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Home My WebLink About2673 SAUSALITO AVE; ; CB112041; Permit09-21-2011 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: Applicant: City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No: CB112041 Building Inspection Request Line (760) 602-2725 2673 SAUSALITO AV CBAD PME 1675121600 Lot#: 0 CRUZEN: CHANGE OUT FURNACE &ADD NC Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 09/21/2011 JMA 09/21/2011 09/21/2011 LIBERTY MECHANICAL INC 2959 HOLLY RD AVERILL WINIFRED TRUST 01-29-91 ALPINE CA 91901 619-247-0458 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees 2673 SAUSALITO AVE CARLSBAD CA 92010 $0.00 $0.00 $150.00 $0.00 TOTAL PERMIT FEES $150.00 Total Fees: $150.00 Total Payments To Date: $150.00 Balance Due: Inspector: Clearance: $0.00 NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, rese1Vations, 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 capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOA DOES IT APPLY to any t x i n I whi h hav r vi usl n iv n N Tl imi r h' r whi h h Ir i «~'» ~ CITY Of CARLSBAD Building Permit Application 1635 Faraday Ave., Garlsbad, CA 92008 760-602-2717 / 2718 / 2719 Fax: 760-602-8558 www.carlsbadca.gov SUITE#/SPACE#/UNIT # Plan Check No. Est. Value Plan Ck. Deposit Date Z--1 I f APN PHASE # # OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME SWPP CONSTR. TYPE OCC. GROUP EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE YES □#_ NOD AIR CONDITIONING FIRE SPRINKLERS YES □ NOD YES □ NOD APPLICANT NAME (Primary Contact) APPLICANT NAME (Secondary Contact) ADDRESS ADDRESS CITY STATE ZIP CITY STATE ZIP PHONE FAX PHONE FAX EMAIL PROPERTY OWNER NAME A ADDRESS ()J. CITY STATE ZIP PHONE FAX AIL ARCH/DESIGNER NAME & ADDRESS STATE UC.# (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to_construct, alter, improve, demolish or repair an): structure, J)rlor to its issuanc , 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 00 of DivIsIon 3 of the Business and Professions Code} or that he is exemJ;lt 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 {$500)). ' ' WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penally 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 pertormance of the work for which this permit is issued. □ I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the \Nllrk for which this permit is issued. My workers' compensation insurance carrier and policy • number are: Insurance Co. ______________________ Policy No. ______________ Expiration Date _________ _ !section need not be completed if the permit is for one hundred dollars ($100) or less, Certificate of Exemption: I certify that in the perto'l)'""'"'-J~,e 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 rnia. WARNING: Failure to sec ' mpensatl coverage is unlawful, and &hall subject an employer to crlmlnal penaltln and civil fines up to one hundred thousand dollars (&100,000), in II,;: addition to the cost of compen1 , damages as vlded for i Section 3706 of the Labor code, interest and attorney's fees. ,/15 CONTRACTORSIGNATU,:::_-~:.,.. ~ □AGENT OATE -2--I C> 1111 IIIE R•ll II tU, EJt Pr, 4.~AR_kT'i_ON I hereby affirm that I am exempt from Contractor's Ucense Law for the following reason: □ 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). O 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 personaJly plan to provide the major labor and materials for construcUon of the proposed property improvement. D Yes □ No 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/ 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 I address/ phone/ 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/ type of 'Mlrk): _6! PROPERTY OWNER SIGNATURE □AGENT DATE COMPLIM'II THIS SIICTION FOR 11101!1-RES!OIINTIAL 11!.IH.l>ING l'IIRMltS ONLY Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration fonn 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 from the air pollution control district or air quality management district? □ Yes □ No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? O 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, I certtfythat I have iead the application and state that the above lnfonnatlon Is correct and that the infonnatlon on the plans is accura1e. I agree to c:omply'Mlh all City ordinances and StatB laws mlating to building construction. I hereby authorize representative of the City of Cartbad to enterup:)11 the alxlve mentK>ned property br inspeciion purposes, I Af..S0 AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO EXPENSES WHICH MAY IN ANY WAY ACCRUE AG/>JNST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: M OSHA permrt is required br excavatKlns over 5'0' molition or construction of structures ova: 3 stories in height. EXPIRATION: Every pennil issued by the B · rlhe provi · ns of this Code shall expire by limitatkJn and become null and void if the buik:ling or Y.«k authorized by sudl permrt is not commenced Wthin 180 days from the date of such P3rmit o · e building or authorized such pennlt is suspended or abandoned at anytirre after the w:irk is commenced for a perbd of 180 days (SectkJn 100.4.4 Unifonn Building Code). ~ APPLICANT'S SIGNATU DATE City of Carlsbad Bldg Inspection Request For 11/07/2011 Permit# CB112041 Title: CRUZEN: CHANGE OUT FURNACE Description: & ADD AJC Type:PME Sub Type: Job Address: Suite: 2673 SAUSALITO AV Lot: 0 Inspector Assignment: ~ Phone: 6198514255 Location: Inspector: ---- OWNER AVERILL WINIFRED TRUST 01-29-91 Owner: AVERILL WINIFRED TRUST 01-29-91 Remarks: A M PLEASE Total Time: Act Comments Requested By: NA Entered By: CHRISTINE CD Description 43 AirCond/Furnace Set 49 Final Mechanical f----- Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# Inspection History Date Description Act lnsp Comments