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HomeMy WebLinkAbout1243 MARIPOSA RD; ; CB050812; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 03-16-2005 Mechanical Permit Permit No: csosoa12 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: 1243 MARIPOSA RD CBAD MECH 2122203900 $0.00 WILKE RES ADD 2 A/C UNITS .,··;__,. ---.., Applicant: MAJOR LEAGUE HEATIN IR CONDITIONING 1356 OLINK DRIVE VISTA 92083 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 Status: Lot#: 0 Applied: 2 0 0 0 0 0 Entered By: Plan Approved: Issued: Inspect Area: Owner: WILKE MARK W&NEILSON LORNA I 1243 MARIPOSA RD CARLSBAD CA 92009 ISSUED 03/16/2005 SB 03/16/2005 03/16/2005 $15.00 $18.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $33.00 Total Fees: $33.00 Total Payments To Date: $0.00 Balance Due: $33.00 Inspector: 3913 03/1.6/05 0002 0.1 CGP 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. 02 33. 00 FOR OFFICE USE ONLY ~ ,-= PLAN CHECK NoCft O '.:> vol 'L PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST. VAL. _________ _ Address (include e1fg1suite #) Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Existing Use Proposed Use SQ. FT, #of Stories # of Bedrooms # of Bathrooms ~ame 7Go J/-31-C/bt 7 Telephone# ·i;. ;·,, !el!IIIITl!A'eTOB;,,.QOMl!AN'I'' MME• . (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 e emptlo!l, Any violation of Section 7031 5 by any applicant it subjects e appli nt to civil penaty of ot m e than five hu dred dollars ($500)). License Class #Jfrl- Designer Name Address City State/Zip Telephone State License # _________ _ ~, ' ,i:w,af!~, lil!MPUltAmbN ' Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: D I have end 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. -hZC 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 rsued. My worker's c ensation ins nee carrier a policy nu ber are: :,): Insurance Company , Policy No. J/(}(:'//51) ,'J..'i't/JP 3 Expiration Date 7µ YjtJ S- (THIS SECTION NEED NOT B COMPLETED I HE PERMIT IS FOR ONE HUNDRED DOLLARS 1$100) OR LESS! D CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure secure workera' compensation coverage la unlawful, and shall subject an employer to criminal penattiea and civil fines up to one hundred thousand dollars O 001, In dlt cost of compe tlon, damages as provided for In Section 3706 of the ~b~ code'....lnte,d attorney's fees. SIGNATURE•:c:':~~~2:,4,~~!'.21~'4'~~'.'.'.'..--,-....,..--,--,-,cc,-----,-----,-DATE ,-1 lb t', '.:L_ ,7, 'hbw~u1J!D$!Q~c;!i.\iRA:ti · 11 I hei'eby affirm that I am exempt from the Contractor's License Law for the following reason: D 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. lf, 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). 0 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). 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. D YES ONO 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 propossd construction (include name / address I 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 I contractors license number).,_------------------------------------------------ 5. I will provide soma of the work, but J have contracted (hired) the following persons to provide the work indicated (include name I address / phone number / type of work): _____________________________________________________ _ PROPERTY OWNER SIGNATURE _____________________ _ iQQll'!!liffl~IS>Seonoi,UFOR'l\'ONi'ffl;,S/QENT/ALie!-ll~l;>INQ·~ERMITS ONUY 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-Tanner Hazardous Substance Account Act7 D YES D NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? D YES D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site7 0 YES D NO !F ANY OF THE Af'!SWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS. OF THE OFF.ICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. !lb\ , CW,!~'rll,I.ICTIOlll'~~Nl;>IN!l;AGENCV . I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec, 3097(i) Civil Code). LENDER'S NAME ______________ _ rji;,M,il!BJ!!:10A11;r'~elir1F1Q!iTION · 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 Citt 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 comm d within 180 days from the date of such permit or if the bulldlng or work authorized by such permit is suspended or abandoned at any time after the work is co o a period o .18 ys ecti~n 106.4;.Y'11form Building Code). APPLICANT'S SIGNATURE L_,.,t.~~""'~4 ';2.lf:2J~~~'=;il~--------DATE ,~1£-a s:::: : Applicant PINK: Finance . -City of Carlsbad Bldg Inspection Request For: 04/07/2005 . Permit# CB050812 Title: WILKE RES ADD 2 A/C UNITS Description: Type: MECH Sub Type: Job Address: 1243 MARIPOSA RD Suite: Lot 0 Location: OWNER WILKE MARK W&NEILSON LORNA I Owner: WILKE MARK W&NEILSON LORNA I Remarks: AM EARLY PLEASE Total Time: Inspector Assignment: PD --- Requested By: MARK Entered By: JANEAN CD Description Act Comment 43 _A_i_rc_o_n_d_/F_u_r_n_ac_e_s_e_t ___ ~ ,( / N ftL: Associated PCRs/CVs Inspection History Date Description 04/05/2005 43 AirCond/Furnace Set Act lnsp Comments CO PD ONCARD