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HomeMy WebLinkAbout1658 CALLIANDRA RD; ; CB070288; Permit02-01-2007 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Mechanical Permit Permit No CB070288 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Valuation Reference # Project Title 1658 CALLIANDRA RD CBAD MECH 2159005500 $000 Lot# ROHRLICK RES- INSTALL 2 NEW A/C UNITS WITH ELECTRIC Status Applied Entered By Plan Approved Issued Inspect Area Applicant ASI HASTINGS 1250 GREENFIELD DR ELCAJON, CA 92167 619-223-9016 ISSUED 02/01/2007 LSM 02/01/2007 02/01/2007 Owner ROHRLICK FAMILY 2001 TRUST 01-15-03 1658 CALLIANDRA RD 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 $15 00 $1800 $000 $000 $000 •$ooo $000 $2000 $000 $5300 Total Fees $53 00 Total Payments To Date $53 00 Balance Due*$000 Inspector FINAL APPROVAL Date 5>// /<t7 Clearance NOTICE Please lake NOTICEihat 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 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 ONLY PLAN CHECK NO EST VAL Plan Ck Deposit Validated By _ Date ^7'/<r? Address (include Bldg/Suite #}Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total tf of units Assessor's Parcel # (3 Existing Use Proposed Use Name iB^OcqNTRA'CTORfilCOMPANYFNAME (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 exemption A.py violation of Section 7031 5 by_a/iy applicant fflr a permit^u^jects^the applicant to a civil penalty of,not njpje than,five hundred dojhirs&L " Name Of iT^-~ Address /~f*n "h^ ~3f/> Cltv ~* State/Zip telephone* , State License # J\CA \*) License Class O't/V AJ> ^)(f/ C|ty Business License » if^O^T^OM &•' \L&& *^/ Designer Name Address State License # City State/Zip Telephone Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations 0 ' 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 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 ed My worker's condensation insurance carrier and-pDlicy number are Insurance Company 1^6 CO ' 0\~ 11f)& KMi T Policy No (kjff)3\[()\ 1 \?AJy~ Expiration Datejj (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100} OR LESS) n 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 wgrkei£f, compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,00^/db/addnip(iAO the cost of compensation, damages as provided for in Section 3706 of the L Apr code, interest and attorney s fees SIGNATURE AT/ '${.4. ^ - DATE t ' I (/7 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason Q 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) Q 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 contractorls) licensed pursuant to the Contractor's License Law) n 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 Q YES 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) _^ i ^ 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 COMPLETE iTHIS SpCTIONjFORWOff-flCS/OfiVTi&U BU1LDINQ,PERMITS 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 O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Q YES D 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 r~ ^*»ia^vi*y<^ViXi^!'^i^riri^FA!>«M»i^^M^4 P!f!>!7!rsflf ^^-^ !,,» s>" ti«j1?n?1r |fts « uijh •> sij i , in itstt? P/VT~<J lVi a » P-WS „»£!?;T"YJ""r'^p'f"™ & "*« '>• '•"**f jilLlifME*-? I "mSf 'JO?! LpHpHSU* A**cNCT|W' !1!1 *!)„ IT!s „ !!™JE * issi&,tSs S1L, ••£? si i 1. !