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HomeMy WebLinkAbout2653 SAUSALITO AVE; ; CB000255; Permit. V5h~L/ City of Carlsbad 01 /27/2000 Mechanical Permit Permit No: CB000255 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: Building Inspection Request Line (760) 602-2725 2653 SAUSALITO AV CBAD MECH 1675117400 Lot#: 0 $0.00 MONTGOMERY RES-NEW A/CW/ ELEC Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 01 /27/2000 RMA 01 /27/2000 01 /27/2000 Applicant: COASTAL AIR MECHINICAL MONTGOMERY EAMIL Y TRffiPr4d0Lfi7g'&'() 0001 01 02 12860 WAREHOUSE ST SAN DIEGO CA 92129 61 9-679-7951 2653 SALJSALIT© AVE CARLSBAD CA 92008 Total Fees: $44.00 Total Payments To Qate: $0.00 Balance Due: 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 TOTAL PERMIT FEES Inspector: Clearance: $15.00 $9.00 $0.00 $0.00 $0.00 $0.00 $0.00 $20.00 $44.00 C-PRHT 44-00 $44.00 NOTICE: Please take ICE that approval of your project includes the 'lmpcsition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as 'fees/exactions." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Ca~sbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their impcsition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capactiy changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project NOR DOES IT APPLY to any fees/exactions of which ou have reviousl been iven a NOTICE similar to this, or as to which the statute of limitations has reviousl otherwise ex ired. CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 PEiiMIT APPLICATION FOR OFFICE USE 0~ PLAN CHECK NO. '[;00 Qfj_ CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 EST. VAL. ________ _ Plan_ Ck. Deposit -----++....---- Validated B'llrr----,----+.;;;.---- Date_---1,-+-+---+.,...,..~-:,,'------ Addrua (include Bldg/Suite #I Bu.inNs Name (It this addras) Legal Description Lot No. Subdivilion N1m1/Number Unit No. PhHe No. Total II of units Auuaor'■ Parcel# Exi■tingUn Propo■ed Use , of Bathrooms · ... ·---.t ... , :• .... N1me AddrNS City St1te/Zip Telephone I Fax fl . ·'' f-'. ?:ri~-~~~~~~:#0:.~~·,.:·--~--~' ··s,.Z;. C?fi-z:,;i; "3~-i/f'i/,-o~'l_/ Name City State/Zip Telephone , J?:r,.c:p ,?u;J;.;rGtJmay· · ~~s-3 At!drNS S4<+5&417p,· ~,;~~;;;$~~~-:~··;;#? · ~-.231/-3 N1me City State/Zip Telephone II ._,,. Designer Name Address City State/Zip State License II _________ _ ~iWCJB~lCO'~N"'""•SS""""Si"""·~'::."':a ... ~_,_ C'.!'!-!l:l':!· ~-~-'!l_~at;e=:!!:· ~~.:P.:.W,;1i,,.~?!=-~~:~~S~:..'$;"·!".'.:f' --~--•- workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following decl1r■tions: Telaphone O I hive end will miintein I certificata of consent to s1lf-insur1 for workers' compenution H provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is iaaued. O I hive and will maintain workers' compensation, a■ required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My worker' a compensation insurance c1rri1r ind policy number· 1r■: lnsurence Company_____________________ Policy No. Expiration Date _______ _ O:Hl~ON NEED NOT IE COMPLETED IF THE PERMIT 19 FOR ONE HUNDRED DOLLARS rnoo, OR LESS) · "- (lP'cERTIRCATE OF EXEMPTION: I c1rtlfy that In the performance of the ;,..ork for which thia permit i1 is■u■d, I ■hill not employ· any person in any m1n'ner 10 11 to become subject to the Workers' Companiation Laws of California. WARNING: Failure to Hcur■ w en' Ntlon C0"'8g■ II IA'llllwful, iind ■hall IUbj■ct an employer to c:rimlnll ~ end civil finu up to one hundred thowllld doll•• 1*100,0001, -of ~tlon. clamegu .. pnrncbd far In S■ctlon 3708 of the Labo, code, lnter11t end lttom■y'a •-· SIGNATURE~r:;;;:;;~:;:;~;;;;;;;;..Jt;-; --~-; -~;;;:~;;:;::;;;;:;~;;;;.:;;;,;;~;;;~~ DATE /-~ iZ,--CJcJ ?.;;JJoWJiEif.iiUitollt'br~=~~;;:si~~t~~$fiil~•t~:.~~'f~~~/1tt:t-:.;_.:~~~:~r~-:F•Y~ .... t.~J:7·::;;:::-~· ,·· ··· ·~---.