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Home My WebLink About1295 CYNTHIA LN; ; CB112111; Permit10-03-2011 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No: CB112111 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: 1295 CYNTHIA LNCBAD PME . 1562310900 Lot#: MOLDOVAN RES- REPLACE FAU Status: ISSUED Applied: 10/03/2011 Entered By: RMA Plan Approved: 10/03/2011 Issued: 10/03/2011 Inspect Area: Applicant: MOLDOVAN MATTHEW&TIMBERLAKE JAYME 1295 CYNTHIA LN CARLSBAD CA 92008 Owner: MOLDOVAN MATTHEW&TIMBERLAKE JAYME 1295 CYNTHIA LN CARLSBAD CA 92008 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES $0.00 $0.00 $150.00 $0.00 $150.00 Total Fees:$150.00 Total Payments To Date:$150.00 Balance Due:$0.00 Inspector: FINAL APPROVAL Date: [* PR (Clearance: NOTICE: Please take NOTICE thafapproval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. J$.<|f Building Permit A $*£' 1635 Faraday Ave., Car\sbXT' CITY OF 760-602-2717/271? /""ADI CD A Pi Fax 760-602-85 V-> /* l\ l_ <3 D/% L/ www.carlsbadca.c JOB ADDRESS 1295 Cynthia Lane CT/PROJECT* LOT* PHASE # # OF UNITS 16 1 DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) Installed furnace in existing furnace space EXISTING USE PROPOSED USE Owner Occupied N/A # BEDROOMS 3 KH||MUA» Plan Check No. l/H | ( '(/ ( | (pplication ** ad, CA 92008 Est. Value / 971 Q Kn * Plan Ck. Depositr>H l\ , °v /4 Date //)/?// / swppp SUITE#/SPACE#/UNIT# \ APN ' 156 - 231 - 09 - 00 * BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP 2 . A furnace was not installed in the home when it was purchased. GARAGE (SF) 441 APPLICANT NAME (Primary Contact) .. ... ,.Matthew moldovan ADDRESS 1295 Cynthia Lane CITY STATE ZIP Carlsbad CA 92008 PHONE FAX (858) 947-8250 EMAIL mmotdovan@jmail.com PROPERTY OWNER NAME .. ... .. , ,Matthew Moldovan ADDRESS 1295 Cynthia Lane CITY STATE ZIP Carlsbad CA 92008 PHONE FAX (858) 947-8250 EMAIL mmofdovan@jmil.com ARCH/DESIGNER NAME & ADDRESS STATE LIC. # PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS YES[7]# 1 NOT~1 YESQ]NO[7] YES[~~|NOr71 APPLICANT NAME (Secondary Contact; ADDRESS CITY STATE ZIP PHONE FAX EMAIL CONTRACTOR BUS. NAME ADDRESS CITY STATE ZIP PHONE FAX EMAIL STATE LIO.# CLASS CITY BUS. LIC.# (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 theapplicant 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 theBusiness and Professions Code) or that 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 acivil penalty of not more than five hundred dollars ($500)). Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: I 11 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. I 11 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 workers' compensation insurance carrier and policy number are: Insurance Co _. Policy No..Expiration Date _ This section need not be completed if the permit is for one hundred dollars ($100) or less. [/[ Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. £$ CONTRACTOR SIGNATURE L~]AGENT DATE / hereby affirm that I am exempt from Contractor's License Law for the following reason: ["/] 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 sate). I | 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). |7| !am exempt under Section Business and Professions Code for this reason: 1.1 personally plan to provide the major labor and materials for construction of the proposed property improvement. I lYes I iNo 2.1 (have / have not) signed an application for a building permit for the proposed work. 3.1 have contracted with the following person (firm) to provide the proposed construction (include name address / phone / contractors' license number): 4.1 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 / contractors' license number): 5.1 will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone / type of work): .^PROPERTY OWNER SIGNATURE 0AGENT DATE 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 QNO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or airouality management district? L_Kes I I No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? I lyes I I No EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address tjngto building construction. I hereby authorize representative 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 OSHA: An OSHA permit is required for excavations over SO1 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 within 180 days from 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 180 days (Section 106.4.4 Uniform Building Code).n j >£f APPLICANT'S SIGNATURE -L /III , —— DATE City of Carlsbad Bldg Inspection Request For: 10/04/2011 Permit# CB112111 Inspector Assignment: Title: MOLDOVAN RES- REPLACE FAU Description: Type: PME Sub Type: Phone: 8589478250 Job Address: 1295 CYNTHIA LN Suite: Lot: 0 Location: Inspector: OWNER MOLDOVAN MATTHEW&TIMBERLAKE JAYME Owner: MOLDOVAN MATTHEW&TIMBERLAKE JAYME Remarks: Total Time: Requested By: MATHEW Entered By: JANEAN CD Description Act^ Comments 44 Rough/Ducts/Dampers 49 Final Mechanical Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# Inspection History Date Description Act Insp Comments