HomeMy WebLinkAbout1155 CHESTNUT AVE; ; CB022249; Permitu
08-02-2002 X
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Electrical Permit Permit No: CB022249
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Reference #:
Project Title:
1155 CHESTNUT AV CBAD St: TP
ELEC
Lot#:
TEMP POWER POLE
Status: ISSUED
Applied: 08/02/2002
Entered By: MDP
Plan Approved: 08/02/2002
Issued: 08/02/2002
Inspect Area:
Applicant:
POWER PLUS
436 N QUINCE ST
ESCONDIDO CA 92025
760 839-9430
Owner:2934 08/02/02 0002 01 02
CGP 20 = 00
Total Fees:$20.00 Total Payments To Date:$0.00 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
Additional Fees
TOTAL PERMIT FEES
0
0
'$10.00
$0.00
$0.00
i$0.00
$0.00:$o.oo,
$10.00:
$0.00
$0.00
$0.00
$20.00
Inspect
FINAL APPROVAL
Date: 0-Clearance:
NOTICE: Please tfke NtfTliE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively
referred to as "fere/exactiwfs." 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
fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired.
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
1. PROJECT INFORMATION
FOR OFFICE USE ONL
PLAN CHECK
EST. VAL.
Plan Ck. Deposit.
Validated By
Date
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 Use Proposed Use
Description of Work«^
2. CONTACT PERSON (if different from applicant)
SQ. FT.#of Stories # of Bedrooms # of Bathrooms
Name Address City
3. APPLICANT Q Contractor "^JAgent for. Contractor D Owner Q Agent for Owner
State/Zip Telephone #Fax*
Address City State/Zip Telephone #Name
S. 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
exemption^Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$5001).
~ ^V. il« <y^i^e--r - - -
Address '~
License Class (—
Name
State License #
City • State/Zip
City Business License tt
Telephone #
2-
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:
O 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.
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:
Policy No. /5\S Tf<O ^~Z- Expiration Date J .^7 ^ Q >Insurance Company
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$1001 OR LESS)
l~l 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 secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred
thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees.
SIGNATURE f~^~J^\^ DATE Sr— / f-€5*~
7. OWNER-BUIlDER~bE^LARATIQN ~~~, ;~ '
I hereby affirm that I am exempt from the Contractor's License Law for the following reason:
l~| 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 sale).
l~l 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
pursuant to the Contractor's License Law). ......
l~l 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. l~l YES l~lNO
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 nameTaddress / 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 Act? d YES Q NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Q YES O NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Q YES Q 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 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
9, APPLICANT CERTIFICATION
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 City 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 under 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 180 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned
at any time after the work is commenced for aperiod of 180 days (Section 106.4.4 Uniform Building Code).
APPLICANT'S SIGNATURE .r-A'H ^--/ DATE
WHITE: File YELLOW: Applicant PINK: Finance
City of Carlsbad Bldg Inspection Request
For: 08/08/2002
Permit# CB022249
Title: TEMP POWER POLE
Description:
Inspector Assignment:
Type: ELEC Sub Type:
Job Address: 1155 CHESTNUT AV
Suite: TP Lot 0
Location:
APPLICANT POWER PLUS
Owner:
Remarks:
Phone: 7608399430
Inspector:
Total Time:
CD Description Act; ^Comments
32 Const. Service/Agricultural
Requested By: MICHELE
Entered By: CHRISTINE
Associated PCRs/CVs
Inspection History
Date Description Act Insp Comments
07/29/02
Confirmation of meter and service request
Customer HERMOSA CONSTRUCTION 7697297064 Want date:
Service Address .1133 CHESTNUT AV TP CB
PPSS142142 <m
Cofltact:Phone:760 $39 9430
We have investigated your request for temporary service and (Jeteimfcied that th* facilities jrajj have
ideutifidj tu KE3606 are tncohanaoally available fosr your us« in providing terapOTSKy powsr for your
project, if the tempomy service is to be provided ovtfh^ad, please place your facilities no closer than 10
ft or no flutter than 100 ft from the pole Usted above. Place temporary pole within 25 it of a driveable
surface* or use 25-class 5 cfimbable pole with depth gauge attached. All facilities should te placed wu the
premises served. A3 sooa as you provide us with a firm, date you plan to install vow facilities, we can
schedule your service installation. The meter will be set pending receipt of both hilling application and
municipal inspection.
For any questions or further information concerning this fbim call JotocAcuna7«0 9317301
___
base. Muten IBS JC£|iikti to b« MftdUy «cet9UDfaj« 24 HK. /day Meiers mutt be
lecitfsd in » wfc «*» floe of >»y pM^aou naiarea or oaanawa i/rarft»«,.
fmviite y »3' ete!B md fevtl uHnftg tifMO In »a«i 01 m«cr. Wtais a*w
coatad tftc fltstfeit BlXiftE office.
usher «ad te idED1«te4 wife
tif
and smjj nutibw S
For ovobead EUUTDS install wittuB
100 ft of the pole.
cmst iMintaja a impunnta «t:
!?• »1 ® point of «a««ctjcin. 18 ft @ Ooutor of <tre«i ur 12
curb whichever it kss. 1$ ft ovw coausmKsia! dm'ewayi.. 1 ?, it ovm
DJg Akrt US(XM22-4)33 at l
4SliB prior te tr«fi<Ssa&.*
meter clips 120/240 Volt:
Utilities maximum
Cuaomer Mratst Steilitiu to receive «t«Ctrk- acrvka an subject (a all loot! wv) TOW f* laa{m.'<laB owWuhy nx<<uiuu«aB,
If'SDOaS OIEWratEn Wsanteus or tank AnUadaJ white jwrftBUJij,B MwnruntiBii «f your r»n/«t, »•««». wt" Itsh feiaMdi«l«b' mil it wi
to mmo w uul/v clem all buantciu] or touc nwterlal r*^ to SDC*K coUJmufij oaiWtwtto^ SDtuit ituU isve ua Jiobilily nr ahtifatafa to cliaa, KjnAve
or mediate toy tmxnkrae or tank material dwovomi -Mig its wufu of tusaWuctioa. UiUcw U i« thiuueK nv-Kligcocc a/ SD(>«E.
revised 12/29/00
t>0 S3oi/\y3s
...... 11: 55 fiPR 03> 2002 *1247-: 2/3
OF LIABILfTY
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Inauranea Scurvies*
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Cevin* CA 91723
Phona: 626-966-3664 F««; 6*6-966-3395
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HOUHeR. TMB tERTWCATE DOES NOT AUEHD, EXtEKD OR
ALTER THE COVtRAGg AFFQROEP flY Wi POLfCIBSM16W.
Hartford Fire Inuyurtno't Co.
State
Mferkal la*. Ca.
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