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HomeMy WebLinkAbout1335 SHOREBIRD LN; TP; CB990631; Permite,L*(ytSO City of Carlsbad 02/17/1999 Electrical Permit Permit No:CB990631 Building Inspection Request Line (760) 438-3101 Job Address: Permit Type: 1335 SHOREBIRD LN CBAD 1 f ELEC Parcel No: Lot#: 0 Reference #: Project Title: BELLA LAGO TEMP POWER POLE Applicant: TEMP POWER SYSTEMS 750 N. CITRACADO PKWY. ESCONDIDO CA 92025 760 439-1999 Total Fees: $20.00 Electric Issue Fee Single Phase per AMP Three Phase per AMP Three Phase 480 Per AMP Remodel/Alteration per AMP Remodel Fee Temporary Service Fee Test Meter Fee Other Electrical Fees TOTAL PERMIT FEES Inspector: Owner: Total Payments To Date: FINAL ~OVAL Date: 3, '1J J 6519 02/17/99 0001 01 Status: ISSUED C-PRMT Applied: 02/17/1999 Entered By: RMA Plan Approved: 02/17/1999 Issued: 02/17/1999 Inspect Area: Clearance: $10.00 $0.00 $0.00 $0.00 $0.00 $0.00 $10.00 $0.00 $0.00 $20.00 $20.00 NOTICE: Please take NOTICE that approval of your project includes the 'Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as 'fees/exactions." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capactiy changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any fees/exactions of which ou have reviousl been iven a NOTICE similar to this, or as to which the statute of limitations has reviousl otherwise ex ired. CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 02 20.00 FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NO. qq _ CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA~200 (760) 438-1161 I ....... _..ll.}.FO~., ?O~:~!~~~~-,,,;-,_.';_· . · ;--~~~,,;~._,_,, ''f(At'";;'" -.7~7-~.· ,_,, ___ ,.~,•••. ' . ~~_ ...... ~~._... = ~ ~· !!!-::zu ::ave l),6tt?► et :,;p,;1 t c Addreas (include Bldg/Suite I) Buain•u N•me Cat this •ddres1) &, c> wb'i e)ai Legal Description Lot No. Subdivision N■ma/Numbar Unit No. Phase No. Total I of units Assessor's Parc•I I Existing UH Proposed Use Description of Work SQ. FT. #of StoriN I of Bedrooms. I of Bathrooms Name AddrN1 City State/Zip Telephone I N•me Addr-===---City S.t■t•/Zip Telephone I [t~.CONl'RlCTOli-~cbMPANi.~$:..~~ ..... 'i&#W-i.~i ~~~~~~~~~.!:¾.~t:":i~~-¥,•·· !Sec. 7031.6 Buainas1 and ProfN1ions Cod•: Any City or County which raquirN ■ p■rmit to cONtNCt, altar, improve, demolish or repair any structure, prior to Its issuance, ■110 raquirH tne applicant for 1uch permit to file ■ lligned statement that he la licansad pursuant to tne 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 la exempt therefrom, end the basis for the alleged exemption. Any vio tion of Section 7031.5 by any applicant for ■ parmit subjects tha applicant to ■ civil penalty of not more than live hu red liars 1$5001). --s-o ». · ~<v oi r c:> -, si State License I tf-If r<f J ] License Clesa _C __ ·_I V ____ _ Designer Nam■ AddrNI City St■ta/Zip Telephone State LicenH I _________ _ 11:·s~-wORmtr~OMPENSATIOtfr-Z~~~1:'m~~m?.i~~;~~~~.~~~~~[~~;ci::r~:~t!".r~~·.~w;.;;=.~~;:~:: .. ::~~~f~~-- Workers' Compenaatlon Declaration: I hereby affirm under penalty of perjury one of the following daclarationa: 0 I have and will maintain I certificate of consent to sell•inaure for workers' compenaatlon H provided by Section 3700 of the Labor Code, for the performance of the work for which this permit la l11ued. 0 I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the parformance of the work far which this permit is issued. My worker's compens::n insurance carrier and policy number are: / r Insurance Company C t!_ A Policy No. I O I 9 '8'0 ,2..9<;-c/ Expiration Date /Q ( 9 9 ' (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS) 0 CERTIRCATE OF EXEMPTION: I cartify that In the performance of the work for which tnis permit is iaaued, I shall not employ any person in any manner so IS to become subject to the Workers' Compens.ation Laws of California. WARNING: F■ikn to aacun, wor11 .. • COfflllln■a1ion coverage le unlawful, and lhal ■ubject an amployar to crtminal peneltln end clvQ finH up to on■ hundred thousand dollar• ($1 00), addition to the coat of compena■tlon, d■magu u _provided fM In Section 3708 of the~ coda, lntaraat and attorney'• fHa. SIGNATURE_....J;,~~~-~~~.o!::::=====------------------------DATE C9. .. J.1..:> / 9£ ~·~-~ ~~~~~~~~~~~~ID:~,:;~;fl5.~~~;:~~~~~~~47~'?!