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HomeMy WebLinkAbout102 ACACIA AVE; ; CB031585; PermitCity of Carlsbad 1635 Faraday Av Carlrbad, CA 92008 Building Inspection Request Line (760) 602-2725 Electrical Permit Permit No: CEO31585 \ 06-09-2003 ' Job Address: Permit Type: ELEC Status: ISSUED Parcel No: 2042331000 Lot#: 0 Applied: 06/09/2003 Reference #: Plan Approved: 06/09/2003 Issued: 06/09/2003 Project Title: VIOLA RESIDENCE Inspect Area: 102 ACACIA AV CBAD Entered By: MDP ELECTRIC WORK FOR SPA Applicant: VIOLA THEODORE D 102 ACACIA AVE CARLSBAD CA 92008 102 ACACIA AVE CARLSBAD CA 92008 Electric Issue Fee Single Phase per AMP Three Phase per AMP Three Phase 480 Per AMP RemodeVAlteration per AMP Remodel Fee Temporary Service Fee Test Meter Fee Other Electrical Fees Additional Fees 0 0 0 0 $10.00 $0.00 $0.00 $0.00 $0.00 $10.00 $0.00 $0.00 $0.00 $0.00 TOTAL PERMIT FEES $20.00 Total Fees: $20.00 Total Payments To Date: $0.00 Balance Due: $20.00 Date: Clearance: NOT CE Pease me hOTlCE lnal approua. 01 fhf prc,en m .oes Ire '.mFosr on' of toes, owxal on% resmal ons of other exadions nereaher cn ea ne y relened 10 as -feesexan~ons.' Yo. have 90 0a)S from Ine oale In s perm I has ssxo 10 prolesl mpos I On of lnese feesexact ons. f )OL prolest Inem. )ou muSl Io ou In8 p'oI6~1 procea.res sel lonn n Gorernment Cooe Sen on 660201al aco I e Ine protesl an0 any olner required nlomal.on m lh Ine Clry Manage8 tor process ng n amroance u.In Car sbad M.n,ctpa Cwe Senon 3 32 030. Fa .re 10 I me y Io on lnal procedure *.I oar an! s.oseqLen1 lega action to anaclt. re, ew setasoe. mo. oiann. tnelrirnpositon You are nereoy FJRTdER NOT F.ED lnal your I gnl IO protest me spec.1 eo leesexact ons DOES hOT APPLY IO mler ana sewer mnnection lees and capadty PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 FOR OFFICE USE ONLY PLAN CHECK NO. 61- ,* EST. VAL. Plan Ck. Deposit Validated By Date Business Nama (at this address1 Legal Description Cot No. Subdivision NamalNumber Unit No. Phase No. Toid X of units 00 ?am$ Assessor's Parcel X Existing Use Proposed Use X of Bedrooms X of Bathrooms Name Address City Statelzip Telephone # issumce. aim requires the applicant for such permit to fils a signed statement that he is licensed pursuant 10 the piovioions of the Contractor's License Law [Chapter 9, commending with Section 7000 of Division 3 Of the Business and Professions Codel or that he is aximpt therefrom, and the basis for the allaged exemption. Any violation of Section 7031.5 by my applicant for I permit subjects the applicant 10 a civil penalty of not more than five hundred doilars 1850011. Name Address City StmIZip Telephone X state Lieanss X License Class City Business License X Designer Name Address ' city Stateltip Telephone 0 of the work for Which this permit io issued. issued. My worker's compensation insurance carrier and policy number are: Insurance Company Policy NO. Expiration Date ITHIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 181001 OR LESS) 0 CERTIFICATE OF EXEMPTION I Certify that in tho performance of the work for which this permit is issued. I ohali not employ any parson in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Faliun to .ecun workers' oompan.mlon coverage i. u~~Iarvtul. and ahan subiect an ernployn to crlminal penalties and clvll fines up to one hundred thousand dollars ~8100.000l. In addition to the cost of cornpansation. damages 8. pr0~M.d lor In Seetlon 3700 01 the Labor code. imerast and 8nornoy.s fees. SiGNATURE DATE i hereby affirm that i am exempt from the Contractor's License Law for the following reason: lell I, as owner of the propeny or my empioyees with wages as their sole compensation, will do the work and the structure is not intended or offemd for sale ISec. 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 doer such work himself or through his own employees, provided that such improvements ire not intended or offarad for saie. 