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Home My WebLink About1313 CASSINS ST; ; CB961918; PermitBUILDING PERMI 10/07/96 08:52 Page 1 of 1 Job Address: 1313 CASSINS ST Suite Permit Type: ELECTRICAL Parcel No: Lot#: Valuation: 0 Occupancy Group: Reference*: Description: TEMPORARY POWER POLE-MARFIORE r Permit No: CB961918 Project No: A9602738 Development No: 0202 10/07/96 0001 01 02 C-PRHT 20.< Construction Type: NEW Status: ISSUED Applied: 10/07/96 Apr/Issue: 10/07/96 Entered By: RMA Appl/Ownr : TEMPORARY POWER SYSTEMS 750 N CITRACADO PARKWAY,STE A ESCONDIDO CA 92025 *** Fees Required 619 439-1999 lected & Credits Fees : Adjustments: Total Fees: Fee description Enter "Y" for Elect Enter "Y" for Tempo * ELECTRICAL TOTAL * * * . 0 0 . 0 0 20.00 Ext fee Data 10.00 Y 10.00 Y 20.00 CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION City of Carlsbad Building Department 2075 Las Palaas Dr., Carlsbad, CA 92009 (619) 438-1161 1. PERMIT TYPE From List 1 (see back) give code of Permit-Type: For Residential Projects Only: From List 2 (see back) give Code of Structure-Type:. Net Loss/Gain of Dwelling Units. PLAN CHECK NO. EST.VAL PLANCK DEPOSIT VALID. BY f rfK>&—— DATE 7~&\^ (Cf£ " 2. PROJECT INFORMATION FOR OFFICE USE ONLYMdress Nearest Cross Street ST Building or Suite No. LEGAL DESCRIPTION Lot No.Subdivision Name/Number unit No.Phase No. «£CHECK BEUUW IF SUBMIT! . D 2 Energy Calcs D 2 Structural Calcs D 2 Soils Report D 1 Addressed Envelope ASSESSOR'S PARCEL DESCRIPTION OF WORK SQ.FT. ISED USE # OF STORIES # OF BATHROOMS 3. UJN IAL;I rejfsuN in cunereni rrom applicant; NAME (last name first) Je^V^^ J o Sr/> U ADDRESS OTY cOMg/*?) STATE Cq ZIP CODE .$-PAY TELEPHONE Y39-/9994. APPLICANT DUJ NAME Oast name first) CITY jtN I rUK UJn 1 HAL 1UK Jo 5 f^K ADDRESS STATE ZIP CODE a rUR _ . £« V< DAY TELEPHONE CITY STATE C? 7*^/0- ADDRESS- ZIP CODE ^3657 DAY TELEPHONE /%/ f 51 6A 6, CONTRACTOR NAME (last name first) CITY O*-l C/, <3/0 STATE STATE LIC. ^ * rrMv ADDRESS ZIP CODE £5*0 JUT""" DAY TELEPHONE LICENSE CLASS Cr( O CITY BUSINESS LIC. # DESIGNER NAMt (last name first) QTY STATE ADDRESS ZIP CODE DAY TELEPHONE STATE UC. # 7. Workers' Compensation Declaration: 1 nereoy atlirm that I nave a certificate ot consent to sell-insure issued by the Director ot industrial Relations, or a certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified by the Director of the insurer thereof filed with the Building Inspection Department (Section 3800, Lab. C). INSURANCE COMPANY /if ,yfc<«CPOUCY NO.X^ 6 C>3 730 ^XPIRATION DATE ) (Q -/ - Certificate ot Exemption: 1 certify that in the pertormance'ot the work lor 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. ^DATE /X2-7-76 v^prncr-DUiiuer L^ciarauon. i nereuy aiiitiu uiai i aui exempt from uic xx/nuaciors ucense Law lor uic louowing reason. 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.). O 1, 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). Q 1 am exempt under Section Business and Professions Code for this reason: (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, commencing 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 [SSOO]). SIGNATURE DATE COMPLETE THIS SECTION t'UR 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 D NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? D YES D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? O YES D NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OP OCCUPANCY MAY HOT BE ISSUED AFTER JULY 1,1989 UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. 