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Home My WebLink About2855 AVENIDA HELECHO; ; CB994601; PermitCity of Carlsbad 12/13/1999 Electrical Permit Permit No:CB994601 Building Inspection Request Line (760) 438-31 01 Job Address: Permit Type: ELEC Status: ISSUED Parcel No: Lot #: 0 Applied: 12/13/1999 2855 AVENIDA HELECHO CBAD Enterem l23M3799 OOoi 01 02 Reference #: Pian Approved: 1211 3/1988r#m 20.00 Issued: 1211 3/1999 Project Title: TEMP POWER POLE Inspect Area: Amlicant: Dhi^" TEMP UTILITY SERVICES 1167 LAW ST SAN MARCOS, CA 92069 61 9-471 -5494 Total Fees: $20.00 Electric issue Fee Single Phase per AMP Three Phase per AMP Three Phase 480 Per A RemodeVAl tera tion per Remodel Fee Temporary Service Fee Test Meter Fee Other Electrical Fees TOTAL PERMIT FEES FINAL APPROVAL Clearance: Inspector: Date: 12 c 27- NOTICE: Please take NOTICE that approval of your project includes the 'Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "feeslexactions." You have 90 days from the date this permit was issued to protest imposition of these feeslexactions. 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 feeslexactions 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 feedexactions of which you have previously been Qiven a NOTICE similar to this, or as to which the statute of limitations has previously othenvise expired. CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 1 FOR OFFICE USE ONLY I PLAN CHECK NO. c09q+(roi EST. VAL. Plan Ck. Deposit Validated By Date (21 I" a11\ Busmas Name (at ttws addnu) Total X of units Legal Deacnmon Lot No. UM No. Phase No. Address (inclcJdd6#&Ite Proposed Use 'J?d;xP~~tI@.d L? Assessor'a Parcel # GMtIng uu Name stateltp Telephone X Fax I (Sec. 7031.5 Burinass and Professions Code: Any Ci or Cwmy which mquinr a pannit to conmuct, dm, improvm. demoliah or npair any structure. pnor to its iwuance, also requires the applicant for ruch permit to file a aignod statement that hm is licensed pumwnt to tha provbiw of the Contractor's LICOMO Law [Chapter 9, commending with Seaon 7000 of Addrnsa -b statemp \TeIebhone 1 LicenseClw c 61 city Bu*ne8s License # Name Stat0 LiCOMO # Designer Name Addm Cirv Statenip Telephone State Llcmse # Workers' Compensation Doclarmon: I hereby affirm der peMW of perjury one of tha fOllOWInQ ddantions: 0 of the work for which this permi is iuud. 0 issued My worker's romp at n ma Insurance Compeny 575 rQb Policy No. )cJg 1 1 .. fi Expiration Date lfHlS SECTION NEED NOT BE COMPETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 181001 OR LESS) 0 to become subject to the Workan' Cornpensanon Lnws of California. thwaud doNan W?qa;qOlp+ ddiabn to -7- ' n. dmwou u povibd tah SKakn 3706 0th Laacocl.Jnt~~n nd monwy'sfoo~. Gahfah-a- I have and will maintain s cwtifaate of consent to self-tnsure for workers' compensation aa provided by Section 3700 of the Labor Code, for the performance I have and will maintain workers' campanamon, as required by Section 3760 of the Labor code, for the performance of the work for which this permit is +I -41 ca caa snd policy number are: CERTIflCATE OF EXEMPTION: I certify that in the performance of the work for whkh thu permit n uswd, I shall not employ my penon in any manner IO as WARNING: FJh to socum w' compm IS WhWfId. d rh.l WbiM NI Omploy.rto aMrul#n)ti.r and dvil fm UP to OIU htdd I hereby affirm that I am exempt from the Comnkior's License Law for the following mason: 0 I, as owner of the propony or my employees with wap aa their sole compensation, will do the work and the structure is not intended or offered for sah (Sec. 7044, Business end Professions Code: The Contmctor's Uwnsa Law dams nol apply to an owner of propertv who builds or improves thereon, and who doas such work himself or through his own emplovees, provided that such impmoments am not intended or offred for sale. If, however, the building or improvement is sold within one year of completion, the ownar-buildr will have tha burden of proving that he did not build or improve for the purpose of sale). 0 I, as owner of the propotty, am exclusively comnctinp with licensed contncton to construct the project (Sac. 7044, Business end Professions Cods: The Contractor's Licenae Law does not apply to an owner of property who builds or improvas thereon, and contracts for such projects with conttactorls) licensed pursuant to the Contractor's License Law). 