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HomeMy WebLinkAbout1712 CATALPA RD; ; CB984036; PermitSuite 11/23/98 10 41 B U I L D I N G P E R M ! Page 1 of l Job Address. 1712 CATALPA RD Permit Type: ELECTRICAL Parcel No. 215-511-05-00 Valuation: Occupancy Group Description- UPGRADE SERVICE FROM**! 0(T AMPS TO 200 AMPS 0 r Permit No CB984036 Project No: A9805258 Development No 3721 11/23/98 0001 03 02 C-PRMT 35-00 Construction Type VM Appl/Ownr BRENNEIS ELECTRIC 5764 POTOMAC STREET SAN DIEGO CA 92139 x,. Fees Required *** Fees • Adjustments. Total Fees- Fee description 619 267-4795 Collected & Credits Applied 11/23/98 Apr/Issue 11/23/98 Entered By• Enter "Y" for Single Phase Per /AM * ** .00 . 00 35.00 Ext fee Dara 10 00 Y 25.00 FINAL APPROVA CLEARANCE. CITY OF CARLSBAD 2075 Las PalmasDr, Carlsbad, CA 92009 (760)438-1161 PERtfTIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr, Carlsbad CA 92009 (760)438-1161 !i" PROJECT INFORMATION"" " " FOR OFFICE USE PLAN CHECK NO EST VAL Plan Ck Deposit Validated By Date Address (include Bldg/Suite Business Name {at this address) Legal Lot No Subdivision Name/Number Unit No Phase No Total # of units Assessor's Parcel #Existing Use Proposed Use Description of Work SQ FT c J2 CONTACT PERSON (if different from applicant) #of Stories # of Bedrooms # of Bathrooms Name 13 »" APPLICANT . Address O Contractor O Agent ,for_Contractor City Owner ~Q Agent for Owner State/Zip Telephone Fax # Name Address PROPERTY OWNER tity State/Zip Telephone tt Address City State/Zip Telephone #Name ;5 CONTRACTOR - COMPANY NAME -."""_. V _" V-/"" _"_" L - ~ I" " - V (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]) C A ^ £Li 3 Name State License SO. Address License Class -f- ' City State/Zip City Business License ff Telephone # Designer Name Address City State/Zip Telephone State License # 6 WORKERS' COMPENSATION ,„ . / " s „ ri , Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations Q 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 Q I have and will maintain workers compensation, as required by Section 3700 of the Labor Code for the performancEi 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 ($100] OR LESS) £3^ CERTIFICATE OF EXEMPTION I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers Compensation Laws of California WARNING Failure to secure workers compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($£00,000), in additiontojhe cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney s fees SIGNATURE <&&** C-^O^'(^S^s&z^^ DATE U I "2 "?' / *? & 7 OWNER-BUILDER DECLARATION , " -\ ' „ , I hereby affirm that I am exempt from the Contractor s License Law for the following reason Q 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 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 Q YES f~lNO 2 I (have / have not) 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 / phone number / contractors license number) 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 contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type of work) PROPERTY OWNER SIGNATURE DATE ^COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY, . 1 __ , ' , 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 2S505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? Q YES Q NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district7 Q YES Q NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Q YES Q 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 18 _ CONSTRUCTS N~LENDING AGENCY L~I1-'~~":~T1- I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(0 Civil Code) LENDER'S NAME (/O O U rT-— ' _ LENDER'S ADDRESS __ '9'" APPLICANT CERTIFICATION IV , ,~ •—_--_ ^ -f ^^- -^-. ______ - ____ -~^ ^ ^ ,^- - ^ 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 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 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 365 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after theajork is commenced for aperiod of 1 80 days (Section 1 06 4 4 Uniform Building Code) / /Z- 3APPLICANT'S SIGNATURE £DATE WHITE File YELLOW Applicant PINK Finance /I CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB984036 FOR 11/25/98 DESCRIPTION: UPGRADE SERVICE FROM 100 AMPS TO 200 AMPS TYPE: ELEC JOB ADDRESS: 1712 CATALPA RD APPLICANT: BRENNEIS ELECTRIC PHONE: CONTRACTOR: PHONE: OWNER: PHONE: INSPECTOR AREA PLANCK# CB984036 OCC GRP CONSTR. TYPE VN STE: LOT: 619 267-4795 REMARKS: C/RIENHARDT/619/267-4795 NOON INSPECTOR SPECIAL INSTRUCT: PLEASE INSPECT AROUND NOON SO SDG &E CAN RE-ENGERGIZE TOTAL TIME: CD LVL DESCRIPTION 33 EL Service Change/Upgrade ACT COMMENTS DATE DESCRIPTION ***** INSPECTION HISTORY ***** ACT INSP COMMENTS