9. UUIMSTKUCTHJN LENIUNU AlitNCY 1 hereby attirm that mere is a construction lending agency tor te performance ot tne work tor wmcn this permit is issued (Sec 3097 (i) uvii code;. LENDER'S NAME LENDER'S ADDRESS Id. AfKUUUM 1 UEKI1MLAUUH I certify tnati nave read the application and state tnat the aooye information is correct. 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 CCTY OF CARLSBAD AGAINST ALL UABOmES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID COT 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 36S days from the date of such permit or if the building or work authorized by such permit is suspended or abaadonad at any time after the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code). APPLICANTS SIGNATURE''/.^ ^--^/7^7 _- DATE: /Q»7- ,OW: Applicant PINK: Finance CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB961918 FOR 10/08/96 DESCRIPTION: TEMPORARY POWER POLE-MARFIORE TYPE: ELEC JOB ADDRESS: 1313 CASSINS ST APPLICANT: TEMPORARY POWER SYSTEMS CONTRACTOR: OWNER: REMARKS: MW/JOE SPECIAL INSTRUCT: INSPECTOR AREA PLANCK* CB961918 OCC GRP CONSTR. TYPE NEW STE: LOT: PHONE: 619 439-1999 PHONE: PHONE: INSPECTO: TOTAL TIME: CD LVL DESCRIPTION 32 EL Const. Service/Agricultural ACT COMMENTS DATE DESCRIPTION ***** INSPECTION HISTORY ***** ACT INSP COMMENTS C.T CONSTRUCTION PHASING EXHIBIT PHASE 4 11 LOTS 2.61 AC. PHASE 7 14 LOTS 3.26 AC. PHASE 8 12 LOTS 2.93 AC. PHASE 3 12 LOTS 3.27 AC. PHASE 2 13 LOTS 3.19 AC. PHASE 1 12 LOTS 3.46 AC. PHASE 6 11 LOTS 2.80 AC. r CW W9 City of Carlsbad Building Department WORKERS' COMPENSATION DECLARATION I hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self-insure for A. 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 workers' 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) 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 •• C. workers compensation laws of California. Signature Date Warning: Failure to secure workers' compensation coverage is unlawful, and shall be 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. March 3, 1995 2075 Las Palmas Dr. - Carlsbad, CA 92009-1576 - (619) 438-1161 • FAX (619) 438-O894 Milestone Insurance Agency 8 Corporate Park, #130 Irvine. CA 92714-5105 (714)852-0909 Fax(714)852-1131 Power Fabricating, Inc. DBA* TEMP POKER SYSTEMS 1111 TUSTIN AVE ANAHEIM CA 92807 DATE 10/11/1995 IMS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATJON'oNLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTWfCATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAOE AFFORDED BY THE POUOtS BELOW. .. - COMPANIES AFFORDING COVERAGE COMPANY l£TIB1 A California Ind«ity IEHBI COMMNTIEITER COHPHff IOIH» COMP/WV l£T1BI THIS IS TO CBOIFY THAT THE POUOES OF INSURANCE U5TB> BaOW HAVE KEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PEROD INDICATEO. KOTWITHSTANDWO ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN. THE INSURANCE AFFORDED BY THE POUCffiS DESCRIBED HERON IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. UMTS SHOWN MAY HAVE BEEN REDUCE) BY PAN) CLAIMS. DAK (MMXWY)OME(MMO/rV) UABUIY OAM8MAOE \ OCCUR. OWNERS A ccwiiMcnm PROT. PBOOOCtWXMPCP Ma EACH OCCURRENCE Mir AUK) AU.OWNB1AUIOI SCHEDULED AUIO5 Hna>AVK96 NCM4MHCD AU1M OARAQE UABUTY BOOLYMMRY 00M.VNIUHV DAMAQE EACH OCCURRENCE OIHER THW UMBHELLA FORM I* STATUTORY uwifj 10/01/95 FOR INFORMATION ONLY.