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HomeMy WebLinkAbout1307 CORVIDAE ST; ; CB961358; PermitBUT,L DING PERMIT Permit No. CB961358 07/26/96 11 04 ' Project No A96G1947 Page 1 of 1 Development No Job Address 1307 CORVIDAE ST Suite. Permit Type MECHANICAL ' 8?6j- 07/26/96 0001 0.1 02 Parcel No 215-690-02-00 Lot# Valuation 0 Occupancy Group Reference* Description INSTTALL 2-A/C UNITS Appl/Owrir TEAM MECHANICAL 1157 E MISSION RD FALLBROOK CA 92028 Construction Type- NEW Status ISSUED Applied 07/26/96 Apr/Issue 07/26/96 Entered By RMA 619-728-2213 *•<,* Fees Required **•*/. 'A- A Fees Collected & Credits * A * Fees 24.00 Adjustments . 00- Total Fees- 24.Of Fee desc.nption .• • "oral. Payments ;. . Balance Due: . Uri its Fee /Ur.i t 00 00 24 00 Ext fee Data Enter 'Y' for Mechanical Issue Fee> Install Furn/Ducts/Heat Pumps , > * MECHANICAL TOTAL 15. 00 Y 9 00 24 00 DATE t&L CITY OF CARLSBAD 2075 Las Palmas Dr , Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION City of Carlsbad Building Department 2075 Las PalMec Dr., Cartsbod, CA S20O9 (619) 438-11(51 From List 1 (see ba< k) give code of Permit-Type For Rfctidpnnal Projtvts Only From List 2 (see back) give Code of Structure Type __________________ Net Loss/Cain of Dwelling Umcs. PLAN CHECK NO.^> EST VAL PLAN <_X DEPOSIT , . VALID. BYDATE """tf/lf —'\L\^i-, — 2. PROJECT INFORMATION FOR OFFICE USE ONLY Address Nearest Cross Street building or SuiteNO 1307 CORVIDAE - CARLSBAD - CA - 92009 LEGAL DESCRIPTION u>t No subdivision Name/Number2 MARFIORE @ AVIARE Phase I WitCK BEUOW IF SUBMU ILL) D 2 Energy Calcs Q 2 Structural Calo D 2 Soils Report 01 Addressed Envelope ASSESSORS PABCCL PROPOeFr) 1ISP DESCRIPTION O? WO FT 5 # OF BATHROOMS (JUNIAWJ rctuAJn \\i Qiiiereni iron) applicant,) NAME (last name First) CITY STATE ADDRESS ZIP CODE DAY TELEPHONE 4 AmJUAHT ^EneUffl NAME (last nartfnBwjT rLNl rUK LUMKAUUft UOWhtrl Lj ._JHANICAL """"..^r.LBRQOK STATE CA ZIP CODE 9 ^ U ^ o DAY TELEPHONE RD. CITY ERTYOW KEESE, RICHARD ADDRESS 1307 COR57IDAE CITY CARLSBAD STATE CA ZIPCQDE 910 0 9 DAY TELEPHONE (619)603-5375 OtDNTRSCTOirNAME (last name first) ^ MEGHAN ICAL ADDRESS 1157 E. MISSION RD . CITY FALLBROOK STATE CA ZIP CODE 92028 DAY TELEPHONE (619)728-2213 STATEuc #56205SJCENSECLASS C-20_ <XHBUSINESSuci 12029 7 7 NAME uast nan CITY SI ATE ZIP CODE DAY TELEPHONE 'STATE LIC # 7 WORKERyOOMii'tNSATlOJr workers compensation Declaration i hereby atlirm mat l nave a ceruncateoi consent to self insure luued by ihPl . Relations, or a certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified • by the Director of the insurer thereof filed with the Building Inspection Department (Secoon WOO, Lab c) , - /. INSURANC-OOM^ #£ST INSURANC^UCVNO G95A125^82^^ WV - L^iTjiicatc or tjcemct so as to become sJbj SIGNATURE As H UWNhK BULLLJtHpSJ UWdci Builder O I as owner ofjl offered for sale onitl Im certiry mat in the performance ot ine worK tor wnich tm$ permit is uuucd, i shall not employ any person in any manner he Worker** Compensation Laws of Califormi T1ON Doflbdrauon i hertDy dtunn that i am exempt irom tne Uinu-dcLors ucense Uw ;oc Uie tollowmg re^ysn tV^owrTy or my employees with wages as their sole compensauon, will do the work and the structure is not intended or ;S& TO44, Business and Profession* Code The Contractor's License Uw 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 noi intended or offered lor 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 ) 1, as owner Of llle property, am exclusively contracting with licensed contractors to construct the project (Sec 7944, Business and Professions Cede The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projectswith eoniractarfc) licensed pursuant to the Contractor's License Law) I am exempt under Section ____^^_____ Buane» and Professions Code for this reason (Sec 7031 .5 Business and Professions Code Any City or County which requires a oermit to construct alter improve, demolish, or repair is licensed pursuant to the and Professions Code) . . ... . . applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars (SSOOl) SIGNATURE . DATE 1HU StL'llbiN f OK NON' RESIDENTIAL BUILDING PEHMl'fS ONLY is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or nsk management and prevention progiam under Sections 45505, 2S533 or 15534 of the Presley-Tanner Hazardous Substance Account Act? O YES D NO Ij the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management dismcrfD YES Q NO is the facility to be constructed Within 1,000 feet of the outer boundary of a school site?D YES D NO r ff ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED AFTER JMXl,19*9UNiESSTHKAtPIXMrT HAS MET OR IS MIETmCTm REQUIREMENTS OF THE OFFICE OF EMEROENCY'SERVICES AMD THE AfR TOLUmOH CONTROL DISTRICT i riereoy ariirm