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Home My WebLink About2595 REGENT RD; ; CB061817; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 06-23-2006 Mechanical Permit Permit No: CB061817 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 2595 REGENT RD CBAD MECH Status: Parcel No: 2081331254 Lot#: 0 Applied: Valuation: $0.00 Reference#: Project Title: PAVLOFF RES-INSTALL NEW A/C Applicant: PAVLOFF KATIA 2595 REGENT RD CARLSBAD CA 92010 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 1 Entered By: Plan Approved: Owner: PAVLOFF KATIA 2595 REGENT RD CARLSBAD CA 92010 Issued: Inspect Area: Total Fees: $40.50 Total Payments To Date: $40.50 Balance Due: ISSUED 06/23/2006 LSM 06/23/2006 06/23/2006 $15.00 $9.00 $0.00 $0.00 $0.00 $0.00 $16.50 $0.00 $0.00 $40.50 $0.00 EXPIRED PERMIT Inspector: FINAL APPROVAL Date: PERMIT HAS EXPIRE\J IN /EGORDANCE WITH C.B.C. SECTION 106.4.4 AS AM[NQEO BY C.M.C.18.04.030 DATI:ih'3.µ. SIGN/\TURE__,d._r4,,,1,."'('----- Clearance: NOTICE: Please take NOTICE that approval of your project includes the 'Imposition" of fees, dedications, reseivations, 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 Ca~sbad 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 ff APPLY to any fe x i n f hi h have vi Tl E imil r hi r i h th limi I h rw· FOR OFFICE USE ONLY ' ti PLAN CHECK NO. ~ 0 (a/~ I ) . PERMIT APPLICATION EST. VAL. __________ _ CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 Plan Ck. Deposit (?: Validated By ~;;J Date 0 / ;;>.. °6 / O(o 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 Desaiptlon of Work . tJei)}. SQ. FT. r/-A-ov1N& ,ti,z C.76NI>;·hoNiJJG 2. CONTACT PERSON (If different from applicant) #of Stories t of Bedrooms # of Bathrooms Name Address City State/Zip Telephone# Fax# 3. APPLICANT □ Contractor □ Agent for Contract>r )( Owner □ Agent for Owner k"lfTi/1 &IVU>l'F ,,Ro951(E&GNT 1<olt/J Ct/£Lf>J3/tD (!,4 1201() 7t,O ~ 7"J.0· f.337: Name Address City State/Zip Telephone# 4. PROPERTY OWNER K/'trtA fJ/JVl-OFr ~.5'16 'R1=:.t:rcwr 1<MD e11~BA-D C/1-C/20/D Name Address City State/Zip Telephone# 5. CONTRACTOR· COMPANY NAME (Sec. 7031.5 Business and Professions Code: Any City Of County which requires a pem1it to construct, alter, improve, demolish Of 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] Of that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a pem1it subjects the applicant to a civil penalty of not more than five hundred dollars [$500)). Name Address City State/Zip Telephone# State License, ________ _ License Class __________ _ City Business License I __________ _ Designer Name Address City State/Zip Telephone# State License# _______ _ 8. WORKER'S COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: □ 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. □ I have and will maintain worker's compensation, as required by Section 3700 of the labor Code, for the performance of the work for which this permit Is issued. Mt 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 [$100) OR LESS) □ CERTIFICATE OF EXEMPTION: I certify that In the perfoonance of the work for which this pennit Is issued, I shall not employ any person In any manner so as to become subject to the Wortcers' Compensation Laws of California. WARNING: Fallure to MCure wort<ers' compansatlon coverage Is unlawful, and shall subject an employer to crlmlnal penaltlN and cMI flMS up to one hundred thousand dollars($100,000), In addition to the cost of compensation, damages are provided for In Section 3708 of the Labor Coda, lnwrest and attorney's fan. SIGNATURE. ______________________________ DATE 7. OWNER-BUIU>ER DECLARATION ·-------:=====--~ I hereby affirm that I am exempt from the Contractor's License Law for the following reason: □ I, as owner of the property Of my employees with wages as their sole compensation, will d the work and the structure is not intended Of offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds Of improves thereon, and who does such work himself or through his own employees, provided that such improvements are not intended Of 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 Of improve for the purpose of sale). )( I, as owner of the property, am exdusively contracting with lioensed 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 Of 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. □ YES □ NO 2. I (have/have not) signed an application for a building permit for the proposed worll. 3. I have contracted with the following person (firm) to provide the proposed construction (indude name /address/ phone number/ contractors license number): 4. I plan to provide portions of the work, but I have hired the following person to cooldinate, supervise and provide the major wor1I (indude name/ address/ phone number I /ontractors license number): ------------------------------------------ 5. I wiM provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (indude name I address/ phone number I type of work): PROPERTYOWNERS"IO\TURE ~7;Q~ .. ,. 6P .:/62 P~Rll1T APPLICATION .. CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 Page 2 of 2 COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY Is the applicant or future building occupant required to submit a business plan, aartely hazardous materials registration for or risk management and prevention program under Sections 25505, 25533 or 25534 or the Presley-Tanner Hazardous Substanoe Account Ac%? □ YES □ NO Is the applicant or future building occupant required to obtain a pennit from the air pollution oontrol disbict or air quality management district? □ YES □ NO Is the facility to be constructed within 1,000 feet c:A the outer boundary or 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 ANO THE AIR POLLUTION CONTROL DISTRICT. 8. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a oonslnlction lending agency for the performance of the wor1( for which this permit is issued (Sec. 3097(1) Civil Code). LENDER'S NAME _________________ _ LENDER'S ADDRESS __________________ _ 9. APPLICANT CERTIFICA110N 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 oroinances and State laws relating to building construction. I hereby authorize representatives of the City of Car1sbad to enter upon the above mentioned property for Inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY ANO KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILmES, JUDGEMENTS, COSTS ANO 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 of 5'0" deep and demolition or C0llSlrudion of structures over 3 stories in height EXPIRA110N: Every pennit issued by the building Official under the provisions of this Code shaU expire by Hmitation and become nuU and void if the building or wol1( authorized by such permit is not oommenoad within 180 days from the date of such permit or if the building or wol1( authorized by such permit Is suspended or abandoned at any time after .. -•-"'•~v_~..:;;u,_, ,..,.,_,. /4 AP~SSIGNATIJRE w~ DATE h/43, C.