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HomeMy WebLinkAbout2322 LA COSTA AVE; E; CB023847; PermitCity of Carlsbad ~ 12-23-2002 1635 Faraday Av Carlsbad, CA 92008 Mechanical Permit Permit No: CB023847 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: Applicant: 2322 LA COSTA AV CBAD St: E MECH 2163101408 Lot#: 0 $0.00 WISSINK RES/REPLACE FAU Owner: LE ANN WISSINK 2322 LA COSTA AVE UNITE# E LE ANN WISSINK CARLSBAD CA 92009 753-5728 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 0 753-5728 Total Fees: $24.00 Total Payments To Date: $0.00 Fl NAL APP/QVAL Date: © I-9--p ? Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 12/23/2002 CB 12/23/2002 12/23/2002 $15.00 $9.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $24.00 Balance Due: $24.00 4123 12/23/02 0002 01 CGP Clearance: NOTICE: Please ta ICE that pr al of your project includes the "Imposition" of fees, dedications, reseivations, or other exactions hereafter collectively referred to as "fees/exactions." Y av 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 Cooe 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 f I h I TIE"ilr whi h Iii in h 02 24.,JO PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 FOR OFFICE USE ONLY PLAN CHECK No.{',f;o'23'f;ff-] EST. VAL. __________ _ Plan Ck. Deposit _________ _ Validated By _ _::C,e,,:::.·=------- Date /£..-2 ::,,o-z_ ~~1~eosi %,e. ft{Jjf t};_L=&·;: W>JLL&t&'l1~~&&&i~l>~&&.: Add{!' (mcl,dr BldtSwte #) Th cf~ A-j< (/. •~ess 7.;;· (atth,s ad~~ /5 Legal Descr1pt1on Lot No. Subd1v1s1on Name/Number Unit No. Phase No Total# of units -I Propos~d Use J-. S # of Bedrooms # of Bathrooms Name Address City State/Zip Telephone# Fax# ,:~~= =~"'t:'. c3¥ .. e.1¥ t;;:!t~'f:r~~ 'I ;;71 ,~"'i 4 !?' 7 JIJ -J'fj::y Name Address City State/Zip Telephone# issuance, also requires the applicant for such permit to file a the Contractor's license Law (Chapter commending with Section 7000 of Division 3 of the Business and Pn;,fes.sic,asCode] or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by it suqjects the.applicant to a civil penalty of not more than five hundred dollars ($500]). ec-h ' / e t, t c vi C.. Address City -:142 1lw# State License # _"T~_.,-.c..,,,;g<,;,.._,__X_._::!~--- "7t!JCJ l.J<f License Class ___ __.,(!_,"""''----_,J_C)L_Qu __ 1 1 / A Telephone# City Business License # --~~~,l/',_,rl'----------1 Designer Name Address City State/Zip Telephone# State License# ________ _ !!l!i!flll ~.<;.:..~ts~-~i'~ Worker,· CompenHtion Dederation: I hereby affirm under penalty of perjury one of th• following declaration,: □ 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 worker's 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 _________________ Policy No. ____________ Expiration Date ___________ _ (THIS SECTION NEED 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 penaltles and civil fines up to one hundred thousand dollars{$100,000), In addition to the cost of compensation, damages are provided for in Section 3706 of the Labor Code, interest and attorney's fees. SIGNATURE.1]A■iiijiiiijiiiiiiiiiiiii~iiiiifi-;jiiiiiiiiii~bliii DATE P~.Y .i"~>lii4,; ,;;23Cl!fr,;;,._ f'i/.C:T !iiilllft I hereby aflrm that I am exempt from th• Contractor's Licen•e Law Jor th• following reHon: D I, as owner of the property or my employees with wages as their sole compensation, will d 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 wilt have the burden of proving that he did not build or improve for the purpose of sale). K 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. 2 3 4. I personally plan to provide the major labor and materials for construction of the proposed property improvement. □ YES □ NO I eave not) signed an application for a building permit for the proposed work. I have contracted wrth the following person (firm) to provide the proposed construction (include name I address I phone number I contractors license number): 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 f address f phone number f fontractors license number): ----------------------------------------------- 5. I will provide some of the work, but I have n cted (hired) the following persons to provide the work indicated (include name I address I phone number I type of work): WHITE: File YELLOW: Applicant PINK: Finance PE~MIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 Page 2 of 2 c~EU/1,S !~~/~J!iQj!LERMl't$LQllti t&£Zu~·,, ,,~ (;!,;,:¥':)t~T!JJBTI!LUU2 ..• ll .0L.i;f~k3 Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration for or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? D YES □ NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? □ YES □ NO ls the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ YES D 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. ~-9.SfSTllll_cp-!, ;;:c,: ';~--,:-! I hereby affirm th■t lh•r• i■ a construction lending agency for the perform■nc• of the work for which this permit is i■■ued (Seo. JQg7(1) Civil Code). LENDER'S NAME _________________ _ LENDER'S ADDRESS ____________________ _ -,.,mc:t..-a,~lt~~,r'!-i~-?•lM',;i,,_;;;;;;a I c.rtify th■t I have r-■d th• ■pplic.tion ■nd ,tale that th• ■bov• information i• correct and that th• information on the plan, i■ acx:ur■t■. I agree to comply with ■II City ordinances and State laws relating to building construction. I hereby authorize 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, JUDGEMENTS, COSTS AND EXPENSES WHICH MAY IN ANYWAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavations of 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;, commenced fo, a pe,;od of ~4.4 Un;fo,m Bu;1a;ng Code) _ • APPLICANTS SIGNATURE ~ t..JA ~ L DATE-,l/_,_&.........,:c-,;).=:._J::::,_-_,O::...,Y,c__ __ WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 01/10/2003 Permit# CB023847 Title: WISSINK RES/REPLACE FAU Description: Type: MECH Sub Type: Job Address: 2322 LA COST A AV Suite: E Lot o Location: APPLICANT LE ANN WISSINK Owner: Remarks: PLEASE INSPECT AT 2PM Total Time: CD Description Act Comment 49 Final Mechanical _&_ £1qA{.... Associated PCRs/CVs Inspection History Date Description Act lnsp Comments Inspector Assignment: JE --- Phone: 00000000000 Inspector: ---- Requested By: HOMEOWNER Entered By: CHRISITNE • -,q.-{( C-,,l.,;l.e C ?]~ /Yll.A-6E.. 12/27/2002 43 AirCond/Furnace Set CO JE SECURE CONDENSATE WIRE, PROTECT ELECTRICAL AT THERMOSTAT WIRING