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Home My WebLink About1375 SHOREBIRD LN; TP; CB981092; PermitB U I L D I N G P E R M I T Permit No: CB981092 ProJect No: A9801449 Development No: 04/17/98 11:16 Page 1 of 1 Job Address: 1375 SHOREBIRD LN Permit Type: E~ECTRICAL Parcel No : Valuation: 0 Lot#: 20. 00 Occupancy Group : Reference#: 6134 04/17/98 0001 01 02 C-PRMT Construction Type: NEW Status: ISSUED Applied: 04/17/98 Apr/Issue: 04/17/98 Entered By : JM 439-1999 Description : TEMP POWER POLE Appl/Ownr : TEMP POWER SYSTEMS 750 N CITRACADO PRKWY ESCONDIDO CA 92025 * )c It. Fees Required Fees: Adjustments: Total Fees : 760 .00 .00 20.00 *** Fee description Ext fee Data Enter "Y" tor Elect 1c Enter "Y" for Remod l 10 .UO Y 10.00 Y I Fl PROVAL- INS -~~--DATE 4.-?JtJ [cLEARANCE---i~-~~o~~~~,~&~>-- CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (6 I 9) 438-1161 P.ERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 FOR OFFICE USE 0 ~1 PLAN CHECK NO. 1)!5({JC/v EST. VAL. __________ _ Plan Ck. Deposit ---::,_,.,;'------'U=-_"_w;c____ Validated By __ -._;-=-..;..~-,-,-~/--.lcc....,..,.,,_. Date ____ --"~+-'{':......:7c...;..(__,_YJ4-,'£'.,,,,_J Address (include Bldg/Suite #) Business Name (at this address) ~ Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Par~ ~71,-Existing Use Proposed Use Description of Work SQ, FT. #of Stories I of Bedrooms # of Bathrooms Name Address City State/Zip Telephone # ·Fax# c~i>u'c.ANf~ ""= , c'iimraci'o_r_'i'.,.,.. ': ~~ :=-~~=lL<-1~ ~%'""''•""'~""· .-· ... ~o.i-... ~,2?~35p$~ .. ~ Name Address City State/Zip Telephone# 1s.~~:coNrRAtTtiR;.:co-MPANv-=NAMei::.~~~~r::z::E~~~~~~~~~~~~~~"';~~;.N~JE?!~~~~~~~,~~2:~~~~ (Sec. 7031.5 Business and Professions Code: Any City ~r County which requires a permit to construct, alt er, 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 ~n._ AJ)j v· ion of Section 7031.5 by any applicant fo/ ~ermit subjects t plicant o a civil penalty of not more t n five hundred dollars ($5001). 't!:"Mv""' (!).•,,,~,LJ S.~ :SO , Ci; o ,1),,.-bo 9~.s-Qtto) ~~ Name · ~/.8 'Z'.U?f ~ Address /.? -/,,.,...., Telephone# State License # -~7.J~=-o/__,L.._ __ 0 __ ~~-License Class --'L-=-_...:__......,____ City Business License I ________ _ Designer Name Address City State/Zip Telephone State License # __________ _ .6.---~ WORKERS~. COM PENSA TtON3:;~~:~~-:_:;;::~::_:__;,· ·~!•~:·.~r~1c~:,. ·~!;~·~:~:~~~: ~ ~=2:I~!:-~~1·:''.~.;!~~·~=~~L'JZ-~~~ ~~~~~:;:~~~~;:_:~:;-~~~ .. :r:-~~~~~~ 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 as provided by Section 3700 of the Labor Code, tor the performance ~ ~ork for w hich 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 co nsation i~urance carrier and policy number are: , /. ,k/ · /6 Insurance Company A<-/.t""-~ -:;;-c,.., Policy No.~~ ?{;)t!)(!!._.. Expiration Date /e,/1,_~ I (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100} OR LESS) 0 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 b~come subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' ompensetlon coverage is unlawful, end shell subject an employer to criminal penalties end clvll fines up to one hundred itlo to the cost of compensation, damages as provided for in Section 3706 of the La code, I erest end attorney's fees. SIGNATURE __ L--~-"---c.,,c,::,_=;__-"'::.....--'l------------------ 7:·-... QWNER.BUl(tiER'OECL'.AJ\AT10Nl;ll~f~~~:~~;-;1E=?•.~7;1:~~s:g-~~f±t~i~:;~~"'-:~Jtr";r::_:~'T:ii~~" .. ~_::~:.;_;r~:~ff?-~t~i~~~~t,-~\~ I hereby affirm that I am exempt from the Contractor'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 ottered 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, end 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). 0 I, es 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). 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 a building permit for the proposed worlc. 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 persons to provide the work indicated (include name / address / phone number/ type of work):. __________________________________________________________ _ PROPERTY OWNER SIGNATURE ______________________ _ DATE _________ _ '.c0Meili:E.tffi1s SECTION'l'OR N<i1v;1it'sfli,"i;lriAJ.~Bri1LDiN<l'.:P.EBMltif6'f1LYg;<liw~~~~~~':;;;1,'m~-mm~;)%~ 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 POLLUTION CONTROL DISTRICT. ~~~Q~~~Il(4.¢ItQN:t~~~C?IN~qIN:cy.-g~~E:L!~lz~~~~~~:=;!rt:a~m~:S~~t~~~~~~f~~i,~¥b~}~~~-~~~;~~~~~-;,~~·r:fr;,~~~~~·~~~i/ 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). LENDER'S NAME LENDER'S ADDRESS :S&qJ.ef>l.JCAN'l:~CERUFfc~Tio"N;~~,...~-,, • :;~', , . < • • , ~f:",2:.t~~1.\:.~f.l'~~'¾-~~ 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 u der 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 3 days from the date of such permit or if the building or work author' ed by s ch permit is suspended or abandoned at any time after the work · for period of 180 days (Section 106.4.4 Uniform Building Code). WHITE: File YELLOW: Applicant PINK: Finance