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 purpo~e of ialel. 0 I, as owner of the propeny, am exclusiveiy contracting with licensed COPI~C~O~S to c~nstruct the project ISec. 7044. Business and Professions Code: The C~ntrnctor's License Law does not apply to an owner of property who builds or improves thsmon. and contracts for such projects with CmtraCtoriSl licensed pursu*nt to the Contractor's License Law). 0 1. 2. 3. I have and will maintain LI certificate of consent to ssif-insure for workers' compansation as Provided by Section 3700 of the Labor Code. for the psrfarmance I have and will maintain workers' compensation. as required by Section 3700 of the Labor Coda, for the performance of the work for which this permit is I am exempt under Section I personally plan to provide the major labor and matariais for Construction of the proposed pmperty improvement. YES ON0 I lhava I have not1 signed an application for a building permit for the proposed Work. I haw contracted with the following Parson (firm) to provide the proposed construction iinclude name I address I phone number I contractoi~ license number): Business and Professions Code for this reason: 4. number I Contractors license numberl: i plan to provide portions of the work, but i have hired the following person to coordinate. supnwise and provids the major work linclude name I address I phone ' PROPERTY OWNER SiGNATURE ~~~~~~~i5~~c~~~.~~ 1s the applicant or future building occupant required to submit B business plan. acutely hazardous materials registration form or risk management and prevention program under Sections 25505. 25533 or 25534 of the Prsstey-Tanner Hazardous Substance Account Act7 YES 0 NO io the spplicant or future building occupant required to obtain a Permit from tha air poilution control district or air quality management district7 Io the facility to be EOnstrUcted within 1,000 feet of the OUtBr boundary of a school rite? 0 YES 0 NO 0 YES 0 NO IF ANY OF THE ANSWERS ARE YES. A FINAL CERTlFiCATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETiNG THE REOUIREMENTS OF THE OFFICE OF EMERGENCY SERViCES AND THE AIR POLLUTION CONTROL DISTRICT. gBmt I hereby affirm that there is B construction lending agency for the performance of the work for which this permit is isrusd ISec. 30971i1 Civil Codel I certify that I have {cad the application and state that the above information is correct and that the information on the plans is eccurate. I agree to comply with all City ordinances and State iaws relating to building Construction. I hereby authorize representatives of the Citr of Carisbad to enter upon the above mentioned property for inspection PU~POEBB. i ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAiNST ALL LIABILiTIES. JUDGMENTS, COSTS AN0 EXPENSES WHiCH MAY IN ANY WAY ACCRUE AGAINST SA10 CITY IN CONSEQUENCE OF THE GRANTING OF THiS PERMIT. OSHA: An OSHA permit is required far BXCwationS over 5'0" deep and demolition or Construction of stmct~res over 3 stories in height. EXPIRATION Every permit authorized by such permit is at any tirr 'ter the work is Uniform Building Code). APPLiCA . SIGNATURE DATE 6--743 thls Code shaii expire by limitation and become null and void If the building or work permit or if the building or work authorized by such permit is suspended or abandoned WHITE File YELLOW Applicant PINK Finance City of Carlsbad Bldg For: 0611 012003 Permit# CB031585 Title: VIOLA RESIDENCE Description: ELECTRIC WORK FOR SPA Type: ELEC Sub Type: Job Address: 102 ACACIA AV Suite: Lot 0 Location: APPLICANT VIOLA THEODORE D Owner: VIOLA THEODORE D Remarks: Total Time: Inspection Request Inspector Assignment: PD Phone: Requested By: TED Entered By: CHRISTINE CD Description Act ,,Comment Associated PCRdCVs lnswction History Date Description Act lnsp Comments