~~~~~~~?:~~~~~~~f:.litiffEt I hereby affir rom tha Contractor's Ucanae Law for the following ra11an: 0 I, as owner of the property or my amplov-with wages es their aola compensation, will do the work and the atructure is not intended or oflared for sale !Sac. 7044, Bu1ina11 end Professions Code: The Contractor's Ucen11 Law doe• not apply to an owner of prop■rty who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intanded or offered for s■la. If, howaver, the building or Improvement is sold within one year of completion, thl owner-buildar will have the burden of proving that he did not build or improve for the purpose of s■le). 0 I, IS owner of th■ property, 1m exclusively contracting with llcen11d contractors to construct th• project (Sec. 7044, Buainass end ProfeHions Code: The Contractor's License Law doe, not apply to an o-of prop■rty who build• or improves thereon, and contracts for such projects with contractorlal licansed pursuant to the Contractor's License Law). 0 I am exempt under Saction ______ Business end Professions Code for thi1 raeson: 1. I personally plan to provide the major labor and materi•I• for construction of the proposed property improvemant. 0 YES ONO 2. I (have/ have not) signed an application for a building pa,mit for tna propo11ad work. 3. I have contracted with the following person (firm) to provide the proposed construction (include n■m■ / addraas / phone number / contractors license number): 4. I plan to provide portions of the work, but I hava hired the following person to coordinate, supervise and provide the major work (include nema / addreas / phone number / contractors license numbar): _______________________________________________ _ 5. I will provide some of the work, but I have contracted lhired) the following parsons to provide the work Indicated (include name / address / phone number / type of work): _________________________________________________________ _ PROPERTY OWNER SIGNATURE______________________ DATE _________ _ COMPmE'1l!IS 'SECJ'JON'FOR 'iirfi/#SfliENYIAiflliDING~»_~s~m1r~~~1i-~:::f!J;;;:.:~:.::::::::~~::.:Z;..TI:::::r~:;.i?;,.L .. Is the applicant or future building occupant required to submit ■ bullineu plan, ■cutaly haurdoua matariala r■gistration form or risk management and prevention program under Saction1 25505, 25533 or 25534 of the Prealey•T■nner Hazardou1 Substance Account Act?-D • ¥E& O NO . Is the applicant or futura building occupant required to obt•in ■ permit from the 1ir pollution control district or air qu1llty m■n1gement district7 O YES O NO Is the facility ta be constructed within 1,000 feet of the outar boundary of ■ school site? 0 YES O NO IF ANY OF THE ANSWERS ARE YES, A ANAL CERTIRCATE 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. a~-...:CQNl:niVCTIDl{.[EN01Ncl~ctii~~~~~&i~l..~%t'i:1!,.@.~:~>::~,!:';tf'V'~•:;.J.i.~~:-:::·~ .... ~·~t:~z-~·· I hereby affirm that there is• construction lending agency for the performance of th■ work for which this permit is issuad (Sec. 309711) Civil Code). LENDER'S NAME______________ LENDER'S ADDRESS :9~tJAPNCAtn::CERtlfiC4lttOti4t~~~~~~,cu-r:;::~m:-fl•?"~"i'i·imii ·•~'i~iri·.i,..';c~..,i. iii.~~Wf·"~r.i:i'.r::ui~rrf~-:::.~·0::;·1;~~~~--~?;,;;..3IS··~J)_ .. '.:;~~~:: .. :":'[,·~~;.~.~=~~-=-·-~:::: ... ::·~ .. =:~::: .. =--~:.~- I certify that I have read the application and stat■ that th• above information i1 correct and that the information on the plans is accurste. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize represant■tivn of the Cltt 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 AU. 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 structuras over 3 stories in height. EXPIRATION: Every permit is~u_ed by the Building ~i~•I under the provisions of this Code shall expire by limitation and become null and void ii the building or work authorized by such permrt 1s not commenced wtth1n 365 days from the date of such permit or ii the building or work authorized by such permit is suspended or abandoned et any time after the wo ' commenced for a 'od of 180 d■VI (Section 108.4.4 Uniform Building Code). APPLICANT'S SIGNATURE -~~~='---~~~:a::===;:;._-_______ DATE a..fr2 /2 5' YELLOW: Applicant PINK: Finance City of Carlsbad Inspection Request For: 3/4/99 Permit# CB990631 Title: BELLA LAGO TEMP POWER POLE Description: Type:ELEC Sub Type: Job Address: Suite: Location: 1335 SHOREBIRD LN Lot 11.PPLICANT : TEMP POWER SYSTEMS Owner: Remarks: Total Time: CD Description 32 Const. Service/Agricultural 0 _jS/J Comments Inspection History Date Description Act lnsp Comments Inspector Assignment: Phone: Inspector: ,tll/ Requested By: JOE Entered By: ROBIN