HomeMy WebLinkAbout1594 POINSETTIA LN; TP; CB020537; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
02-20-2002 Electrical Permit Permit No:CB020537
Building Inspection Request Line (760} 602-2725
Job Address:
Permit Type:
Parcel No:
Reference#:
Project Title:
1594 POINSETTIA LN CBAD "If
ELEC
Lot#:
SURF POINT/STANDARD PACIFIC
TEMP POWER POLE
0
Applicant: Owner:
POWER PLUS
436 N QUINCE ST
ESCONDIDO CA 92025
760 839-9430
Total Fees: $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
Total Payments To Date:
0
0
0
0
Status:
Applied:
Entered By:
Plan Approved:
ISSUED
02/20/2002
CB
02/20/2002
02/20/2002
$0.00
Issued:
Inspect Area:
141+2 02/20/02 .)002 "J1.
Balance Due:
$10.00
$0.00
$0.00
$0.00
$0.00
$0.00
$10.00
$0.00
$0.00
$0.00
CGf'
$20.00
EXPIRE~-PERMIT
PERMIT HAS EXPIRED IN ACCORDANCE WITH U.B.C.
:~:10: ~~:~;:S SKJNATURE &J '
FINAL APPROVAL
Inspector: 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 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
fees/exactions of which uou have nreviousl" been niven a NOTICE similar to this or as to which the statute of limitations has nreviousl11 otherwise exnired.
FOR OFFICE USE ONLY
PERM LT APPLICATION PLAN CHECK No.t~J C637
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
EST. VAL. __________ _
Plan Ck. Deposit--=--------
Validated By _ _,ci..-.;@~----------
Date -:Z,-:2 O-Q&
1. PROJECT INFORMATION JS-qLj
Address (include Bldg/Suite #)
Lm 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 ~ VV\ p .PG\},._) i'.A s'i?~l 7
#of Stories # of Bedrooms # of Bathrooms
2. CONTACT PERSON (If different from applicant) M, c.. '-".~l l-c.. Sc o,rl
Name Address City
l3. APPLICANT O Contractor ~nt for Contractor O Owner O Agent for Owner
►> o "'-V\ 13 c --ho ~t--, Po B:':f \'1 '"l, "L l.4:Y~ ,~ d..e
State/Zip Telephone# Fax#
Name Address City State/Zip Telephone#
4 . f:'ROPERTY OWNER
Name Address City S.tate/Zip Telephone#
l6, CONTRACTOR • CQMPANY 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
exemptio ny violation o action 7031 . 5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars I$ 500)). o vV-CfL Iv IV , :.ic St 8 9 2o2~--"3 '-130
Name
State License # __ £"_2-_3_S'_O,_C, __ _
Address City State/Zip Telephone #
License Class (_ ~ \ City Business License # / u:J b, L::,-L
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.
O 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 ~ ~ Policy No. t 6"5"S-! / 0,.. (J } Expiration Date 2 -J I -O L
(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 ona hundred
thousand dollars ($100,000), in add I n to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees.
SIGNATURE. ____ ___,_+-___..-+ff-------------------DATE 2, -'Z..o-Ol..
7. _RATI ri! ... ~ _
I hereby affirm that I am exempt from the Contractor's License Law for the following reason:
0 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).
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(s) licensed
pursuant to the Contractor's License Law).
O 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 / 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 I address I 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 I phone number/ 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 Act7 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 site7 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.
i8, CQNSTRUCTION LENDING AGEl'-IC:Y
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 CERTIFICATIOl'l.
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 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 180 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned
at any time after the work is commenced for a p 18 ays lion 106.4.4 Uniform Building Code).
APPLICANT'S SIGNATURE DATE
YELLOW: Applicant PINK: Finance