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Home My WebLink About1414 SAPPHIRE DR; TP; CB994631; PermitCity of Carlsbad 12/15/1999 Electrical Permit Permit No:CB994631 Building Inspection Request Line (760) 438-3101 Job Address: Permit Type: Parcel No: Reference #: 141 4 SAPPHIRE DR CBAD ELEC Lot#: 0 Project Title: TEMP POWER POLE-MARBRISA Applicant: POWER PLUS 436 N QUINCE STREET ESCONDIDO CA 92025 760-839-9430 Owner: I\. Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 12/15/1999 JM 12/15/1999 12/15/1999 Total Fees: $20.00 Total Payments To Date: Balance Due: $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 Date: $10.00 $0.00 $0.00 $0.00 $0.00 $0.00 $10.00 $0.00 $0.00 $20.00 NOTICE: Please take that approval of your project includes the "Imposition· of fees, dedications, reservations, or other exactions hereafter collectively referred to as ·rees/exactio s." 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 Cartsbad 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 O~Y 4 . 1 PLAN CHECK NO. q Q CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Pal mas Dr., Carlsbad CA 92009 (760) 438-1161 EST. VAL. _________ _ Plan Ck. Deposit_,.,,,._ ______ _ Validated By, --.L...~_.__...,...-+---,-+-..:i-7~ Date. ________ ,__'-+~~.__....,._ Address (include Bldg/Suite I) Business Name (et this addressl Legel Description Lot No. Unit No. Phase No. Total I of units Assessor's Parcel I Existing Use Proposed Use Description of Work .-!f'bn f () w-e.r () -e9-. FT. lot Stories I of Bedrooms I of Batllrooms 2. CONTACT PERSON Of :C.,.,t,1,oin'.appilc:lntH2~'i'f,~~_;. \':!.\;;,~\i'tt::'·:•~. t:,F,~ ;i:IJ.5:,~~;\';: ~¥\ r,;c!, :,:'.,-.rf~:,}. ,,.~' ,.; ,,, ,.,,:~ •• ~:;;;,...; ' Name Telephone II Fax II :3. . APPLICANT {19 .,2)..3 ydlb Name Address City State/Zip Telephone II '4. PROPE~ ~~ER sf~;~ :,·:71#;!/!!.Y:r'~l {1:117 3· '"··)~11:?Ttt ;~r;, 'Jir)J~ ;•,,;:"/'-, (~l'fJ:fdc : Name Address City State/Zip Telephone I (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, end the basis for the alleged exemption. Any violation of S ction 7031.5 by any •~pµ<:an3ttor a permit subjects the appli.cant to •;:iv~ penalty of not more than five hundred d9l!ars )$509,l). tJu;e f/.5 J./:Jt ;v (jlll;, c..e Sr };J-'Cr1?1ct1ch ) o:i.S-t-d-?[31:f -'If~ Name l.'"2 ?f C/ Address City State/Zip Telephone II State License # _v=-i<C:....a..?.,..:,z, ..... _,L ..... "----License Class _..=c::....;t....:....I ____ _ City Business License II _______ _ Designer Name Address City State/Zip Telephone State License II _________ _ 6. WORKERS' .COMPENSATION . ' ~,. Workers' Compensation Declaration: I hereby affirm under penalty of perjury _one of the following declarations: D I have and will maintain I 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. !J 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 compensat! insurr -e carrie'i'and policy number are: 7" . . _ -:?/ _,t O Insurance Company , '£-,4:{J:!t. _ ti J/1 d Policy No. J ,:;...,. S-J"' /1 ~ ..._ fl Expiration Date_~ __ 'J __ '1!_,__ __ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS )$100) OR LESS) D CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of Califomie. WARNING: Failure to 1■cure worlutn1' compe tlon coverage 11 unlawful, and ahan aubject an employer to criminal penaltle1 and civil finaa up to one hundred thouHnd dollar• ($ 1 ), In ■dditi!>"# ost of compensation, damages II provided for In Section 3706 of the La~ ~ ~e~and attorney'■ fHa. SIGNATURE. __ ..1,_...a,~:L..:.......L..-~~,J-...,,1t.:::...:...;...:;_______________ DATE _:..../_2 ______ _ 7. OWNER-BUILDER DECLARATION · 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 salel. 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, end contracts for such projects with contrector(s) licensed pursuant to the Contractor's License Lawl. 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 tha proposed property improvement. D YES ONO 2. I (have/ have not) signed en 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) .. ·_-----'------------------------------------------- 5. I will provide some of the work, but I have contracted (hired) the following per1on1 to provide the work indicated (include name / address / phone number / type of work):. ________________________________________________________ _ PROPERTY OWN~R SIGNATURE--------------~------- COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDINO PERMITS'.ONLY '''"" DATE _________ _ Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management end prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? D YES O NO Is the applicant or future building occupant required to obtain I permit from the air pollution control district or air quality management district? D YES D NO Is the facility to be constructed within 1 ,000 feet of the outer boundary of • school site? D YES D 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 AND THE AIR POLLUTION CONTROL DISTRICT. :a·. ~:~ ~~ONsTRUCTIQN' ~·"~~~~~~]~FIJ'J.1~~'3u'l1i!t~~~;~~r~~~'.~t~{:f::~~:~:t~r11~;i~~~t;t~~:t~r;:;_;:-:~•:'~:''..:\ ;::~:rt;-/J ": ·• ~ ; ··: ·r I hereby affirm that there is • construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(1) Civil Code). LENDER'S NAME______________ LENDER'S ADDRESS. _______________________ _ '94, "APPLICANT :CEATIFICATION~:;~z~~!;~~1~~..[~~~l":lt~,1.~~~~~~~J,~~~~~~f.§~ii~/£:~~~~f.i}!!~31f:~!:~~~~ ,:~•;t;~\:~/ -~-~'~: ~,-. 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 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 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 end become null and void if the building or work authorized by such permit is not commenced within 36 days from the date of such permit or if th11 building or work 1\lthorized by such permit is suspended or abandoned at any time after the commenc~~r eriod of 180 days (Section 106.4.4 Uniform Building Code). · ~ 9' APPLICANT'S SIGNATURE ' --;;._. l6"//AA../ DATE )J._.,.. /.J -j' YELLOW: Applicant PINK: Finance