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HomeMy WebLinkAbout1171 CANNON RD; ; CB980598; PermitOff**? Permit No: CB980598 Project No: A9800759 Development Not BUILDING PERMIT 02/24/98 15:14 Page 1 of 1 Job Address: 1171 CANNON RD Suite: Permit Type: ELECTRICAL 435202/24/98000101 02 Parcel No: Lot#: C-PRtfT 35-00 Valuation: 0 Construction Type: VN Occupancy Group; Reference^: Status: ISSUED Description: 100 AMP PED. FOR PRESSURE Applied: 02/24/98 : REDUCING STATION Apr/Issue: 02/24/98 Entered By: MDP Appl/Ownr : R.E.HAZARD 619 587-3600 P.O.229000 SAN DIEGO, CA. 92192 *** Fees Required *** Collected & Credits *** Fees : Adjustments: Total Fees: Fee description Enter "Y" for Eleq Single Phase Per 35. . 00 .00 35. 00 Ext fee Data 10. 00 Y 25.00 CLEARANCE. :;.-7-f.ff CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760)438-1161 1 . PROJECT INFORMATION|H, QAKJIJQU FOR OFFICE USE ONLY PLAN CHECK NO. V* EST. VAL. Plan Ck. Deposit Validated By Date Address (include Bldg/Suite »)Business Nam* lit thi» address) Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Totil * of units Assessor's Parcel *Existing Us*PropoHd Use Description of Work SQ.FT.f of Bedrooms # of Bathrooms r^PQV^taD Nam* is. 'APPLICANT Address it for Contractor D Owner City O Agent for Owner Name 4. PROPERTY OWNER. Address City State/Zip^ Telephone f Ctty State/Zip Telephone *Name Address s. CONTRACTOR - COMPANY NAME " """ —""•" "r""" —"^-: TrTTTTTT:""T" TTTT"""'"*" "^—— ; (Sec. 7031.5 Business and Professions Code: Any City or County which require* a permit to construct, alter. Improve, demolish or repair any structure, prior to Its issuance, slso requires the applicant for such permit to ftte a signed statement that ha b licensed pursuant to th* provisions of th* Contractor's License Law IChapter 9, commending with Section 7000 of Division 3 of th* Brahms and Professions Code) or that ha is exempt th*r*from, and the basis for the aHaged Any violation of Section 7031.5_by any applicant for a permit subjects the applicant to a civil penalty of net more than fiv* hundred dollars (1500)).van 4Name State License * Address License Class A City Stata/Zip CrW Business License* elapholSe* Address City State/Zip TelephoneDesigner Name St*t* License » _ 6. WORKERS' COMPENSATION -,..-..,-,, .... r.. .. ._.__„„....__,. :_.T_,.._... ,. . Workers' Compensation Declaration: I hereby affirm under penalty of perjury on* of the following declarations: Q I have and will maintain a certificate of consent to serf-insure for workers' compensation as provided by Section 3700 of the Labor Coda, for the performance of the work for which this permit is Issued. I hsve end will maintain workers' compensation, as required by Section 3700 of the Labor Coda, for the performance of the work for which this permit Is issued. My worker's compensation insurance carrier and policy number are: Insurance Compan*3£MnV) IrUfrUgAMAg QO > Policy No.^Q^ I Y2f3£fl_ Expiration DatelZJ^I (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OH LESS) D CERTIFICATE OF EXEMPTION: I certify that in the performance of th* work for which this permit is issued, I shefl not employ any person in any manner so as to become subjecttflj*»e Wukojs' Compensation Laws of California. amBMaatton coverage I* unlawful, and aha! aub)act an employer to criminal penalties end eh* flnas up to one hundred of compensation, damage* ee provided for ai Section 3706 of the Labe* code. Interest and attorney'* fee*. 