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HomeMy WebLinkAbout1299 SHOREBIRD LN; TP; CB980813; PermitB U I L D I N G P E R M I T Permit No: CB980~1j ProJect No: A98U1076 UJ/2U/98 U':J:59 Paqe 1 of 1 Job Address: 1299 SHOREBIRD LN Permit Type: ELECTRICAL Parcel No: u Lot#: ...,... Development No: Suite: if 5250 03/20/98 0001 01 02 C-PRHT 20-00 Construction Type: Valuation: Occupancy Group: Reference#: Description: TEMPORARY POWER POLE-BELLA : LAGO-BROOKFIELD Status: Applied: NEW ISSUED 03/20/98 03/20/98 RMA Appl/Ownr : TEMPORARY POWER 750 N CITRACADO ESCONDIDO CA Fees Required -------------------------- Fees: AdJustments: Total Fees: Fee description Enter "Y" for Ele Enter "Y" for Tern 760 Apr/Issue: Entered By : 439-1999 Collected & Credits .00 ,00 20,0U Ext fee Data ------------------ 10.00 Y 10.00 Y I FINAL APP r 'lVAL- 1 ,NsP.t-< fJ D. . . .Lf· ~ ·9}>' CLEA~NCE _____ _ CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION FOR OFFICE USE ONLY <1( O PLAN CHECK NO. '9.9'0 0 1 ...J CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 EST. VAL. _________ _ Plan Ck. Deposit----....... ---- Validated By -,.,-,.....,....r:::--~ ....... ...._ ____ _ Date_.....,_.,__+":,..;;~c.::;,.q.. ______ _ Address (include Bldg/Suite #) So/' Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Existing Use Proposed Use SQ. FT. #of Stories # of Bedrooms # of Bathrooms Name Address City State/Zip Telephone # Fax 11 c;; ...... '"_,~....,,~. -~~ i~. ' ==r=-=;;,: --~ ... ~-- Name Address rty State ,. ~:-'•PROPERTh':OWNER"~1°'•':.':~-ti'"t"'.;¢ifO:J;:j.'~~~~~~~~~~~~~~~if~~-~'f!Ek~l!l'.P:!,!_;';Jw,mf!Ji!'IJ::."i,~~~'.:;t~-::?'."J::;,'l'; t, .,.. -• . , /~-'{_ b-,-,.--.r..... . '(Ei:S-.."''();~u~:z!::'iif...--"~~~Ai:.t .ll~~~ .. ....i.. .. ..ai-•.i't,al· ........ •;?,,il•. "'"• ~-... ~•c,,,. Name Address City S.tate/Zip Telephone # ~5.~~~<::coNTRACT OR.~·coMPANV:NAM~t~~~_;.~~at.1M~l;',r.-;!t'..:t';.$"~~~~~~~~'tm~;:;:_·~'il•:* (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 filo 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 thot he is exempt therefrom, and the besis tor the alleged ~on. An~tion of Se~on ~031.5 by any applicant f ,r»ermit subjects th licant to a civil penalty of not more th n five hundred dollars ($500)). c P T()UJ'i ~ ~ c,-~~ _,......,__ ~~t'61J. ~ -~~ Name · 1 /2 Address City State State License It _ __,'t!-_'B_'i5_.c.V_3~3~_ License Class _...:(3=:...._-_/<_0 ____ _ City Business License # _______ _ Designer Name Address City State/Zip Telephone State License It __________ _ .6: ___ WORKERS~ CbMPENSATI0N·~:~:.::~2:i~:;.:~~}~~.:;;~~~~~:~-z:1t~;-,77~:2~~~.::.':~~:{=-rm-srrE-·F~":~~f:~~~~~~~.'2.~Z.f.-~%~~~~~~ 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 ~ork 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 copr@isation insurance carrier and policy number are: •/' V.¢"~ . ../ L,, Insurance Company ~/ r _:z:-At!z:x:U,t;Ur>("'Y Policy No. /t(bO ~ Expiration Date /Od~ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100) OR LESS) D CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shell not employ any person in any manner so as to b~come subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' co pensation coverage is unlawful, and ahall aubject an employer to criminal penalties an civil fines up to one hundred thousand dollars ($100, , in ddi · n the cost of compensation, damages as provided for in Section :3706 of the Labo code, tereat and attorney's fees. 7. ~-·,owNER .. BUILDER~□ectARAJ10N~~~~p.t.;;_~~~~~~~E:1.'?52e_~3~l!:N~:;:~~~~~r~~t~!t~l?5;~~~:;itfu=n.:~~~~~.;.=~~ 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 int ended 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). D 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). D 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 I have not) signed an application for a building permit for the proposed worlc. 3. I have contracted with the following person (firm) to provide the proposed construction (include name I address I 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 I address / phone number / type of work): _____________________________________________________________ _ PROPERTY OWNER SIGNATURE________________________ DATE _________ _ :coMl'LETE;ffi1s· SECTION'l'OR NOk-ilESIQEl\'.iiAI:ii()"j[o1ij·ct.eEi!Mfts;t[Wi(~~~~~~~~~~~Jn.~ 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 S~bstance 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? D YES D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES D 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. ~~~@s.fj:iii¢,:iq;-(CENi?fN~~~:<f~NJ~v.-F.;~~~~t,'~~w~~~~'S'.~~~~~~~~1~K~§B:,.g-W~>g?}.~:~;;!~;,: 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 :s:~,;:~eeffcANT,'CEl\:(IF(c.o;.TioN.ff!i ...... .,..,~ . LENDER'S ADDRESS 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, JUOGMENTS, 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 permit is not commenced w thin 365 days from the date of such permit or if the building or work authorized by sue permit is suspended or abandoned at any time after the w is com en d for a period of 180 days (Section 106.4.4 Uniform Building Code). WHITE: File YELLOW: Applicant PINK: Finance .. ' PERMIT# CB980813 DESCRIPTION: TEMPORARY POWER LAGO-BROOKFIELD TYPE: ELEC CITY OF CARLSBAD INSPECTION REQUEST FOR 04/03/98 POLE-BELLA JOB ADDRESS: 1299 SHOREBIRD LN STE: INSPECTOR AREA PS PLANCK# CB980813 OCC GRP CONSTR. TYPE NEW LOT: APPLICANT: TEMPORARY POWER SYSTEMS CONTRACTOR: PHONE: 760 439-1999 OWNER: REMARKS: C/BOB/439-1999 SPECIAL INSTRUCT: FINAL TEMP POWER TOTAL TIME: CD 32 LVL DESCRIPTION EL Const. Service/Agricultural PHONE: PHONE: INSPECTOR ACT COMMENTS fl_f _____ _ ***** INSPECTION HISTORY***** DATE DESCRIPTION 033198 Const. Service/Agricultural ACT INSP CO PS COMMENTS