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Home My WebLink About2817 VIA PAJARO; ; CB071438; PermitCity of Carlsbad .. > 1635 Faraday Av Carlsbad, CA 92008 05-24-2c!o1 Mechanical Permit Permit No: CB071438 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: Applicant: 2817 VIA PAJARO CBAD MECH 1673300900 Lot #: $0.00 GOSS RES-REPLACE FURNACE & A/C NO ELECT/DUCTS 0 Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ACTION AIR COND.& HEATING-S.D. GOSS GLENN F&JACQUEL YN A 2517 BS. SANTA FE VISTA,, CA 92083 619-727-41 52 Mechanical Issue Fee Install/Furn/Ducts/Heat Pumps Fee Fireplace Installation Fee Exhaust Fan Fee Installation/Relocation Vent Fee Hood Fee Boiler/Compressor to 15HP Fee Other Additional Fees TOTAL PERMIT FEES 2 0 0 0 0 0 2817 VIA PAJARO CARLSBAD CA 92010 Total Fees: $33.00 Total Payments To Date: $33.00 Balance Due: FINAL AZR%AL Date: v l'fJ o 7 Clearance: ISSUED 05/24/2007 RMA 05/24/2007 05/24/2007 $15.00 $18.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $33.00 $0.00 NOTICE: Please take NOTIC 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 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 f PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 Address (include Bldg/Suite #) Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Assessor's Parcel # Existing Use SQ. FT. J-/C"": Jv ~ Zoto 3. Name 4:-TPERTY OWNER . , / ~· G!22 Goss llY1 //Id _Jdm Name Address City State/Zip 5. CONTRACTOR -COMPANY NAME FOR OFFICE USE ON~ PLAN CHECK NO. ClJo 7/L/Jf EST. VAL. __________ _ Plan Ck. Deposit __ __,._,__ _____ _ Validated By ~----H~T1------ Date _ __._,__,__,~....:::,ir+-.1,,£----+------ Phase No. Total# of units Proposed Use Telephone# Fax# Telephone# 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 pP,licant for a permit subjects h applicant to a civil penalty of not mo e than five undred dollars [$5 OJ). • s Sd State License# ,)OCj fuS" Designer Name Address City State/Zip Telephone# State License# ________ _ 6. WORKER'S COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 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 h this permit is issued. have and will maintain worker's 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 insurnw ca~er anq policy n~blr are: Insurance Companv fa}j . Ce::n,-\'('r~.:¼[~ J,\J':\;uX>lk PolicyNo.,jo-1..-4,gj:S· 0 \B Expiration Date /2 -3/-OB (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) □ 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. e orkers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand lf'!ll~!ll~~~~-~"'!'O'"Pensatlon, damages are provided for in Section 3706 of the Labor Code, Interest and attorney's fees. DATE_• ________ _ 7. I hereby affirm that I am exempt from the Contractor's License Law for the following reason: □ I, as owner of the property or my employees with wages as their sole compensation, will d 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/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 I address I phone number / contractors license number): 4. I plan to provide portions of the work. but I have hired the f llowing person to coordinate, supervise and provide the major work (include name / address / phone number/ /ontractors license number): I 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 ____________ _ PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 Page 2 of 2 COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY Is the applicant or future building occupant required to submit a business plan. acutely hazardous materials registration for 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 permit 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? 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 POLLUTION CONTROL DISTRICT. 8. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construclion lending agency for the performance of the work for which this permit is issued (Sec. 3097(1) Civil Code). LENDER'S NAME ___________________ _ LENDER'S ADDRESS ____________________ _ 9. APPLICANT CERTIFICATION 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, JUDGEMENTS, 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 of 5'0" deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the buildin 1cial 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 180 fro the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced for a period of 06.4.4 Uniform Building Code}. APPLICANT'S SIGNA City of Carlsbad Bldg Inspection Request For: 06/13/2007 Permit# CB071438 Title: GOSS RES-REPLACE FURNACE & A/C Description: NO ELECT/DUCTS Type: MECH Sub Type: Job Address: Suite: 2817 VIA PAJARO Lot: 0 Inspector Assignment: t Phone: 7607309754 Location: Inspector: OWNER GOSS GLENN F&JACQUEL YN A Owner: GOSS GLENN F&JACQUEL YN A Remarks: Total Time: CD Description Act Comments 43 ---- Requested By: GLEN GOSS tered By: CHRISTINE AirCond/Furnace Set -A:x#- ---~ ----- Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act lnsp Comments