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Home My WebLink About1085 CHINQUAPIN AVE; ; CB051109; Permit03 29 2005 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Mechanical Permit Permit No CB051109 Building Inspection Request Line (760) 602 2725 Job Address Permit Type Parcel No Valuation Reference # Project Title 1085 CHINQUAPIN AV CBAD MECH 2061204000 $000 OLSENRES REPLACE FAU Lot* Status ISSUED Applied 03/29/2005 Entered By LSM Plan Approved 03/29/2005 Issued 03/29/2005 Inspect Area Applicant ARS STE 100 6162 NANCY RIDGE DR SAN DIEGO CA 92121 858 677 5455 Owner OLSEN KATHLEEN E 30247 CHIHUAHUA VALLEY RD WARNER SPRINGS CA 92086 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 1 0 0 0 0 0 $1500 $900 $000 $000 $000 $000 $000 $000 $000 $2400 Total Fees $24 00 Total Payments To Date $0 00 Balance Due $2400 03/J9/05 OC02 01 CGF 02 Inspector FINAL APPROVAL Date $Clearance 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 prxessmg 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 fees/exactions of which vou have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave Carlsbad CA 92008 FOR OFFICE USE ONLY PLAN CHECK NO (At& > EST VAL Plan Ck Deposit. Validated By Date Address (include Bldg/Suite #) Legal Description Assessor's Paisel # /7 A/JZ/yV^ & Description of Work Business Name (at this address) Lot No , ^-Subdivision Name/Number Unit No Phase No i Existing Use Proposed Use 2fiY4&e \ SO FT #of Stories # of Bedrooms Total # of units # of Bathrooms liOjfrACTJlllQN «f#ittere1«%6m applicant) Name mtraotirJ Address ntra City l^ner < D Age!; for^Owner " State/Zip Telephone #Fax # Name Address City State/Zip Telephone OWNER5 Name Address T , City (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 £pde] or thatr^ie is exempt therefrom and the pasis for the alleged exernjjftioirt /(ny violation of Section 7^?1 $ byeny applicant/^/^srlr^s^bjec/sAhejappJicannola civjf-perfllty of/f0t/rnoi|e-tha/i five on 7000 of D fJilT Name State License # Address License Class City State/Zip t City Business License # Address City State/Zip Telephone s fees »f Designer Name State License # 6 WORKERS COMPENSATION Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations (~1 | 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 'Dlx I have and will maintain workers compensation as required by Section 3700 of the Labor Code,ior the performance of the work for whjch_this permit is issued My worker s irf!bi»U)ei1featipjwrisuVance carrier! aro(Tpilirfv\rnjmber are O//I/9//7 \yf ^"1-^-/^) I Insurance Company J I \fl\r7~!f] IA _//! I Policy No /^ iV/C>iV ' / \ Expiration Date_ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) 0 CERTIFICATE O^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 worker* comperaiatiD^i coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (Wl OffpbprLffljaddition to ttuwtwt if/conipepsation damages as provided for in Section 3706 of the LabO) q SIGNATURE V^ \_ UJ\K,.sf~\/^ ^V ' \^A^-^~ DATE 1 hereby affirm that I am exempt from the Contractor s License Law for the following reason l~] 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) [U 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. 4 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? fj 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? CH YES O NO Is the facility to be constructed within 1 000 feet of the outer boundary of a school site? D YES |~l 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 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 30970) Civil Code) LENDER S ADDRESSLENDER S NAME 9 APPLICANT* CiRtlFlcAflSN r * " i , * ^ •' •'•' -W ' -^xft. ', .