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Home My WebLink About2856 RANCHO DIAMONTE; TP; CB001365; Permit, City of Carlsbad 04/11/2000 Electrical Permit Permit No:CB001365 Job Address: Permit Type: Parcel No: Reference #: Project Title: Applicant: Building Inspection Request Line (760) 602-2725 2856 RANCHO DIAMONTE CBAD St: TP ELEC Lot #: 0 RELOCATE TEMP POWER POLE Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: TEMP UTILITY SERVICES ISSUED 04/11 /2000 RS 04/1 1/2000 04/11/2000 1167 LAW ST 3889 04/11/00 ~M¥, 02 20. 00 SAN MARCOS, CA 92069 619-471-5494 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 TOTAL PERMIT FEES Total Payments To Datei Clearance: $10.00 $0.00 $0.00 $0.00 $0.00 $0.00 $10.00 $0.00 $0.00 $20.00 $20.00 NOTICE: Please take NO CE 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 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 FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK N0.°'6 00(3~_, CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 EST. VAL. _________ _ Plan Ck. Deposit ________ _ Validated By __________ _ Date ______________ _ Address (include Bldg/Suite #) Business Name (at this addressl Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total I of units Proposed Use Q Description of Work llof Stories II of Bedrooms II of Bathrooms State/Zip Telephone, Fax # (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 th1t 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. Any '!iq)ation of Section 7031.5 by any a licant for a.permit subjects the applicant to• civil p,na!_;y of not mor than five hundred do ars l$5001). oiPer r1u5 , Qu/1tce: 5/; cone✓-txo 920~ ?. o J9-9 ~o Name Address / License Class __ G_-__ <c> __ / ___ _ City State/Zip Telephon # State License II City Business License II _______ _ 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 1s provided by Section 3700 of the Labor Code, for the performance of the work for which this permit Is issued. ~ 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 •~olicy num rare: Insurance Company Yrer .T e... -~ "?, Policy No. / ~5"5" /IO -00 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1•1001 OR LESS) Expiration Date <fJ-3 -JJ-o I 0 CERTIFICATE OF l 'EMPTION: I certify that in the performance of the work for which this permit is issued, I shell not employ any parson in any manner so es to become subject to the Workers' Compensation L1ws of California. WARNING: Failure t varaga la unlawful, and ahaH 1ubject an employer to crfmlnal panaltla1 and clvll fines up to one hundred compan1■tlon, damage• es provldad for In Section 3706 of the1,../-/'f8.:...~'flat and attomay'1 fNs. SIGNATURE __ .,._""'-'""-'c.....;;~------"-....,.11---''----------------DATE ________ _ 7. I hereby affirm that I am exempt from the Contr• r'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 1re 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 ha 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 t o the Contractor's License Law). 0 I am exempt under Section ______ Business and Professions Coda 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 parson (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): ______________________________________________ _ 5. I will provide some of the work, but I have contracted (hiredl the following persons to provide the work indicated (include name / address / phone number / type of workl: _________________________________________________________ _ PROPERTY OWNER SIGNATURE ______________ ~-------DATE _________ _ COMPLETETHIS SECTION FOR NON-RES/DEN71AL"8Uli.DING 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 Act? 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 .site? 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 POUUTION CONTROL DISTRICT. 8, CONSTRUCTION LENDING ~GEN~f i(:.~.~:i,J;t:I ::'.~Jt:· T?i7'.'.'~';:~?'f·1•~, "},:'·. '.';-. · 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). I LENDER'S NAME _____________ _ LENDER'S ADDRESS _______________________ _ ·94 ' -APPLICANT ·cERTIFtCA noN ~?.:~~4~{~:;-t,;_,~~!~~,..~~"~~~i~~:~:~tJ;.:;;]¥fZi~1~J~:J,~1:;I~~~!~1J!~:;j;~i1:f~~~Y.J:f~~~~:5.:~T."~~~ ,:~~/;t ... ~ ··.-~ I certify that I have read the application and stat■ that the above information Is 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 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 11 required for excavations over 6'0" deep and demolition or construction of structures over 3 storiea 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 no commenced within ~65 vs f m the date of such permit or If the building or work authorized by such permit is suspended or abandoned at any time after the o · commenced for a od 80 days (Section 106.4.4 Uniform Building Coda). 1/-/ / ; C) / APPLICANT'S SIGNATURE ---->-..:::....=-=---+--.....:..._-:_~J_,:.l_'k_,:_-:_-:_-:_________ DATE PINK: Finance