Loading...
HomeMy WebLinkAbout2502 NAVARRA DR; 214; CB040900; PermitCC-/ City of Carlsbad • 1635 Faraday Av Carlsbad, CA 92008 03-18-2004 Mechanical Permit Permit No: CB040900 Building Inspection Request Line (760) 602-2725 Job Address: 2502 NAVARRA DR CBAD St: 214 .. Permit Type: MECH - Status: ISSUED Parcel No: 216170492529 Lot #: 0 Applied: 03/18/2004 Valuation: $0.00 Entered By: RMA Reference #: . . Plan Approved: 03/18/2004 Issued: 03/18/2004 Project Title: LURIE RES-REPLACE AIC&FURNACE Inspect Area: Applicant: Owner: THOMPSON HEATING & AIR HEMB40—CK DEBORAH L 2502 #211 1023 FULTON RD 92069 CARLSBAD CA 92009 760 471-5800 / \ /°)> Mechanical Issue Fee - $1500 Install/Furn/Ducts/Heat Pumps Fee ,-$18.00 Fireplace Installation Fe / <)$0.00 Exhaust Fan Fee / / 0V]j \ (3 $0.00 Installation/Relocation Vent Fee 0 " V $0.00 0 C~_$0.00 4;e It I ir/0 00d Fee npressorJ15H Additional Fees $000 TOTAL PERMIT FEES ~3100 A?j \c '1.JLL Ih II ccJ/I Total Fees $33.00 Total Payments To Date hMA II $0.00 ' o 1-BaIance Due / $33 00 \ © INCORPORATED 1952 - % ~> q1 . - st (0 _780/3 EXPIREXPIREDMIP E RT PERMIT HAS EXPIRED IN ACCORDANCE WITH U.8.0 SECTION 106.4.4 DATE 2- ...SIGNATuR 33-00 03/18,04 0002 oj 02 COP FOR OFFICE USE ONLY PLAN CHECK No.ü ESTVAL. . 11 Plan 'M Deposit Validated. 'By Date____________________ BupinessName (at this address), Legal Description . Lot No. Subdivision No Unit No. Phase No. Total #of units Assessors Parcel # Existing Usa Proposed Use Description of Work ..J I . SQ. FT. #of Stories # of Bedroómá # of Bathrooms ij up)W mm- ; : iZ .14 Name - Address : City State/Zip Telephone #-. . Fax 1/ - . .. [3 APIT 000Agent fo, 0 Qvner- .DgenUor qwn p.c) I F,,, 9 'oj9 >'ç .Fy Name . Addres . . City . - State/Zip Telephone # ibb 6 MJX,— Y) c14Nt FJ t,frv/M C4 9cth kfP— Name . Address -" . - City -' , State/Zip Telephone #, (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, Aemolish 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 t the provisions of the Contractor's License Law (Chapter 9, commending with Section 7000 of Division 3of the Business and Professions Codel 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 ($5001L 1cTVPJ/ Jii,fifCv4' rti/9 9/-4?QO Name Address . -.. City .---State/Zip Telephone # State License # F'1j') 99' License Class C City Business License Designer Name , - - Address City State/Zip Telephone State License # Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: . . . . I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for whih thjs permit is issued. My worker's compensation insurance carrier and policy number are: . . - / - Insurance Company. -j' 7#77'€. / Ci A.) v.5) '- * Polic . y No. _/SfP'..? Expiration Date -:9 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$ 1001 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 tothe -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 thousanddollars ($10 .0 0), In a ition a C St of compensation, damages as provided for in Section 3706 of the / Lab code, ,$terest and attorney's fees. SIGNATURE" DATE 41 I heieby affirm that I am 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 an owner of property who -builds or improves thereon, and who does - such -work himself or through his own employees, provided that sch 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): C] I, as owner of the property, am exclusively contracting with Iiéensed, contractors to construct the project (Séc 7044; Business and Professions Code: The Contractor's License Law does not apply.w 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 Profession 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 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): -, - 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 I contractors license number):_-- -- - - 5. I will provide some of the work, but .1 have contracted (hired) the following persons to provide the work indicated (include name / address! phone number / type of work): - - - - - - - - - PROPERTY OWNER SIGNATURE- - - - - - - - - DATE - -- - - - Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration f I orML 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 requiredto obtain a permit from the air pollution control districtor air quality management district? 0 YES 0 NO - Is the facility jo be'çnstructed within 1,000 feel 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. - - - - TRUC31ONLENGAGEN t J Thereby affirm that there is a Construction lending agency for the performance of the work for which this permit is issued (Sec 30970) Civil Code) LENDER'S NAME ---- _- LENDER'S ADDRESSppLIC.ANT - - ---------- _.L XqT I certify that I have read the application and state that the above information is correct and that the information on-the plans isaccurate. I agree to comply with all City ordinances and State laws relating to building Construction. I h6reby, authorize representatives of the Cit 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 requiredfor 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 beáome null and void if the building or work authorized by such permit is not commenced within 180 days from the date f such permit or if the building or work authorized by such ermit is uspended or abandoned at any time after the work is com &Jfor eno0 Uniform Building Code) APPLICANT'S SIGNATURE DATE - - - - - WHITE: File LLOW: Applicant PINK: Finance - -- - • -- - - -- PERMIT APPLICATION CITY O'F CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA. 92008,