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Home My WebLink About1648 OLIVENHAIN RD; ; CB971930; PermitB U I L D I N G P E R M I T 07/17/97 10:39 Permit No: CB971930 Project No: A9702451 Development No : Page 1 of 1 Job Address : 1648 OLIVENHAIN RD Suite: Permit Type: ELECTRICAL Parcel No: Lot#: Valuation: 0 Occupancy Group: Reference#: Construction Type: NEW Status : ISSUED Applied: 07/17/97 Apr/Issue : 07/17/97 Entered By: RMA Description: TEMPORARY POWER POLE-STREET : IMPROVEMENTS Appl/Ownr : POWER PLUS 11671 LAW ST SAN MARCOS CA 92028 619 471-5494 *** Fees Required *** *** Fees Collected & Credits *** Fees : Adjustments : Total Fees: Fee description 20 .00 .00 20.00 Enter "Y" for Electric Issue Fee > Enter "Y" f or Temporary Service > * ELECTRICAL TOTAL Total Credits : Total Payments: Balance Due: Units Fee/Unit CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-ll6l .00 .00 20.00 Ext fee Data 10.00 Y 10 .00 Y 20.00 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (619) 438-1161 FOR OFFICE USE ONLY PLAN cHEcK No.q:4 /Vv EST. VAL. _________ _ Plan Ck. Deposit ____ ':""T ___ _ Validated By"'T""_--:----1"-'----- Date ----;7"1'-t--f'r..,...-,.------- Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total II of units Telephone II ~:iuti.:r (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 e signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9, co.mmending with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom, end the basis for the alleged Any vi 'on of Se~rn 7031.5 by any applicant for e it subjects applican to a civil penalty of t more an five hundred dollars 1$500 I. Name State License ,;r;f:)~ Address License Class -'CJ.g-=:...,\'------- Designer Name Address City State/Zip Telephone State License II _________ _ liu~;:.WQRKERS:.~coMPENSA notu:-~;~:~;fi~~~•.:=::·!Js;~!;.~'1:~}::t;:;-3~·~~~~~ ··~· ~ .. ~:~.ll~;,;~.:~; ~:-~-~~~~:~L ;~jj).;fi~'~h1~J.~~~~;~:::t'r'.:i~11.~j-~~,I.: ~i'.:;~:~J ... ~ . :, · .. ;,,1-~;·.. .. ,1 Workers' Compensation Declaration: I hereby affirm under penalty of perjury_ one of the following declarations: 0 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. j( 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 iasued. My worker's mpensation · urance catrier and policy number are: Insurance Company ..., __ :.a....._,r.&.._.....:.._..,""'-'.._..,,,..""",c:;.,-------Policy No. <!n:riol l \QI Expiration Date \-\ ..qe, ITHIS 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 ahall not employ any parson in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to aacura•workera• compensation coverage la unlawful, and ,hall subject an employer to criminal penaltlea and civil finea up to one hundred thousand doll.,-, ($100,0001, In addition to the coat of companaation, damages II provided for In Section 3706 of tha LatHv code, lntaraat and 1ttomey'1 tao. SIGNATURE. _______________________ "-'."" _______ DATE _________ _ t1."'~~~.0WNER-BUILDER DECLARATION••~~.y· .. \·.(f,;~:·· -~ L ln.,. ;1;-..::t, · .-:·· ~'.. . .. , : .··, ;. ';'.'~ 1 .• -1~.,l~~~~Lwfill;:.::11a~.tr~-ii~t!~~ffl1~JUJr~~~~y~~~~-:::~~~~;':-' ,/;;-~:~ ... 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 ISec. 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 8!8 not Intended or offered for sale. If, however, the building or improvement is sold within ona veer of completion, the owner-builder will have the burden of proving that he did not build or Improve for the purpoaa of Hie). 0 · I, as.owner of the property, am axcluaivaly contracting with licensed contractors to construct the project (Sec. 7044, Buaines, and Profeaalons Coda: The Contractor's License Law does not apply to an owner of property who build& or improves thereon, and contracta for auch project, with contractor(al licenaed pursuant to the Contractor's License Law). 0 I am exempt under Section ______ Business and Professions Coda 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 / have notl signed an application for a building permit for the proposed work. 3. I have contracted with the following parson (firml to provide the proposed construction (include name / address / phone number / contractors license numberl: 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 numberl:. ______________________________________________ _ 5. I will provide some of the work, but I have contracted lhiredl the following persons to provide the work indicated (include name / address/ phone number/ type of workl: ________________________________________________________ _ PROPERTY OWNER SIGNATURE _____________________ _ [j;_o~iSECTION;F.QI\N!)N:RESIP.EUIJA.kllUIU>.ING;P,W.,jJ_$,;Q~I.Y~~~~17~~~:1mrm,emm~~".~~!,g':-'.-'fi.,:;~),jt.J;~·,.,. DATE ________ _ Is th, l;!plic::nt or future buil<lir.jjj cccuparit r•quirw.:l ,o •ulimit a bu~inoa.:i µIan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Actl O 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 tha facility to be constructed within 1,000 Ifft of the outer boundary of a school site? 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. fb~'ri&OJ(tr6U.CTIO,N .LENO,ING'~GENCY},)"':1;-~~~~1'~~~!l'J;~~",l;:~t~'fim~}.'),_;: :\'.f~-:.:~1~,ir~~"!.;.,::r~;~.W~T~fr,nt:.:', ., : ·'if':~,: · I hereby affirm that there is a construction lending agency for the performance of the work for which this permit ia issued (Sec. 3097(i) Civil Coda). LENDER'S NAME _____________ _ LENDER'S ADDRESS.-:--::-:-::-:-::-:-::-:---:-=--------------- af;t~~::.AP.PUCANT.-CERTIFICA TlON "ii+ . :' ·;~:-~_:i4; 0 • lq~f~'/,T: '):,{,~~ .'.~:'!."";:;, ~-~ -~ 1:·:/ :·: ~~'::~(" ·~~ ~f°'f:: ,:;,, ;--~~:.·~)?lr.~~if.':i,:S·)ittitr~i.~~~!~~~~~i.'~.i.~~'f.~1:"~.:1:c: ;l ... ·. ~'; I certify that I have raad the application and state that the above information is correct and that the information on the plans Is accurate. I agree to comply with ~II 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 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 and demolition or construction of •tructuras over 3 atories 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 per IS no commenced w1th1n 365 days from the date of such permit or If the building or work author'zed by s h permit is suspended or abandoned at any time aft r the wo is comm, d for .Ta1,1,4!18TS"i::illction 106.4.4 Uniform Building Codel. DATE 7 -~'--I'----+--➔'------ DIii.iV. C:-.--.. ----- U) f p -rP ,. . ,,,,. , . r r . ~ v·,. ., . ~ 1 . .. . ..... -· ··--. ··-......... .. ~--... .... , ..... ,<. ' -, -_, __ , __ 0 .... L.:--➔~-