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HomeMy WebLinkAbout1009 DAISY AVE; ; CB091216; Permit07-23-2009 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Mechanical Permit Permit No CB091216 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Valuation Reference # PC# Project Title 1009 DAISY AVCBAD MECH 2144221400 $000 Lot# ZAWISTOWSKI RES- REPLACE FAU Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 07/23/2009 LSM 07/23/2009 07/23/2009 Applicant WEST COAST APPLIANCES SUITE B 10728 PROSPECT AV 92071 619-557-0446 Owner ZAWISTOWSKI FAMILY TRUST 10-25-06 1009 DAISY AVE CARLSBAD CA 92011 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 $1500 $900 $000 $000 $000 $000 $000 $000 $000 $2400 Total Fees $24 00 Total Payments To Date $0 00 Balance Due $2400 Inspector Clearance NOTICE Please take NOTICE that approval of your project includes the Imposition of Tees 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 capacity 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 CITY OF CARLSBAD Building Permit Application 1635 Faraday Ave Carlsbad CA 92008 760 602 2717 / 2718/2719 Fax 7606028558 www carlsbadca gov Plan Check No Est Value lfl.1 Plan Ck Deposit Date SUITE#/SPACE#/UNIT0 » BEDROOMS # BATHROOMS TENANT BUSINESS NAME_ DESCRIPTION OF WORK Include Square Feet of Affected Areafsj fl _ C CONSTR TYPE I OCC GROUPbE I OC( o EXISTING USE PROPOSED USE GARAGE (SF) CONTACT NAME (If Different Font Applicant) ADDRESS CITY STATE ZIP PHONE 1 FAX EMAIL PROPERTY OWNER NAME t r 5JQ^A <lXXO^> V^-VO O^^X^A ADDRESS _ A OCX} .DOIXS.U. ov.oe CITY . , c \ STAIE ZIPcksWwN LA mou PJHOKE i rv_ o <~\ -\/~ "") IFAX EMAIL ARCH/DES GNER NAME & ADDRESS STATE LIC # PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS YES D # NO D YES D NO D YES D NO D APPLICANT NAME ADDRESS CITY STATE ZIP PHONE 1 FAX EMAIL CONTRACTOR BtlS./f|AME i .\ \-O\KJftM UocxM YSnt), ITVY* ADDRESS ~ \ 1 ' _/, ft C AG~m^> vrO5>he<oA Oo^jf 4f 9,S CITY \ STATE ZIP JAJW\ X^^7 ^- A~^ ^^ L^-J ' pyOME FAX EMAIL , 4^9 •>?'2^- b^Z,\ STCic6 O^O e\o|c2olTr f\* \M 1 (Set 7031 S tusness 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 pursue 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 there from 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 "impensation Declaration / hereby affirm under penally of perjury one of the following declarations O I ha> c 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 G I ha,(.and will maintain workers compensation as requiretUjy Section 3700 of the Labor Code for the r^rformWce\^eVoWs^ffltrt^S|emitjs«sue4. My workers compensaiiop m num'-prare Insurance Co U-v\f \XX UJt VA-C yi4 \ wVCj, -fQ. \A CV Policy No VU"\1 KAAA- \M r\ \J\ Expiration Date. Th's secli .in need not be completed if the permit is for one hundred dollars (S100) or less O Certi/i-ate 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 sublet to the Workers Compensation Laws of California WARNING Failure to secure workers compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100 000) in addition 'o the cost of compensatiorCSanjages as provided for inaction 3706 of the^ Labor code, interest and attorney s fees A ACONTRACTOR SIGNATURE DATE / hereby afhrn that I am exempt horn Contractors 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 he did not build or improve for the purpose of sale) El I as owner of the property am exclusively contracting with licensed contractors to construct the proiect (Sec 7044 Business and Professions Code The Contractor s License Law does not apply to an owner of property wt o builds or improves thereon and contracts for such pro|ects with contractor(s) licensed pursuant to the Contractor s License Law) d 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 3 Yes n 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 mapr work (include name / 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 work) xt^fpROPFRTY 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 Tani '_r Hazardous Substance Account AcP Cl Yes D No Is the applit ant or future building occupant required to obtain a permit from the air pollution control district or air quality management district' a Yes n No Is the facility to be constructed within 1 000 feet of the ouler boundary of a school site' n Yes O No IF ANY OF THE