HomeMy WebLinkAbout2374 ALTISMA WAY; ; CB042286; Permit06-08-2004
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Building Inspection Request Line (760) 602-2725
Mechanical Permit Permit No: CB042286
Job Address:
Permit Type: MECH Status: ISSUED
Parcel No: 2152403410 Lot #: 0 Applied: 06/08/2004
Valuation: $0.00 Entered By: SB
Reference #: Plan Approved: 06/08/2004 Issued: 06/08/2004 Project Title: CHAMBERLIN RES REPLACE FURN Inspect Area:
2374 ALTISMA WY CBAD
Applicant: ARS
STE 100
6162 NANCY RIDGE DR
SAN DlEGO CA 92121
858-677-5455
Owner: CRITCHLEY J RONALD&ELIZABETH C F
9139 MOUNT ISRAEL RD
ESCONDIDO CA 92029
Mechanical Issue Fee
InstalllFurnlDuctslHeat Pumps Fee
Fireplace Installation Fee
Exhaust Fan Fee
Installation/Relocation Vent Fee Hood Fee BoilerlCompressor to 15HP Fee
Other
Additional Fees
TOTAL PERMIT FEES
$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: $0.00 Balance Due: $24.00
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
FOR OFFICE USE ONLY
PLAN CHECK Nd3 -7% 1 ZLSb
EST. VAL.
Validated By
Dag
Business Name (at this address) d~q A/+ Legal Description- Lot No. $ubdivision NamelNumber Unit No. Phase No. Total # of units
Address (include Bld IS i #)
Assessor's Parcel # Y"l$3 Proposed Use
' '
Description of Wor #of Stories # of Bedrooms # of Bathrooms
Name
(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 ha is licensed pursuant to the provisions of the Contractor's License Law
IChaoter 9. commendina with Section 7000 of Division 3 of the Business and Professions Code] or that he IS exempt therefrom, and the basis for the alleged a civil penalty of not more than five hundred dollars I55001). 617sy ss-
T ephone #
City Business License 7 Q SO $ crc>
QA/hI
City State/ 'p
State License # CaO,,C3b
Designer Name Address City StatdZip Telephone
State License #
0 of the work for which this permit is issued.
=I have and will maintain workers' comp
issued. My worker's c ensatio insurance
Insurance Company T\rg ~sL
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ISlOOl 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. and shall subject an employer to criminal penalties and civil fines up to one hundred
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
ion 3700 of the Labor Code, for the performance of the work for which this emit is w Policy No. 2 9 3Sbq3 - Ol Expiration Date
ion to the cost of compensation. damages as provided for In Sectlon 3706 o
0 1, 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 ha did not build or improve for the purpose of sale).
0 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).
0
1.
2.
3.
I am exempt under Section
I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES UNO
I (have / have not) signed an application for a building permit for the proposed work.
I have contracted with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors license number):
Business and Professions Code for this reason:
4.
number I contractors license number):
5.
of work):
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
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
PROPERTY OWNER SIGNATURE 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 0 NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES 0 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.
0 YES 0 NO
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).
LENDERS NAME LENDERS ADDRESS
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 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 ate of such permit or if the building or work at any time after the work is ion 106.4.4 Uniform Building Code).
APPLICANT'S SIGNATURE DATE
YELLOW: Applicant PINK: Finance