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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 I i -- A-