&. 'WW .«** *T " " 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 JUDGMENTS COSTS AND EXPENSES-A/VrflCH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT OSHA An OSHA permit is required/or excavations over 5 0 deep and demolition or construction of structures over 3 stories in height EXPIRATION Every permit issihdby the builffling 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 cbrflmenced wittim 180 days from the date oSsuchpermit or if the building or work authorized by such permit is suspended or abandoned at any tim after the work is comr^8Yice/l7o/%4f*fi)>d of 180 days (§i$foji/<r v6./'47jniform Building Code) APPLICA IT S SIGNATURE DATE WHITE File YELLOW Applicant PINK Finance City of Carlsbad Bldg Inspection Request For 05/09/2005 Permit* CB051109 Title OLSEN RES REPLACE FAU Description Inspector Assignment 1085 CHINQUAPIN AV Lot 0 Type MECH Sub Type Job Address Suite Location APPLICANT ARS Owner OLSEN KATHLEEN E Remarks Phone 7608 Inspeci Total Time CD Description 43 AirCond/Furnace Set Act .-Comment Requested By STEPHANIE Entered By CHRISTINE Associated PCRs/CVs Inspection History Date Description Act Insp Comments MEMORANDUM OF INSURANCE 11/15/04 PRODUCER <\ON RISk SERVICES INC OF ILLINOIS AON CENTER 200 EAST RANDOLPH STREET CHICAGO ILLINOIS 60601 D/B/A A R kl r i S -v ot III CA L e eff0095O INSURED Amcncin Rcbiduilnl S mces LLC iS. Additional Entities Listed B THIS MEMORANDUM IS A MATTER OF IMFORMATION ONLY THIS MEMORANDUM DOES NOT \MEISD EXTEND OR \LTER THE COVERAGES AFFORDED B\ THE POLICIES iELOtt CO1MP4NIE 1 FORDIiNG COVERAGE COMPANY V Zuich Amciic nil u n (. i| inv COMPANY B low COMPANY C COMPANY D COVERAGES NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF WY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHIC H THIS CERTIFICATE MAY BE ISSUED OR MA\ PERTAIN THE INSURANCE AFFORDED BY THE POL1CICS DESCRJBED HEREIN IS SUBJECT TO ALL TIIC TCRMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS CO LTR A A A A B A TYPE OF INSURANCE CCNERAL LIABILm COMMERCIAL CCNERAL LIABILITY OCCURRENCE AUTOMOBILE LIABILITY ANY AUTO GARAGE LIABILITY CXCESS LIABILITY UMBRELLA FORM WORKERS COMP V EMPLOYER S I IABILITS THE PROPRIETOR/ PARTNERS/ EXECUTIVE OFFICERS ARE INCLUDED PROPERTY POLICY NUMBER GLO 293 8645 01 BAP29386460I (AOS) BAP2938647 01 (VA) TAP2938648 01 (TX) See attached for evidence of coverage WC-OW43 01 (AOS) POLICY ECTECT1VE DATE (MM/DD/YY) 04/0 IP 004 04/OJP004 01/01/200 1OLIC\ EXPIRATION DATEfMM/DDAI/) 01/01/2006 )I/OI/->OU Ol/OI/200f LIMITS ( CNCRAL AGGREGATE 1 1 ODIKTS COMP/OP AGO 1 1 1 SONAL S. ADV INJURY 1 til OCCURRENCE 1 11 C DAMAGE ( y t ) II D L\l 1 I ) ( MMBINED SINGLE LIMIT 1 ODILY INIURY (1 1 ) UUDILY INIURY ll It) 1 ROPERTY DAMAGE \UTOONU ( h It) ) fl IER THAN AUTO ONLY 1 \LII ACCIDENT ( r RFCATP 1 l II OCCURRENCE M ( TLCUC WC St tut -v 1 ts 1 LEACH ACCIDENT i ; niscASC POLICY LIMIT 1 L DISCASC EA EMPLOYEE $5 000 000 Included in Above $3 000 000 $3 000 000 •SI 000000 $5000 $5 000 000 SI 000000 SI 000000 S 1 000 000 Tl M n 1 1 n tt t t tl lyt itl z d \ sf th t lu ly 1 t i,ht p v w t H M n cl n TI M n ra du lo t i 1 I 1 It th rglrblblwTIM 1 n v ly b p 1 | t 1 1 1 t b t 1 tl ll 1 Inylyb ddwdby tl 1 w t t t -n 1 A y tl 1 pi 1 t b t HI M n 1 tl t tl t t A Rl 1 S ~v | 1 b t 1 A th d w h II nea n t ty p 11 uth zed by tl s 1 n 1 h t tl VI 1 A 1 Th f i t t II 1 li d t t IT d t b A R k S -v 1 11 1 I bl t, t t p 1 t It t Tli M monnlin otlnsn ncc serves solely to IIM msvmncc policies limits ind htcs ot COVCIILC Any modihc ti n hciu c ot uithonzcd