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HomeMy WebLinkAbout1203 PALOMAR AIRPORT RD; ; CB994757; PermitCity of Carlsbad 12/28/1999 Electrical Permit Permit No:CB994757 Building Inspection Request Line (760) 438-3101 Job Address: Permit Type: 1203 PALOMAR AIRPORT RD CBAD ELEC Parcel No: Reference #: Project Title: KELLY CORP. TEMP. POWER POLE Applicant: TEMP UTILITY SERVICES 1167 LAW ST SAN MARCOS, CA 92069 619-4 71-5494 Total Fees: $20.00 Electric Issue Fee Single Phase per AMP Three Phase per AMP Three Phase 480 Per AM Remodel/Alteration per AM Remodel Fee Temporary Service Fee Test Meter Fee Other Electrical Fees TOTAL PERMIT FEES Lot#: 0 FINAL APPROVAL Date: J-/1 -Ot> Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: Clearance: ISSUED 12/28/1999 MOP 12/28/1999 12/28/1999 0.00 0.00 0.00 $0.00 $0.00 $0.00 $10.00 $0.00 $0.00 $20.00 $20.00 NOTICE: Please take NOTICE that approval o your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as '1ees/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 capactiy 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 ou have reviousl been iven a NOTICE similar to this, or as to which the statute of limitations has reviousl otherwise ex ired. CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK No. ?CJ' L{7~7 CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 EST.VAL. __________________ _ Plan Ck. Deposit--------- Validated By __________ _ Date _________________ __ Legal Description Lot No. Subdivis· Unit No. Phase No. Total I of units b Jrcif ing Use I 0-IW.r" {O/t. Proposed Use Assessor's Parcel I ,, Description of Work SO. FT. #of Stories I of Bedrooms I of Bathrooms 2. Name Address ' City State/Zip Telephone I ::3. ~ APPLICANT 0 Contractor ~Bf Agenttof'"cionncto.--:::'~~0 cOwner"':Q •~foi:0wner· -:~, . Name ·4. PROP Name :Address s. ··coNTRACTOR • COMPANY NAME"·. ,:.c '-. -,~:,..,, ~- City State/Zip e7°A ... lt ~;; ·l);.:''~=tf -I :;,,~.,, .. ,.,.~ i ;,: . City St1te/Zip r _,.._.,..., -.. ,....., •• _,.... "1' ·•q··.t.-•'.?''; ~--.. -• • •.•--,,,_. .,.,._...._,. __ -;-.. • ·-; --·. ':"'11:'",.'~:"""~':.~ ............... ;o.. ~_ .. ;.i;_~~,.,.. .......... ~ ~-.-"I. ........... "l""""" :'.:' ·. Telephone I Telephone I Fax I (Sec. 7031.5 Business and Professions Coda: Any City or County which requires a permit to construct, attar, 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 o! the Business and Professions Code! or that he Is exempt therefrom, and the basis for the alleged exemption. An violation of Sa iop 7031 .5 by an applica t for a armit subjects the 1pplica~t to a civiyP•/alty of not more than five hundred dollars ($5001). c. tvs v,;,""St e-c11do '!J.OJ..> 7/"c,-J'l'-9'J./StJ Name State License I _:J_,.,_'J.._3_,S'f'. __ c ___ _ Address City State/Zip Telephone I License C!ass ____ C.. __ {_/ _____ _ City Business License I -------- Designer Name Address City State/Zip Telephone State License I---------- 6. WORKERS' COMPENSATION Workers' Compensation Decl1r1tion: I hereby affirm under penatty of perjury.one of the following declarations: D I have and will maintain I certificate of consent to self-insure for workers' comp1nS1tion 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' compan11tion, as required .by Section 3700 of the Labor Code, for the perform1nce of the work for which this permit is issued. My worker's compens?'!n inSUJ'"Ce c1;tr ind policy number are: . S-: -s"/ I tJ ,. r 'I . ;2.,. J.8-9'? Insurance Company s fa .e, r ,J /1 Polley No. I J Expiration Data_/ ______ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS! O CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not employ 1ny person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Flilure to secure worken' compenutlon coverage ii unlawful, end lhlll aubject 1n employ• to c:rtm1na1 penlltlel end c:1v11 flnet up to -hundred thousand dollars ($100,000 to th\j9st compenNtlon, dlm1ga a provided for In Section 3706 of the Labor code, Interest end 1ttomey'1 fH1. SIGNATURE °"'7-DATE /).. -)._9',-9 '? 