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Home My WebLink About1310 CHUPAROSA WAY; ; CB961100; PermitBUILDING PERMIT Permit No CB961100 06/17/96 14 00 Project No A9601570 Page 1 of 1 Development No Job Address 1310 CHUPAROSA WY Suite Permit Type MECHANICAL Parcel No 156-110-53-00 Lot# Valuation 0 Construction Type NEW Occupancy Gz-oup Reference* Status ISSUED Description INSTALL 36000 BTU A/C-W/ ELECT Applied 06/17/96 ADD 30 AMP CIRC Apr/Issue 06/17/96 Entered By RMA Appl/Ownr M A LEWIS HEATING & AIR COND 619-561-9205 P O BOX 754 LEMON GROVE CA 91946 **-< Fees Required Fees Adjustments Total Fees =___._._7~ Enter 'Y' for Mechaiiia^-Pss" Install Furn/Ducts/ftefft~-Pjlirap Each Install/Reloc l/vfdt f) Other v * * MECHANICAL TOTAL 00 00 49 00 Ext fee DataFee description INCOrtPORATED / 1952 49-00 15 00 Y 9 00 4 50 20 00 ELECT PERM 49 00 CITY OF CARLSBAD 2075 Las Palmas Dr , Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION City of Carlsbad Building Department 2075 Las Palmas Dr , Carlsbad, CA 92009 (619) 438-1161 1 PERMIT TYPE From List 1 (see back) give code of Permit Type For Residential Proiects Only From List 2 (see back) give Code of Structure Type Net Loss/Gain of Dwelling Units PLAN CHECK NO EST VAL PLAN CK DEPOSIT. VALID BY I DATE 2. PROJECT INFORMATION FOR OFFICE USE ONLY Add Building or Suite No Street LEGAL DESCRIPTION Lot No Subdivision Name/Number Unit No Phase No CHECK BELOW IF SUBMITTED D 2 Energy Calcs D 2 Structural Calcs D 2 Soils Report D1 Addressed Envelope ^ASSESSOR S PARCEL EXISTING USE DESCRIPTIONOFWORK rc* FT AC- ~7V /£y/£r/*/( ^^fU— V *# OF STORIES 34.66^ &TV # OF BEDROOMS # OF BATHROOMS J UUN IALI HhKMJN (.it ditlerent from applicant NAME (last name first) A^T£f /» S CITY *g^U STATE ADDRESS ZIP CODE 4 APPLICANT .^CONTRACTOR — D AGEN'l' FO NAME (last name first) NTRACTOR — DOWNER ADDRESS £>£> „ && ZlPCODE^/9^6^ DAY TELEPHONE ^£>/ 9 2~O 3~ D AGENT WR OWNER STATE CM DAY TELEPHONE 5 PROPERTY OWNER NAME (last name first) CITY STATE ADDRESS J^l O ZIP CODE 7!2-&0 y DAY TELEPHONE 7-2*7- 6 CONTRACTOR NAME (last name first) CITY . /? . STATE STATE LIC # ZIP CODE LICENSE CLASS ADDRESS *» ¥ <=» DAY TELEPHONE NAMt (last name lirst)ADDRESS 7 WORKERS COMPENSATION Z1PCODE<9|9'V (o PAY TELEPHONE Workers7 Compensation Declaration I hereby amrm that I have a cerulicate or consent to self insure issued by the Director oi Industnal 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 (Section 3800, Lab C) INSURANCE COMPANY v*i POLICY NO DATE ? , Jj/9 Certificate oi Exemption I certify that in Jhe performance of the work tor whicn this permit is issueoTT shall not empleyany person in any manner so as to become subject to the Workers' Compensation Laws of California SIGNATURE DATE 8 OWNER BUILDER DECLARATION uwner Builder Declaration I hereby atrirm that 1 am exempt trom tne Contractors License Law tor tne lollowing reason D 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 ) D 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) D I am exempt under Section Business and Professions Code for this reason (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, commencing 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 applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500]) SIGNATURE DATE COMPLETE THIS SECTION FOR NON RESIDENTIAL BUILDING PERMITS ONLY Is the applicant or future building occupant required to submit a business plan acutely hazardous matenals registration form or nsk management and prevention program under Sections 25505, 25533 or 25534 of the Presley Tanner Hazardous Substance Account Act? D YES D NO Is the applicant or future building occupant required to obtain a permit from the air pollution control distnct or air quality management district? D YES D 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 AFTER JULY 1,1989 UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT 9 CONSTRUCTION LENDING AGENCY 1 hereby atlirm tliat there is a construction lending