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Home My WebLink About2578 ROOSEVELT ST; TP; CB080529; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 03-24-d\J0B Electrical Permit Permit No: CB080529 Job Address: Permit Type: Parcel No: Reference #: Project Title: Applicant: Building Inspection Request Line (760) 602-2725 2578 ROOSEVELT ST CBAD 1f ELEC 2031023300 Lot #: ROOSEVELT GARDEN-100 AMP TEMP POWER 0 Owner: Status: Applied: Entered By: Plan Approved: issued: I nsped Area: ISSUED 03/24/2008 LSM 03/24/2008 03/24/2008 SAN DIEGO HABITAT FOR HUMANITY CITY OF CARLSBAD REDEVELOPMENT AGENCY 10888 SD MISSION ROAD SAN DIEGO 92108 619 516 5264 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 0 0 0 0 PUBLIC AGENCY 00000 $10.00 $0.00 $0.00 $0.00 $0.00 $0.00 $10.00 $0.00 $0.00 $0.00 $20.00 Total Fees: $20.00 Total Payments To Date: $20.00 Balance Due: Inspector: FINAL APPROVAL Date: '-r ,,.-;?,..-~ Clearance: $0.00 NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, er other exactions hereafter collecUvely referred to as 'fees/exactions." You have 90 days from the date this permit was issued to protest imposition of these fee5/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 1nfonnation with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar ~my 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 :lnd sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project NOR DOES IT APPLY to any h . T i h h City of Carlsbad 1635 Faraday Ave., Garlsbad, CA 92008 760-602-2717 / 2718/ 2719 Fax:, 760-602-8558 Building Permit Application , SUITE#/SPACE#/UNIT# Plan Check No. Est. Value Plan Ck. Deposit Date APN .;?o3 -/D .;I, -..3J> CT/PROJECT# LOT# PHASE# # OF UNITS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE acc. GROUP 1/ l'I /I DESCRIPTION OF WORK: EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF} FIREPlACE AIR CONDITIONING FIRE SPRINKLERS YES □# __ NOD YES □ NO □ YES □ NO □ CONTACT NAME (ff Different Fom App/leant) APPLICANT NAME ADDRESS ADDRESS /().;Jj..J. CITY STATE ZIP CITY s,,t,.JO,u,c, STATE .. C-,7. ZIP PHONE FAX FAX "' f -.J. 'I') -"l,ory EMAIL PROPERTY ~WNER NAME C , '.':;, 13 />-.0 CONTRACTOR BUS. NAME ADDRESS zq1,5 Rrxc,cvcu s, ADDRESS CITY CITY STATE ZIP PHONE FAX EMAIL STATE LIC. # STATE UC.# CLASS CITY BUS. UC.# (Sec. 7031.S Businm and Pr~~ssions Code: lilly City, or _County: which requim a permit 10 co~struct. .alter improve\ ~molish or reP.air. any structure, p[ior to its issuance, ah~ requires the appliant for such permit to file a signed s~ttment that he is fice~sed _11unuant to the p~v1$1on1 of the (9ntraqor s License \,aw {Chapter 9, commend mg with Section 1000 of Division 3 of tht Business and Prolts11on1 Code} or that he is exempt therefrom, and the bam for the alleged exemption. Any violation of SeChon 7031.5 by any applicant for a permit subiects tht apphcant to a c1v~ penally of not more than five hundred dollars {$500}~ WORKERS' COMPENSATION Workers' Compensation Declaration: / hereby affirm under penalty of perjury one of the following declarations: □ 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. □ 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 workers' compensation insurance carrier and policy 11umber are: Insurance Co ADP :Iotftt, SOMGE' • GPlfc...lA:&. 'r'f Rell( Policy No. ______________ Expiration Date __ ~E,=,.f.~CS=----- Tbis section need not be completed if the permit is for one hundred dollars ($100) or less. ifll4,Vtc4.f • 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: Fallure to secure workers' compensation coverage Is unlawful, and shall subject an employer to crtmlnal p1t11altles and clvll fines up to one hundred thousand dollars (&100,000), In addition to the cost of compensation amages as provided for in Section 3706 of the Labor code, Interest and attorney's fees. _15 CONTRACTOR SIGNATURE ~ I hereby affirm that I am exempt from Contractor's Ucense Law for the following reason: □ 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. lf,·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). )( I, as owner of the properly, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's Lice11se Law does not apply to an owner of property who builds or improves thereon, and co11tracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). □ 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. □ Yes □ No 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 I phone/ 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/ contractors' license number): 5. I will provide some of the work, but I ha~e co11tracted (hired) the following persons to provide the work indicated (include name/ address/ pho11e / type of work): ( '·•, · .. I .,I!$ PROPERTY OWNER SIGNATURE \1 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? □ Yes □ No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? □ Yes □ No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ Yes □ 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. I certify that I have read the appllcatlon and state that the above lnfonnation Is correct and that the infonnatlon on the plans is accurate. I agree to comply with all City ordinances and State I~ relating to butrdlng oonstruction. Lhereby aul!ionze representative of ~e Cly of Ci>lsbad to enter upon~•-mentioned property fur •specibn purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CrTY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES 'MilCH MAY IN ANYWAY ACCRUE AGAINST SAID CfTY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavations r:J,lf!f 5'0' deep and demolition or construction of strucbJres over 3 stories in he'Jhl. EXPIRATION: Every pem'lit issued by the Building Official under the provisions of this Code shall expire by limitation and become nul and YOO if the building or work authorized by such permit is not commenced wthin 180 days from the date of such pemit or if the building or work authorized by such pelTllit is suspended or abandoned at anytl'ne after the work is commenced for a period of 180 days (Section 106.4.4 Unifolm Building Code). L5APPLICANT'SSIGNATURE ~ DATE 3/~ 68 City of Carlsbad Bldg Inspection Request For: 04/03/2008 Permit# CB080529 Ti_tle: ROOSEVELT GARDEN-100 AMP Description: TEMP POWER Type: ELEC Sub Type: Job Address: 2578 ROOSEVELT ST Suite: tp Lot 0 Inspector Assignment: Phone: 6192473054 OWNER CITY OF CARLSBAD REDEVELOPMENT AGENCY Owner: CITY OF CARLSBAD REDEVELOPMENT AGENCY Remarks: PERMIT IN SRVC PANEL Total Time: CD Description Act Comment 32 Const. Service/Agricultural Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act lnsp Comments Requested By: JOE Entered By: JANEAN