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HomeMy WebLinkAbout1380 CYNTHIA LN; ; CB070209; Permit01-25-2007 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Mechanical Permit Permit No CB070209 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Valuation Reference # Project Title 1380 CYNTHIA LNCBAD MECH 1562315400 Lot# $000 FROST RES-NEW A/C UNIT @ BACK YARD W/ELECTRIC Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 01/25/2007 RMA 01/25/2007 01/25/2007 Applicant LEGEND SERVICE SUITE 15 2588 PROGRESS ST VISTA CA 92083 760-631-8397 Owner FROST STEPHEN&MARLA REVOCABLE TRUST 04-25-06 1380 CYNTHIA LN CARLSBAD CA 92008 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 $1500 $900 $000 $000 $000 $000 $000 $2000 $000 $4400 Total Fees $44 00 Total Payments To Date $44 00 Balance Due $000 Inspector FINALAPBR<tj, I ^Date / C Clearance NOTICE Please take NOTICE that approval of your project includes the Imposition" 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 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 vou have previouslv been qiven 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 AddressTHiclutfe Bldg/Suits'tf) FOR OFFICE USE ONLY PLAN CHECK NO EST VAL Plan Ck Deposit Validated Date Business Name {at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total # of units Assessor's Parcel # Description of Work Existing Use SQ FT #of Stors, Proposed Use ?~of Bedrooms # of Bathrooms State/Zip Telephone #Fax* (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 IChapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code] or that he rs exempt therefrom, and the basis for the alleged exemption Any violation of Section 703J 5 by anyjapplicant for a permit subjects the applicant to a civil penalty of not more than foye" hundred dollars [$50011 Name State License # Address License Class City ' " State/Zip Telephone # City Business License # f f^/& 7 y _? Designer Name State License # Address City State/Zip Telephone Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations Q 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 of the work for which this permit is issued ^QT ' nave and Wl" maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is nssueo* My worker's compensation insurance carneir_arjd policy number are Insurance Company /^/Vl jpfoH £ ^ f^l ^Orftl/,/7- Policy HoI~M 1KOU/0 0 ~> CS. J Expiration Datefl ^HU 6 ' (THIS SECTION NEED NOT BCOpETED IF THE PERMllS FOR ONHUNDRED DOLLARS [$100) OR LESS) 0 CERTIFICATE OF EXEMPTION I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California WARNING Failure to secure workers' compensation coverage is unlawful, and) shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($£4)0,000), in addition to the^ooCt of compeaaation, damageajU-provided for in Section 3706 of the Labor code, interest and attorney's fees SIGNATURE 7'X^yV7!>Ki_ . 6^"^^"" --- 1-*-— ""^ _ DATE / — 2- ^~~ 0 i7ir;SQWNlFs-BUftife^Eci^RATioNii M j^ Jfeff . \s*$* ^^L : & 'sui^^ji !vi^ s< $&'*> I»B^ *dtf& i !( i,' *.3 £\ "zl ZMJ. &'•' L* £ , 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason [~l 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) d 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) Q 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 VES QNO 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 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 / 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 number / type of work) _ . _ _ PROPERTY OWNER SIGNATURE DATE >iWo^ 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? Q YES Q NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Q YES Q N° Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Q YES Q 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 |8VScoNSTRUCTra^^^ ^f^'^Jt&itftt 415?