HomeMy WebLinkAbout1715 BLUEBIRD LN; ; CB053998; Permit' ...
1 1-1 7-2005
feeslexactions of which vou have Dreiouslv been given a NOTICE simi
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Building Inspection Request Line (760) 602-2725
Electrical Permit Permit No: CB053998
ar tothis. or as to which the statute o f limitations has Dreviouslv otherwise exoired.
Job Address: Permit Type:
Parcel No:
Reference #:
Project Title:
1715 BLUEBIRD LN CBAD
ELEC 21 58801 208
MAYBAUM RESIDENCE ELECTRIC FOR BBQ
Applicant:
PARADISE LANDSCAPE
6709 CLOVER CT
CARLSBAD, CA 92009
760-535-91 11
Electric Issue Fee
Single Phase per AMP
Three Phase per AMP
Three Phase 480 Per AMP RemodeVAlteration per AMP Remodel Fee Temporaty Service Fee
Test Meter Fee
Other Electrical Fees
Additional Fees
TOTAL PERMIT FEES
Total Fees: $20.00 Total Payments 1
FIN
InsDector: L. Dah
NOTICE: Please lake NOTICE that approval of your project includes t
referred to as 'feeslexactions." You have 90 days from the date this pc
follow the protest procedures set forth in Government Code Section 66
processing in accordance with Carlsbad Municipal Code Section 3.32.(
review, set aside, void, or annul their imposition.
You are hereby FURTHER NOTIFIED that your right to protest the spe
changes, nor planning, zoning, grading or other similar application proc
Status: ISSUED
It#: 0 Applied: 11/17/2005
Plan Approved: 1 111 712005
Issued: 1 111 7/2005
Entered By: MDP
Inspect Area:
Owner:
MAYBAUM LOUIS S&MICHELLE T
171 5 BLUEBIRD LN CARLSBAD CA 92009
$10.00 $0.00
$0.00
$0.00
$0.00
$1 0.00
$0.00
$0.00
$0.00
$0.00
$20.00
Date: $20.00 Balance Due: $0.00
S' Clearance:
Imposition" of fees, dedications, reservations, or other exactions hereafter collectively
t was issued to protest imposition of these feeslexactions. If you protest them, you must
(a), and file the protest and any other required information with the City Manager for
Failure to timely follow that procedure will bar any subsequent legal action to attack,
id feeslexactions DOES NOT APPLY to water and sewer connection fees and capacity
ing or service fees in connection with this project. NOR DOES IT APPLY to any
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
FOR OFFICE USE ONLY
PLAN CHECK NO.
EST. VAL.
Plan Ck. Deposit --
Validated j3; ! !~ f@&
Date
Assessor's Parcel # Existing Use Proposed Use
Description of Work SO. FT. #of Stories t of Bedrooms t of Bathrooms
c IA ,I=. #=2QcdhCe 1
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its
issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law
[Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code] or that he is exempt therefrom, and the basis for the alleged violation of Section 7031.5 by any applicant for a permit subjects tke applicant to a civil penalty of not more than five hundred dollars I55001).
fw L&J 7646 &e Y, 4 c ha rrzts CK I Telephone # StateEip
CqwJkGW.
Name Address City
State License # 'b q~ t cc K License Class Ca- 7 City Business License t 1.7 ,LO 07 3,
Designer Name Address City StateEip Telephone
State License t
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
0 of the work for which this permit is issued.
issued. My worker's compensation insurance carrier and policy number are:
Insurance Company sshb F-$ Policy NO. \%a 9 3% 0 5- Expiration Date 0 '+ -6 I - 6 b
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
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
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [81001 OR LESS)
0 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.
WARNINQ: FaUum to secum wor(Cer8' compensation coverage is mlewM, and rhdl subject en employer to cdmhal penalties and civil fines up to one hundred
thousand Wars (6100.000). in additkn to the cost of compensation, damnoes as provided for in Sdon 3706 of the Labor code, interest and attorney's fees.
SIGNATURE DATE
I hereby affirm that 1 am exempt from the Contractor's License Law for the following reason:
0 1, 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).
0 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 icense Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed
pursua to e Contractor's License Law).
