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HomeMy WebLinkAbout1216 LAGUNA DR; ; CB022001; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 07-03-2002 Electrical Permit Permit No: cso22001 Job Address: Permit Type: Parcel No: Reference #: Project Title: Applicant: Building Inspection Request Line (760) 602-2725 1216 LAGUNA DR CBAD ELEC 1561642600 KING RESIDENCE Lot#: 0 UPGRADE EXISTING SERVICE FROM 100 TO 200 AMPS Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 07/03/2002 MDP 07/03/2002 07/03/2002 KING MICHAEL KING MICHAEL 0610 07/03/02 )002 :}!. 1216 LAGUNA DR 92008 Total Fees: $35.00 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 Inspector: 1216 LAGUNA DR 92008 Total Payments To Date: 100 0 0 0 $0.00 Balance Due: Clearance: $10.00 $25.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $35.00 CCPF" $35.00 NOTICE: Please take NOTICE t at approval of your project includes the "Imposition" of fees, dedications, reservations, 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. JJ X' FOR OFFICE USE ONLY PERMJT APPLICATION PLAN CHECK NO. d..,-2.,,~\ CITY OF CARLSBAD BUILDING DEPARTMENT EST. VAL. _________ _ 1635 Faraday Ave., Carlsbad, CA 92008 Plan Ck. Deposit ________ _ 'A Validated By __________ _ Date. ______________ _ 1 / ,,_PRQJ!;CT INFOJlt,IIA TIO!'( /-.t ~ L t>r~ vrJI\ Address (include Bldg/Suite #) Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Aµl!ssor' s Parcel # Existing Use Proposed Use .... J_t:Lcc,a,r 4L -;:en,.;,c.£ vf>G r'<A I)€" /\°escription of Work SO. FT. #of Stories # of Bedrooms # of Bathrooms J OD A-'1") ,<J "--,0 ?_ 0 0 ,4vi,,, ,.0 S ~v,cC \z;. CQf!IA_<U.f!;RSON (If 9lfferent fJom applicant) Name Address [3. APPLLCANT O Contractor O Agent tor Contractor O Owner Address Address City 0..!!gent for Owner City Di4... City State/Zip Telephone# Fax# State/Zip Telephone# S.tate/Zip Telephone # (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 ($500)). Name Address City State/Zip Telephone# State License # _________ _ License Class _________ _ City Business License # _______ _ Designer Name Address City State/Zip Telephone State License # _________ _ 6. WO..RK~S' 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. O 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: Insurance Company _____________________ Policy No._____________ Expiration Date _______ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($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 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 DATE l-QY.,N~~.:BV!LD!;R DECLARATI.QN . ·-'"•-""-. ---:;--;;::::;:::==:;;:;;;;;::;;;:::;;;:=--~---·----,,,..,-~--.. ., .. , I hereby affirm that I am exempt from the Contractor's License Law for the following reason: 0 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 w ill have the burden of proving that he did not build or improve for the purpose of sale). Ji!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). 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 6 ave no_!) 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 name / address I phone number / contractors license number): NDt5Lc 'ELEZ-7?'-?-cl( Lie.. /[(o2.0l4 2- 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 contra ed (hired) the following persons to provide the work indicated (include name / address / phone number / type of work): _________ --::::;-----,,,,.'-'r-7----,-------------------------------------- PROPERTY OWNER SIGNATURE ..:/-_~ ___ Y_+",__.,,...:;__ ____________ _ DATE_..c.7_-~3=-_-_0_~--- COMPLETE THIS SECTION FOR NON-RES/DENTl L BU!.!,D NG 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? 0 YES O NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site7 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 AND THE AIR POLLUTION CONTROL DISTRICT. 8. CONSTRUCTION Ll;NDJNG ~GEN_CY 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 __________________________ _ !l, APPLICANT CEl3TIFICA TIO~ 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 Citt 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 th·e provisions of this Code shall expire by limitation and become null and void if the building or work authorized by such permit 1s not commenced withiryl 80 days from the date of such permit or if the bu1ld1ng or work authorized by such permit is suspended or abandoned _J at any time after the work 1s commenced fo~f'i'od of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE /J?-~1½' DATE /-f -Q 2_ / WHITE: File YELLOW: Applicant PINK: Finance ~ w City of Carlsbad Bldg Inspection Request For: 07/18/2002 Permit# CB022001 Inspector Assignment: Title: KING RESIDENCE Description: UPGRADE EXISTING SERVICE FROM 100 TO 200 AMPS Type:ELEC Sub Type: Job Address: Suite: Location: 1216 LAGUNA DR Lot APPLICANT KING MICHAEL 0 Owner: SYMONS CECELIA M LIVING TRUST 04-23-94 Remarks: Total Time: CD Description Act Comments Phone: 7607207478 Inspector: ---- Requested By: MIKE KING Entered By: CHRISTINE 33 _s_e_rv_i_ce_c_h_a_ng_e_,_u_pg_r_a_d_e __ ~ ~ /J1 t( Associated PCRs/CVs Inspection History Date Description Act lnsp Comments