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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 i .- -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 GEt ^^__ OERAL LIABILITY COMMERCIAL CSNCRAL LueiUTY ~~| CLAIMSMADC | | OCCUR <3EN1_ AGGREGATE UMlT APPLIES PER: AUTOMOBiLS UABUTY — - QAf ANY AUTO ALL OWNCD AUTOS SCHEDULED AUTOS HIR60 AUTOS NOMOWNED AUTOS IACE LIABILITY ANY AUTO BtCSSS UAEJUTY ) OCCUR | | CLAIMS M/»DE DEDUCTIBLE RETENTION . f EMPLOYERS' UABILTTY OTHER POUCYNUMBCR | D^TE»£uDl^6|fOATgY«^Sr?T?N| LIMITS W99D3136203 03/19/99 O3/19/00 EACH OCCURRENCE FlKE OAMASB (uny DM lh^ *«EO CW (Arty aiw panari) POaotWL ft ADV INJURY GENERAL AQOREGATE PRODUCTS . COMp/OP ffsa (El aeddwiQ (Parpcnen) BODILY INJURY PROPERTY DAMAGE AUTO ONLY . EA ACCIDENT QTUettfUM, E*ACC AUTOONLT: f^ EACH OCCURRENCE AGOREOATE XlToRYUMrrel IUER' E.L EACH ACOOENT E.L. DISEASE . EA EMPUDYEJ E.L. DISEASE . POLICY UMIt- 5 S S S s s s s s f s s I s 1000000 $1000000 3 1000000 . 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