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Home My WebLink About2616 LA COSTA AVE; ; CB010888; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 ---. 03/05/2001 Mechanical Permit Permit No: CB010888 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: 2616 LA COSTA AV CBAD MECH 2162800300 $0.00 Lot#: SILVER RES-REPLACE FAU & A/C UNITS 0 Applicant: Owner: SILVER LEONARD&CAROL YN REVOCABLE TRUST 10-26-98 SILVER LEONARD&CAROLYN REVOCABLE TRUST 10-26-98 Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 03/05/2001 RMA 03/05/2001 03/05/2001 2616 LA COSTA AVE CARLSBAD CA 92009 2616 LA COSTA AVE CARLSBAD CA 92009 3080 03/05/01 0002 01 02 Total Fees: $33.00 Total Payments To Date: $0.00 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 TOTAL PERMIT FEES Inspector: 2 0 0 0 0 0 FINAL APPROVAL Date: ¢z/J Balance Due: Clearance: $15.00 $18.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $33.00 CGP 33-00 $33.00 NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/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 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 capactiy 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 nreviouslv been niven a NOTICE similar to this or as to which the statute of limitations has oreviouslv otherwise exoired. PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 FOR OFFICE USE ONLY PLAN CHECK NO. C,(!p1 EST. VAL. _________ _ Plan Ck. Deposit-----~~-- Validated By /?7,_ f1F Date 3dol Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # Existing Use Proposed Use # of Bathrooms Name Address City State/Zip Telephone# Fax# ~ii!!iif!\flilfdAiit"l'.,'l'El{¢flimliptorZ, cE)1Asen!'lii/,¢Wriiraii\iir G:El\'Oilii~~,: \l)it:;liiiiint'(or\aw~af: (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 ($5001). Name Address City State/Zip Telephone# State license # _________ _ license Class _________ _ City Business license # _______ _ Designer Name Address City State/Zip Telephone State license # _________ _ !!:,::il!Wllil!D(!jj;t::~llMemr11 r1i,1, 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 work for which this permit is issued. 0 I 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 compensation insurance carrier and policy number are: Insurance Company______________________ Policy No. ____________ _ Expiration Date, _______ _ ITHIS SECTION NEED NOT BE COMPLETED IF THE PERMIT 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, l 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 la unlawful, and shall subject an employer to crlmlnal penalties end civil fines up to one hundred thousand dollars 1$100,000), In addition to the coat of compenaatlon, damages ea provided for In Section 3706 of the Labor code, Interest and attorney'• fees. SIGNATURE DATE -/., ~,,~~1~b!f!!!ill/l\ll;iit1)ltii,,•n;c;t,. I hereby affirm that I am exempt from the Contractor's License Law for the following reason: D I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's license Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended or offered for sale. If, however, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale). till I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The 4::ontractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). 0 I am exempt under Section ______ Business and Professions Code for this reason: 1' 2, 3. /KJND 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone number/ contractors license number),:_------------------------------------------------ 5, I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name/ address/ phone number/ type o work): ~ ~ ::f- PROPERTY OWNER SIGNATURE I~ (I --d! ~ ;_DATE _3 /S/CJ / ll!<!Mffii'ml/f$;jJ!tjfJO:lllil!!fll!,ld,\'.,il~l>EJ'i'ffllL\lil(ltjjlNG'liERl'lilttr1WIW11'.;i!;J:tr,i'"''!f,;: ff. fI\',i:iil:1ii'~~iit!?;1,,;:J;,\l!ilt~\f:f: 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 D 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? D YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site7 D 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. :s,1,:mll!O:illi!tRll<:i'lbN.tf.l!l\ldiilli:l'AIIEillt:t,:,, 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 _____________ _ i!i'i~·i'1!11!1/lil!i'4ti:rc!iii!Rtil'ii:l!tiblii'> h\ 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 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 fs not commenced within 180 days from the date of such permit or if the building or work authorized by such pe it is suspended or abandoned , /at any time after the work is com e d for a period of 1 d ion 106.4.4 Uniform Building Code). -I.. · ..A APPLICANT'S SIGNATURE _J:~~~~='l!.dra.:::::.a~~!::.~::::::==--------1 'DATE _J__,'--~-/.-"--/------ WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 1)3/21/2001 Permit# CB010888 Title: SILVER RES-REPLACE FAU & Description: A/C UNITS Type:MECH Sub Type: Job Address: 2616 LA COSTA AV Suite: Lot 0 Location: Inspector Assignment: -/4 If,. Phone: 7609421699 Inspector: fl-~ . APPLICANT SILVER LEONARD&CAROL YN REVOCABLE TRUST 10-26-98 Owner: SILVER LEONARD&CAROLYN REVOCABLE TRUST 10-26-98 Remarks: Total Time: CD Description 43 AirCond/Furnace Set Associated PCRs Inspection History Date Description A f Comments Act lnsp Comments Requested By: LEONARD Entered By: CHRISTINE ------ ( 10-1z)