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HomeMy WebLinkAbout2041 CUMBRE CT; ; CB060110; Permit01-12-2006 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Mechanical Permit Permit No CB060110 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Valuation Reference # Project Title 2041 CUMBRE CT CBAD MECH 2164912600 $000 Lot* STARR RES REPLACE EXISTING FAU Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 01/12/2006 KG 01/12/2006 01/12/2006 Applicant LEGEND SERVICE SUITE 15 2588 PROGRESS ST VISTA CA 92083 760-631-8397 Owner MANLEY NIELS&STARR 2041 CUMBRE CT CARLSBAD CA 92009 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 $1500 $900 $000 $000 $000 $000 $000 $000 $000 $2400 Total Fees $24 00 Total Payments To Date $24 00 Balance Due $000 PERMIT HAS EXPiRC-0 IN ACCORDANCE WfTH C B C. SECTION 106 4 4 AS AMENOhO BY C M C 18 04 030 Inspector FINAL APPROVAL Date Clearance NOTICE Please take NOTICE that approval 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 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 PROJECT INFORMATION FOR OFFICE USE ONLY PLAN CHECK EST VAL Plan Ck Deposit Validated By Date /-s Address (include Bldg/Suite #)Business Name (at this address) Legal Description Assessor's Parcel # Description of Work Lot No Subdivision Name/Number Existing Use SQ FT #of Stories Unit No Phase No Total tt of units Proposed Use tt of Bedrooms tt of Bathrooms 2 CONTACT PERSON (if different from applicant)U'&y c5o /J rp-i Name "~ ' Address ' ' " ' City 3" APPLICANT "^D'Cbntrajctpr ^ Agent for Contractor-- u O Owner Gj/Agent for Owner State/Zip fete &*)•&&? Telephone tt Fax tt Name 4 PROPERTY OWNER City State/Zip Telephone # '»::: " : Addr£ss City State/Zip Telephone #Name B.II CONTRACTOR • COMPANY NAME ;i , ,::... '- :jtt..: • Jfif, I! T:^M7;;:- . ... . 'H:i3/, •i- '««• "SL :-:^ (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 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]) Name State License #"70^ Address License Class City State/Zip City Business License # Telephone # Designer Name Address City State/Zip Telephone State License # 6- WORKERS' COMPENSATION ' v: . •.• : " " :""" ' " .. 5W|:r . . "'.'"<,; i: T: : J^l 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 workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued |w I 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 worker's compensation insurance carrier and policy number are Insurance Company 4Ssffl/'L£s~^l*^l > fJO/j^X^ Policy No^y^y^?^^^/o'a.X'~'^~JV^Expiration Date_ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) n 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,OOOM^£&ltjfaj!Kf<fthe cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney s fees SIGNATURE ^^^^^^ DATE 7. OWNERJ^KM^eCBoCRAS-ION;;: -•: ^-,r-- •• ,-*r ,T> •••- :. - :.£*> - .T* :: f " •-«;.-, J; I hereby a11\rr<ftb0r\am exempt from the Contractor's License Law for the following reason f~| 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) f~| 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 p'roperty who builds or improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law) |~l 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 C~l YES l~lNO 2 I (have / have not) 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 / address / 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 / 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 DATE •COMPLETE THIS SECTION fp* NON-RESIDENTIAL BUILDING PERMITS ONLY ; , " "^ ^ ,-, :5 ; '*".. " ':••,.... .,...,.. 