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Home My WebLink About1080 PALM AVE; ; CB051579; PermitUL lu {_ \~ -l · City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 05-03-2005 Electrical Permit Permit No: CB051579 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: 1080 PALM AV CBAD ELEC 2051900900 Status: Lot#: 0 Applied: Entered By: Reference #: Plan Approved: Project Title: GHEZZI RES-UPGRADE OVERHEAD ELECTRICAL FROM OLD TO ONE 100 AMP PANEL Applicant: CVETICHAN DIANE 1080 PALM AVE CARLSBAD CA 92008 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 Owner: CVETICHAN DIANE 1080 PALM AVE CARLSBAD CA 92008 Issued: Inspect Area: ISSUED 05/03/2005 LSM 05/03/2005 05/03/2005 $10.00 $0.00 $0.00 $0.00 $0.00 $10.00 $0.00 $0.00 $0.00 $0.00 $20.00 Total Fees: $20.00 Total Payments To Date: $0.00 Balance Due: $20.00 7303 05/03/05 0002 ()1 CGP Inspector: Clearance: NOTICE: Please take NOTICE at approval of your project includes the "Imposition" of fees, dedications, reseNations, 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 f x i n f wh' . . T . . . whi h f limi . . . i 02 20.00 FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NO.ffi 0 ~) S-)Cj CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA _92008 EST. VAL. __________ _ Validated By __ ~..--,--'--,,------- Plan Ck. Depo·· Date . 5" 'S Busines~ Name (at this address) Legel Description Lot No. Subdivision Name/Number Unit No. Phase No. Total I of units '. "Xcssessor's Par;"~ ov-e.r ht:.A-0 i::t~s~ Se.--v" .. G..--fo /00 zed Use / ·--escrlp lo f Work SO. FT. lot Stories I of Bedrooms I of Bathrooms 1~4.e-~1Jf.~ijJGatt!i~t;lN1lftrcillt•rt1:iJ~ml'ifilW~,rilt~.i~ll'fs~~ffi·~:ii.iNJ,,'1,t:1'-11iii-fiotfw~rj.\~ 1 :i.\i:.L:, -.~t,•.t•:~ ,,:,,•S;_1;,·•"i, "~,.,1,~.,r1;-l,M•;1.:i.tr:.t~;-;·· ::.-if: . i. 1;;.1::2:1 -~ , ~-~·-· .;. Name Address City State/Zip Telephone I Fax I ~-~1m¢iJt ,l:~wwK_qq . \Irr ' ~S.9.lliffgtor:ii~~i,if.5,fGJ;14if~lli,(9s_~ri;;~r4 1\1' ?i~f.'~~~r,er~w.~•tiZ'"-~~t -·;0rt~ . '4'::.~c. --fr Name Addreaa City State/Zip 1'elephone I .~ll~tff~.: ~~~~ ,,;.,~~wir4tp;4,~~~77~~~,~~1'f~~r;~;:i:.f>f;t;.~~~~~~,,;~. r Name Address City S.tate/Zlp Telephone I 11 · .J:irlM~m0~!OO'M~&I.M . " ~'ffi'~;;r~t-':~11:~., .. :'i?~'t!WJi~•~ •E~ t~S.Zt1!!'1'~t11t,'l;~'1\l1i1,ii'.;lf<iw,4'~~~\tii•,i,.'i,W:~J.'jti!.-i :i!~•. ~~-~~ (Sec. 7031 .5 Buslneaa and Professions Code: Any City or County which requir~s I permit to construct, alter, Improve, demolish or repair any structure, prior to Its l11uance, also requires the applicant for such permit to file a signed statement that he Is licensed pursuant to the provisions of the Contractor'• License Law (Chapter 9, commending with Section 7000 of Division 3 .of the Buslneu and Profesalons Code) or that he la exempt therefrom, and the buls for the alleged exemption. Any violation of Section 7031.6 by any applicant for a permit subjects the applicant to• clvll penalty of not more than five hundred dollars r•soon. Name Address City State/Zip Telephone I State License I _________ _ License Class _________ _ City Business License I _______ _ Designer Name Address City State/Zip Telephone State License I _________ _ rt~il.lllDJ.[fj .1 M~P:~ ;,L~~z:~~a~&.i.~J~fJ,t~.ii/;.,:~l:J)~f~i◄i:r:wr~~jA~~~i~~ith~f/t?~~4·t~!~~'f,,:1!.:~i~)-;i~:,r~~~~r.~lt~i~~~~~f.~:;/:j;~•;(;~·~M~~i.-~J1;~~J Workers' Compensation 0ecleratlon: I hereby affirm under penalty of perjury one of the following declarations: 0 I have and wlll maintain a certificate of consent to self-Insure for workers' com·pensatlon as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit la l91ued. 0 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 lsaued. My worker's compensation Insurance carrier end policy number are: ln,urance Company_____________________ Polley No.____________ Expiration Date _______ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1•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 become subject to the Workers' Compensation Laws of California. WARNING: Failure.to 'Hcure workers' com.,.n■atlon cov•r•11• l1 unlawful, and shall subject an employer to criminal panaltlH and civil fines up to one hundred thou■and dollars ($100,000), In eddltlon to the cost of compensation, damages H provided for In Section 3706 of the Labor coda, Interest and attomey'a fees. ?(SIGNATURE . 0ATE~----------•m.,.....,=i:=...rllll"=. ~"""" IJ"L~=~ _,,;;;-i;r,:,.•t""'ll"',.nt:i.""•-.:r, .•·--7~"-l;)!l!:J'f,,.==-··~=-=•-:=•· ,_,. -. ·~ · Qnl,l_l,;.t_~~~.!M.~0.~!J.@Jl~ 1 -~ :-.· ·.. ~ . , ,~~F~L.'tr~mr..~~~~~~~~~~~•{.i_~ .. ~~'t~t1~L"2'''~:'rt~-!f!;!;;."!