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Home My WebLink About2450 IMPALA DR; ; CB150453; PermitCity of Carlsbad 1635 Faraday Av Carlsbad.CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 02-11-2015 Permit No: CBI50453 Building Inspection Request Line (760) 602-2725 Job Address; 2450 IMPALA DR CBAD Permit Type: PME Status: ISSUED Parcel No: 2090412000 Lot#: 0 Applied: 02/11/2015 Entered By: LSM Reference*: Plan Approved: 02/11/2015 PC#: Issued: 02/11/2015 Inspect Area: Project Title: MYRON L- REPLACE SPLIT SYSTEM ROOF TOP CONDENSER/AIR HANDLER/ HEAT PUMP LIKE FOR LIKE Applicant: Owner: CHC REFRIGERATION INC MYRON L CO P O BOX 275 2450 IMPALA DR SAN MARCOS CA 92079 CARLSBAD CA 92010 760-505-7299 Plumbing Fees $0.00 Electrical Fees $0.00 Mechanical Fees $160.00 other PME Fees $0.00 TOTAL PERMIT FEES $160.00 Total Fees: $160.00 Total Paynnents To Date: $160.00 Balance Due: $0.00 FINAL ARPRpVAL^ Inspector: f^H/^tZ-—- Date: <2>/ y Clearance: NOTICE: Please take NOTICE tjpt approval of your project Includes the "Imposition" of fees, dedications, reseivations, or other exactions hereafter collectively refen-ed to as "fees/exactions." You have 90 days from the date this pemiit 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 infomnation 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 previously been oiven a NOTICE similar to this, or as to which the statute of limitations has oreviouslv otherwise expired. THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERI«1T ISSUANCE: nPLANNING nENGINEERING •BUILDING npIRE nHEALTH OHAZMAT/APCD City of Carlsbad Building Permit Appiication 1635 Faraday Ave., Carisbad, CA 92008 Ph: 760-602-2719 Fax:760-602-8558 email: bullding@carisbadca.gov www.carlsbadca.gov Plan Check No. (2^f 5(0M'53 Est. Value Plan Ck. Deposit SWPPP JOB ADDRESS SUITE#/SPACE#/UNrr# CT/PROJECT# # OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TVPE OCC. GROUP DESCRIPTION OF WORK: (nc/ude Square Feet of Affected Area(s) iooo 5 f /nutriftt. i/irii/'5 /^oor^ EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE YESn# N0| I AIR CONDITIONING YES I |NO| I FIRE SPRINKLERS YEsQ N0| I APPUCANT NAME Primary Contact PROPERTY OWNER NAME ADDRESS ADDRESS CITY STATE, CITY /i STATE ^ ZIP PIHONT FAX PHONE FAX (7(0^ EI^AIL EMAIL DESIQN PROFESSIONAL CONTRACTOR BUS. NAME ADDRESS CITY STATE ZIP CITY ^<!^i/ljf^<^tCoS STATE ZIP^ PHONE PHONE FAX EMAIL EMAIL uc.# C20 CITY BUS. Lies (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, dennoiish 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 tnat 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)). Woriters' Compensation Declaration: / hereby affimi under penalty of peijury one ofthe following declarations: 11 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. 25-1 h'** maintain worlters' compensation, as required by Secfon 3700 of the Labor Code, for the performance of the work for which this pemiit is issued. My wodters' compensation insurance carrier and policy number are: insurance Co._ TCiT£>n I y^ Policy No. Expiration Date. This section need nol be compleled if the permit is for one hundred dollars ($100) or less. I I Certificate of Exemption: I certify that in Ihe performance of the worit for which this permit is issued, I shall not employ any person in any manner so as to become subject to Ihe Woriters' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an empioyer to criminal penalties and civil fines up to one hundred thousand doiiars (&100,000), in addition to the cost of compensation, damages ajtjyovijadfoi^Sectlon 3706 of the Labor code, interest and attorney's fees. JS£ CONTRACTOR SiGNATURE • AGENT °ATE g-//-/:> / hereby affirm that I am exempt fmm Contractor's Ucense Law for the following reason: I I I, as owner of tfie property or my employees with wages as (heir sole compensation, will do the worit and the structure is not intended or offered for sale (Sec 7044, Business and Professions Code: The Contractor's — License Law does nol apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided Ihat 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). I I I, as owner of the property, am exclusively contracting with licensed contractors to constaict the project (Sec. 7044. Business and Professions Code: The Contractor's License Law does not apply lo an owner of property who builds or improves thereon, and contracis for such projects with contraclor(s) licensed pursuant lo the Contractor's License Law). I I I am exempt under Section Business and Professions Code for this reason: 1.1 personally plan to provide ttie major labor and materials for constmction of the proposed prtiperty Improvemenl •Yes I INO 2.1 (have / have not) signed an application for a building permit for the proposed wortt. 3.1 have conlracted with the following person (firni) to provide the proposed construction (include name address / phone / contractors' license number): 4.1 plan to provide portions of the work, but I have hired lhe following person lo coordinate, supervise and provide lhe major worit (include name / address / phone / contractors' license number): 5.1 will provide some of the work, bul I have conlracled (hired) the following persons to provide the work indicated (include name / address / phone / type of worit): jS^PROPERVf OWNER SIGNATURE QAGENT DATE Is lhe appiicant or future building occupanl required to submit a business plan.aculely hazardous malerials registration form or risk management and prevenlion program under Sections 25505,25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? Yes Is the applicanl or future building occupanl required to obtain a pennit fromlhtrSlr pollution control district or air qy^i&management district? Yes Qjo^ Is the facilily to be constmcted within 1,000 feet of the ouler boundary of a school site? Yes 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 mm I hereby affimn that there is a construction lending agency for the performance of the worit this permit Is issued (Sec. 3097 (I) Civil Code). Lender's Name Lender's Address 1 cert% that I have read the application and state thatthe above infomiation Is conect and that the Inforniation on the pians is accurate. 