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Home My WebLink About2892 CAMINO SERBAL; ; CB010453; Permit04/02/2001 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Mechanical Permit Permit No: CB011247 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: 2892 CAMINO SERBAL CBAD MECH 2552830300 Lot #: $0.00 GOLDSTEIN - ADD (2) AC W.ELEC Status: ISSUED Applied: 04/02/2001 Entered By: JM Plan Approved: 04/02/2001 Issued: 04/02/2001 Inspect Area: Applicant: LEGEND SERVICE SUITE 15 2588 PROGRESS ST VISTA CA 92083 760-631-8397 Owner: 5648 04/02/01 0002 01 GOLDSTEIN ERIC S&ANDREA K CQp 2892 CAMtNO SERBAL CARLSBAD CA 92009 02 53.00 Total Fees:$53.00 Total Payments To Date:$0.00 Balance Due: $53.00 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 Additional Fees TOTAL PERMIT FEES 2 0 0 0 0 0 $15.00 $18.00 $0.00 $0.00 $0.00 $0.00 $0.00 $20.00 $0.00 $53.00 Inspector: FINAL APPROVAL Date:Clearance: 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 you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. PERMIT APPLICATION *- CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 FOR OFFICE USE ONL PLAN CHECK NO. EST. VAL. Plan Ck. Deposit Validated By. Date I ./// Address (include Bldg/Suite *)Business Name (at this address) Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Total * of units Assessor's Parcel ## f ft/C Existing Use Proposed Use Description of Worl/SQ. FT.#of Stories # of Bedrooms (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 [$5 L Name ^.^ Address ' _ ^ State License # xO^ «5 OV License Class £-• « City S6te/Zip Telephone* j JL-/0 City Business License # / S^. / Otf £/^ // ' V^ Designer Name Address State License # City State/Zip Telephone Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: Q 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. yPT^ 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 issOBoT My worker's compensation insurance carrier and policy number are: Insurance Company (/ A// T&jQ /ffi"£ / f- f ^ Poll (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) 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 workerjj_compen»ation coverage Is unlawful. antt^haB jbbject an employer to criminal penalties and civil fines up to one hundred thousand dofrp-U 100.000). In addition to the cqajLot-sprnpensatton, dam*iQe*_as_££»jlea for In Section 3706 of the Labor code/ntereit andjrttomey'a fees. I hereby affirm that I am exempt from the Contractor's License Law for the following reason: n 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). Q 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). ("] I am exempt under Section Business and Professions Code for this reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. Q YES QNO 2. I (have / 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 / 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 / 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 of work): PROPERTY OWNER SIGNATURE DATE 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? Q YES Q NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Q YES Q N0 Is the facility to be constructed within 1 ,000 feet of the outer boundary of a school site? Q YES Q 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. .- ' •:•';:'-#.> - 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 _ LENDER'S ADDRESS _VA^^fwK^sramti^^Tiim- •• • -"" . ••>,>',---* ' ' ' ,,i, j kr*j, 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 City 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 i$ 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 sha|U»<pire, byjmitalon and become null and void if the building or work authorized by such permit is not commenced within 1 80 days from the date of such permit or if the^uilding orw&fk^thorized by such permit is suspended or abandoned at any time after the work is comrnenced for a period of 180 day* (Section 106.4.4 Uniform APPLICANT'S SIGNATURE ~ WHITE: File YELLOW: Applicant PINK: Finance -07 City of Carlsbad Bldg Inspection Request For: 04/25/2001 Permit# CB011247 Title: GOLDSTEIN - ADD (2) AC W.ELEC Description: Inspector Assignment: Type: MECH Sub Type: Job Address: 2892 CAMINO SERBAL Suite: Lot 0 Location: APPLICANT LEGEND SERVICE Owner: Remarks: PM PLEASE Phone: 7606357862 Inspector: Total Time: CD Description 43 AirCond/Furnace Set Comments Requested By: ANDREA Entered By: ROBIN Associated PCRs Inspection History Date Description Act Insp Comments CERTIFICATE OF LIABILITY INSURANCI*^DATE{MWDD/YY) 06/22/00 <CR ,._^_ J. Associates Ins. Svcs. _A DOI License #0303623 138 Camino Del Rio South #112 San Diego CA 92108 Phone:619-908-3100 Fax:619-908-3110 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURER* United Pacific Insurance Co. Service Centeren fi Sue Ehart INSURER B: C: Progress StreetVista CA 92083 INSURER O: INSURER Et COVERAGES AMY REQUIREMENT, TERM OR CONDITION OF AMY CONTRACT OR OTHER DOOlMEimNrm RESPECT TO WHICH TMSCERTK^TE MAY BE ISSUED OR IMY PERTAIN. 1WINSUMHCE AFTORDO} BY nc KXJC« OESCia^ POLICIES. AGGREGATE UMTS SHOWN MAY HAVE BEEN RBDUCHJ BY FMD CLAWS.m I A TYPEOFMSURANCE GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY ~~| CLAMS HADE | | OCCUR GEM. AGGREGATE UMTT APPLIES PER ~l«)ucr! |5I§F 1 !«« AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS MON-OWNED AUTOS (5A!>*r*is > UHH rrv ANY AUTO BCC1^8 LIABILITY I]OCCUR [ | CLAIMS WADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AMD OTHER POLICY NUMBER NWA27B337800 SVfSSSa^T 06/14/00 '0WlMHS^YY?M 06/14/01 UNITS EACH OCCURRENCE FIRE DAMAGE (Any on* fln) MED EXP (Any an* pmon) PERSONAL I ADVMJUKY GENERAL AGGREGATE PRODUCTS - COMHOP AG6 COMBINED SINGLE UMTT(EaKddwtt) BODILY INJURY<Pwp«»on) BODILY INJURY (PWMXWMQ PROPERTY DAMAGE(Pv«ecUw« AUTOONtY - EA ACCBKHT OTHER THAN EAACC AUTO ONLY: MQ EACH OCCURRENCE AGGREGATE X ) %n! STAkU- 1 lOlfH-iTORYUMrrsI 1 ER EJ_ EACH ACCIDENT E.L. DISEASE - EA EMPLOYE! EX. DISEASE - POLICY UMTT $ S *t t $ t $ s $ *$ $ $ $ s t % $ 1000000 s 1000000 t 1000000 DESCRtPTtON OF OPERATK)NSft.OCATIONS/VEHKftES<EXCLUSmNS APOH> BY ENOORSEMEH'Uil'CCIAL PROVISIONS CERTIFICATE HOLDER N ADDITIONAL INSURED: INSURER LETTER:CANCELLATION FORINFO SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING INSURER VMLL ENDEAVOR TO HAIL 10 DAY»«W«nENNOTIC£TOTHECERTIFICATEHOLDERNAMEDTOTHE LEFT. BUT FAILURE TO DO SO SHALL MPOSE NO OBLIGATION OR LIABILITY OF I THE INSURER. ITS AGENTSyOR REPRESENTATIVES. .el E./Beolc ACORD 25-S (7/97)- ACORD CORPORATION 198f