0 Is emptundersection Business and Professions Code for this reason:
1. I pe
2.
3. I x ave contracted with the following person (firm) to provide the proposed construction (include name I address I phone number I contractors license number):
ally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES ON0
I ( avo have not1 signed an application foc a building permit for the proposed work.
I plan to provide portiona of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone
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
n 4L ber / contractors license number):
5.
of work):
PROPERTY OWNER SIGNATURE DATE
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
authorized by such permit is not commen
at any time after the work is commenced
APPLICANT'S SIGNATURE DATE ~ 17- '-
sions of this Code shall expire by limitation and become null and void if the building or work
of such permit or if the building or work authorized by such permit is suspended or abandoned
106.4.4 Uniform Building Code)
City of Carlsbad Bldg Inspection Request
For: 12/2 1 /2005
Permit# CB053998
Title: MAYBAUM RESIDENCE
Description: ELECTRIC FOR BBQ
Type: ELEC Sub Type:
Job Address: 1715 BLUEBIRD LN
Suite: Lot 0
Location:
APPLICANT PARADISE LANDSCAPE
Owner: MAYBAUM LOUIS S&MICHELLE T
Remarks:
Total Time:
CD Description
29 Final Plumbing
39 Final Electrical
Inspector Assignment: PC
Phone: 7605188886
Inspector: E-
Requested By: SHAWN
Entered By: CW
w
.~ __ ~ -. -~ _ . . ____
Comments/Notices/Hold
Associated PCRslCVs
Inspection History
Date Description Act lnsp Comments
11/29/2005 31 UndergroundlConduit-Wiring AP PC
37Al-E OMPENS ATION N s u R A N c m =u N
S INSURANCE IS EFFECTIVE FROM 01 A.M., PACIFIC STANDARD TIMe CONTINUOUS POLICY 1820939-05
28-05 TO 4-01-06 MD SHALL OWATICALLY RENEW EACH 4-01 IL CMCBLLBD MAY 182005
HOME OFFICE SAN FRANCISCO POLICY DECLARATIONS
CALIFORNIA WORKERS' COMPENSATION AND EMPLOYEKS LIABILITY POLICY
THESE DECLARATIONS ARE A PART OF THE WORKERS COMPENSATION POLtCY INDICATED HEREON.
PARADISE LANDSCAPE DEPOSIT PREMIUM $743 .OO
7040 AVENIDA ENCINAS #lo4 CARLSBAD, CALIF 92009 MINIMUM PREIdIUX $650 .OO PREMIUM ADJUSTMENT PERIOD QUARTERLY N SD
NAME OF EMPLOYER- RODRIGUEZ, JESUS AND
RODRIGUEZ, CARA
(HUSBAND AND WIFE)
TRADE NAMES- PARADISE LANDSCAPE
LOCATIONS- 001 7040 AVENIDA ENCINAS #lo4
CARLSBAD CA 92009
1. WORKERS' COMPENSATION INSURANCE - PART ONE OF THIS POLICY APPLIES TO THE
WORKERS' COMPENSATION LAWS OF THE STATE OF CALIFORNIA.
2. EMPLOYER'S LIABILITY INSURANCE - PART TWO OF THIS POLICY APPLIES TO
LIABILITY UNDER THE LAWS OF THE STATE OF CALIFORNIA. THE LIMIT OF OUR LIABILITY INCLUDING DEFENSE COSTS UNDER PART TWO IS,
$1,000,000 -
CODE NO. PRINCIPAL WORK AND RATES EFFECTIVE FROM 04-28-05 TO 04-01-06
INTERIM
PREMIUM BASE BILLING
BAS IS RATE RATE*
0042 LANDSCAPE GARDENING--ALL OPERATIONS--
INCLUDING MAINTENANCE OF GARDENS
EXPERIENCE MODIFICATION
04-28-05 TO 04-01-06
********BUREAU NOTE INFORHATION********
FEIN 300035439
5-19-88-05
8320 18.73 18.73
159 X
TOTAL ESTIMATED ANNUAL PREMIUM $2,477
INTERSIGNED AND ISSUED AT SM FRANCfSCO MAY 5, 2005 POLXCY L PAGE 1 OF rnr #era n1 c ecb
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