUTHORIZED IS NOT COMMENCED WLTHIN 120DAYSJ)R IF ~ FLOOR-SINK OR pR..-..:,__•_. _ , -~ CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED ~OR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM SLOP SINK ~· MENCED GAS SYSTEMS NO. OUTLETS I HEREBY CERTIFY THAT I HAVE REAO AND EX AMINED THIS APPLICATION ANO KNOW THE SAME T O BE TRUE AND CORRECT. WATER PIPING & TREATING EQUIP. ALL PROVISIONS OF LAWS ANO ORDINANCES GOVERNING THIS ,,. TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED WASTE INTERCEPTOR HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT ' PRESUME TO GIVE AUTHORITY TO V IOLATE OR CANCEL THE VACUUM BREAKERS ·,: PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. LAWN SPRINKLER SYSTEM SEWER NUMBER CLEANOUTS 1/kt,/79 CESSPOOL l(h-I SEPTIC TANK a, PIT :./:Id· .. r ROOF DRAINS < .$1GNATU"E or CONTRACTOR 0" AUTHO"IZED AGtMT (DA TE) ISSUANCE FEE 5 1GNATU"E 0,. OWNEIIII ltr OWNE" 8U ILO£,t) (DATE) TOTAL FEES WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. INSPECTOR /7 L CITY LIC. NO. ·a:. .: Fee $ ~ $ $ ~ (, _j CASH INSPECTION REPORTS DATE ITEM REMARKS INSPECTOR ' le - USE SPACE BELOW FOR NOTES, FOLLOW-UP, ETC. CITY OF CARLSBAD BUILDING DEPARTMENT 729-1181 -·Ext. 36 10073 Owner's Name ,.,:,;~_.,i,&.__u~k::t:~~~£:2::~-.--- Mail Addres~ /J g-'O ·~b1.L.&:., Contrector ~------- Contr. Address ----------------- To Const. ~ To Add D To Alter 0 Convert D To Move From ------------------ Type of Const. __ '27Z.L...!-J.~~::i;=~~==--=----------- Frame, Masonry, etc. To Be Used For __ ;;.z.....:~:::::::::..=:....=~==:::::=---====------ Kind of Foundetion 01:?Aec-·1•fo. of Stories, _____ _ / ,I Floor Spece (Sq. Ft.) / ::5: ,?' d' /:1,::i_ Gerage Floor Spece (Sq. Ft.) Atteched, _______ _ Detached, ________ _ Legel Description-----------------Block Lot Subdivision ------------------or Section Township Renge No. of Existing Building --------------- Will this construction in~de ~lumbing instelletion or alter- ation? Yes O No~ Signeture of Applicent I ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY AND STATE LAWS REGULATING BUILDING. I CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY CITY OF CARLSBAD AND STATE OF CALIFORNIA O;:fTHA AM THE LE AL OWNER OF THE ABOVE DESCRIBED R E P ERTY. SIGNATURE OF PERM ITTEE ' . Applitallon ( BUILDING Permit .,,,J_ ' C> Building Permit Fee ,. v .a. 21-67 ~P::0 138*******4.50 0 CJ Set Beck Bid . Veluetion Front P.l. Mein Bldg. Side P.L. Gare e Rear P.L Other Gro~ Approveri!!4 Contractor City Bus. Lie. No. ------------- Weter Meter Sewege Disposal System Inspection Record Utility Company Notified -Dale•------BY----- Finel If e check is tendered for peyment for the above fee end the check is not honored when presented for peyment, your building permit will be immedietely revoked. City of Cerlsbed Building Dept. if work is not commenced within 60 deys of inuenc:e. CITY OF CARLSBAD BUILDING DEPARTMENT 729-1181 -Ext. 36 To Alter D Convert D ·o Move From ------------------ Type of Const. /.L)trr,: £1 "' J Frame, Masonry, etc. To Be Used For ·7&r r. C ="'----. Kind i Foundatio,._ __ ,._-___ No. of Storie,._ ____ _ ~ ;;,-~e (Sq.R.) ~~--L--S.--""!!!!!"'-~~~~~~~~ Garage Floor Space [Sq. R.) Attached ___ /~----- Detached _ _../~------ Section Township Range No. of Existing Building --------------- Will this construction includR4 plumbing installation or alter- ation? Yes D No~-' Signature of Applicant I ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY AND STATE LAWS REGULATING BUILDING. I CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY CITY OF CARLSBAD AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROPERTY. SIGNATURE J,,.,>;;z_~/'":(~A, ~V OF PERMITTE~~ ~ !) Application lor BUILDING Permit 8 3 Q S Bu ilding Permit Fee ~G~ IUV •IJ-6~ ~p~:0 1816*******2.00 Building De t. Use Onl B,ild;•g Add~e<4 :', St. Near ---=---~ --- Set Bock Bldg. Valuation /~ ,.._,_ .. Front P.L. I Main Bldg. Side P.L. I Goroge Rear P.L. I Other Group Z~e? t3 Approved by · -t ~,,)l ?J t: Contractor City Bus. Lie. No. Water Meter Sewage Disposal Sysfem Ins pection Record Utility Company Notified -Date, ______ By, ____ _ Final If o check is tendered for payment for the obove fee and the check is not honored when presented for payment. your building permit will be ir.imediately revoked. City of Corlsbod Building Dept. Permit void if work is not eommeneed within 60 days of issuanee.