0 1. 2. 3. I am exempt under Section I personally plan to provide the nupr lsbor and mot.ria)r tor wnmuction of tho proposed pr0p.n~ impmenwnt. 0 YES ON0 I (have I have not) signed an appfiution for a building permit tor the propoaed work. I have contrected with the following person Ifirm) to provide the propoaad construction Iinctude name I addrw I phone number I contractors limnre numbrr): Burinrs end Profmarions Code for this reason: 4. number I contractors license number): 5. of work): i plan to provide poniona of the work, but I have hired the following person to coordinate, superviae and provide the major work (include name I addrnsa I phone I will provide some of the work, but I have contractad (hired) the following persons to provifb the work indicated (include name I addreas I phone number I type DATE PROPERTY OWNER SIGNATURE COMWET&THlS.SEC%Um, is the applicant or futun bullding occupant required to submii e businas plm. acutely huudour m-riab regirtmion form or risk management and prevention program under Sectiw 25505,25533 or 26534 of tha R.rley-T.nmr Hu8rdoul subnanca Account Act? Is the applicant or future building occupant mquind to obtain a permit from the 8k pdlution control district or air qwli management district? 0 YES 0 NO Is the facility to be constructed wkhin 1,OOO faat of the mer boundary of a school rite? 0 YES 0 NO 0 YES 0 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. '3 I hereby affirm that there ia a construction lending agency tor the performace of the work for which this permit is irsued ISec. 3097iil Civil Code). LENDER'S NAME LENDER'S ADDRESS I certify that I have read the application and state that the above information b correct end that the information on the plans is accurate. I agree to comply with a11 City ordinances and State laws relating to building construction. I henby authorize reprasmativ~ of the Ci of Carlsbrd to enter upon the above mentloned property for inspection purp~es. I ALSO AGREE TO SAM. INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS. COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AWNST 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 conmuction of strUCtUm over 3 stories in hsieht. --.-- ~~ EXPIRATION: Every permit issued by the Building Official under the provisions of this cod. ahall expire by limitation and become null and void if the building or work authorized by ruch permit is not commenced within 365 ys from the dm of such pormit or If the building or work authorized by such permlt IS suspended or abandoned at any time after APPLICANT'S SIGNATURE -. -- Qylr [Section 106.4.4 Uniform Building Code). UAlt I.' A/- -. ._ E: File YELLOW: Applicant PINK: Finence City of Carlsbad Inspection Request For: 12/23/1999 Permit# CB994601 Inspector Assignment: Title: TEMP POWER POLE Description: Type: ELEC Sub Type: Job Address: 2855 AVENIDA HELECHO Suite: Lot 0 Location: APPLICANT TEMP UTILITY SERVICES Owner: Remarks: Phone: 7608399430 w Inspector: Total Time: Requested By: MICHELLE Entered By: BARBARA A t Comments + CD Description 32 Const. ServicelAgricultural Associated PCRs InsDection Historv Date Description Act lnsp Comments , From: Accurate Permit Co. To: Fax#1-780438-0894 Date: 12/13/99 Time: 15:52:08 Page 3 of 4 -I=*- -=-- E- L I-* €- STATE P.O. BOX 420807, SAN FRANCISCO, CA 941424607 C~M P E N SAT I o N ;m igGK6 CERTIFICATE OF WORKERS’ COMPENSATION INSURANCE POL HARCH 31, 1999 CERTlFlC r CITY OF CARLSBAD BUILDING 6 SAFETY OEPARTHENT CARLSBAD, CA 92888 JOB: ALL OPERATIONS 1200 ELI - 99 L This is to certify that we have issued a valid Workers’ Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon ten days‘ advance written notice to the employer. We will also give you TEN days’ advance notice should this policy be cancelled prior to its normal expiration. .This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other document with - may pertain, the in EHPLOYER’S LIABILITY LIHIT INCLUDING DEFENSE COSTS: S1,008 EMPLOYER r 0 S.R. BRAY CORPORATION DBA: POWER PLUS! TEMPORARY UTILITY SERVICES 1281 EAST SUNSHINE WAY ANAHEIH CA 92806