HomeMy WebLinkAbout1578 BASSWOOD AVE; ; CB102397; Permit12-08-2010
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Mechanical Permit Permit No: CB102397
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Valuation:
Reference #:
PC#:
Project Title:
1578 BASSWOOD AV CBAD
MECH
2050603900
$0.00
Lot#:
BRIGGS RES-REPLACE FAU-SAME
LOCATION
Status: ISSUED
Applied: 12/08/2010
Entered By: RMA
Plan Approved: 12/08/2010
Issued: 12/08/2010
Inspect Area:
Applicant:
BEST SERVICE CO
STEJ
770 SYCAMORE AVE 92083
619-438-3989
Owner:
BRIGGS FAMILY TRUST 11-20-03
1578 BASSWOOD AVE
CARLSBAD CA 92008
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
$15.00
$9.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$24.00
Total Fees:$24,00 Total Payments To Date:$24.00 Balance Due:$0.00
Inspector:
FINAL APPROVAL
Date:Clearance:
NOTICE: Please take NOTICE mat approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively
referred to as lees/exactions." fou 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.
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CITY OF
r* ADI CD A Pi
V* f\ IX L*3 D/\ LJ
Building Permit Application
1635 Faraday Ave., Carlsbad, CA 92008
760-602-2717/2718/2719
Fax 760-602-8558
www.carlsbadca.gov
Plan Check No.
Est. Value
Plan Ck. Deposit
ate SWPPP
JOB ADDRESS SUITE#/SPACE#/UNIT#
CT/PROJECT*PHASE # # OF UNITS # BEDROOMS ft BATHROOMS TENANT BUSINESS NAME CONSTR.TYPE OCC. GROUP
DESCRIPTION OF WORK: Include Square Feet of Affected Area(s)
EXISTING USE PROPOSED USE GARAGE (SF)PATIOS (SF)DECKS (SF)FIREPLACE
Nd| |
AIR CONDITIONING
YES | JNO| |
FIRE SPRINKLERS
YESJ~|NO|~|
CONTACT NAME f/f Fom Applicant)APPLICANT NAME**<?*>£RESS ADDRESS
STATE ZIP CITY ZIP
&
PHONE FAX PHONE FAX
EMAIL EMAIL
PRO OWNER CONT OR BUS. NAME
ADDRESS ADDR .
Bl
CITY STATE ZIP CITY STATE
fa
FAX
ZIP
PHONE FAX PHONE
EMAIL EMAIL
ARCH/DESIGNER NAME & ADDRESS STATE 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 tp its issuance, also requSSstneapplicant 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: / hereby affirm under penalty of perjury one of the following declarations:
LJ I 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; sfletlfinneed 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.
^CONTRACTORSIGNATURE /JJ/y^e^^ * , £>. Ci nAGENT DATE S~2~I 0/1 O
/ 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 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).
I 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 |Yes I JNo
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):
j£f PROPERTY OWNER SIGNATURE QAGENT 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 I iNo
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air_guality management district? I JYes I 1 No
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? I JYes I JNo
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 if) Civil Code)
Lender's Name Lender's Address
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
AGAINST ALL LIABILITIES, JUDGMENTS, 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 over 5'0' 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
APPLICANT'S SIGNATURE V°ATE
- 8- /£>V7
City of Carlsbad Bldg Inspection Request
For: 12/10/2010
Permit* CB102397
Title: BRIGGS RES-REPLACE FAU-SAME
Description: LOCATION
Inspector Assignment:
1578 BASSWOODAV
Lot: 0
Type: MECH Sub Type:
Job Address:
Suite:
Location:
APPLICANT BEST SERVICE CO
Owner: BRIGGS FAMILY TRUST 11-20-03
Remarks:
Phone: 7607292650
Inspector:
Total Time:Requested By: FRED BRIGGS
Entered By: CHRISTINE
CD Description
43 AirCond/Furnace Set
Act Comments
Comments/Notices/Holds
Associated PCRs/CVs/SWPPPs Original PC#
Inspection History
Date Description Act Insp Comments