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Home My WebLink About2899 CAMINO SERBAL; ; CB043396; Permit08-30-2004 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Mechanical Permit Permit No: CB043396 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: 2899 CAMINO SERBAL CBAD MECH 2552832000 $0.00 MOCK RESIDENCE INSTALL A/C Applicant: MOCKJOHNL&MARYA 2899 CAMINO SERBAL CARLSBAD CA 92009 Lot#: Status: ISSUED Applied: 08/30/2004 Entered By: MDP Plan Approved: 08/30/2004 Issued: 08/30/2004 Inspect Area: Owner: MOCKJOHNL&MARYA 2899 CAMINO SERBAL CARLSBAD CA 92009 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 $15.00 $9.00 $0.00 $0.00 $0.00 $0.00 $0.00 $20.00 $0.00 $44.00 Total Fees:$44.00 Total Payments To Date:$0.00 Balance Due:$44.00 9949 08/30/04 0002 01 02 COP 44.00 FINAL APPROVAL DAT!/^ SIGNATURE .CLEARANCE PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 >,i;.,PROJECTI—Itlo FOR OFFICE USE ONLY PLAN CHECK NO. EST. VAL. Plan Ck. Deposit Validated By Date 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 *Existing Use Proposed Use Inscription of Work SO. FT.tot Stories * of Bedrooms * of Bathrooms Name Address City <M3'<i^^ for Owner State/Zip Telephone #Fax # Name (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 l$5001). Name State License * Address License Class City State/Zip City Business License f Telephone * Designer Name State License # Address City State/Zip Telephone Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: O 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 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1*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 worker*' compensation coverage Is unlawful, and ahal subject an employer to criminal penalties and civil fines up to one hundred thousand dollars 1*100000). Mi addition to the cost of compensation, damages aa provided for hi Section 3706 of the Labor code. Interest and attorney's fees. SIGNATURE-——•""""fo-*-*-' / DATE VSmffBiBjf 1 hereby affirrfr-thaU^m exempt from the Contractor's License Law for the following reason: O 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 ha did not build or improve for the purpose of sale). d_-l, 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). n I sm 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. D 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): v of \ 5. I will provide some of the work, but^ffliave contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type of work): _/ l_ OPERTY OWNER SIGNATURE Is the applicant or future building occupant required to submit a business plen, acutely hazardous materials registration form or risk management and prevention program under Sections 2SS06, 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 O NO 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. ISiliMlSDa^ „- ...-„,._ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(0 Civil Code). LENDER'S NAME LENDER'S ADDRESS 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 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 at any time after the work is commencedlbr a period of 180 days (Section 106.4.4 Uniform Building Code). / / ICANT'S SIGNATURE ^^^^"^T^»*l. * -. DATE &/^£)/G- \ APPIII WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 09/20/2004 Permit* CB043396 Title: MOCK RESIDENCE Description: INSTALL A/C Inspector Assignment: RB Type: MECH Sub Type: 2899 CAMINO SERBAL Lot 0 Job Address: Suite: Location: APPLICANT MOCK JOHN L&MARY A Owner: MOCK JOHN L&MARY A Remarks: Phone: 7609449460 Inspector: Total Time: CD Description 43 AirCond/Furnace Set Act Comment Requested By: N/A Entered By: ROBIN Associated PCRs/CVs Inspection History Date Description Act Insp Comments 09/08/2004 43 AirCond/Fumace Set CO RB SEE NOTICE (1147-H2) City of Carlsbad Bldg Inspection Request For: 09/08/2004 Permit* CB043396 Title: MOCK RESIDENCE Description: INSTALLA/C Inspector Assignment: 2899 CAMINO SERBAL Lot 0 Type: MECH Sub Type: Job Address: Suite: Location: APPLICANT MOCK JOHN L&MARY A Owner: MOCK JOHN L&MARY A Remarks: Phone: Inspector: Total Time: CD Description 43 AirCond/Furnace Set Act Comment Requested By: MOCK RESIDENCE Entered By: CHRISTINE Associated PCRs/CVs Inspection History Date Description Act Insp Comments C!TY OF CARLSBAD BUILDING DEPARTMENT DATE NOTICE (760) 602-2700 1635 FARADAY AVENUE TIME LOCATION PERMIT NO. FOR INSPECTION CALL (760) 602-2725. RE-INSPECTION FEE DUE? FOR FURTHER INFORMATION, CONTACT YES PHONE CODE ENFORCEMENT OFFICER