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Home My WebLink About2440 LA COSTA AVE; ; CB051726; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 05-16-2005 Mechanical Permit Permit No: CB051726 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: Applicant: LEGEND SERVICE SUITE 15 2588 PROGRESS ST VISTA CA 92083 760-631-8397 2440 LA COSTA AV CBAD MECH 2161601100 $0.00 SMITH RESIDENCE REPLACE FAU 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 Status: Lot#: 0 Applied: 1 0 0 0 0 0 Entered By: Plan Approved: Issued: Inspect Area: Owner: SMITH LEETATE DAVID&JULIE ANN PO BOX 131357 CARLSBAD CA 92013 Total Fees: $24.00 Total Payments To Date: $0.00 Balance Due: EXPIRED PERMIT ISSUED 05/16/2005 MDP 05/16/2005 05/16/2005 $15.00 $9.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $24.00 $24.00 PERMIT HAS EXPIRED IN ACCORDANCE WITH §~6 ,, . 1 SECTION 106.4.4 AS AMENDED BY C.M.C.18.04.030 •.• OSi "·6' OS DATE s\ ,-, \w;a SIGNATURE C Cu ( ◊002 01 CGP Inspector: FINAL APPROVAL Date: Clearance: NOTICE: Please take NOTICE that approval of your project includes the "Imposition' of fees, dedicalions, reservations, or other exactions hereafter collectively referred to as iees/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 acoordance with Cansbad Municipal Code Section 3.32.030. Failure to timely frnlow 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 rightto 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 fwhi h V r i I N i h limi h I h i ·J2 PERMIT APPLICATION FOR OFFICE USE ONLY ,.... PLAN CHECK NO.(?~ ,.. \71', . CITY OF CARLSBAD BUILDING DEPARTMENT EST. VAL. _________ _ 1635 Faraday Ave., Carlsbad, CA 92008 Plan Ck. Deposit ________ _ Validated By __________ _ Date ______________ _ 1. PROJECT INFORMAT:N r9 lf l./0 k:_ 0t Address (include Bldg/Suite #) [osfv, A 11-e, Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Proposed Use # of Bedrooms # of Bathrooms 2. C0NTACT PERSON,(lf different from•eppllcent) Name 3. Name ,4,' Name :5_ CONTMCiJ"OR • COMPANY NAME Fax# (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 S~ction 7000 of Oivisio~ 3 of the Busi~ess a_nd Professio~s Code) or_ that he is exempt therefrom, and the basis for the alleged ~ exemption. Any v_!1Iatj,sl.q of Section 7031.5 by any ap hcant for a permit subIects the pHcant to a I "',na!;l( of not more:\ n five hundred dollars [$500)). -, "'v L,\ .JI/( l C , e O uce C Ci o b 3 -fJqr Name Address City State/ 1p Teleph ne # , 7 · State License # 7 03 5 '-/ / License Class _________ City Business License # / d-/ 0 9 <./ -........J Designer Name Address City State/Zip Telephone State License # _________ _ 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 w or which this permit is issued. 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 c~pensayon insurance carrier and poli Y num~!!'tt' . MAp A/<7'<7 ? -Q 7 , . Ob -oZ~-QS Insurance Company 10 ( -r,v, Polley NofJlL. {), ibl O,._Q___) ~p11at1on Date. _______ _ IS FOR ONE HUNDRED DOLLARS [$1001 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 wortcers' compensation coverage Is unlawful, • thousand dollars ($100,000), In addition lie the cost of compens n, damage -,!'.GN~~=:R;Blllt~-z£; shaft subject en employer to criminal penalties and clvll fines up to one hundred aa provided for In Section 3706 of the Labor cocte, lntereat and attorney's fees. DATE s -/6 -0 5 I hereby affirm that I em 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 en 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 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 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 / 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 _________ _ cCOMPLE:fE'THIS.SEC:TION FOR NON-RESIDENnAL 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 Act7 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? O YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site 7 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. 18.. CQNSTRiJCTION 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 ______________ _ '9. APPLICANT CERTIFlCATION LENDER'S 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 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 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 lhe 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 Jhe work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE __________________________ _ DATE ____________ _ WHITE: File YELLOW: Applicant PINK: Finance