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HomeMy WebLinkAbout1755 DOVE LN; TP; CB993176; Permit08/23/1999 City of Carlsbad Electrical Permit Permit No:CB993176 Builiding Inspection Request Line (760) 438-3101 Job Address: Permit Type: Parcel No: Reference #: Project Title: 1755 DOVE LN CBAD St: TP ELEC Lot#: Status: Applieij: Entered By: Plan Approved ISSUED 08/23/1999 RMA 08/23/1999 VIA DONNA-TEMP POWER POLE Appiicant: TEMP UTILITY SERVICES 1167 LAW ST SAN MARCOS, CA 92069 619-471-5494 Issued: 08/23/1999 Inspect Area: 3208 08/23/99 OOOl 01 C-PRHT 02 20-00 Totai Fees: $20.00 Total Payments To Date: SO 00 tee Due: $20.00 Electric Issue Fee $10.00 Singie Ptiase per AMP $0.00 Ttiree Phase per AMP $0.00 Three Phase 480 Per AMP $0.00 Remodel/Alteration per AMP $0.00 Remodel Fee $0.00 Temporary Service Fee $10.00 Test Meter Fee $0.00 Other Electrical Fees $0.00 TOTAL PERMIT FEES $20.00 Inspector FINAL APPROVAL Date Clearance: NOTICE: Please take NOTICE that approval of your project includes the 'Imposition' of fees, dedications, reservations, or other exactions hereafter collectively referred to as fees/exactions.' You have 90 days from the date this permit was Issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth In Govemment Code Section 66020(a), and file the protest and any other required Information with the City Manager for processing In accordance with Carisbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their Imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactlons DOES NOT APPLY to water and sewer connection fees and capactiy changes, nor planning, zoning, grading or other similar application processing or service fees In connection with this project NOR DOES IT APPLY to any fees/exactlons of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously othenwise expired. CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760)438-1161 l.ri;-: PROJECT' 17^5- FOR OFFICE USE ONLY PLAN CHECK N0._ ^ EST. VAL. r Plan Ck. Deposit Validated By. Date M\7^ Address (include BIdg/Suite #) Business Nsme (st tliis eddress) Legsl Description Lot No. Subdivision Nsme/Number Unit No. Phsse No. Totel # of units As|essor's Psrcel # ^ Existing Uss J^n$i-^// » 7g/»r^ fbvt/er Fol^ Description of Wortc 7 SQ. FT. Proposed Use Description of Wortc / SQ. FT. #af Stories # of Bedrooms # of Bsthrooms Name Address City Stste/Zip Teleptione $ Fax # -Z, Kmaatm .•Comnetor'^ll Name ^ Address ^4. ^ ;-niopEinT£OWNEii" 'f r*-:.• i>:;»'4^|tifti0r, , W^S-Z^rn Fcrc:^7c houT,„^_, 2. Cc*w,Ao U'cgfa City ^A7<j2jk7 -2.2.^-90/^ State/Zip &707. Teleptione # itStefZip TelepllSne f Name City (Sec. 7031.5 Business and Professions Code: Any City or County wtiicti requires e permit to construct, etter, improve, demolish or repeir any structure, prior to Its issuance, elso requires ttie epplicant for sucti permit to file e signed ststement that he is iteensed pursuant to the provisions of the Contrector's Ucense Lew IChepter 9, commending with Section 7000 of Division 3 of the Business and Professions Code) or thet he is exempt therefrom, end the bests for the elleged exemption. Any violation of Section 7031.5 by eny applicant for a parmit subjects the appijsant to a chn| penalty of not more then five hundred dollers ItSOOl). Fo\JJ&r nu/ tfJ^ 717 r^viinc& a^co^,c/c C^92o2^ %y'9'9V^a Name State License # Address Ucense Cisss C-^7 City Stste/Zip City Business Ucense # Telephone $ Address City Stete/Zip Telephone Designer Name State Ucense # «. WORKERS' COMPENSATION Woricers' Compensstion Decleretion: I hereby effirm under penelty of perjury one of the fallowing decleretions: O I t**ve end will msintsin s csrtificsts of consent to self-insure for workers' compensstion ss provided by Section 3700 of the Lsbor Code, for the performance of the work for which this permit is issued. I have and will maintein workers' compensstion, ss required by Section 3700 of the Lebor Code, for the performence of the work for which this permit is issued. My worker's compensstion insursnce csrrisr sn^ policy number ere: ____ r3 9 i ^-tc^T^e T^U^Xy Policy No. / SSS7/0 Exoir.tionD.te ^'^f'OQ Insurance Company, (THIS SECTION NEED NOT BE COMPLETED IF THE PERMTT IS FOR ONE HUNDRED DOLLARS IS100] OR LESS) Q CERTinCATE OF EXEMPTION: I certify ttiet in the performence of the work for which this permit is issued, I shell not employ eny person in any manner so es to become subject to the Workers' Compensstion Lsws of Cstlfomia. is unlawful, and shall subject an amployar to criminal penalties and chril fines up to one hundred lation, danwgaa as provided for in Section 3706 of theXabqr code, MeiMt and attomey'e feea. DATE f^zJJ^rr WARNING: Failure to eei thousend dollara (S100,((D0J, SIGNATURE comp#nMrtion to the m 7. OWNER-BUILDER DECLARATION I hereby effirm that I am exempt from the Contractor's ^enae Law for the following reason: D I, as owner of the property or my employees with wsges ss their sole compensstion, will do the work end the structure is not Intended or offered for ssle (Sec. 7044, Business snd Profsssions Code: The Contrector's Ucense Lew does not spply to sn owner of property wtio builds or improves thereon, end who does such work himself or through his own employees, provided thst such improvements sre not intended or offered for ssle. tf, however, the building or improvement is sold within one yeer of completion, the owner-builder witl heve the burden of proving ttiet he did not buiid or improve for the purpose of ssle). Q I, es owner of the property, am axctusively contrecting with licensed contrsctors to construct the project (Sec. 7044, Business snd Professions Code: The Contrector's Ucense Lsw does not apply to an owner of property who builds or improves ttiereon, end contrscts for such projects with eentrsctorls) licensed pursusnt to the Contrector's Ucense Lew). n I sm exempt under Section _________ Business snd Profeesions Code for this reeeon: 1. I personslly ptsn to provide the mejor lsbor snd msteriels for construction of the prepoeed property improvement. • YES ONO 2. I (heve / heve not) signed sn spplicstion for s building permit for the propossd. work. 3. I hava contracted with the foitowing person (firm) to provide the proposed construction (include neme / eddress / phone number / contrectors licenss number): 4. I plen to provide portions of the work, but t hsve hired the foitowing person to coordinste, supervise end provide the major work (include neme / eddress / phons number / contrsctors licsnse number); 5. I will provide some of the work, but I heve contrected (hired) the fotlowing persons to provide the work indiceted (inciude nsme / sddress / phone numbar / type of work): PROPERTY OWNER SIGNATURE DATE COMPLETETHIS SECTION POR mMMESDSK^ . ,.- ^ • Is the applicant or future building occupent required to aubmit a business pIsn, scutely tiezerdous msteriels registretion form or riek menegement end prevention progrem under Sectlone 25505, 25533 or 25534 of the Presley-Tenner Hezerdous Substsnce Account AetT Q YES O NO Is the eppiicent or future building occupent required to obtein e permit from the eir poiiution control district or sir quslity msnsgsment district? Q YES Q NO Is the facility to be conatructed within 1,000 feet of the outer boundary of a aehool stte? • YES • NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTinCATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPUCANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFnCE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. 8. T^NSTHUOTIOMtENDIWi'AGfNi^SiSi^^^ ' ' 1 hereby affirm that there is s construction Isnding sgeney for the performsnce of the work for wMch this permit is issued (Sec. 3097(1) Civil Code). LENDER'S NAME LENDER'S ADDRESS I certify thst t hsve reed the spptiestion and ststs thst the sbovs informstion is corrsct snd thst ttie informstion on the pIsns is sccurste. I egree to comply with ell City ordinsnces snd State lews rststing to building construction, t hsreby euthorize representstives of the Citt of Csrtsbsd to enter upon the sbovs mentioned property for inspection purposss. I ALSO AQRS TO SAVE. INDEMNIFY AND KEEP HARMLESS THE CfTY OF CARLSBAD AGAINST ALL UABILITIES, 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 requirsd for sxcsvstlons over B'O* deep end demetition or construction of structures over 3 etoriee In height. EXPIRATION: Every permtt ieeued by the Building Offidel under the provieions of this Code ehsit expire by limitstion snd become null end void if the building or work suthorizsd by such permit is not commenced within 366 dsys from ths dsts of such permit or if the building or work euthorized by such permit is suspended or sbendoned et eny time efter thy^(k is commenced for|tperio^m/l 80 deys (Section 106.4.4 Uniform Buiiding Code), O r^ O O WHn-EWIe YELLOW: Applicem PINK: Finance APPLICANT'S SIGNATURE City of Carlsbad Inspection Request For: 8/24/99 Permit# CB993176 Titie: VIA DONNA-TEMP POWER POLE Description: Inspector Assignment Type: ELEC Sub Type: Job Address: 1755 DOVE LN Suite: TP Lot C Location: APPLICANT TEMP UTILITY SERVICES Owner: Remarks: Phone: 7608399430 inspector: 3^ Total Time: Requested By: MICHELE Entered By: CHRISTINE CD Description 32 Const. Service/Agricultural Act Comments Inspection History Date Description Act Insp Comments T.835 9 mm r-m P.O. 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