that uiere is a construction lending agency lor trie perrmance or tne wor or wnicn this permit b issued I LENDERS NAME LENDER'S ADDRESS -- - - i certiry tnat i lutvc read trie application ana sute tnat cne apove inlurmauon is correct agree o comply with aM city ordinances ana state laws relating to building construction 1 hereby authorize representative! of the City of Carlsbad to enter upon the above mentioned property for inspection purposes I ALSO AGRJ& TO SAVE INDEMNIFY AOT KEEP lURMX^ THE CTTY OF CAJU^ AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF TOE GRANTING OF THIS PERMIT OSIIA. An n<?HA permit is required for excavation* over 50" deep and demolition «r construction of nructurta over 3 stones in height Expiration Every permit issued by the j building or work authorized by such p such permit is suspended or abandon^ APPLICANTS SIGNATURE 1 under the provisions of this Code Shall expire by limitation and become null and void if the t commenced within 36S days from the date of such permit or if the building or work authorized by fftime after the work is commenced for a period of ISO days (Section 303{d) Uniform Bui''1 . DATE JE File YELLOW- Applicant PINK. Finance ' CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB961358 FOR 07/31/96 DESCRIPTION: INSTTALL 2-A/C UNITS TYPE: MECH JOB ADDRESS: 1307 CORVIDAE ST APPLICANT: TEAM MECHANICAL CONTRACTOR: OWNER: REMARKS: MW/728-3213 PHONE: PHONE: PHONE: INSPECTOR AREA PLANCK# CB961358 OCC GRP CONSTR. TYPE NEW STE: LOT: 619-728-2213 INSPECTOi SPECIAL INSTRUCT: NO YELLOW CARD/DIDNT COME IN MAIL/CAN INSP BRING ONE TOTAL TIME: CD LVL DESCRIPTION 49 ME Final Mechanical ACT COMMENTS DATE DESCRIPTION ***** INSPECTION HISTORY ***** ACT INSP COMMENTS City of _Carlsbad WORKERS' COMPENSATION DECLARATION \ hereby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self-insure for A, workers' compensation as provided by section 3700 of the Labor Code, for the performance of the work for which this permit 1$ issued. I have and will maintain workers' compensation, as required Dy section 3700 B. of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and poiicy number ere: INSURANCE COMPANY POLICY NO EXPIRATION DATE; POST INSURANCE G95A125782 10/1/96 (THIS SECTION NEED NOT 86 COMPLETED IF THE PERMIT IS FOR ONE HUMORED DOLLARS ($100) OR LESS) 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 •* C. workers compensation laws of California. Signature Warning: Failure to secure workers' compensation coverage is unlawful, and shall be 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. March 3, 1995 Las Palmas D«- « Carlsbad, CA 95009-1576 - (319) 438-nsi • FAX (619) 433-OS94 AGOIM. CERTIFICATE OF INSURANCE PRODUCER H '<• to n F CAL. TFORNTA P n -1 T n c! i" <? n c e Services " i S,". T o i" i" =t n c i? Blvd. T r, ;~ r? n c e . C ft 9 0 f. 0 1 INSURED F P =; rp topeh^nic*! Hasting and Ait- Conditioning 11 j 7 F . Mission R o R d F*l1brnak CA 92028 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE COMPANY . LETTER « COMPANY rj LETTER D COMPANY LETTER COMPANY LETTER COMPANY LETTER United Pacific Insurance Co. United Pacific I n s 1 1 r- T n r <= Co. C 3 1 i f o r n i * COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED, NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS COLTR TYPE OF INSURANCE POLICY NUMBER GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY CLAIMS MADEX OCCUR .< OWNER S & CONTRACTOR S PROT X PPi OED $1000 NSfll POLICY EFFECTIVE POLICY EXPIRATION DATE (MM/DD/YY) DATE (MM/DD/YY) 2/OJ/95 2/01/36 LIMITS AUTOMOBILE LIABILITY > ANY AUTO ALL OWNED AUTOS / SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS GARAGE LIABILITY ? / 0 I / 9'2/01 GENERAL AGGREGATE PRODUCTS COMP/OP AGG PERSONAL & ADV INJURY EACH OCCURRENCE FIRE DAMAGE (Any one lire) MED EXPENSE (Any one person) S COMBINED SINGLE , LIMIT * BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE * 2000000 * 2000000 * ]000000 * 1000000 s 5 Of-00 i o o o o 1 0 0 0 0 0 0 EXCESS LIABILITY UMBRELLA FORM OTHEP THAN UMBRELLA FORM WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY OTHER G95A1257R2 10/01 10/01 EACH OCCURRENCE $ AGGREGATE $ X STATUTORY LIMITS EACH ACCIDENT $ DISEASE-POLICY LIMIT $ DISEASE—EACH EMPLOYEE $ 1000000 1000000 1000000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS •'0 MY C'-iNC FXCFF'T NONPflY/NONRF FOR F TNG (IF PAYROll, WHTTH <TRT HOi DER IS ftDO'l IN5HRFO PER FORM CH2009 ftTTftTHEO, ! 3 R rj S F £C Tji ft u_ c ft |. IF f) R N I A OPERATIONS. CERTIFICATE HOLDER CANCELLATION 10 DAYS r A •< i ntf-w •'44 61 RTDRF ROUTE HIM.9, Cfl SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TOo A MAIL -:>v DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES AUTHORIZED REPRESENTATIVE ' ' ACORD 25-S (7/90)©ACORD CORPORATION 19901 -