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Home My WebLink About1653 POINSETTIA LN; MP; CB981715; Permitt- PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 1. Address (include Bldg/Suite #) Legal Description Lot No. 2. CONTACT PERSON (If different from applicant) FOR OFFICE USE ONLY ,,_-, PLAN CHECK NO. qf (JI~ EST. VAL. __________ _ Plan Ck. Deposit _________ _ Validated By __________ _ Date _______________ _ Total # of units #of Stories # of Bedrooms # of Bathrooms Name Address City State/Zip Telephone # Fax# 3 · J/Jl~'t/h°#J~edMge~?J)Jfii;y#)}J)IIH-~,;f.Jl~/A-JL!MPf}l{II/ 7/l •'/~/.//1(} Name Address City State/Zip Telephone # 4. ~~f IMNE~YE Name Address City State/Zip Telephone# 5. COlllTRACTQR -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 e77~'al,XtMit1JtJ/y ~:p;lip.~~'PJ1Jt/rts, th~»)°//#l}Benalty of ntllr~flfl h"~ cJ/Jf P:~ld. Name /J.J}-,_,,,_ Address /I. {!// City , . , State/Zip~ iiflJ,,)phone # State License # r. 1 License Class 1 City Business License # __ /'_.:..7_ ((}_ ' ___ _ l'l/71 Designer Name , / State License # ____ #_./!~~::---- Address City State/Zip Telephone 6. WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: D 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 f e work for which this permit is issued, 1 have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for wh0Ic )is permit is ed. My worker's co")P1'19~on~./4~~and policy number are: , tflPP3pf/31)/ . . J/2'J ~'/ Insurance Company -~/IJL!...!l)'...:fr:..!.......:~~-1=::....:.....:Mf"...:.,._________ Polley No,____________ Expiration Date_~------ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1$1001 OR LESS) D 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 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 and attorney's fees. SIGNATURE.______________________________ DATE 7. OWNER-BUILOl;R l;,lEQJARA_TION --:::;;;::;:;;;:-::-=-=::=::::;:=.a __ ~-.,,,-.--~-~ I hereby affirm that I am exempt from the Contractor's License Law for the following reason: D 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). D 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). D 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. D 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 / 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):, ______________________________________________ _ 6. 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 __________ _ 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~ or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? D YES )ttf NO _ / Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? D YES ){J NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES yNo 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 cons r ~on lending agency for the performance of the work for iy7'~ 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 Citt 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 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 366 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 period of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE __________________________ _ DATE _____________ _ WHITE: File YELLOW: Applicant PINK: Finance sos/··,. . iiiii-~ ELECTRIC METER & SERVICE LOCATION l\n Enova Compan,. WANTED DATE ()'7':I" □OVERHEAD i!UNDERGROUND SPECS ATTACHED //cJ.7-/35 T.B. ---'-------- O JT MEET REC'D ~OMM'L □RESIDENTIAL ' NAME . /flJlft/2./t PH ltSE 3 t}}..JIT .l PROJECT NO . 7/i./;i.,q JOB NO.t)/O ADDRESS /l,,c:;_; .POJvCc'tll A LJt-tJ/3" C-8 MORATORIUM EFFECT -AGENCY TYPE DATE CRITICAL · PENDING STREET RESURFACING POWER SOURCE I CONTACT MONTH YEAR S "Hl 755·479 I PHONE# TCP REC'D□ ST EXC & PERMITS REC'D O CUST O SDG&E SERVICE ATTACHMENT POINT AND/OR METER LOCATION: IN.STA-LL tJcw mETlfi 7-'t::-psm L .t <:s-rEE!, WJ-3, OF XJ=m/2..,Srft-7.