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Home My WebLink About1353 CASSINS ST; ; CB960427; PermitBUILDING PERMIT U3/14/96 08:44 Page 1 of 1 i Job Address: 1353 CASSINS ST Suite: TP Permit Type: ELECTRICAL Parcel No: 215-691-38-00 Lot#: Valuation: 0 Occupancy Group: Reference*: Description: TEMPORARY POWER POLE-MARFIORE : TAYLOR WOODROW Permit No: CB960427 Project No: A9600615 Development No: 6502 03/14/96 0001 01 02 Appl/Ownr : TEMPORARY POWER SYSTEMS 1111 N TUSTIN ANAHEIM CA 92807 Construction Type: NEW StatuVf%TSSUED 20. CO Applied: 03/14/96'"^ Apr/Issue: 03/14/96 Entered By: RMA 619-439-1999 *** Fees Required Fees : Adjustments : Total Fees: Fee description * * * .-.***'• -5 • , 20 . 00 .*••"" . ft$ : ••- '•..' 2 0> 0<> "*.*'• r/"'-^'gPSIW-;.3SEgilJLected & ~ - " ^ ^ ^ V * -fotal Cre<$d-.'t"i(-s- Total Payirtebtss. " : " • Balance Due ; Units P«e/urii^ Enter "Y" for Electr ieZTssufT Fee > Enter "Y" for Tempor^"^.VS®rvice > * ELECTRICAL TOTAL *~ ti Credits .00 . 00 2 0 . 0 0 Ext fee 10.00 10.00 :' 20.00 * * * Data Y Y 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 DATE I<A- 2. PROJECT INFORMATION FOR OFFICE USE ONLY Address Nearest Cross Street Bulldmg or Sulte LfcuAL DESCRIPTION Subdivision Name/Number LHtCJK BELOW IF SUBMITTED: D 2 Energy Calcs D 2 Structural Gales D 2 Soils Report D 1 Addressed Envelope -ASSESSOR'S PARCEL EXISTING USE PROPOSED USE DESCRIPTION OF WORK SQ.FT.# OF STORIES # OF BEDROOMS # OF BATHROOMS 3. vJJNiAUi rtjtsuN I.U auierent irom applicant; NAME (last name first) CITY STATE ADDRESS ZIP CODE DAY TELEPHONE 4. APPLICANT NAME (last name first) CITY TORQAGENTFOR CONTRACTOR QOWNER ( QAOENJ rUR OWNER ADDRESS DAY TELEPHONE 5. PROPERTY OWN! NAME (last name first) CITY STATE ADDRESS ZIP CODE DAY TELEPHONE O. UUNTKAUIUK ' ADDRESS |\\V STATE L1C.LICENSE CLASS CITY BUSINESS UC. # DESICiNEK NAMK (.last name lirstj ADDRESS CITY WORKERS1 COMPENSATION STATE ZIP CODE DAY TELEPHONE STATE LIC. # Workers' Compensation Declaration: I hereby affirm that I nave a certificate of consent to sell-insure issued by the Director of 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 -"TD^2,tiat in the p POLICY NO.DATE \Q -\ - Certilicate of Exemption: 1 certiry that in the performance ot 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. SIGNATURE DATE 8. OWNER-BUILDER DECLARATION uwner-Buiiaer Declaration: i nereoy aitirm mat i am exempt from the contractors License Law lor me toiiowmg reason: O 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 oroffered 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 intendedor 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.). D I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and ProfessionsCode: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projectswith contractor^) licensed pursuant to the Contractor's License Law). D I 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 repairany 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 [5500]). 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 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? D YES D NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED AFTER JULY 1,1989 UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OP THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. '. UJNS1RUU11UN LENDING AGENCY 1 hereby amrm that there is a construction lending agency lor the performance ot the work tor which this permit is issued (Sec 3097 UJ uvii (Jodej. LENDER'S NAME LENDER'S ADDRESS 10. APPULANT CEK1U-KXIKJN I certiry mat i have read the application and state that the above inlormation 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 CITY OF CARLSBAD AGAINST ALL UABUJTIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID OTY 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 authorizedhy-such perrnips-TronwpiTfieffted within 365 days from the date of such permit or if the building or work authorized by such permit is suspended tffabandoned a(any time/after the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code). APPLICANTS SIGNATURE /^? /^ /( X DATE: ?,--\' "~ ' WHITE: Fftr YELLOW: Applicant PINK: Finance PHASING EXHIBIT Milestone Insurance Agency 8 Corporate Park, #130 Irvine, CA 92714-5105 (714)852-0909 Fax(714)852-1131 Power Fabricating, Inc. DBA: TEMP POWER SYSTEMS 1111 TUSTIN AVE ANAHEIM CA 92807 THIS CERTIFICATE IS ISSUED AS A HATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE COMPANY LkllbK A California Indemnity COMPANY LHIBt B COMPANY LETTER COMPANY nLETTER U COMPANY. LETTER : Vv Xj "if- "Vy! THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING 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 POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. TYK OF MtUMNCI POUCYI MUCV STBTME MTI (MMJDD/VY) MUCY BCnRATKM DAIRtffHVOD/YY) 8ENERAL AQQREQATE COMUEBC1AL OEN9W. UABUJTY i CLAIMS MADE ! OCCUR. OWNERS I CONTHACTOFre PROT. PROOUCT&COMNOP AQa PERSONA!.« ADV. INJURY EACH OCCURRENCE HHE OAMAQE (Any era fa»> MED! EXPENSE (iiiy eitii"pmion) I ; ANY AUTO j ALL OWNED AUTOS ! SCHEDULED AUTOS JHHEO AUTOS ; NON-OWNED AUTOS i GARAGE LIABILITY CQMBMED SINQLE LMTf BOOLYHURY <PW ptnon) BOOLYHURY PROPERTY DAMAGE UUUTY UMBRaiAFORM OTHER THAN UMBRELLA FORM AND amomar UAMUTY EACH OCCUFBENCE AOOHEOATE " STATUTORY LJMfTS N6037302A ao/oi/95 > 1,000,000 DBEASE - POLtCV LMTT DBEASE - EACH EMPLOYEE » 1,000,000 * 1,000,000 FOR INFORMATION ONLY. CITY OF SAN DIEGO 1222 FIRST AVE., MS301 SAN DIEGO CA 92101 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WHITEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY MND UPON THE COMPANY. US AGENTS OR REPRESENTATIVES. 'X »- , fr