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Home My WebLink About2804 LA COSTA AVE; ; CB023842; Permit\\~lQ City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 12-!3-2002 Mechanical Permit Permit No: CB023842 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 2804 LA COSTA AV CBAD MECH Status: Parcel No: 2162802300 Lot#: 0 Applied: ISSUED 12/23/2002 SB 12/23/2002 12/23/2002 Valuation: Reference #: Project Title: Applicant: DTW MECHANICAL $0.00 HEIM RES REPLACE FURNACE LIKE FOR LIKE 9625 LOS COACHES RD 92040 619-749-8544 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 1 0 0 0 0 0 Entered By: Plan Approved: Issued: Inspect Area: Owner: 4085 12/23/02 0002 01. 02 PAUL L&PATRICIA REVOCABLE TRUST 08-13-9t;:GP 24. 00 2804 LA COSTA AVE CARLSBAD CA 92009 $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 FINAL p,porir"\\/AL INSP. -,fl-".,.+--,;· ... 0~ AJ7/IQ _} CLEARANCE FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NoCPo-Z.. '3 S '-It CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST. VAL. _________ _ Plan Ck. Deposit K Validated ~--~-'"'-"~...,;'------ Date 1., ·t,_--Z 3,-a?_ Business Name (at this address) Unit No. Phase No. Total # of units Proposed Use #of Stories # of Bedrooms # of Bathrooms Name Address City State/Zip Telephone# Fax# :~:i~tH&1iii.1PiXij.,i%:k;8tP@□~r11itor2_:,~1;1m~J#aloft~~~ntm·91or;;;;::;:fi=h~n101~1:mlf!g.:n41:or~j!r:-. <.:)!¥, ,::,,·' -· Telephone# Designer Name Address City State/Zip Telephone ~~,;~;;i~~~~!~~D~~t~~~~~~:;;~~~:::i:::~~~~;;~~;\;}~;~:;;;~;:;~~;;1f;~:;~\;~:;~;~;;,,;;;;~~: 0 I have and will maintain a certificate of consent to self-insure for workers' compensation as pi'ovided by Section 3700 of the labor Code, for the performance of the work for which this permit is issued. D 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 _______ _ ITHl¢TION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS) Q;" 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 la unlawful, and 1hall subject an employer to criminal penaltie1 and civil fines up to one hundred thouaand doll 0,000), In addition to 'ffr\ cost of compensation, ~amagea as provided for in Section 3706 of e Labor code, interest and attorney's fee1. ~ SIGNATURE ,.___,_.,,, DATE ·z.t',l!!m 'ilmi I hei'eby affirm that I am exempt from the 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). D 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). D I am exempt under Section ______ Business and Professions Code for this reason: 1. I personalty plan to provide the major labor and materials for construction of the proposed property improvement. D YES ONO 2. I (have I 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 I address I phone number I 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 I 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 I address / phone number/ type of work): __________________________________________________________ _ 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? D YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site 7 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,lbj~!;fpJll[Tf\~97"1QNl~l>INil':AllENdv ·, • •·. :;;;.; J hereby 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 •~;.c:1&fP.l~~l!iANTl¢¢~el8jjfr1!1~ictC:ifJ!M•T\t((l;;:Ni;=;o:;i;11j::-,~0~;::;i;;;;:~}: I certify that I have read the application and state that the abo\le 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 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 ... JI any time after the work is com for period of 180 days ection 106.4.4 Uniform Building Code) . .ll APPLICANT"S SIGNATURE -4~~L.L~~i.._;.!',,=,=::'...______________ DATE }Zc:13 --aQ WHITE: File YELLOW: Applicant PINK: Finance ~ /\y City of Carlsbad Bldg Inspection Request ,o For: 05/07/2003 Permit# CB023842 Title: HEIM RES REPLACE FURNACE Description: LIKE FOR LIKE Type: MECH Sub Type: Job Address: 2804 LA COST A AV Suite: Lot 0 Location: APPLICANT DTW MECHANICAL Inspector Assignment: JE --- Phone: 7609447288 Inspector: ---- Owner: PAUL L&PATRICIA REVOCABLE TRUST 08-13-96 Remarks: Total Time: Requested By: PAUL HEIM Entered By: CHRISTINE CD 43 Date Description AirCond/Furnace Set Act Comment bt'r7, J ,4P -'--,C._:,,4---'-,_,.;4/~_' _____ ,_, ,.~,--·_F_ ;, Associated PCRs/CVs Inspection History Description Act lnsp Comments