HomeMy WebLinkAbout1775 CASSIA RD; ; CB993273; Permit09/01/1999
City of Carlsbad
Electrical Permit Permit No:CB993273
Building Inspection Request Line (760) 438-3101
Job Address:
Permit Type:
Parcel No:
Reference #:
Project Title:
1775 CASSIA RDCBAD
ELEC
Lot#:
POINSETTIA HEIGHTS-100 AMP
ELECTRIC METERED PEDISTAL FOR IRRIGATION
Status:
Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
ISSUED
09/01/1999
RMA
09/01/1999
09/01/1999
Applicant:
WESTERN PACIFIC HOUSING
STE107
2385 CAMINO VIDA ROBLE
CARLSBAD CA 92009 92009
760929-1600
• - t'Z' *
3549 09/01/99 0001 01 02
C-PRMT 35-00
" 1.
Total Fees: $35.00 " TBfel Payments To Data
Electric Issue Fee 'f^u ;
Single Phase per AMP ~*f|~: *
Three Phase per AMP '•* i
Three Phase 480 Per AMP ;
Remodel/Alteration per AMI* * "
Remodel Fee
Temporary Service Fee r **-
Test Meter Fee '-"• ~>l
Other Electrical Fees
100
0
-- 0
0
* v%
" , "•• ^- ,
•>• "•g%-^_j;- iUl-
$0.00 Balance Due: $35.00
* «c ^
j ii/
1
^ ;T*3jfl|po.OO
L »f j^'f'^$0.00
;? '->^i $0.00
, ;;/ J'^-j*,-' $0.00
r.'/ti " ^^Sy $°-°0
ttA^ll * -i^S* $0.00
ttf "f 1 , ^*"t-* $0.00
TOTAL PERMIT FEES
FINAL APPROVAL
Inspector: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 Government Code Section 66020(a), and file the protest and any other required information with the City Manager for
processing in accordance with Carlsbad 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/exactions 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/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise 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
1. PROJECT INFORMATION
FOR OFFICE USE ONL
PLAN CHECK NO.
EST. VAL.
Plan Ck. Deposit
Validated By.
Date
Business Name (at this address)
Legal Description Total tt of units
Assessor's Parcel tt Existing Use Proposed Use
ription of Work SO. FT.#of Stories Bedrooms # of Bathrooms
Name
3, APPLICANT
Address
or -.D Agent for Contactor Q Owner
City
I Agent for Owner
State/Zip Telephone #
• P. GWQs
Fax*
Name
5. CONTRACTOR - COMPANY NAME
(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 toja civiLoenalty of not more than five hundred dflllars
Name ' Address ,~
State License # Gf ' 5 7 Ci ^^ License Class *~^
Designer Name IK \ 1 \ Address
State License # ' >» 1 **•
City State/Zip Telephone # ^"2.
City Business License # ^ 2. Cl^^TO /
City State/Zip Telephone
C WORKERS' COMPENSATION
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
D 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.
"*KT 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
'issued. My worker's compen
Insurance Company
on insurance carrier and policy number are:
Policy No.Expiration Date
h this permit is
/ /
I 'T./^T'O
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS)
0 CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as
to become subject to the Workers' Compensation Laws of California.
WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred
thousand dollars 1$ 100.000). in additu» to the cost ot£ompensationrdamages as provided for in Section 3706 of theLabor code, interasland attorney's fees.
SIGNATURsHI^X cy ~-fS^\^ /O^^_Co^V^O>fcL-v~--^_ DATE /^• /' Y f
7. OWNER-BtfjtpER DECLARATION
1 hereby affirm mat I am exempt from the Contractor's License Law for the following reason:
f~1 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).
f~l 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).
C] 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 CDNO
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 FOB NON-K£SID£HTtAL BUILDING PERMITS ONLY
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 25505, 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 district? l~l YES l~l NO
Is the facility to be constructed within 1 ,000 feet of the outer boundary of a school site? D 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.
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(1) Civil Code).
LENDER'S ADDRESSLENDER'S NAME
9. APPLICANT CERTIFICATION „
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 CitV 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 permrOs not commenced within 365 /fa\s from the date of such permit or if the building or work authorized by such permit is suspended
or abandoned at any time af^er the\work is comr^enc^d/\o^ p<riod\f 180 days (Section 106.4.4 Uniform Building Code).
APPLICANT'S SIGNATURE JXy(j//fV\DATE
WHITE: File YELLOW: Applicant PINK: Finance
POINSETTIA HILL
15:51 FAX 310 648 7207 P H WPH CARLSBAD @}002
^ CERTIFICA; J OF LIABILITY iNS»R,<Nc^c^3" | ™szz.
fi Company
.cense #0008309
. Box 820
-h Pasadena CA 91031
.-_^ne; 626-799-7000 Fax
ISUREO
West«zn PacificDevelopment LP .
ana Western Pa.c:
£1 Seepindo CA St
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.-
-0820
.: 626-441-3233
pHS*fi??at«Cfio Housing- r
Blvd,Suit«s 390
3245
1 HI5> CtKTIPICATE IS ISSUED AS A MATTER OF INFORMATION ~~
ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE
HOLDER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR
ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW
INSURERS AFFORDING COVERAGE
INSURER A:cali±emo.a Compensation Ins.
INSURER K
IN9URBRC
INSURER D:
INSURERS:
AVERAGES — "
ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTR" CT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CCRTIFICATE MAY BE ISSUED OR
MAY PERTAIN. THE INSURANCE AFFORDED BY THE POUCIE 3 DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS Of SUCHPOLICIES. AGGREGATE UMTTS SHOWN MAT.HAVE BEEN RHJUCCD BY PAID CLAMS. .. . _ ...
rc*i ° TYPE OF INSURANCE
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COMMERCIAL CSNCRAL LueiUTY
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EMPLOYERS' UABILTTY
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POUCYNUMBCR | D^TE»£uDl^6|fOATgY«^Sr?T?N| LIMITS
W99D3136203 03/19/99 O3/19/00
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SCfMPTION OF OPERATOI>4S/LOCATlONS/V6HfCLEHEKCLUSIONS AOOGO BY ENDORSEMENT/SPECIAL PROVISIONS
0 day cancellation for non-payment of premium
a: Western Pacific Hemsinsr-Seripps IX, LLC
jRTIFICATE HOLDER H ADomoNAL INSURED: INSURE.* LETTER: CANCELLATION
SANDIE3
^_s CITY OF SAN DIEGO
1222 First Avenue, 2nd Floor
San Diego CA 92101
SHOULD ANY OF THE ABOVE DESCRIB6C P3UO6S BE CANCELLED BEFORE THE
EXPIRATION DATE THEREOF. THE ISSUING INSURER WILL ENDEAVOR TO MAIL
30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE
LEFT, BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR UABIUTY OF
ANY KIND UPON THE INSURER. pgAC^lWS OR REPRESENTATIVES.
Javl^fcv (/£-*• >^%?Y^
.ORD 25-S (7/97) '' " /" f/ " ACtfRD CORPORATION 1 9B8