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Home My WebLink About109 POINSETTIA LN; TP; CB994758; PermitCity of Carlsbad 12/28/1999 Electrical Permit Permit No:CB994758 Building Inspection Request Line (760) 438-3101 Job Address: 109 POINSETTIA LN CBAD -f-f Permit Type: Parcel No: Reference #: Project Title: Applicant: ELEC FIELDSTONE/ POINSETTIA TEMP. POWER POLE TEMP UTILITY SERVICES 1167 LAW ST SAN MARCOS, CA 92069 619-471-5494 Status: Lot#: 0 Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 12/28/1999 MOP 12/28/1999 12/28/1999 Total Fees: $20.00 .;' • 0 ii'.iafll>aymenls To Date,··· $0.00: !, a ,;B.Wlce Due: 4 . t 2 • $20.00 • \ 4 .' ''." . "\ t ., .. ', + + fa \> ,11 / TOTAL PERMIT FEES $20.00 Inspector: Clearance: NOTICE: Please take NOTIC that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures et forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capactiy changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project NOR DOES IT APPLY to any fees/exactions of which ou have reviousl been iven a NOTICE similar to this or as to which the statute of limitations has reviousl otherwise ex ired. CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 PERMIT APPLICATION FOR OFFICE USE ONLY rd PLAN CHECK NO. 1qJ-{? ') Q CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-11 61 EST. VAL. _________ _ Plan Ck. Deposit ________ _ Validated By __________ _ Date. ______________ _ Address (inclu~ Bldg/S~e It j /0 1 rCJ/n ~ Legal Description Assessor's Parcel I 1a L;,, Business Name lat this address> Lot No. Subdivision ,t;ime/Numb,.L., ro/hJ,e,t/ ,a.. Existing Use Unit No. Phase No. Proposed Use Total II of units Description of Work !'O-Wif f&Sf.};_T. #of Stories I of Bedrooms I of Bathrooms 2. CONTAC't"PERSON'.Of clffinnt•11om'.aiiiiiceml;~1::'i~~.li(€-.,r.;.$:i!liit:~;~~h~~:,i/i~ii;,'i:;C:~~~i;,;~~J.,ii:'.~:,,,£:,~,;4j,j;,/i'~.4 ' ,;:~,, ·; .•. Name Address ' City State/Zip Telephone I Fax I o:~ -~ -~~ i:.o"G!ior'.'~Ag7f~;";~)J!f6wit"ir:,ID'pit]boiii.r:;'·,::s,s, ·._;., ••·· ~'.f 1:'.~~f1;7' ,,-? / 'f --2. 23 ~ 'l ()/' Name Address City State/Zip Telephone I ·4, · r~"lTJ·swr.::,; ~. •'' ~it} "J,~,:( •~Pft{rd~:,'5f ¥-r,'J,;J•i r:Jj~i~!j);lf'-ifi6 .2~•&~yy/at.>:;';,;,,,c:; ;J./2 f Name Address City State/Zip Telephone I & .. : · ·coNTRACTOR' ~-•COMPANY: NAME~•1tJ~.i;.t;.;_~~~:~TJ~~J::)j~:' ;;,;,· ~~;\ ~~;;:~ )t'::i~J;?.;~;:;;.:~~ ;.~;_!~~l;~~:::~:'l" -· :.:.:2.~--:·;..::.:~-:-t.:;;:.: '::":~\:~, ··:;~~ .. ~:~· ~ (Sec. 7031.5 Business and Professions Code: Any City or County which requires• 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 stetemen; that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9, commending with Section 7000 of Division 3 o! the Business and Professions Code! or that he is exempt therefrom, and the basis for the alleged exemption. ,WY violation of S~i9n 7031.5 by anl /~icant f~ ~•:1it subjects the ~plicant~ • civil penitlty}>f not mor~han five hundred dollar"l$5001),.,wag r <Hv ,C.,Y r tll'J 5C, /V {:!//lh L,G ..>f' t'.9Cd'H c/ld(J r".J..d.lf' J(d--<J"39-7 t .7 Name Address City State/Zip Telephone I State License I SJ.. 3.S-9 ( License Class ___ C.....::.{_;_/ ____ _ City Business License II _______ _ Designer Name Address City State/Zip Telephone State License II -'0=--------- 6. WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury .one of the following declarations: O I have and will maintain a certificate of consent to self-insure for workers' compensation IS provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. ~ I have end will maintain workers' compensation, as required .by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My worker's comp~satio~suran~arrier 1nd policy number are:/$".f'J// ~,,. 9 9 'J ,3/-tJ {!) Insurance Company _:) +a-f-v / t/110 Policy No .. _._____________ Expiration Date _______ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 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 ncure workers' com"'"Htlon COV8fl98 la unlawful, and ■hen subject an employer to criminal penalties end civil flnea up to one hundred thou11nd dollars ($1P'?\9j)OI, In ■dclhloiLO coat of compen11tlon, damages aa provided for In Section 3706 of the Labor rr• ln~reat and 1ttomey'a fHa. SIGNATURE c.;::fA,'l,L,f ~ -DATE / t ,... J_ ,..._ y 'l 7. OWNER-BUILDER DECLARATION .... , . I hereby affirm that I am exempt from the ontractor's License Law for the following reason: O I, IS 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 Lew does not apply to an owner of property who builds or Improves thereon, and who does such work himself or through his own employeea, provided that such improvements are not intended or offered for -■le. 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 Hie>. O 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 auch projects with contrector(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 / have not) signed an application for • 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 end 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 / phone number / type of work>:. _________________________________________________________ _ PROPERTY OWNl:R SIGNATURE ______________ ~-------DATE _________ _ COMPLETE THIS SECTION FOR NON-RESIDEN.TIAL 'BUILDING PERMITS:ONL Y,";"" :;, .. l' ,., , I.·• ~ •·I' · .... ,~,.;~It Is the applicant or future building occupant required to submit • 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 • 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 • 11chool .sit1? 0 YES O NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT IE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES ANO THE AIR POUUTION CONTROL DISTRICT. -: :· ·.•.. ' .... I hereby affirm that t here 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 _______________________ _ 19 . ._ -APPLlcANT·cERT1F1CAnoN·~?,1;r~?'~~~~~~~~~~~~~;al~~~,~.,~~?}~f[t~~l~~~E~f:_r:!r::~;1:::JI! ~-~-. · .•-··· ;•-· I certify that I have read the application and state that the above information la correct and that the Information on the plans is accurate. I igree 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 ANO KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAIC 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 iaaued 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 65 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 thew · commenciP,o period of 180 days (Section 106.4.4 Uniform Building Code). · APPLICANT'SSIGNATURE ---=-::..:.::~-~-~-A'---------------DATE /),.. ;.8' -1Cf YELLOW: Applicant PINK: Finance I City of Carlsbad Inspection Request For: 1/11/2000 Permit# CB994758 Title: FIELDSTONE/ POINSETTIA Description: TEMP. POWER POLE Type:ELEC Sub Type: Job Address: Suite: Location: 109 POINSETTIA LN Lot APPLICANT TEMP UTILITY SERVICES Owner: Remarks: Total Time: CD Description 0 Act Comments Inspector Assignment: PY --- Phone: 7608399430 Inspector: ----- Requested By: MICHELE Entered By: CHRISTINE 32 Const. Service/Agricultural Ai------- Associated PCRs Inspection History Date Description Act lnsp Comments 1/5/2000 32 Const. Service/Agricultural CO PY BREAKER SIZE ILLEGIBLE