HomeMy WebLinkAbout167 REDWOOD AVE; ; 77-9066; PermitELECTRICAL PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA 92008
Applicant to complete numbered spaces only Phone 729-1181 Permit No 7 7-
JOB ADDRESS
.LEGAL
1DESCR (QjSEE ATTACHED SHEET)
MAIL ADDRESS
A CLbovK, "12*1-510
CONTRACTOR MAIL ADDRESS STATE LIC NO CITY LIC NO
ARCHITECT OR DESIGNER MAIL ADDRESS LICENSE NO
MAIL ADDRESS LICENSE NO
COMPENSATION INS CARRIER MAIL ADDRESS
USE OF BUILDING
\
8 Class of work D NEW DDITION D ALTERATION D REPAIR
9 Describe work , ST t <>> G *S €> v/ * C T 4o TU)C>
PERMIT FEES
SPECIAL CONDITIONS SWIMMING POOL WIRING,
NO INCREASE IN SERVICE
No Each Fee
APPLICATION ACCEPTED BY ...PLANS CHECKED BY APPROVED FOB ISSUANCE BY
NEW CONSTRUCTION, FOR EACH
AMPERES OF MAIN SERVICE, SWITCH,
FUSE OR BREAKER
NOTICE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS,OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM
MENCED
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS
APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT
ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS
TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIEDHEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOTPRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THEPROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING
CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION
NEW SERVICE ON EXISTING BLDG
FOR EA AMPERE OF INCREASE
IN MAIN SERVICE, SWITCH, FUSE
OR BREAKER
REMODEL, ALTERATION, NO CHANGE
IN SERVICE, FOR EA AMPERE OF
INCREASE
TEMP SERVICE UP TO AND INCLUD-
ING 200 AMP
<"y fi-WA.. w-ix-'X V>-> • ry--'
TEMP SERVICE OVER 200 AMP
PER 100
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT ISSUANCE FEE
SIGNATURE OF OWNER (IF OWNER BUILDER)IDATEI
TOTAL FEES
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK MO CASH PERMIT VALIDATION CK MO CASH
INSPECTOR
in-•••-• •%
INSPECTION REPORTS
DATE ITEM REMARKS INSPECTOR
USE SPACE BELOW FOR NOTES. FOLLOW-UP, ETC
*- ' CITY OF CARLSBAD
BUILDING DEPARTMENT
(714) 729-1181
CERTIFICATION
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
If, after making this certificate, I become subject to the workers' compensation pro-
visions of the California Labor Code, I will forthwith comply with Section 3700 of the
Labor Code
I understand that if I fail to comply with the workers' compensation laws, this permit
shall be deemed revoked
I further certify that if I should contract or subcontract with any person, including any
firm or company, to do all or part of the work for which this permit is issued, I shall assure
compliance by that contractor or subcontractor with Section 3,800 of the California Lat
Code
SIGNED
PRINT NAME AND TITLE \>AM\ E"L l_ TOE-i^OL.
JOB ADDRESS _1
DATED P^OC, JS",