agency tor the performance ot the work tor which this permit is issued (Sec 3097(0 Civil Code) LENDER S NAME LENDERS ADDRESS 1O AHPJJCANl ChKliFICATlON 1 certify that I nave read tne application and state that the above mtormation is correct 1 agree to comply with all City ordinances and State laws relating to building construction I hereby authonze 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 WIDCH MAY IN ANY WAY ACCRUE AGAINST SATO CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT OSHA. An OSHA permit is required for excavations over 5 0' deep and demolition or construction of structures over 3 stones in height Expiration Every permit issued by the Buildin building or work authorized by such such permit is suspended or aband APPLICANT'S SIGNATURE nder the provisions of this Code shall expire by limitation and become null and void if the ' within 365 days from the date of such permit or if the building or work authonzed by the work is commenced for a period of 180 days (Section 303 (d) Uniform Building ffiodsQy DATE ff?////7L*' WHITE File YELLOW Apphcant PINK. Finance CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB961100 FOR 06/25/96 INSPECTOR AREA DESCRIPTION: INSTALL 36000 BTU A/C-W/ ELECT PLANCK* CB961100 ADD 30 AMP CIRC OCC GRP TYPE MECH CONSTR. TYPE NEW JOB ADDRESS: 1310 CHUPAROSA WY STE LOT APPLICANT: M.A LEWIS HEATING & AIR COND PHONE: 619-561-9205 CONTRACTOR* PHONE OWNER- PHONE REMARKS MW/JACK/729-5726 INSPECTOR SPECIAL INSTRUCT TOTAL TIME: —RELATED PERMITS— PERMIT* TYPE STATUS CB961113 PLUM ISSUED CD LVL DESCRIPTION ACT COMMENTS 49 ME Final Mechanical ***** INSPECTION HISTORY ***** DATE DESCRIPTION ACT INSP COMMENTS City of Carlsbad Building Department WORKERS' COMPENSATION DECLARATION I 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 is issued I have and will maintain workers' compensation, as required by 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 policy number are INSURANCE COMPANY '7 POLICY NO Cotys-?/ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED 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 Date 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), m 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 2075 Las Palmas Dr • Carlsbad CA 92009-1576 - (619) 438-1161 • FAX (619) 438-0894 ACORlfc. CERTIFICATE OF INSURANCE V % ISSUE DATE (MM/DO/TY) 06/27/95 ~ THE INSURANCE STORE INC - < * SAN DIEGO CA 92120-1198 \ ^i,f NSURED M A LEWIS HEATING & AIR CONDITIONING PO BOX 0754 LEMON GROVE CA 91946 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 %Hfi£" A CALIF COMPENSATION INS CO ( i COMPANY p LETTER D COMPANY f* LETTER ° COMPANY n LETTER u COMPANY p LETTER c THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY 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 TYPE OF M8URANCE GENERAL LJABUTY COMMERCIAL GENERAL LIABILITY CLAIMS MADE OCCUR OWNERS & CONTRACTOR'S PROT AUTOMOBLE UABLTTY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HRED AUTOS NON-OWNED AUTOS OARAOE LIABILITY EXCESS LMBUTY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND EMPLOYERS'UABUTY OTHER POUCY NUMBER POLICY EFFECTIVE DATE (MM/DD/TY) POUCY EXPRATON DATE (MM/DD/YY)UMTS GENERAL AGGREGATE I PRODOCTS-COMPADP AGO $ PERSONAL & ADV MJURY f EACH OCCURRENCE $ FIRE DAMAGE (Any ona fte) $ MED EXPENSE (Any on* ptnon) $ COMBINED SINGLE LIMIT * BOOLY MJURY (PW pawn) * BODLY MJURY (PwacddwO * PROPERTY DAMAGE I EACH OCCURRENCE I AGGREGATE W95-7I8839 07/01/95 07/01/96 STATUTORY LIMITS EACH ACCIDENT I DISEASE POUCY UMIT « DISEASE EACH EMPLOYEE f 1000000 1000000 1000000 JESCHIPnON OF OPERATIONSAJOCATIONSNEHICLESySPECML ITEMS \LL OPERATIONS OF THE NAMED INSURED EN DAY NOTICE OF CANCELLATION IN THE EVENT OF NON-PAYMENT OF PREMIUM OR NON-REPORTING OF PAYROLL COUNTY OF SAN DIEGO 5201RUFFINRD STE B SAN DIEGO CA 92123 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF AMYyiNO U»ON/THE COMPANY ITS AGENTS OR REPRESENTATIVES / / / //X / /.< . AUTHORIZED COHPOMTtOK 1«0 CIN