~~~~:t1iffl$)i;~~·itr •. x1: l)'i:~ .. ~.-: ".''k:'.~;;:!J'.i;f,::',:'~( I hereby affirm that I am exempt from the Contractor's License Law for the following reason: · M' I, ae 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 ~c. 7044, Business and Profeaalons 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 lmprovaments·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, a"!' exclusively contracting with licensed contractors to construct tha project (Sec. 7044, Business end Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and convects for such projects with contractor(al licensed pursuant to the Contractor's "License Lew). .- 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 eppllcatlon for • building permit for the proposed work. 3. I have contracted _with the following person (firml to provide the proposed construction (Include name / address / phone-number / contractors license numberl: • 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 umber/ contractors license number): ______________________________________________ _ 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 workl: __________ -.:::::---------::=~------------------------------------- ROPERTY OWNER SIGNATURE 1 • DATE S:• 3 •l!)~- ~ijtiJJfi.,:l;tt_il[~j~'fliiQl~~}ij~f.@RUJ/it~T))([~ · -· 1&01t e .:o~l}v~~8Mf~t~-.·t,.ti:. .Jft.;J;"~.f. :;1i:;:l-1~;.1:"1 .,: . ....,,:,· . .t. ..;:~~-: ,..._ ..,.1,, :., Is the applicant or future building occupant required to submit • business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25506,.26533 or 26534 of the Presley-Tanner Hazardous Substance Account Act? 0 YES O NO Is the applicant or future building occupant requlied to obtain a permit from the air pollution control district or air quality management district? O YES O NO Is the facility to be constructed within" 1,000 feet of tile outer boundary of a school site 7 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 ANO THE AIR POLLUTION CONTROL DISTRICT. Ui.r. ,; j~~-a1j_ffil{~ ' '.""~'t?i~~J,t1~~ :~,{~:i~~~;i'~lt,{l~••!f~~;~;fi(~~~~~~~~~~j::~~t~~;' :-.,,!(••~:~~:1,~::i1.. '.'J':'.1,J!C.'ii~/:'.?:.~r-*, :: /tJ\1, .;,;: ,., 11: : ,,((1~. l j ~~'i'.~:..., :.... ·,,f ,1-,•, ,f'-i-~~".ir...:.i(~u.,,,'l:~ ... ~l~J.'w.•~!"f,t..,:f;~:~"t.1'1 .. .;.J,Ti;'.:r.;l,,,.,J~,:l.:•~:!f.~J!. • ., .... ~1•1,,, .... ~., .... '1.7'~,·•,···~·~·;r~{' l·'IJ,i-111.•·J11 ,,,;;, • __, ,· Ir "Tl I hereby affirm that there Is a construction lending agency for the performance of tha work for which this permit Is issued (Sec. 3097(11 Civil Codel. LENDER'S NAME______________ LENDER'S ADDRESS ~-~lellla'~JE.!\Mc»lW ·' ~~f~l~!G~~~rc;;~---.-.-,-:J-!ij-~-U-_,i.;-:~-fr.lf-~-, -. ~-~-..I:_fi:_W-.,l_-. ~-.--,-~-Jl!-t"'-·!--~-, --, -~-.;;r-~-,;.-,i'c-,~--~-\-~1:;-~--,-•lli-~'-~--.-I~-i~-~ri~ I certify that I have read the application and state that the above Information Is correct end that the Information on the plans Is accurate. I agree to comply with all City ordinances and State l1w1 relating to building construction. I hereby authorize representatives of the Cit\' of Carlsbad to enter upon the above mentioned property for Inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY ANO 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 6'0 " deep end demolition or construc;:tlon of structures over 3 storlaa In height. EXPIRATION: Every permll Issued by the building Official under the provisions of this Code shall expire by llmllatlon and become null and void (f the building or work authorized by such permll Is not commenced within 180 days from lhe dale of such permit or If lhe building or work authorized by such p rmtt Is s pended or abandoned , ) at any time alter the work Is commenced a period ol 18 (Secllon 106.4.4 Uniform Building Code). "]-APPLICANT'S SIGNATURE --f-+'""'-...:....;.....:_tril'--":...a.c.""7"")"':;!lp,f-----------DATE ~:::_.=....µ..a.L-.4-~-=:__ ___ _ City of Carlsbad Bldg Inspection Request For: 05/23/2005 Permit# CB051579 Inspector Assignment: PY --- Title: GHEZZI RES-UPGRADE OVERHEAD Description: ELECTRICAL FROM OLD TO ONE 100 AMP PANEL Type: ELEC Sub Type: Phone: 7604343878 Job Address: 1080 PALM AV Suite: Lot 0 Location: Inspector: ----- OWNER CVETICHAN DIANE Owner: GHEZZI DIANE J Remarks: DID NOT LEAVE INSPECT TYPE Total Time: CD Description 34 Rough Electric Act Comment Requested By: TOM Entered By: JANEAN ~------ ------------------------------------- Associated PCRs/CVs Inspection History Date Description 05/18/2005 33 Service Change/Upgrade 05/17/2005 39 Final Electrical Act lnsp Comments CO PC SEE NOTICE -REQUIRES GROUND ROD CO PY NEED GROUND