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HomeMy WebLinkAbout2045 CHARLEEN CIR; ; CB023720; Permit12-11-2002 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Mechanical Permit Permit No: CB023720 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: 2045 CHARLEEN CR CBAD MECH 2053302100 $0.00 Lot#: MOORE RES-FREE STANDING GAS STOVE-HEAT LIVING RM W/GAS Status: ISSUED Applied: 12/11/2002 Entered By: RMA Plan Approved: 12/11/2002 Issued: 12/11/2002 Inspect Area: Applicant: MOORE FAMILY TRUST 05-19-87 2045 CHARLEEN CIR CARLSBAD CA 92008 Owner: MOORE FAMILY TRUST 05-19-87 2045 CHARLEEN CIR CARLSBAD CA 92008 3299 12/11/02 0002 01 02 CGP 55=50 Total Fees:$55.50 Total Payments To Date:$0.00 Balance Due:$55.50 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 1 0 0 $15.00 $9.00 $0.00 $0.00 $4.50 $0.00 $0.00 $27.00 $0.00 $55.50 Inspector: FINAL APPROVAL Date:Clearance: NOTICE: Please take<W0TICE Mt approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as lees/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 vou have oreviouslv been aiven 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 1. PROJECT INFORMATION FOR OFFICE USE ONLY PLAN CHECK NO. C^f\D 33 7°?^ EST. VAL. Plan Ck. Deposit Validated By Date ll /It /I ^ i (. Address (include Bldg/Suite #)Business Name (at this address)- z Legal Description Z&S--- 2-/ Lot No.Subdivision Name/Number Unit No.Phase No.Total # of units Assessor's Parcel #Existing Use 7"Q Proposed Use Description of Work £rCONTACT PERSON (if/Biffw^rfrom appli SQ. FT.#of Stories # of Bedrooms tt of Bathrooms -A Name Address ' City 3. APPLICANT Q Contractor, Q Agent for Contractor QJ'Owner O Agent for Owner State/Zip Telephone tt / (7^'J -372J Fax* Name 4, PROPERTY OWNER Address Crfy State/Zip Telephone tt City #<£>(&! <£"£»&> Afe R~ State/Zip TelephoneName Address 5. CONTRACTOR - COMPANY NAME ('f-ffl'S {S (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 [$500]). Name State License tt Address License Class City State/Zip City Business License tt Telephone tt State/Zip TelephoneDesigner Name Address City State License ft 6. WORKERS' COMPENSATION „. , ' ....... . . .. Workers'Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: Af0fl£ ° / VlLt, &> 7*V/£" [~1 I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 0 I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My worker's compensation insurance carrier and policy number are: Insurance Company j 'I'lQ I Is /*~A t@A\ Policy No. C? ,$ / .J ~ Z-<^ ^ ' ~/ Z- Expiration Date ^ ~ ' ~ O-? (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) l~l 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. SIGNATURE S%.^e>< ^ X^tffZe. DATE /' 2-~~ ? ~ O 2- 7. OWNER-BOTLDER DECLARATION 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason: GO'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). PI 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). (~1 I am exempt under Section Business and Professions Code for this reason: E'YES DNO with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors license number): /if , , ^J M , j t ^* f Tt *} g* f. jt _. f ^ jCV~" if/ I*" a— f*7 r~ * - ^ » __ „ . «_ „ * . *- Jt A.X —7 fc ^— MM fTf j~^—T—~f ft im&^f*** ftM. - f i f * ^ » ft m i T wt t~ifr I r I * w-^f~~ I AJ t ^m^—i^—M^z^—^if~^*^H^r**~-^—t^~—an-^~-~&. y\ ^ t '-f * ^-, I personally plan to provide the major labor and materials for construction of the proposed property improvement. (.1 (havey hajy/at) signed an application for a building permit for the proposed work. I have contraqti fr* *" ^ 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 tp provide the work indicated (include name / address / phone number / type PROPERTY OWNER SIGNATURE DATE COMPLETE THIS SECTION FOR NOMftESIDENTIAL BUILDING PERMITS ONLY 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? fj YES [JJ^FjO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? d YES Q^O Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? d 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. 8, CONSTRUCTION LENDING AGENCY ! 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 9, APPLICANT CERTIFICATION 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 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 180 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 the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE ^A^e^T /*• //t&ing^ DATE / 2 ~ ?~ O2i WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 01/29/2003 Permit* CB023720 Title: MOORE RES-FREE STANDING GAS Description: STOVE-HEAT LIVING RM W/GAS Inspector Assignment: 2045 CHARLEEN CR Lot 0 Type: MECH Sub Type: Job Address: Suite: Location: APPLICANT MOORE FAMILY TRUST 05-19-87 Owner: MOORE FAMILY TRUST 05-19-87 Remarks: Phone: 7604343728 Inspector: Total Time: CD Description 23 Gas/Test/Repairs 43 AirCond/Furnace Set 44 Rough/Ducts/Oampers Comment Requested By: JOEL MOORE Entered By: CHRISTINE Associated PCRs/CVs Inspection History Date Description Act Insp Comments 12/10/2002 23:00 7S8-434-3728 JOEL.MOORE •/ © PAGE 02 © jra ~ 2^ 'J "/^ rX* '"' ^^ JX^«- A/^W. !; ^ - — •''-W) 12/11/2002 04:03 760-434-3728 JOEL MOORE PAGE 81/01 -/IT ,*M"*-r <s&*y&*S& v / 4...JLL .^Qo/A^ J. .:.1