ANSWERS ARE YES EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec 3097 (i) Civil Code) Lender s Name Lender s Address ii^sis^^ck^^ I certify that I lave 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 at*. me representative 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 A L LIABILITIES JUDGMENTS COSTS AND EXPENSE&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 ove>5 0 deea^hd demolition or construction of structures over 3 stones in height EXPIRATIOr I 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 authonzed by such permit is not commenced within 180 days Iron the date of such permit or if the buitdmg,or work ailhonzed by such permit is suspended or abandoned at any time after the work is commenced for a penod of 180 days (Section 106 4 4 Uniform Building Code) ^ T> *JSS APPLICANTS SIGNATURE \A en TV City of Carlsbad Bldg Inspection Request For 08/19/2009 Permit# CB091216 Title ZAWISTOWSKI RES- REPLACE FAU Description Type MECH Sub Type Job Address 1009 DAISY AV Suite Lot 0 Location OWNER ZAWISTOWSKI FAMILY TRUST 10-25-06 Owner ZAWISTOWSKI FAMILY TRUST 10-25-06 Remarks Inspector Assignment Phone 7604382007 Inspector Total Time CD Description 44 Rough/Ducts/Dampers 49 Final Mechanical Act _ Comments Requested By RON Entered By JANEAN Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act Insp Comments 07/27/2009 43 AirCond/Furnace Set CO MC SEE NOTICE CITY OF CARLSBAD BUILDING DEPARTMENT DATE NOTICE (760) 602-2700 1 635 FARADAY AVENUE TIME. LOCATION. PERMIT NO FOR INSPECTION CALL (760) 602-2725 RE-INSPECTION FEE DUE1? _ YES FOR FURTHER INFORMATION, CONTACT ^£>2. - "2."? 11 PHONE BUILDING INSPECTOR CODE ENFORCEMENT OFFICER ® CARLSBAD Unscheduled Building Inspection Building Department 1635 Faraday Avenue Carlsbad CA 92008 760-602-2700 DATE INSPECTOR PERMIT #CONTACT PHONE# JOB ADDRESS DESCRIPTION CODE DESCRIPTION ACT 60 COMMENTS Bldg Inspection Form Page 1 of 1 Rev 06/09 Check a License or Home Improvement Salesperson (HIS) Registration - Contractors Stat Page 1 of 1 Department of Consumer Affairs ***>• Contractors State License Board Contractor's License Detail - License # 810930 /l\ DISCLAIMER A license status check provides information taken from the CSLB license database Before relying on this information you should be aware of the following limitations CSLB complaint disclosure is restricted by law (B&P '! 2<; (5) If this entity is subject to public complaint disclosure a link for complaint disclosure will appear below Click on the link or button to obtain complaint and/or legal action information Per B&P 707! 17 only construction related civil judgments reported to the CSLB are disclosed Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration Due to workload there may be relevant information that has not yet been entered onto the Board s license database License Number Business Information Entity Issue Date Expire Date License Status Classifications Bonding Workers Compensation 810930 Extract Date 07/23/2009 WEST COAST APPLIANCE SERVICES INC 10744 PROSPECT AVE #B SANTEE CA 92071 Business Phone Number (619) 572 6221 Corporation 07/24/2002 07/31/2010 This license is current and active All information below should be reviewed CLASS DESCRIPTION C20 C10 WARM AIR HEATING VENTILATING AND AIR CONDITIONING ELECTRICAL CONTRACTOR'S BOND This license filed Contractors Bond number 69367861 in the amount of $12,500 with the bonding company WESTERN SURETY COMPANY Effective Date 01/01/2007 Contractors Bonding History BOND OF QUALIFYING INDIVIDUAL 1 The Responsible Managing Officer (RMO) ALEX PODKOZHURNIKOV certified that he/she owns 10 percent or more of the voting stock/equity of the corporation A bond of qualifying individual is not required Effective Date 07/24/2002 This license has workers compensation insurance with the ENDURANCE REINSURANCE CORPORATION OF AMERICA Policy Number WEN00941902 Effective Date 11/14/2008 Expire Date 11/14/2009 Workers Compensation History Personnel listed on this license (current or disassociated) are listed on other licenses Personnel List 1 Other Licenses Conditions of Use | Privacy Policy Copyright © 2009 State of California https /7www2 cslb ca gov/OnlmeServices/CheckLicense/LicenseDetail asp 07/23/2009 u a it& •o$2a 01 2 m 9 <u 0)5 ai=o•- c** cS 5 •£