7, OWNERjBllpER DECLARATION I hereby affirm thanl am ax«mpt from the Contractor's License Law for the following reason: D I •* owner of th* property or my employees with wages as their sole compensation, wHI do the work and the atructur* Is not intended or offered for sale (Sec. 7044, Business and Professions Code: Th* Contractor's License Law does not apply to an owner of property who buHda or Improve* thereon, end who does such work himself or through his own employees, provided that such improvements are not Intended or offered for sale. H, however, the building or Irnprovamant la sold within one year of completion, th* owner-buHdar wffl have the burden of proving that he did not buHd or Improve for the purpoaa of aala). D I. as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sac. 7044, Buam*** and Profession* Coda: The Contractor's License Law does not apply to an owner of property who builds or improve* thereon, and contract* for such project* wrth contreetorts) lleenaad pursuant to the Contractor's License Law). Q I em exempt under Section ________ ^^ _____ BusinoM and Professions Code for this reason: 1 . I personally plan to provide th* major labor and materials for construction of th* proposed property Improvement. Q YES QNO 2. I (have / h*ve not) cigned an application for a building permit for th* proposed work. 3. I hav* contracted with the following parson (firm) to provide the proposed construction (Include name / address / phone number / contractors Kcame number): 4. I plan to provide portions of th* work, but I have hired the foltowfng parson to coordinate, supervise end provide the major work (mdudo name / address / phone number / contractors license number): ..__•. _________ __ 5. I will provide some of th* work, but I hav* contracted (hired) the following parsons to provM* the work Indicated (Include name / address / phone number / type of work): PROPERTY OWNER SIGNATURE DATE COMPLETE THIS SECTION FOR AWWWHDWTMi SULDMG PERMITS ^^^^^^^^^^^-'-^^r^r^' Is th* applicant or future building occupant required to submit s business plan, acutely hazardous matenato ragjra •^GKaummnVfffVPt'&'f'F*' n form or risk management end prevention program under Sections 25506, 25533 or 2S534 of the Presley-Tanner Hazardous Substance Account Act? Q YES Q NO Is tr* applicam or future hiildng occtipam required to Q YES D NO Is the facility to be constructed within 1 ,OOO feet of the outer boundary of a school ait*? 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. «." CONSTRUCTION LENDING AGENCY ''''——-—~ .^^-^^.^r^™,,.-,M.,~~..- ~ :,^-_.,,._,:_, ,.__,„.,..„_ .. - , - ... . I hereby affirm that there is a construction landing agency for the performance of the work for which this permit is issued (Sec. 3097(1) Civil Coda). LENDER'S NAME LENDER'S ADDRESS • !9. APPLICANT CERTIFICATION "" "*""'.-——^"^r-^™-^^ , ; "TTT — . t certify thst I have read the application and ststs that the above information is correct and that the Information on the plan* ia accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of th* Crty 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 M ANY WAY ACCRUE AGAINST SAID CITY M CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavation* over 6'0' deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the Building Official under th* provisions of this Cod* shall expire by limitation and becoma null and void if the building or work authorized by such permit is not commenced within 365 days from the data of such permit or if the building or work authorized by such permit is suspended or abandoned at any time efter the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE WHITE: Fit* YELLOW: Applicant PINK: Finance CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB980598 FOR 02/26/98 DESCRIPTION: 100 AMP PED. FOR PRESSURE REDUCING STATION TYPE: ELEC JOB ADDRESS: 1171 CANNON RD APPLICANT: CONTRACTOR: OWNER: R.E.HAZARD REMARKS: C/ROBERT/930-4091 OR SPECIAL INSTRUCT: PAGER 899-1478 PHONE: PHONE: PHONE: INSPECTOR AREA PLANCK# CB980598 OCC GRP CONSTR. TYPE VN STE: LOT: 619 587-3600 INSPECT TOTAL TIME: CD LVL DESCRIPTION ACT COMMENTS 32 EL Const. Service/Agricultural DATE DESCRIPTION ***** INSPECTION HISTORY ***** ACT INSP COMMENTS