~:M .. ~-~-: I hereby affirm that I 1m exempt from the C0ntrector's Licens~ Law for th• fc,llowing r1Hon: 0 I, as owner of the propany or my employNs with w■ges II their ■ole comp1nution, will do the work ind the structure la not intended or offered for Hie (Sec. 7044, Business and Prof■s■ions Code: The Contractor'• Ucenn Law does not apply to ■n owner of property who builds or improves thereon, and who does such work himself or through his own emplov■■s, provided th■t such improvements ■re not intended or offered for Hie. If, however, the building or improvement is sold within one yHr of completion, the owner-builder will h■v1 the burden of proving that he did not build or improve for the purpose of uleJ. 0 I, es owner of the propany, 1m exclusively contracting with licen■1d contractors to construct the project (Sec. 7044, Busin1s■ end Prof1uiona Code: The Contr■ctor's License Law does not apply to 1n owner of propeny who builds or improves thereon, ■nd contracts for such projects with comt1ctorls> licensed pursuant to the Contractor'■ Uc1na1 Lew). 0 I 1m exempt under Section ______ Buainn■ and Professions Coda for this r■11on: 1. I p1raon1lly plen to provide the major labor ind materials for construction of the prOl)OHd prop1ny improvement. 0 YES ONO 2 . I (have/ have not) signed an application for• building permit for th• proposed work. - 3 . I have contracted with the following parson (firm) to provide the proposed construction (include name / address / phone number / contractors· license numberJ: 4 . I plan to provide ponions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / addreas / phone number/ contractors license numberl: ______________________________________________ _ 5. I will provide some of the work, but I h■ve contracted (hired I the following persons to provide the work indicated (include name / 1ddre■s / phone number / typ1 of workJ: _________________________________________________________ _ PROPERTY OWNER SIGNATURE______________________ DATE _________ _ 'cdMPLET.EmtlS~Ec:ffl)~7"'~bti~R~i5~~®;M,~S'::1:':~. '··;--:•:~· •·-:~:~::.:~:-':_''' • -· ~: - Is the applicant or future building occupant required to submit I busin.. plan, acutely hazardous m1t1ri1ts registration form or risk management and prevention program under Sections 25505, 25533 or 26534 of the Prutey.T1nn■r H~rdoua Sub■t1nc1 Account Act? 0 YES O NO Is the applicant or future building occupant required to obtain I permit from the air pollution control district or air quality management district? O YES O NO Is the facility to be constructed within 1,000 fHt of the outer boundary of I school site? 0 YES O NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NO'!'!'!~ !!''.Rim \JNIJ!..C:S THE APPUC.tl_",!T HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFRCE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTAOL DISTRICT. lf..~~Or,sfiro'c:rjo~'C:\.a{~-~ · ~~ · !Z;,¥.~'1lf..;;:~~;-:J~~~~~.:.:. ... ,.:: · I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(1) Civil Code>. Ll'NDER'S NAME_____________ LENDER'S ADDRESS. _______________________ _ 11:~9~~CEA.tmCAliO~~~~~~~tlS{!\~'~::;;,··· .. ··-:.-· _ . I cenify that I have read the application ind state thlt the above information Is correct ind that the information on the plans is accurate. I agree to comply with all City ordinances ind Stat■ laws relating to building construction. I hereby authorize r1pre■1nt1tiv11 of the Citt of Carlsbad 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 LIABILITIES, JUDGMENTS, COSTS ANO EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CfTY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for exc1v11tion■ over 5'0" CINp and d1molltion or cx,nstruction of structures over 3 stories in height. EXPIRATION: Every permit iHued by the llding Official under the provi■ions of this Code ■hall 1xpir1 by limitation ind become null and void if the building or work authorized by such permit is not c •~e · 365 dlya from the dllte of ■uch r:,ormit or If the building or work authorized by such permit ,s suspended or abandoned at any time after the wo om c1 or I period of 180 divs (Section 106.4.4 Uniform Building CodeJ. APPLICANT'S SIGNATURE .., ,~ DATE /-o:i,.7---c,o WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 2/4/2000 Permit# CB000255 Title: MONTGOMERY RES-NEW A/CW/ ELEC Description: Type:MECH Sub Type: Job Address: 2653 SAUSALITO AV Suite: Lot 0 Location: APPLICANT COASTAL AIR MECHINICAL Owner: MONTGOMERY FAMILY TRUST 06-17-98 Remarks: Total Time: ----- Inspector Assignment: ~ Phone: 7607202343 Inspector: ---- Requested By: SUSAN MONTGOMERY Entered By: ROBIN CD D-e-s-cr-ip-t-io_n _______ ~. Act Comments fl: ... ---,!7 43 _AirCond/Furnace Set <-rt-~,~.r;;J/_ Associated PCRs Inspection History Date Description Act lnsp Comments