~5-477 - ,V/<PI.)/ Ot: ffltJD ::JJI.JStft LL 5t:7<..t)/C€ 77'~7Llq./ 1--,;; · · Co/\..lI>1,,>1 r /..v , TH f'uLL /2£)/?E /=122)/YI YiJ /07:tL f'£.Dt:i3»71't-L 71? -µ=:m/Z . SDG&E APPLICATION REQ'Df>-3" CALLf -[ft;tl ··'f I/ -/.Pl -3 ~ ,o,e '"'"c RW'D emo"_Ti sn-;,,c,rn__, □STATE --- GENERAL CUSTOMER INFORMATION POLE# LADDER AR S REC'D Ll EXISTING 0 Meter Height -4 •o• min. -6 •3• max. from finish grade to center line of meter base. STOP TT□,· □ rn • FSOM eoce R'5ER au.a __ Meters are required to be readily accessible 24 hours per day. Meters must be located In a safe area free of any potentially hazardous or dangerous conditoon. Provlde3 ft. x 3 ft. minimum clear and level working space in front of meter Where * PC-f~lt Lµ meter room Is proposed, contact the Planner at the nearest SDG&E office. N Meter bases and meter service disconnects must be located at or immediately I adjacent to each other and be identified with address and unit number it serves. o--:r;u -iD OVERHEAD SERVICES ~.:). I\ \ PROVIDE MINIMUM GROUND CLEARANCE OF: 't" ___ Ft. at point of attachment of service wires t ___ Ft. over driveway or parking area ___ Ft. at outer limit of vehicular traffic l',;; -IJ\ ct' i ] ~ O:J. ___ Ft. ~ ~ ~ ~ ~" " ' t·\!.; UNDERGROUND SERVICE ~ ~-~§. t~ PROCEDURE FOR INSTALLATION ~ c~ ·1 .., ~M -i:, 1. Pay all monies due 0 APPLICABLE ~ NOT APPLICABLE (;: .1,,1 2. Phone SDG&E at 'f!;J·,S"f 1.2, 3 working days prior to trenching to arrange '." :i ~ with Inspector and Initiate trenching process. 3. PHONE DIG ALERT 1-800-422-4133 AT LEAST TWO DAYS PRIOR TO TRENCH-ADD'L INFORMATION: (Detach before completing this section.) ING FOR LOCATION OF UNDERGROUND UTILITIES. 4. Excavate trench, Install conduit and service entrance equipment at meter location. CALL ABOVE PHONE# FOR INSPECTION. Do not cover conduit without Inspector's written approval to backfill. 5. Call Inspector when trench Is backfilled and compacted for inspection. If service entrance equipment is installed after backfill, CALL ABOVE PHONE# FOR INSPECTION OF THE EQUIPMENT. 6. Meter will be set after Inspector has approved Installation, including service By APP~ equipment, and receipt of city/county/state· Inspection clearance. JTTRENCH □GAS O TELCO □CATV I SEC HEIGHT CABLE POLE CONDUIT BY □CUSTOMER O SDG&E SIZE JUN 03 1998 CABLE POLE BEND BY D cusT 0 SDG&E 90• ___ RADIUS SCH 80 SIZE __ HANDHOLE BY O CUSTOMER □sDG&E D sro. PAGE# City of CARLSBAD CONDUIT BY S!rc usTOMER □sDG&E SIZE.,/ II BUILDING DEPT. TRENCH INSPECTED & APPROVED BY DATE PAYMENT BY CUST~ CBL PL$ . EXCESS$ MISC$ 3 WIRE /!l!.. PHASE 1~@1/V VOLTAGE 4 p,•.-/PMA ---p ~ METER CLIPS (_ ";/; n1 ,J Ji . '/r7 ., /71-----' MAIN SWITCH /(){) ft METERING: 0 CT'S 'JZ'SELF-CONTAINED ~EST BY PASS FACILITIES RE0'D TErwNE DATE UTILITIES MAXIMUM CONTRIBUTION TO FAULT CURRENTlj~~ AMPS L/j"C>-7 731 /~-11-97 II SDG&E encounters hazardous or toxic material while performing construction of your Customer-owned facilities to receive electrical service are subject to all applicable local and state pro)ect, SDG&E will hall work Immediately and It will be your responsibility to remove of California inspection authority requirements. Bulldlng address andlormeterbase must be posted and/or clean up all hazardous or toxic material prior to SDG&E continuing construction. prior lo meter sel Information on lhis sheet is void after 6 mon ths from date. Keep this notice SDG&E shall have no llablllty or obligation whatsoever to clean up, remove or remedlate wilh building permit. any hazardoua or toxic materlals discovered during the course of construction unless It Is through negligence ol SDG&E. DISTRIBUTION: WHITE ORIGINAL -Customer WHITE COPY -District Operallons YELLOW -Planner GOLD -C.T. Order 107-09212 (5/96)