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? O 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? l~l YES Q NO Is the facility to be constructed within 1 ,000 feet of the outer boundary of a school site? O YES Q 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 AND THE AIR POLLUTION CONTROL DISTRICT ;8V' " ::.C]SNSTRUe^ • • . J:::7!-:" i,":?"' • ",.'. " ' ': : ;. V . :<:;I, "",,„•• :': ••,. ' :"" I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(i) Civil Code) LENDER'S NAME _ LENDER S ADDRESS __ 'Sp- APPLICANT ClERflFICAf ION " • • - ' ;:":--" . '^''^ -^" . • " , ,„, "7. '^"..,-v "\. •:^""'\. •• I certify that I have read the application and state that the above information is correct and 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 CitV 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 stones in height EXPIRATION Every permit issued by the building Official under the provisions of this Code shall expne by limitation and become null and void if the building or work authorized by such permit is not commenced within 180 days frorruhe 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 per|M{x>fi8a<to*?(Section 106 4 4 Uniform Building Code) APPLICANT'S SIGNATURE DATE / WHITE File YELLOW Applicant PINK Finance AGQRR. CERTIFICATE OF LIABILITY INSURANCE oe/zt/zoos •WBWW (800)524-7024 FAX C«OO) 524-4013 Automatic Data Processing Insurance Agency, Inc 1 ADP Boulevard Rose! and, NJ 07068 WSUREO Legcml Service Center 1J84 Broken Hiich Rd Oc«ansid«, CA <tzO'I6-2236 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 INSURERS AFFORDING COVERAGE INSURER A- Employers Insurance Croup INSURER 8 INSURER & INSURER 0- INSURER e NAIC* COVERAGE'S THE POLICIES OF WSURAMCI!: JSTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING ANY REQU1HEMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE /FFOROED BY rH£ POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN M&Y HAVE BEEN REDUCED BY PAID CLAIMS nff A irrfl TYPCOFIWWfUKf Ofl •••VI <HUi.UABturr COIMCRCML GENE&U. .IASIUTY [CLAIMS MADE f~]ocaiR OE>FL AGGREGATt Liurr iftves PER AUTOMOBILE LUWOITV — i AU OWNED AUTOJ HIRED AUTOS NOttOWNCD AUTOS GAMGE UABLITY sxc_J ANT AUTO £SSIUMBREUA LUJKUlt OCCUR [__J CLAIMS MADE DEOUCTBLE RETENTION 3 EMPLOYERS' UAflHJTY ANY HftftPRIBt ORHVtfrrNER)Pg<tff IVEOWCEf JMEMB6« EXCUIDS a nt vti, tfeseftto undv SPECIAL PROVISIONS Mw OTHER POLICY NUMBER ADP0301885-04 •SHEffi^^vF 06/24/2005 p*Y£ f Uff ">gf)fD 06/24/ZOOC LMTS EACH OCCURRENCE DAMM3E TO RENTED MED EXP (Any gw p«non> PCRSONAHAOV INJURY GENERAL AGGREOATE PRODUCTS - COMP/OP AOO CO«HNED SINGLE UMTT BODR.Y »WURY (PRipanon) BODILY INJURY PROPERTY DAMAGE(Per aoddcnl) AUTO ONLY- EA ACCIDENT OTHER THAN EAACC AlffO ONLY- AGG EACH OCCURRaWE AGGREGATE J^gSTATU;.! JOTH- E 1. 5ACH ACCIDENT ELOISEASe EA EMPLOYEE E L. DISEASE - POLICY LIMIT I « » I t t S s s s $ « s 1 1 s } t s l.OOO.OOC s l.OOO.OOC i l.OOO.OOC DCSdnPTTON OF OMRATOW 1 10C HT)MI3 /VEHICLES I EXCLUSKMB ADDED BY EMBORSEMENr 1 SPECIAL PROVBIOM3 CERTIFICATE HOLDER CANCELLATION Insured Copy SHOULD ANY OF THE ABOVE DESCRBEO POLICIES BE CANCELLEP BEFORE THE eXPUIATtOU DATE THEREQP THE SSUtNQ MSURER WILL ENDEAVOR TO MAI. 10 DAYS WRflTEn MOTBX TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAO. SUCH NOTICE SHALL IMPOSE NO OBUOATtON OR LIABILITY OP ANY KNO UPON THI, WSUfJe*. ITS AOENTS Oft REPRfiJCMTATTVES AUTHORIZED REHJtSENTATlve ^, — "f^^^^f^f^.n^- Richard Cossett/JLD ^^vfaf^^> y-flfl^' ACORD 25 (2001/08)©ACORO CORPORATION 1188