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HomeMy WebLinkAbout1316 CASSINS ST; ; CB972994; PermitBUILDING PERMIT 10/10/97 12:30 Page 1 of 1 Job Address: 1316 CASSINS ST Suite: Permit Type: ELECTRICAL Parcel No: 215-690-40-00 Lot#: Valuation: 0 Occupancy Group: Reference*: Description: ADD 4 LIGHTS TO EXIST SWITCH Permit No: CB972994 Project No: A9703814 Development No: Appl/Ownr * * * ALLSCAPE LANDSCAPE INC 905 LILAC CT SAN MARCOS CA 92069 Fees Required *** **t* 0136 10/10/97 0001 01 02 C-PRMT 20-00 Construction Type: NEW Status: ISSUED Applied: 10/10/97 Apr/Issue: 10/10/97 Entered By: RMA 760 480-4041 P*©s Collected & Credits * * * Fees: 20.00 Adjustments: ,00 Total Fees: 20.00 Fee description Total Cr.«aits: Total Paymeitts: •Balance Due: Units Fee/Unit . 00 . oo 20 . 00 Ext fee Data Enter "Y" for Electric Issue Fee > Enter "Y" for Remodel > * ELECTRICAL TOTAL 10.00 Y 10.00 Y 20.00 1MAL APPROVAL CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760)438-1161 3."" Address (Mclude Bldg/Suite »\ FOR OFFICE USE ONLY PLAN CHECK NO. Q 7 EST. VAL. Plan Ck. Deposit. Validated By_ t-^ / Business Name (at this address) Legal Description Lot No.Subdivision Name/Number Unit No. Phase No. Total f of units Assessor's Parcel *Existing Use Proposed Use Description of Work SQ.'fof Stories '$£$$!$?, ?V^* "" L * of Bedrooms # of Bathrooms Name Address City State/Zip Telephone f Fax * Name Address City State/Zip Telephone # Na Address City State/Zip Telephone # (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 to a civil penalty of not more than fiva.hundred dollars 1*5001). 'Name Address State License f ll^OO^I License Class (2 City State/Zip Telephone f "~ 2 ") City Business License # /£. O- 3//ej <Afi£. Designer Name Address State License t City State/Zip Telephone Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: O 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. Q 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 compensation insurance carrier and policy number are: &4*fT /^ Insurance Company flAf'tZ I^Aft^T _ Policy No. fi ? ^ff^ 7& Expiration Date AJ/tO/<? ~> (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) Q 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 la unlawful, and shai subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (*lOQ.OOO).ta addWoai to tip cost of compensation, damages as provided for hi Section 3706 of the Labor code, (merest and attorney's fees. SIGNATURE ^CfajK >t P^ff) _ __ DATE I hereby affirm that I am exempt from the Contractor's License Law for the following reason: D 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 ere 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). Q 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). Q 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 QNO 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 *>* 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? O 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? Q YES D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES O NO REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. |a.^||j ;jKfl . &£ & »* i. , 4/ JB^^s™r %,Sii«.£?sT!!!>*'K?BS! 5S*;™KS? •BBMSfc •HWB.SH5HE:": •* ;S^!WH"" ***** - * »-"'v<*>i>>~»»' f -.c""- ™;-* '•»**• » v '*- r ~.~ __,_ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code). LENDER'S NAME LENDER'S ADDRESS. SiH«SSfcs«i»e^^ - •—- - •"—*•-' 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 City 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, OSHA: An OSHA permit is required for excavations over 5'0* deep end demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the Building Official under the provisions of this Code shell expire by limitation and become .null and void if the building or work authorized by such permit is not commenced within 385 days from the dete of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after tta.work-is commenced for* period of 180 daysJSection 106.4.4 Uniform Building Code). y??*Ss*£s& (PUf\ DATEAPPLICANT'S SIGNATURE WHITE: File YELLOW: Applicant PINK: Finance PERMIT* CB972994 DESCRIPTION: ADD 4 CITY OF CARLSBAD INSPECTION REQUEST FOR 07/14/98 LIGHTS TO EXIST SWITCH TYPE: ELEC JOB ADDRESS: 1316 CASSINS ST APPLICANT: ALLSCAPE LANDSCAPE INC CONTRACTOR: « (, OWNER:P-"?" REMARKS: C/CINDY/480-4041 SPECIAL INSTRUCT: TOTAL TIME: CD LVL DESCRIPTION 39 EL Final Electrical PHONE: PHONE: PHONE INSPECTOR AREA NF PLANCKf CB972994 OCC GRP CONSTR. TYPE NEW STE: LOT: 760 480-4041 INSPECTOR 10 F ACT COMMENTS ***** INSPECTION HISTORY ***** DATE DESCRIPTION ACT INSP 101497 Underground/Conduit-Wiring AP NF COMMENTS IMPORTANT - THIS IS NOT A BILL. SEND NO MONEY UNLESS STATEMENT IS ENCLOSED. STATE COMPENSATION INSURANCE FUND HOME OFFICE SAN FRANCISCO POLICY DECLARATIONS CALIFORNIA WORKERS' COMPENSATION AND EMPLOYER'S LIABILITY POLICY THESE DECLARATIONS ARE A PART OF THE WORKERS' COMPENSATION POLICY INDICATED HEREON. THIS INSURANCE IS EFFECTIVE FROM 12:01 A.M., PACIFIC STANDARD TIME 10-05-96 TO 10-01-97 AND SHALL AUTOMATICALLY RENEW EACH 10-01 UNTIL CANCELLED ALLSCAPE LANDSCAPE AND DESIGN, INC 905 LILAC CT SAN MARCOS, CALIF 92069 CONTINUOUS POLICY 1452630-96 DEPOSIT PREMIUM MINIMUM PREMIUM PREMIUM ADJUSTMENT PERIOD $650.0 $650.C MONTH! N £ NAME OF EMPLOYER- TRADE NAMES- ALLSCAPE LANDSCAPE AND DESIGN, INC (A CORPORATION) ALLSCAPE 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 TO 10-01-97 0042 LANDSCAPE GARDENING—ALL OPERATIONS-- INCLUDING MAINTENANCE OF GARDENS BASE RATE 16.36 INTERIM BILLING RATE* -14.35 ********BUREAU NOTE INFORMATION******** MARK SMITH PRE TRE 50.00X CYNTHIA SMITH SEC 50.00% TOTAL ESTIMATED ANNUAL PREMIUM $2,009 COUNTERSIGNED AND ISSUED AT SAN FRANCISCO OCTOBER 10, 1996 POLICY FORM L 1