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Home My WebLink About1810 FOREST AVE; ; CB013712; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 11-30-2001 Mechanical Permit Permit No: CB013712 Building Inspection Request Line (760) 602-2725 Job Address: 1810 FOREST AV CBAD Permit Type: MECH Parcel No: 1562704700 Valuation: $0.00 Reference #: Project Title: DELOACH RES/ NEW FAU Applicant: ASI HASTINGS 1250 GREENFIELD DR EL CAJON, CA 92167 619-223-9016 Status: ISSUED Lot#: 0 Applied: 11/30/2001 Entered By: CB Plan Approved: 11/30/2001 Issued: 11/30/2001 Inspect Area: Owner: DELOACH JOHN M&SHERRY L 1810 FOREST AVE CARLSBAD CA 92008 5661 11/30/01 0002 01 CGP Total Fees: $24.00 Total Payments To Date: $0.00 Balance Due: $24.00 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 Inspector: 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 ( .. ·~ ,, :;)~RED PERr-~;T i .:,s EXPIRED IN ACCORDANCE WiTH U.B.C. . ·' 10·· 4 4 , . , ,Ai \), • FINAL APPROVAL Date: Clearance: NOTICE: Please take NOTICE that approval of your project includes the ~1mpositionn 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 capactiy 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 nreviouslv been niven a NOTICE similar to this or as to which the statute of limitations has oreviousl" otherwise exnired. 02 24-00 FOR OFFICE USE ONLY PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 PLAN CHECK NO L,fk? /37 {.9, EST. VAL,.---------- Plan Ck. Deposit--------- Validated By_3111c:.f?o=:::l.c::::..,_ _____ _ Date II-30:o( Address (include Bldg/Suite #) Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel II/ h Sta// F JrO Existing Use Proposed Use Description of Work SQ. FT. #of Stories # of Bedrooms II of Bathrooms 2. CONTACT PERSON (It dlff•rent'from •ppll1:11nt) Name Address 3. APPLI~ Ir/}~. Co(;,:o~)~!AgeO~~~ntrat;)p·owner Name Address PROPJRX OWNER.,.. I ' J ' ! Vo It v ~ IO QU1 -~-;, ~0 ,; '·.··;~.~ . lito Forest A-v-t. 4. Name Address 5. ··CONTRACTOR· COMPANY NAME· City O~·for Owner City c~ ",,y /t,i/ City State/Zip Telephone II Fax II 9.i/(7 ~ff/~ f 'll 9ttt' State/Zip Telephone II . 7](106 7ta l(J~ t-j(P/ State/Zip Telephone II (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 Code! or that he is exempt therefrom, and the basis for the alleged exemption. Any tolation ofJ:/t; ;03 ~5 by any iuot fo;,;.;e;;;;ub c~rJ app;cant t~ tcen~lt~ not r°~e ;~£ re ~"/t d~'?H :00~3 ,,a Name Address City State/Zip :::tt II ) _1 State License II License Class C. f 01 J J.I J' City Business License# ~OQt:)_g:r '-ft/ ,~ -()2.,.- Designer Name Address City State/Zip Telephone State License II ---------- 6. WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 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 have and will maintain workers' compensation, as reQuireq .by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My worker's compensation insur1nce carrier and policy number are : Insurance Company z (/ r I t,..h Policy No. ____________ _ Expiration Date, _______ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1$100) OR LESS) 0 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, end shell subject en employer to criminal penalties end civil fines up to one hundred thousand dollars ,000), in add~n t the coat of compensation, damages as provided for in Section 3706 of the ~e~r JtO~e...JnJ-r,st and attorney's fees. SIGNATURE _, d . DATE f / ~ -----------7. OWNER-BUILDER OECLARA TION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: 0 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). 0 I, as owner of the property, am exclusively contracting w ith 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, end contracts for such projects with contrector(sl licensed pursuant to the Contractor's License Law). 0 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. 0 YES ONO 2. I (have I have notl 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 I address I 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 I 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----------------------- COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS .ONLY 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? 0 YES O NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air Quality management district? 0 YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES O 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 ANO THE AIR POLLUTION CONTROL DISTRICT. '.8. ' 'CONSTRUCTION LENOING:A_GENC:r,,::,_, ....... ,:· ;,, ·7 ~·,,,··1··-~· .. : .... .-,t• ~,:,·,, . ,,,,, C ,. I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097h) Civil Code). LENDER'S NAME--------------LENDER'S ADDRESS------------------------- (9. . .APPLICANT 'CERTIFICATION •. ,,: ... ~.!\.. .t, i , ,_,:.:j;,l~J"~~~..;~r-:;r-: .. \.-: ,,.,~~;/i: .. ~-~,.,..J~1:;~·::\~ :!~::.:~:;~,-~.~,; I certify that I hav~ read the application and state that the above information is correct end 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 Citt of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE. INDEMNIFY ANO 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 end 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 5 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 in~ is comm~ period of 180 days (Section 106.4.4 Uniform Building Code). //-J (} -o J APPLICANT'S SIGNATURE ~ DATE ----=:...._ _______ _ YELLOW: Applicant PINK: Finance