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HomeMy WebLinkAbout1202 PLUM TREE RD; TP; CB994630; PermitCity of Carlsbad 12/15/1999 Electrical Permit Permit No:CB994630 Building Inspection Request Line (760) 438-3101 Job Address: Permit Type: Parcel No: Reference #: 1202 PLUM TREE RD CBAD St: TP ELEC 2145432900 Lot#: 0 Status: Applied: Entered By: Plan Approved: Issued: ISSUED 12/15/1999 GMF 12/15/1999 12/15/1999 Project Title: TEMP POWER POLE Applicant: TEMP UTILITY SERVICES 1167 LAW ST SAN MARCOS, CA 92069 619-471-5494 Inspect Area: Total Fees: $20.00 •-; .· ";:f~tatPayments To Date:' ~-4 ,., ... ,,, ¥! \ ... "" i! . .... " *' \$ t:' Electric Issue Fee • ' · . · ' • ·; -~ 0.00 SinglePhaseperAMP :,:!,;.~-·.. 0 ,; .. ,.:;**$0.00 ,t"'0~s+ . i'l':."*"►'4.'ooo Three Phase per AMP -, , , , ., • , O H , , , ., , ·"' • Three Phase 480 Per AMP:':;•;~.-!"' " , 0 : • 0 "0 "t .: ;; : ; ! $0.00 R d I/Alt t. AM,.. •n .. _ .. 0 .• .• ••· ,,.* $0.00 emo e era 10n per r; • .• ,.. .; ; ~ " , i. • "' ... -+ 0 • Remodel Fee "t 1v ""·' -~~ 0 , ,.:~,. ,. •• n,'!',~ $0.00 TemporaryServiceFee •·::;; _,1 •>, '*0 • 01 : __ :::-" $10.00 Test Meter Fee , • ._ ~ ""' · ,,, • · • -} ... • 1' $0.00 Other Electrical Fees 70 "' : -, -~;, 0 0 ,p, '* ,. 1 ~ ,: ~ ;· • : ~ ... · ~ .. 1, :·~ $0.00 0 ..., ,, ¥" f#W4-,t,; ,. +•,,i;iorJ, \/Ii;:'«,<.:-~@'#,}, \c "''Y'l;S-,, TOTAL PERMIT FEES + ':"'' •; ,;; , ·-' •;:: ! • $20.00 ''!'•4 -, ....... ,)tl.... . .t• -il+ +, Inspector:~~ AM r i ' , f .. " ... , \ fa ~"' ... y ., JII; • ' "' • "-' .. FINAL APPROVAL Date: /2'-Z-f-17 Clearance: $20.00 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 vou have nreviouslv been niven a NOTICE similar to this or as to which the statute of limitations has nreviouslv otherwise exnired. CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NO. c.Qiei j'iu30 CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 EST. VAL _________ _ Plan Ck. Deposit ________ _ Validated By_l"':J_r ________ _ Date , 1..I l'; I 'l'I It 1( Address (include Bl.~/S!t7 II .J... D / /J.02.Tr [__u,,, ,r~£ JrcJ Business Name (at this address) Legal Description Lot No. Subdivis~ Na'!{g,urrper qr d..(.. Unit No. Phase No. Total I of units Assessor's Parcel I Existing Use Proposed Use Description of Work / 11 S #of Stories I of Bedrooms I of Bathrooms Name Address ' City State/Zip Telephone I Fax I ~~, ~7,1;,,trt;_';.D 'to~or;~;!':Agf;{ft/~t:~~Tf'fl_-;;:~~WJ/~~'.;c:,:;:,;;•'.·,,: :,··1f'.~~/i:li~:~,/, ... ,. v I? ~). 2-Y.· Clot t, Name Y Addren City State/Zip Telephone I Name Address City State/Zip Telephone I (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 o! the Business and Professions Code) or that he is exempt therefrom, and the basis for the alleged exemption ny violation of Sec}i,077031.5 by an applica'ltJor permit subjects the appli?Dt to a civilfl>jalty of not more tha_o. five hundred dollars ($5001!: r:rw GY r v.s 3t ;v t111c.< 5i c.Sl-lTIJ41 . 6 9"J.Ol) 7ttJ ~9-9rJo Name Address City State/Zip Telephone I r,, 9,~ a, State License I --=.J:c....:..-A.;..::;J:..._·J_,_L...c.V __ _ License Class ---"'(;---'/_I ____ _ City Business License I _______ _ Designer Name Address City State/Zip Telephone State License I _________ _ 6. WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury_one of the following declarations: 0 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. ~ 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 issued. My worker's compensatio~nsuranc;a.carrier ,nd policy number are: /{ </tf J ~ ~/,,. tJl) Insurance Company S f-a l " r tin d Policy No. / 5"' .£"S O .. Expiration Date __ .> ____ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS) O CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not employ eny person in any manner so as to become subject to the Workers' Compensation laws of California. Ion coverage I• unlawful, and ah■II aubj■ct an ■mployer to criminal pen■ltiH end clvll flnH up to one hundred of compenHtlon, d■mege• H provided for in S■ctlon 3706 of the l.aborj ode, int,IIJW and attorney's fNa. DATE /:;.. .,... s--rr I hereby affirm that I am exempt from the Contractor's License Law for the following reason: 0 I, as owner of the property or my employHs 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 aale. 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 License Law does not apply to an owner of property who builds or improves thereon, end contracts for such projects with contractor(sl licensed pursuant to the Contractor's License Law). 0 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. 0 YES ONO 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--------------~------- COMPLETE THIS SECTION FOR NON-RES/DEN71Al."BUILDINO PERMITS:ONLY-."",,., .,: .... : DATE _________ _ 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 26505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? 0 YES O NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES O 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 POUUTION CONTROL DISTRICT. 8. -~·oNSTRUCTION ~DING~~~~y~~::1;~t~~-l·~tJ.J?u\r:~·,~~~~Y~J"\~!1~r~~·,·~~~'.:~:~;:~~)?~;:.~·;i}i& ':'.: .;·· -~-~ _!" I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097111 Civil Code). LENDER'S NAME______________ LENDER'S ADDRESS _______________________ _ ·9. APPLICANT CERTIRCA rtoN -~~~~•~_;;:!;:~;~~ ~1iJk~~Jp~:~:;»2~:~1J~.:~j~~~~~~::.:r~·:l~)Ji:JtiiU~i:t\!!C]1:~~-~~~t t~I.:t~!-t: ,~I~~5,j~~ ::~-~ ·~ ;···?~-. .. ~ 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 Citt 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 ANO 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" dHp 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 permit is not commenced within 366 days from the date of such permit or If the building or work authorized by such permit is suspended or abandoned at any time after the ork is commenc~or period of 180 days (Section 106.4.4 Uniform Building Code). · ~~ 12 -;s-9? APPLICANT'S SIGNATURE ---J."'""':=...-'----'-.l--..:.....::....,,~-------L---------DATE ____________ _ YELLOW: Applicant PINK: Finance City of Carlsbad Inspection Request For: 12/28/1999 Permit# CB994630 Title: TEMP POWER POLE Description: Type:ELEC Sub Type: Job Address: 1202 PLUM TREE RD Suite: TP Lot Location: APPLICANT TEMP UTILITY SERVICES 0 Owner: BRKOVIC MILIVOJE S&NATASHA P Remarks: Total Time: CD Description ~p Comments Inspector Assignment: ~ Phone: 7608399430 Inspector:~ Requested By: MICHELE Entered By: CHRISTINE 32 Const. Service/Agricultural ff.!:. -------+------------- Associated PCRs Inspection History Date Description Act lnsp Comments