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Home My WebLink About2810 MADISON ST; ; CB102542; Permit.. City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 12-27-2010 Electrical Permit Permit No: CB102542 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: 2810 MADISON ST CBAD ELEC 2031103000 REPP RESIDENCE Status: Lot#: 0 Applied: Entered By: Plan Approved: Issued: Inspect Area: UPGRADE ELEC SERVICE FROM 100 AMPS TO 200 AMPS Applicant: ZOUCHA-REPP CAROLYN J 5301 E MITCHELL DR PHOENIX AZ 85018 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 100 0 0 0 Owner: ZOUCHA-REPP CAROLYN J 5301 E MITCHELL DR PHOENIX AZ 85018 ISSUED 12/27/2010 MDP 12/27/2010 12/27/2010 $10.00 $25.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $35.00 Total Fees: $35.00 Total Payments To Date: $35.00 Balance Due: Inspector: Date: Clearance: $0.00 NOTICE: Please take NOT at approval of your project includes the 'Imposition' o fees, dedications, reservations, or other exactions hereafter collectively referred to as 'fees/exactions." ou 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 f Ix cti n fwhi h I I hi h Ii . ~ Z-S't.f L_ «,~> Building Permit Application Plan Check No. Lo - 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value ¥ CITY OF 760-602-2717 / 2718 / 2719 CARLSBAD Fax 760-602-8558 Plan Ck. Deposit www.carlsbadca.gov Date iswPPP JOB ADDRESS 1_8/0 /Y\i«'.\DJ ~?>/~ ~,-, :;UITE#/:;P,...,E#/UNIT# IAPN --- CT/PROJECT# ILOT# I PHASE# I# OF UNITS I# BEDROOMS #BATHROOMS I TENANT BUSINESS NAME I CONSTR. lYPE l occ. GROUP OESCRIPfl~O~WC::i;~£·•"~ .. e~A~i~ 7 i, ,;Al.. 0 AtJcl.-tD 'l-0~ ~trifJ. lC<l-'2JJ cJ EXISTING USE FIREPLACE I PROPOSED USE I GARAGE (Sf) PATIOS (SF) l DECKS (SF) YES0, I AIR CONDITIONING I FIRE SPRINKLERS N<O ves0No0 vesONoD CONTACT NAME (If Different Fom Applicant) APPLICANT NAME ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE IFAX PHONE rAX EMAIL EMAIL PROPERTY owNER NAME c. A l2.sil.. '-f N KiiPf CONTRACTOR BUS. NAME ADDRESS? 'o \ Q •AA ~~~'--- ADDRESS CITY STATE ZIP CITY STATE ZIP ... , '7, A-."i"-'7-9:'i'l I p~! ) 661.: "'3 lJ -\ 7 0 7 IFAX PHONE IFAX EMAIL C:J 'l. P., Eff(? H<::1-r /YIA ll I tJ2 (\(\ EMAIL ARCH/DESIGNER NAME & ADDRESS I STATE LIC. # STATE UC.# IClASS l CITY BUS. UC.# (Sec. 7031.5 Business and Professions Code: AAy City or County which requires a permit to construct. alter, improve. demolish or repair any structure, prior to its issuance, also reciu1res the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law fChaoter 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 violation of Section 1031.5 by any applicant for a permit subjects the appllcant to a civil penalty of not more than five hundred dollars {$500}). · WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of pefjury one oflhe following declarations: D I have and will maintain a ceftificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Lalxlr Code, fof the performance of the wOOI for which this permit is issued. D 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 workers' compensation insurance carrier and policy number ate: Insurance Co _____________________ Policy No. ______________ Expiration Date _________ _ lbi§.section need not be completed if the permit is fof one hundred dollars ($100) or less. LJ 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 HC:Ure workers' compensation coverage i& 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 provided for in Section 3706 of the Labor code, Interest •~d attorney's fees. ~ CONTRACTORSIGNATIJRE □AGENT DATE OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from Contractor's License Law for the following reason: ~ □ □ 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 Dl.lilds 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 lhe burden of proving that he did not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Ccxle: Tha Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with conlractor(s) licensed pursuant to the Contractor's License Law). 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. Oves Oo 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 (firm) to provide lhe proposed construction (indude name address I phone I contractors' license number): 4. I plan to provide portions of the work, but I have hired the following peJSOn to coordinate, supervise and provide the major work (include name/ address I phone 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/ address I phone I type of work): Jt5 PROPERTY OWNER SIGNATURE □AGENT DATE \ COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY Is the applicant or future building occupant required to submit a business.l!!!!J, 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? D Yes LJNo Is Iha applicant or future building occupant required to obtain a permit from the air pollution control district or ai~alily management dislrid? []ves 0No Is the facifily to be constructed within 1,000 feet of the outer boundary of a school site? Oves LJNo IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE lSSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROl DISTRICT. CONSTRUCTION LENDING AGENCY I hereby affirm that there 1s a construction lending agency for the performance of the work thts permit 1s issued (Sec 3097 (1) C1VII Code) Lender's Name Lender's Address APPLICANT CERTIFICATION I ceitlfythal I ha¥e iead the application and state that the aboYe infonnatlon Is conect and that the infonnatlon on the plans Is accurate. J agree to comply with all CH¥ ordinances and State hMs ielatlngto building construction. I hereby a<Jthorize represenlatiw of !he City of Callsbad to enler l4l()ll lhe abow men-property for inspedioo 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 S/>JD CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA perrm is ,equired kt excaaons (1,/fl 5'0' deep and clemdition or oonstrooion of structures over 3 stories in height EXPIRATION: Every pem,lt issued by the Blilcilg Official under the provisions a Ins Code shall 81.pire by limitation and become ruH all:! wid if the bukling or work authorized by such pem,lt is not coovnenaid within 180 days from the date of such pemwt or if the bukling or work authorized by such penm is suspended or abanooned at any time after the work is o:mmenced kta period ol 180 days (Sedion 100.4.4 Uniform Building Cooe) . .JE5 APPLICANT'S SIGNATURE DATE City of Carlsbad Bldg Inspection Request For: 01/11/2011 Permit# CB102542 Inspector Assignment: Title: REPP RESIDENCE Description: UPGRADE ELEC SERVICE FROM 100 AMPS TO 200 AMPS Type: ELEC Sub Type: Job Address: 2810 MADISON ST Suite: Lot: 0 Location: APPLICANT ZOUCHA-REPP CAROLYN J Owner: ZOUCHA-REPP CAROLYN J Remarks: PM PLEASE Total Time: CD Description 33 Service Change/Upgrade Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# Inspection History Date Description Act lnsp Comments Phone: 7605878911 Inspector: ---- Requested By: JEFF Entered By: JANEAN