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Home My WebLink About2809 VIA CLAREZ; ; CB120557; Permit03-30-2012 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No: CB120557 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 2809 VIA CLAREZ CBAD PME Status: ISSUED 03/30/2012 LSM 03/30/2012 03/30/2012 Parcel No: 1673100500 Lot#: 0 Applied: Reference #: PC#: Project Title: FRONC RES-REPLACE FURNACE Applicant: JOHN HUBBARD 2853 ROOSEVELT ST CARLSBAD CA 92008 760-271-5095 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES Entered By: Plan Approved: Issued: Inspect Area: Owner: FRONC H DONALD&MARY ANN L 847 SEMINARY CIR GLEN ELLYN IL 60137 $0.00 $0.00 $150.00 $0.00 $150.00 Total Fees: $150.00 Total Payments To Date: $150.00 Balance Due: Inspector: Date: :>pROVAL •/{,. (2-Clearance: ______ _ $0.00 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." YOL' 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 capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any «~~ Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718/ 2719 Plan Check No. {Jf> I d-0 S-S / ¥ CITY OF CARLSBAD JOB ADDRESS EXISTING USE PROPOSED USE Fax: 760-602-8558 www.carlsbadca.gov # BEDROOMS GARAGE (SF) ZIP q~ Est. Value Plan Ck. Deposit Date.;3 ~ {~ SWPP SUITE#/SPACE#/UNIT# APN # BATHROOMS TENANT BUSINESS NAME PATIOS (SF) DECKS (SF) FIREPLACE YES □#_ NOD APPLICANT NAME (Secondary Contact) ADDRESS CITY STATE PHONE FAX CONTRACTOR BUS. NAME ADDRESS CITY STATE PHONE FAX MAIL STATE UC.# CLASS AIR CONDITIONING YES O NO 0 ZIP ZIP CITY BUS. UC.# FIRE SPRINKLERS YES O NO 0 (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 !hat 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 five hundred dollars ($500)). Workers' Compensation Declaration: I hereby affirm under penally 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 petfonnance of the work for which this permit is issued. D I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the petformance of the work for which this permit is issued. My workers' compensation insurance earner and policy number are: Insurance Co. ______________________ Policy No. _______________ Expiration Date _________ _ This section need not be completed if the permit is for one hundred dollars (SHlO) or less. D Certificate of Exemption: I certify that in the petformance 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 (&100,000), In addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. ,R5 CONTRACTOR SIGNATURE □AGENT DATE I heybY affirm that I am exempt from Contractor's Ucense Law for the following reason: r, 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), □ 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). □ 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 □ Yes D No 2. I (have I 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 I contractors' license number): . I to prov e s of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / address/ phone/ contractors' license number): ·11 ovide s me o he ork, but I have contracted (hired) the following persons to provide the work indicated (include name I address/ phone/ type of work): DATE ~ ~ I 2..-- 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? □ Yes □ No Is the applicant or future building occupant required to obtain a penmit from the air pollution control district or air quality management district? □ Yes □ No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ Yes □ 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. of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Address I certify1hat I have read 1he application and state 1hat the above infonmation is conectand that 1he infonmation on the plans is accurate. I agree to complywi1h all Cltyortlinances and State laws relating to building construction. I hereby authorize representative of the Cily of Carlsbad to enter upon the above mentioned property bf 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 Cl1Y IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: AA OSHA penm! is required tr excavations over S'O' deep and demolition or oonstruction of slructures over 3 stories in height. EXPIRA TON: Eve penmit issued by the au· ing .underthe provisions of this Code shall expire by limijation and become null and void ff the building or v.orl< authorizec by such penmit is not oommenced withri 180 days the t of such:!J.plalllllij,9-jj~btltiliiiiQ.or v.ork authorized by such penm! is suspended or abandoned at any time after the v.orl< is oommenced bf a period of 180 days (Section 106.4.4 Unifonm Buildng Code). ~APP DATE STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. CERTIFICATE OF OCCUPANCY fCommercial ProJects on I y I Fax (760) 602-8560, Email www.building@carlsbadca.gov or Mail the completed form to City of Carlsbad. Building Division 1635 Faraday Avenue, Carlsbad, California 92008. I CO#: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY STATE ZIP Carlsbad CA PHONE I FAX EMAIL OCCUPANT'S BUS. LIC. No. DELIVERY OPTIONS □ PICKUP: o CONTACT (Listed above) o OCCUPANT (Listed above) o CONTRACTOR (On Pg. 1) o ASSOCIATED CB# ·-------□ MAIL TO: o CONTACT (Listed above) o OCCUPANT (Listed above) o CONTRACTOR (On Pg. 1) o NO CHANGE IN USE/ NO CONSTRUCTION D MAIL/ FAX TO OTHER: □ CHANGE OF USE/ NO CONSTRUCTION ~ APPLICANT'S SIGNATURE DATE City of Carlsbad Bldg Inspection Request For: 04/16/2012 Permit# CB120557 Title: FRONC RES-REPLACE FURNACE Description: Type: PME Sub Type: Job Address: Suite: Location: 2809 VIA CLAREZ Lot: 0 OWNER FRONC H DONALD&MARYANN L Owner: FRONC H DONALD&MARYANN L Remarks: call with your ETA Total Time: CD Description Act Comments Inspector Assignment: Phone: 7608011149 lnspecto#L Requested By: DON HUBBAERD Entered By: CHRISTINE 43 AirCond/Furnace Set ¾f-f , ,J A--v Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# Inspection History Date Description Act lnsp Comments