1 agmc to comply with ali City onlinances and State laws relating to building construction. I heiBby authorize represenlative of the City of Carlsbad to enter upon the above mentioned property for inspeclion 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 constmction of stmctures over 3 stories In heighl. EXRRATION: Every permit issued by the Building Official under the provisions of Ihis Code shall expire by limitation and become nul and void if the building or wortt auihorized by such pemiil is not commenced wilhin 180 days fnm the date of such pemiit or if the bulding or wortt authorized by such pemiit is suspended or abandoned al any time after the worit is commenced for a period of 180 days (Section 106.4.4 Uniform Buiiding Code). APPLICANT'S SIGNATURE DATE STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. Fax (760) 602-8560, Email buildlng(5)carlsbadca.gov or Mail the completed form to City of Carisbad, Building Division 1635 Faraday Avenue, Carisbad, Califomia 92008. C0#: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS STATE ZIP CITY STATE ZIP Carlsbad CA EIVIAIL OCCUPANT'S BUS. LIC. No. DELIVERY OPTIONS PICK UP: CONTACT (Listed above) CONTRACTOR (On Pg. 1) MAIL TO: CONTACT (Listed above) CONTRACTOR (On Pg. 1) OCCUPANT (Listed above) OCCUPANT (Listed above) ASSOCIATED CB# IVIAIL / FAX TO OTHER: NO CHANGE IN USE / NO CONSTRUCTION CHANGE OF USE / NO CONSTRUCTION >eS'APPLICANT'S SIGNATURE DATE THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: OPLANNING IZlENGINEERING • BUILDING • FIRE • HEALTH •HAZMAT/APCD Ccityof Carlsbad Buiiding Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 email: building@carlsbadca.gov www.carlsbadca.gov Plan Check No. Est. Value Plan Ck. Deposit Date SWPPP JOB ADDRESS SUITE*/SPACE«/UNrr# APN - CT/PROJECT # LOTS PHASE # # OF UNITS »BEDROOMS # BATHROOI^S TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP DESCRIPTION OF WORK: Include Square Feet ofAftected Area(s) EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE YEsPk Non AIR CONDITIONING YEsj |NO| 1 FIRE SPRINKLERS YESQ N0| 1 APPUCANT NAME Primaiy Contact PROPERTY OW INER NAME ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE FAX PHONE FAX EMAIL EMAIL DESIGN PROFESSIONAL CONTRACTOR BUS. NAME ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE FAX PHONE FAX EMAIL EMAIL STATE UC. # STATE UC.# cuss CITY BUS. LIC.# (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)). Workers' Compensation Declaration: / hereby affinn under penalty ofpeijury one ofthe following declarations: • I have and will maintain a cettificate of consent to self-insure for vrortters' compensation as provided by Seciion 3700 of the Labor Code, for the performance of the worit for v»hich this pemiil is issued. CZ I have and will maintain workers' compensation, as required by Secfon 3700 of the Labor Code, for the performance of lhe worit for which Ihis permil is issued. My woriters' compensalion insurance carrier and policy number are: Insurance Co Policy No. Expiration Date This section need not be completed if the permit is for one hundred dollars ($100) or less. I I Certificate of Exemption: I certify Ihat in the perfomnance of Ihe wortt for which Ihis pennit is issued. I shall nol employ any person in any manner so as to become subjecl to the Wortters' 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 attomey's fees. JS^ CONTRACTOR SiGNATURE • AGENT DATE i hereby affimi that I am exempt fmm Contractor's Ucense Law for the following reason: I I I, as owner of Ihe property or my employees wilh wages as their sole compensation, will do the worit and lhe slmdure is nol inlended or offered for sale (Sec 7044, Business and Professions Code: The Conlraclor's License Law does not apply lo 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, Ihe 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). I I I, as owner of the property, am exclusively contracting wilh licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors 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 Conlraclor's License Law). I I I am exempi under Seciion _ .Business and Professions Code forthis reason: 1.1 personally plan to provide the major labor and materials for construciion of the proposed property improvemenl. •Yes I INO 2.1 (have (have nol) signed an application lor a building pemiil for the proposed worit. 3.1 have contracted with the following person (firm) to provide the proposed constmction (inciude name address / phone / contractors' license number): 4.1 plan to provide portions of lhe work, but I have hired the following person lo coordinate, supen/ise and provide the major work (include name / address / phone / contractors' license number): 5.1 will provide some of the work, but I have contracted (hired) the foiiowing persons to provide the work indicaled (include name / address / phone / type of worit): ^eTpROPERTY OWNER SIGNATURE •AGENT DATE Inspection List Permit#: CB150453 Type: PME MYRON L-REPLACE SPLIT SYSTEM ROOF TOP CONDENSER/ AIR HANDLER/ Date [nspection Item Inspector Act Comrnenjs 03/04/2015 43 AirCond/Furnace Set - Rl EARLY PM PLS 03/04/2015 43 AirCond/Furnace Set PY AP 03/04/2015 49 FinalMechanical - Rl 03/04/2015 49 FinalMechanical PY AP Ttiursday, March 05, 2015 Page 1 of 1