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HomeMy WebLinkAbout2859 ANDOVER AVE; ; CB151313; Permit04-30-2015 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No:CB151313 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC #: Project Title: 2859 ANDOVER AV CBAD PME 1674801833 Lot#: DONOHUE RES- REPLACE FURNACE IN ATTIC Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 04/30/2015 RMA 04/30/2015 04/30/2015 Applicant: DONOHUE CAROL M Owner: DONOHUE CAROL M 2859 ANDOVER AVE CARLSBADCA 92010 2859 ANDOVER AVE CARLSBAD CA 92010 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees $0.00 $0.00 $160.00 $0.00 TOTAL PERMIT FEES $160.00 Total Fees: $160.00 Total Payments To Date: $160.00 Balance Due: $0.00 inspector: FINAL APPROVAL Date: $" V -Clearance: NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, 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 information with the City IVIanager 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 previouslv been oiven a NOTICE similar to this, or as to which the statute of limitations has previouslv othenA/lse exoired. THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: OPLANNING nENGINEERING •BUILDING DFIRE OHEALTH nHAZMAT/APCD 1 City of Carlsbad Building Permit Appiication 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 email: building@carlsbadca.gov www.carlsbadca.gov /^ ^— Plan Check No. /J Est. Value Plan Ck. Deposit Date SWPPP JOB ADDRESS s _ ,1 ^ A At Jt iwm/sru.tUimn*'^ CT/PR0JECT# # OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP DESCRIPTION OF WORK: /ncfude Square Feet of Affected Area(s^ EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) fDECKS (SF) [HREPLACE AIR CONDITIONING YES I |NO| I FIRE SPRINKLERS YES I |NO[ I APPLICANT NAME Primary Contact PROPERTY OWI ADDRESS ADDRESS CITY STATE ZIP PHONE FAX PHONE ~ TFAX EI?IAIL ; I EMAIL DESIGN PROFESSIONAL CONTRACTOR BUS. NAME ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE FAX PHONE EMAIL EMAIL CLASS 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 pursuantto the provisions ofthe Contractor's License Law (Chapter 9, ccmmendingwith Section 7000 of Division 3 ofthe Business and Professions Code) or that he Is exempttherefrom, 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)). mPi^KERS' COMI>ENSATION Workers' Compensation Declaration: / hereby affirm under penalty of perjury one ofthe following declarations: BI 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 perfomiance of the work for which this pennit is issued. I have and will maintain wotliers' compensation, as required by Section 3700 of the Labor Code, for the perfonnance of the wori< for which this permit is issued. My workers' compensation insurance earner and policy number are: Insurance Co, Policy No. Expiration Date Thjs section need not be completed if the permit is for one hundred dollars ($100) or less. I ] Certificate of Exemption: I certify that in the perfomiance of the work for which this pemiit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of Califomia. 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. ygT CONTRACTOR SIGNATURE • AGENT DATE • S;'|l I ,|. D E it.:e C L' AM A T I 'O N / hereby affinn that I am exempt from Contractor's License Law for the fotiowing reason: I I 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 Ujpense 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 impravements are not intended or offered for jsate. 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). 1^ I, as owner of the property, am exclusively contracting with licensed contractors to constmct 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 Ucense Law), I I I am exempt under Section Business and Professions Code for this reason: 1,1 personally plan to provide the major labor and materials for construction of the proposed property improvement. Q]Yes I %Jro) «a^l^va?have not) signed an application for a building pennit for the proposed work. /rt 3.1 have contracted with the following person (fimi) to provide the proposed construction (include name address / phone / contractors' license number): ^ " 4,1 plan to provide portions of the wort(, but I have hired the following person to coordinate, supen/ise and provide the major wori< (include name / address / phone / contractors' license number): 5,1 will provide some of the work, but I have contracted (hired) the following persons to pravide the worts indicated (include name / address / phone / type of work): THIf .$ E C T I'o N ' r o'R M O 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 Act? Yes No Is the applicant or future building occupant required to obtain a pennit fram the air pollution control district or air quality management district? Yes No Is the fxility to be constmcted within 1,000 feet of the outer boundary of a school site? Yes 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. LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance ofthe woi1( this pennit is issued (Sec. 3097 (1) Civil Code). Lender's Name Lender's Address '•P Lie AMT CRRTIFICATIOM I certify that I have read the applkation and state that the above infomiation is conect and that the info I hereby authorize representative ofthe City of Carlsbad to enter upon the above mentioned property fbr inspection purposes, I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL UABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT, OSHA: An OSHA pemiit is required for excavations over 5'0' deep and demolitbn or constnictkin of stmctures over 3 stories in height, EXPIRATION: Every pennit issued by the Building Official under the provisons of this (Ms shall expine by limitatran and become null and void if the building or WDrt< authorized by such permit is not commenced within 180 days from the date of such permit or if the building or WD|)( authorized by such permit is suspended or abandoned at any time after the woris is commenced Ibr a period of 180 days (Section 106,4.4 Uniform Building Code), APPUCANT'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 buildinQ(S)carlsbadca.aov or Mail the completed fomi to City of Carlsbad, Building Division 1635 Faraday Avenue, Cartsbad, Califomia 92008. C0#: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY STATE ZIP Carlsbad CA PHONE FAX EIVIAIL OCCUPANT'S BUS. LIC. No. DELIVERY OPTIONS PICK UP: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) MAILTO: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) MAIL/FAX TO OTHER: ASSOCIATED CB# NO CHANGE IN USE / NO CONSTRUCTION CHANGE OF USE / NO CONSTRUCTION ASSOCIATED CB# NO CHANGE IN USE / NO CONSTRUCTION CHANGE OF USE / NO CONSTRUCTION jeSAPPLICANT'S SIGNATURE DATE Inspection List Permit#: CBI 51313 Type: PME DONOHUE RES-REPLACE FURNACE IN ATTIC Date Inspection Item Inspector Act Comments 05/01/2015 43 AirCond/Furnace Set - Rl FURNACE IN ATTIC 05/01/2015 43 AirCond/Furnace Set PB AP 05/01/2015 49 FinalMechanical - Rl FURNACE IN ATTIC 05/01/2015 49 Final Meciianical PB AP Monday, IVlay 04, 2015 Page 1 of 1