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HomeMy WebLinkAbout1254 BASSWOOD AVE; ; CB011009; Permit03/14/2001 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Mechanical Permit Building Inspection Request Line (760) 602-2725 Permit No: CBOI 1009 Job Address: Permit Type: MECH Status: ISSUED Parcel No: 2050521000 Lot #: 0 Applied: 03/14/2001 Valuation: $0.00 Entered By: RMA Reference #: Plan Approved: 03/14/2001 Issued: 03/14/2001 Project Title: HOLLYWOOD RES-REPLACE FAU Inspect Area: 1254 BASSWOOD AV CBAD Applicant: BOYD ROGERS PLUMBING 2525 FORTUNE WY VISTA CA 92083 760 727-7040 5516 HALIFAX ARCADIA CA 91007 Total Fees: $24.00 Total Payments To Date: $0.00 Balance Due: $24.00 Mechanical Issue Fee lnstall/Fum/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 $15.00 $9.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $24.00 Inspector: Date: Clearance: NOTICE: Please take NOTICE that approval of your project includes the 'Im&iConGf fees, dedications, reservations, or other exactions hereafter collech;vely referred to as "feeslexactions.' You have 90 days from the date this permit was issued to protest imposition of these feeslexactions. 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 feeslexactions DOES NOT APPLY to water and sewer connection fees and capactiy changes, nor planning, zoning, grading or other similar applimtion processing or service fees in connection with this project NOR DOES IT APPLY to any feeslexactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 FOR OFFICE USE 0 PLAN CHECK NO. EST. VAL. Plan Ck. Deposit Validated By Date Total # of units Phase No. Legal Description Lot No. Subdivision NamelNumber Unit No. Existing Use Proposed Use SO. FT. #of Stories # of Bedrooms # of Bathrooms Name Address City Statelzip Telephone # Fax # ,--I , y Y -_ .-.. Name ' Address City Statelzip Telephone # Name Address City Statenip Telephone # F4N (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 Codel or that he is exempt therefrom, and the basis for the alleged penalty of not more than five hundred dollars 1$50011. e+ 227-59VD Name Address City Statelzip State License t qLl2a Y? License Class f' City Business License # Designer Name Address City Statelzip Telephone State License # US Workers' Compensation Declaration:' I hereby affirm under penalty of perjury one of the following declarations: 0 of the work for which this permit is issued. 0 issued. My worker's compensation insurance carrier and policy number are: Insurance Company c 1 0 rd~ - Policy NO. EL t 641 I 7r Expiration Date { 1 -. 3.. (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS IS1001 OR LESS1 0 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 to secure workers' compensation coverage is unlawful, and shall subject an employar to criminal penalties and civil fines up to one hundred thousand dollars (8100,000k in addition to the cost of compensation, damages as provided for In Section 3706 of the Labor code, interest and attorney's fees. 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 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 SIGNATURE DATE 7. ' OWNER-BUILDER OECtARATlON *, I hereby affirm that I am exempt from the Contractor's License Law for the following reason: 0 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). 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 contractodd licensed pursuant to the Contractor's License Law). 0 1. 2. 3. I am exempt under Section I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES ON0 I (have I have not) signed an application for a building permit for the proposed work. I have contracted with the following person (firm) to provide the proposed construction (include name / address I phone number / contractors license number): Business and Professions Code for this reason: 4. number I contractors license number): 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 I phone some of the work, but I DATE 6-PfmLfl cr; PROPERTY OWNER SIGNATURE m 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 Act? 0 YES 0 NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES 0 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. 0 YES 0 NO 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 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 commenced within 180 ays from the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced for a period of~E&ys (Section 106.4.4 Uniform Buildina Code). -. APPLICANT'S SIGNATURE DATE c/ I I/ W \ WHITE: File YELLOW Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 03/16/200 I Permit# CBO11009 Inspector Assignment: Title: HOLLYWOOD RES-REPLACE FAU Description: Type: MECH Sub Type: Job Address: 1254 BASSWOOD AV Suite: Lot 0 Location: APPLICANT BOYD ROGERS PLUMBING Owner: HOLLYWOOD WALTER P TR Remarks: Total Time: Phone: Inspector: fl ;4.. Requested By: RAY RODGERS Entered By: ROBIN CD Description Comments 43 AirCondlFurnace Set Associated PCRs InsPection History Date Description Act lnsp Comments