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