^^ TJ .""MiUvL'-C «LSy '^V^! , ^tir"^ I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097d) 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 City of Carlsbad to enter upon the abova 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 rt the building or work authorized by such permit is not commenced, within l&kdays irom the date ot such permit or if the biiilding orjvork authorized by such permit is suspended or abandoned at any time after the work is commenced for a period of 1 80 days (Section 106 44 Uniform FJuIdinafeoge) APPLICANT'S SIGNATURE DATE ^^^ V WHITE Applicant PINK Finance City of Carlsbad Bldg Inspection Request For 03/06/2007 Permit# CB070209 Inspector Assignment Title FROST RES-NEW A/C UNIT @ BACK Description YARD W/EUECTRIC Type MECH Sub Type Phone 7608091053 Job Address 1380 CYNTHIA LN Suite Lot 0 Location Inspector OWNER FROST STEPHEN&MARLA REVOCABLE TRUST 04-25-06 Owner FROST STEPHEN&MARLA REVOCABLE TRUST 04-25-06 Remarks Total Time Requested By MARLA Entered By JANEAN CD Description Act Comment 44 Rough/Ducts/Dampers Comments/Notices/Holds Associated PCRs/CVs Original PC# inspection History Date Description Act Insp Comments ACQBQ. CERTIFICATE OF LIABILITY INSURANCE PnooucER (800)524-7024 PAX (800)524-4013 Automatic Data Processing Insurance Agency, Inc 1 ADP, Boulevard Rose! and, NJ 07068 INSURES Legend Service Center 13S4 Broken Hitch Rd Oceans ide, CA 920S6-2236 DATE (Murormv) 07/25/2006 THIS CERTIFICATE (8 ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE C CRITIC ATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE (NBUREHA. Ejdployers Insurance Group INSURER B. INSURER C INSURER D INSURER E NAICf COVERAGES ANY REQUIREMENT, TERM OH CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WfTH RESPECT TO WHICH THIS CERTIFICATE MAY BE I3SUED Ofl WAV PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN 18 SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIOMS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED 0V PAID CLAIMS HSRITH A AomMSfir TVrE OF INSURANCE GENERAL LIABILITY COt**flCIAL<3CNERAl. UABIlfTV | CLAMS MADE [" ) OCCUR CEN'L AGGREGATE LIMIT APPLIES PER.n POLCY [""is^r ri^oc Airrouowu UAM.ITV ATiYWro ALL OWNED AimlS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS QAHAQE LIABILITY ANY AUTO EXCESS/UMBflGtU UABILrTY _J OCCUR [ 1 CLAIMS MADE DEDUCTIBLE RETENTION J WONKEDB COMPENSATION ANDEMPLOYERS' UABU/TV ANY PflOPRIEtOR/PARTNEFVCXCCUTlVE OFFICER/MEMBER EXCLUDE D7 If VM. 4M41M vrtd*SPECIAL PROVISIONS bdow OTHER POLICY NUMBS* ADP30188J-05 TOUCV tf=«CTiveruiif fwifftnrr" • 06/24/2006 POLICV EKPIRATigNDAVr aiMJaann 06/24/2007 \ UMTTS EAOHOCCURnENCC DAMAGE TO RENTEDMJCMiOeo ffm «<..wv.h KED EXP (Any orv p«iwi) PERSONAL 4 ADV INJURY OENERAL AGGACQATE PRODUCTS COUPTOPAGQ COMBINED SMOLE LIMIT <Ek«ccl<Mnit BODILY INJURY (Per port on> 8OOILY 1NJURV(PaiacekWM) PROPERTY DAMAO£ (P«r iccrtem) AUTO ONLY EAACCDCNT omen IMAM EAACC AUTOONLV w EACH OCCURRENCE AGfiREOATe WC ITATU [OTrt-TORVUM1TB 1 Bl E.L. EACH ACCIDENT E L DISEASE • EA EMPLOYEE EL DISEASE POLICY UMT « t I S s 1 1 $ I > 1 1 I I I s 1 C i l.OOO.OOC * l.OOO.OOt I l.OQO.WH 1E3CR1PTION Of OPERATIONS / LOCATIONS / VGMCtES t EXCLUSIONS ADDED BY ENDORSEMENT/ SPECIAL PnOVISWM :ERTIFICATE HOLDER CANCELLATION INSURED COPY SHOULD ANY OF THE ABOVE DESCfUBtB POUCln BE CANCELLED BEFORE THf EKPHMTION DATE THERtOF, THE BSUtrtl IN1UREH WILL ENDEAVOR TO MAI. 10 DAV« WRITTEN NOTICE TO THE CERTIFICATE HOLDCn NAMED TO THE LEFT, BUT FAILURE TO (MIL SUCH NOTICE SHALL IMPQU NO OBLKUtnON OR UABIUTV OF AHT wno UPON THE IVSUREH. rrs AGENTS OR REPRESENTATIVES. *urtin«Tcnin.iMii.*uirATiue — ",t*—f .•4*vT*' '~T « Richard Cossett/ADAME —^ -^ f (CORD 26 (2001/08)OACORD CORPORATION 1998