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Home My WebLink About1636 SONGBIRD AVE; TP; CB030486; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 02-19-2003 Electrical Permit Permit No: CB030486 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 1636 soNGBIRD Av cBAD -rP ELEC Parcel No: Lot#: 0 Reference #: Project Title: TEMP POWER POLE@ WEST SIDE OF OF SONGBIRD CORNER OF BLACK RAIL RD Applicant: TEMP POWER SYSTEMS 750 N. CITRACADO PKWY. ESCONDIDO CA 92025 760 439-1999 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 Total Fees: $20.00 0 0 0 0 Owner: Total Payments To Date: $0.00 Inspector: FINAL APPROVAL J...-/:,_~,-,z Date: "'./ Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 02/19/2003 SB 02/19/2003 02/19/2003 $10.00 $0.00 $0.00 $0.00 $0.00 $0.00 $10.00 $0.00 $0.00 $0.00 $20.00 Balance Due: Clearance: $20.00 NOTICE: Please take NOTICE 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 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 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 b·~ :BJact Rail Ra FOR OFFICE USE ONLY PLAN CHECK NO. _____ _ EST. VAL. __________ _ Plan Ck. Deposit _________ _ Validated By __________ _ Date _______________ _ t · ::i;secr INFORMA. TION 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 Parcel # Existing Usij Proposed Use . *Te3Po,e Power Pole Oescnpt1on or SO. FT. #of Stories # of Bedrooms # of Bathrooms 2, CONTACT PERSON (If different from applicant) Name Address City State/Zip Telephone # Fax # 3. APPLICANT O Contractor D Agent for Contractor O Owner O Agent for _Owner *Gary Seyruauc 2458 s Santa Fe Ave Vista, CA. 92084 760-439-1999 Name Address City State/Zip Telephone # 4. PROPERTY OWNER *Lucas &. J'l'1ercier 630 Alta Vista Dr Vista CA 92084 760-726-5600 Name Address ' City State/Zip Telephone # 5. CONTRACTOR ; COMPANY NAME (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, and· thE! basis for the alleged exemptio*.TA~~pap~~~rtis Y~t~~s a24ggcst. tSmit~tpu~eA~~,a~ista: t~iA~en~~5tg21 more than fiv~bTI~~ ~~1 ~1JeJL Name Address City State/Zip Telephone# State License # *483433 License Class ----~c___;_~1~0U----City Business License # 1201652 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: D 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. D 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 and policy number are: lnsmanc, Cornpaav*State fund Pohcy No. ) 589783-02 {THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100) OR LESS) Expication Date 10/01/03 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 he Workers' Compensation Laws of California. • rkers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred n ddition to the cost of compensation, damages as provided for in Section 3706 of th a r code, interest and attorney's fees. thousand dollars S!GNATURE;;;;;;;~~t~~~;;:;;;;:,;:;;;;;;;.;;;;aa---==----------:----------DATE I 'J 7. I hereby affirm that I a D I, as owner of the perty 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 sa!e. If, however, the building or improvement is sold within one ye<1r of completion, the owner-builder will have the burden of proving that he did not build or improve for the ·purpose of sa!e). 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, and contracts for such projects with contractor(s) licensed pu1suant to the Contractor's License Law). 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 the proposed property improvement. D 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 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 __________ _ COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING 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 Act7 O YES O NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air qua!ity management district? O YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? O YES D 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. 8. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction IMding agency for the performance of the work for which this permit is issued (Sec. 3097\i) Civil Code). LENDER'S NAME ______________ _ LENDER'S ADDRESS __________________________ _ 9. AJ='PLICANT CEATIACATION I certify that l 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. l hereby authorize representatives of the Cit\' 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 L1ABIL1T1ES, 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. EX~JRATION: Every permit iss d by the ilding Official under the provisions of this Code shall exp/re by limitation and become null and void if the building or work authori~ed by such permit !s n ilhi~ 180 days from the date of such permit or if the building or work authorized by uch permit is suspended or abandoned at any time after the work 1s c a period of 180 days (Section 106 .• 4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE ,ZQ::)'.3 WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For; 03/11/2003 Permit# CB030486 Title: TEMP POWER POLE @ WEST SIDE OF Description: OF SONGBIRD CORNER OF BLACK RAIL RD Type: ELEC Sub Type: Job Address: 1636 SONGBIRD AV Suite: Lot O Location: APPLICANT TEMP POWER SYSTEMS Owner: Remarks: Total Time: Inspector Assignment: J~ Phone: 7607998703 Inspector: ~ Requested By: GARY Entered By: CHRISTINE CD Description Act Comment 39 Final Electrical ~-------------------'3 ~ _____ j__ ________ _ Associated PCRs/CVs Inspection History Date Description Act lnsp Comments