7. OWNER-BUILDER DECLARATION '"" .. :- 1 hereby affirm that ( em exempt from the Contr1 or's Ucense L1w for the following reason: 0 I, as owner of the property or my employees with w1ges IS their sole compens1tion, will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Codi: The Contr1ctor's License L1w does not 1pply to 1n owner of property who builds or improves thereon, ind who does such work himself or through his own employees, provided that such improvements are not intended or offered for 1111. 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 salel. D I, IS owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License L1w does not apply to an owner of property who builds or improv1S thereon, and contracts for such projects with contractor(sl licensed pursuant 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 1nd materials for construction of the proposed property improvement. 0 YES ONO 2. I (have I heva not) signed an 1pplic1tion for I building permit for the proposed.work. 3. I have contracted with the following person (firm) to provide the proposed construction (include name I address I phone number I contr1ctors license number): 4. I plan to provide portions of the work, but I hive hired the following person to coordinate, supervise and provide the m1jor work (include name I address I phone number I contractors license number>=---------------------------------------------- 5. I will provide some of the work, but I have contr1cted (hiredl the following persons to provide the work indicated (include name/ 1ddrass I phone number I type of work): _______________________________________________________ ~ PROPERTY OWNER SIGNATURE------------------------- COMPLETE THIS SECTION FOR NON-RES/DBV1JAL"IUILDINO PERMITS:ONLY, <!, .. , .,:, .,-. , , DATE _________ _ 'I ..... Is the applicant or future building occup1nt required to submit I business plan, 1cutaly huardous m1t1ri1ls registration form or risk management and prevention program under Sections 26605, 26533 or 25534 of the Presley-Tinner Huardous Subst1nce Account Act? 0 YES O NO Is the applicant or future building occupant required to obt1in I permit from the 1ir pollution control district or 1ir qu1lity m1n1gemant district? D YES O NO Is the f1cility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES D NO IF ANY OF THE ANSWERS ARE YES. A FINAL CERTIFICATE OF OCCUPANCY MAY NOT IE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. ·s· •. CONSTRUCTION LENDING ~-~_t):...;~::'.:'.:_·_.;:;:2'... "'."~~=·::-:r,r~·~r~ ,_-__::~:~-~:::_,:-,,.:;-,. .., t~. I hereby 1ffirm that there is I construction lending 1gency for the performance of the work for which this permit is issued (Sec. 309701 Civil Code). LENDER'S NAME----------------LENDER'S ADDRESS------------------------- ~---APPLICANT CERTtFICATION ~~4,W •• :?;~--~~~'!~;~~=-~=x~~;~r~[~~·~.J~~J~;::i·£-:1!~::.~~IT.~ ·:.. -; "'~ - I certify that I have read the 1pplic1tlon 1nd st1t1 th1t the 1bove information is correct 1nd th1t the inform1tion on the plans is 1ccur1te. I •gree to comply with all City ordinances end St1te laws r1l1ting to building construction. I hereby 1uthorize represent1tiva of the Citt of C1rlsbld to enter upon the 1bov1 mentioned property for inspection purpo111. 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 6'0" deep ind demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the Building Official under the provisions of this Code shlll expire by limitation and become null end void if the building or work authorized by such permit is not commenced within 65 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 th is comm~ 1 period of 180 days (Section 106.4.4 Uniform Building Code). ~ APPLICANT'S SIGNATURE DATE It -J. -r r YELLOW: Applicant PINK: Finance City of Carlsbad Inspection Request Permit# CB994757 Title: KELLY CORP. For: 1/7/2000 Description: TEMP. POWER POLE Type:ELEC Sub Type: Job Address: 1203 PALOMAR AIRPORT RD Suite: Lot 0 Location: APPLICANT TEMP UTILITY SERVICES Owner: Remarks: Total Time: Inspector Assignment: ~ Phone: 7608399430 Inspector: \{)\t1 Requested By: MICHELE Entered By: CHRISTINE CD Description Act Comments 32 _c_o_n_s_t._s_e_rv_i_c_e,_A_g_ri_c_u_ltu_r_a_l~~~~~~~~~~~~~~~~~~~~~~- Associated PCRs Inspection History Date Description Act lnsp Comments :;-U-1 ':J!:fj 118 i 28 5DG&E 760 739 ?494 P. 02/02 ,...--·· -· ----.:: MaElhl-BERYICEtOCA'ftC>N-T.s. 11• 1-n r: W.f.NTeO-OAiE IJl-Jj; . 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