„ s.J^'H' ,iJ si«L IE& %\ uitl* t't t. t «!»,) :•• i lss I'zlJ*'- i "!! i ,,", 3!,!, , I ** „» t" 11,, 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 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 ALL LIABILITIES, JUDGMENTS. COSTS AND EXPENSES WHICH MAY fN 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 days frorruhe date of such permit or ii the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced lor a period oM80May//£3ction 106 4 4 Uniform Building Code) APPLICANT'S SIGNATURE DATE WHITE File YELLOW Applicant PINK Finance City of Carlsbad Bldg Inspection Request For 03/01/2007 Permit# CB070288 Title ROHRLICK RES-INSTALL 2 NEW Description A/C UNITS WITH ELECTRIC Sub Type 1658 CALLIANDRARD Lot 0 Type MECH Job Address Suite Location OWNER ROHRLICK FAMILY 2001 TRUST 01-15-03 Owner ROHRLICK FAMILY 2001 TRUST 01-15-03 Remarks Inspector Assignment Phone 7605181919 Inspector Total Time Requested By NA Entered^ CHRISTINI CD Description 34 Rough Electric 43 AirCond/Furnace Set Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act Insp Comments 12 32 UlESTLftND INS BROKERS -> 95909366 NO 856 0001 iQBA, CERTIFICATE OF LIABILI JCER (619)5ff4-6400 FAX (619)584-6425 estland Insurance Brokers 3838 Canrino Del Rio North «15 P.O. Box 854A1 Ssn Diego. CA 921&6-5481 WSUWD A S I Hastings, Inc. 1250 GREENFIELD DRIVE ' EL CAJON. CA 92021 TY INSURANCE DATE (MM/Ob/YYYY) 01/10/2007 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURER A. INSURANCE COMPANY OF THE WEST INSURER 9 INSURER C USURER D INSURER e NAIC* 27847 COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POUCY PERIOD INDICATED NOTWITHSTANDINGANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED ORMAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCHPOLICIES, AGGREGATE LlMfTS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS wattm A M)D"L ' TYPE OF INSURANCE GO — rfERAl. UAHUTY COMMERCIAL GENERAL LIABILITY ~J CLAIMS MAW j~j OCCUR GENT AGGREGATE LIMIT APPLIES PER, AUTOMOULE LIABILITY ANY AUTO ALL OWNEO AUTOS SCHEDULED AUTO3 HIRED AUTOS NON OWNED AUTOS GARAGE UAMJTY ANYAIJTO ' EXCESS/UMBRELLA LIABILITY | OCCUR r~] CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION ANO EMPLOYERS' LIABILITY ANY PROPRIETOR/PASTNEaEXeCUTIVE QFFICER/MENBeR EXCLUDED? If yes describe \x4ffSPECIAL PROVISIONS Cdow OTHER POUCY Nutnai - WSD216171302 POLICY EFPICTWErtATF tmUODNYL. 10/16/2006 fn^f^D^H 10/16/2007 UMFTS EACH OCCURRENCE OAMGE TO RENTED MED EXP {Any ens person] PERSONAL 4 ADV INJURY GENERAL AQQR£GATC PRODUCTS - CO MP«3P AGO COMBINED SJNGLE UMIT BODILY INJURY 60CHLY fNJURY PROPERTYDAMAtSE [Per flcad«nt] AUTO ONLV . EA ACCIDENT I^THBBTHftM EA ACC AUTO ONLY AGQ EACH OCCWIRENCE AGGREGATE X WCSTATU- 1 OTH-TnBVHpr<!| MR EJ_ EACH ACCIDENT EJL DISEASE EA EMPLOYEE 5.L, DISEASE POLICY LIMIT t S 1 S 1 . I S i 1,000,OOC I l.OOO.OOC s 1,000,000 DESCRIPTION OF OPERATIONS 1 LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT . SPECIAL PROVISIONS issued as evidence of coverage J((JLDPR I-ssued to Named Insured 3,^OULO ANY Of THE ABOVE ASCRIBED PCf IC1ES 3E CAf«.EI Lf D BCFORE THE FXP1RATION DATE FMePEOF. "HE ISSUING NSURER WILL ENDEAVOR TO MAIL _10____ DAYS WRITTSN SOTKE TO THE CERTIFICATE HOLDER NAMED TO "HE LEFT BUT FAILURE TO MAIL SUCH MO*ICF SHALL IMPOSE NO OBLIGA-HON OR i 'ABILITY Of ANY KIND LPON THE INSURER fTS AGENTS OR ^E AL i HORlttO RtPRESENTAI WE Robert.Kempa/jQYR ACORD 25 (2001/08) FAX: (619JS90-9 J66 CORPORATION 11*8