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HomeMy WebLinkAbout1718 BLACKBIRD CIR; ; CB993134; Permit08/19/1999 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: City of Carlsbad Mechanical Permit Permit No: CB993134 Building Inspection Request Line (760) 438-31 01 1718 BLACKBIRD CR CBAD MECH 3113 oS/19/?9 OOOI 01 02 Status: ISSUED C-MT #=oo 2 1 56027000 Lot #: 0 Applied: 08/19/1999 Plan Approved: 08/19/1999 Issued: 08/19/1999 $0.00 Entered By: JM ADD 4 TON NC W/40 AMP ELEC Inspect Area: COASTAL AIR MECHINICAL 12860 WAREHOUSE ST SAN DIEGO CA 92129 61 9-679-7951 Mechanical Issue Fee Install/Furn/Ducts/Heat Pi Fireplace Installation Fee Exhaust Fan Fee Installation/Relocation Vel Hood Fee eDue: $44.00 10 10 10 10 Boiler/Cornpressor to 15HP F Other TOTAL PERMIT FEES SWION 106AA FINAL APPROVAL Inspector: Date: Clearance: ~~ ~~ ~ ~~~~~~~~~~~~~ NOTICE Please take NOTICE that approval of your project includes the 'Imposition'of fees, dedications, reservations, or other exactim hereafter cdlectively referred to as 'feeslexactions." You have 90 days from the date this permit was issued to protest imposition of these feeslexactiis. If you protest them, you must follow the protet procedures setfottb 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 folbwthat 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 prolest the specifii feedexactions DOES NOT APPLY to water and sewer connedim fees and capactj changes, nor planning, zoning, grading or other similar application processing or service fees m connection with this project NOR DOES IT APPLY to any feedexactions 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 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 I' / PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1 1 61 FOR OFFICE USE PLAN CHECK NO. EST. VAL. / i Date - **. b /7/ Burinesa Name Iat thir address) Addresi (include BldglSuita #I Unit No. Phase No. Total # of units Lagal Daacription Lot No. Subdivirion Name/Numbar Proposed Use Existing Uae #of Stories Description of Work % C~WSTIACTDR-COMPAIYY;NAME ity 01 County which rrqui , alter, improve. demolish or repair any structura, prior to its (sic. 7031.5 Business and Profaasion8 Code: Issuance, a180 requires me applicant for such permit to file a signed atatament that he is licensed pursuant to the provisions of the Contractor's UCmSe Law [Chepter 9, commending with Ssction 7000 of Division 3 of tho Business and Professions Codel or that he is axemPt therefrom, and the basis for the alleged applicant for a permit subpcts tho applicant to a ivil penalty not more than five hundred dollars 185001). /2bGo wR&+LSQ &- S$* W 92/29 $S849?-5LPsf Address City Statelzip Telephone 1 Name License class p- 20 . City Business License # Designer Name Address Ctv StatelZip Telephone State LiCOMO # 6. WORK€RS' COYPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perbry one of the following declarations: 0. of the work for which this permit is issued. 0 issued. My workar's compansation insurance carrier and policy number are: Insurance Company (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1$1001 OR LESS) HTIFICATE OF EXEMPTION: I certify that in the performance of tho work for which this permit is issued, I shell not employ any person in eny manner so as to becoma subject to the Workera' Compensation Lnwa of California. WARNINQ: wwlr to m ompIoywto aknH pondth utd dd fhoa up to OIY hundrd mouamd dd.n ($100 In Soation 9706 ot tho Mor SIGNATURE DATE b 7. OWNER-wKD1u) DECLARATR)N I hereby affirm that 1 am exempt from the Contractor's License Law for the following raason: 0 I, as owner of the property or my employees with wagon as their sole compensation, will do the work and the structure is not intended or offered for sale (Sac. 7044, Business and Professions Coda: The Contractor's License Law doer not apply to an owner of property who builds or improves thereon, and who doas such work himself or through his own amployeas. provided that such improvemants are not intended or offered for sale. If, however, the building or improvement is soid within one year of completion, the owner-buildar will have the burden of proving that he did not build or improve for the purpoaa of sale). 0 I, as owner of the proparty, am exclusiwly contncting with licensed contractors to construct the project (Sac. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who build8 or improws thereon, and contracts for such projects with comrector(s) licensed pursuant to the Contractor's Licansa Law). 0 1. 2. 3. 4. number I contractors license number): 5. of work): PROPERTY OWNER SIGNATURE DATE COMM THIS SECTION FOR N0A"IL. WBDINQ PERMlTS91vLY IS the apNicant 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 ar 25534 of the Presley-Tanner Hazardous Substance Account Act? 0 YES 0 NO 1s the applicant or future building occupant requirad to obtain a mit from the air pollution control diatnct or air quality management district? 0 YES 0 NO Is tho facility to be constructed within 1,OOO fret of the outer boundary of a schod 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 MEEnNO THE REOUIREMENTS OF THE OFFICE OF EMERaENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. 8. CONSTRUCTION LENDING AoENCy I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is isswd (Sec. 30971i) Civil Code) I have and will maintain a certificate of consent to self-inswe for workers' compensation as provided by Section 3700 of the Labor Code, for the pertormance I have and will maintain workers' compensation. as raquired by Section 3700 of the Labor Code, for the performance of the work for which this permit is Policy No. Expiration Date and BttonNy'a I..I. I am exempt under Section I ~+mone~~y plan to provide the major labor end meteria~s for construction of the proposed property improvement. 0 YES ONO I lhave I have not) signed an application for a building permit for the proposed work. I have contracted with the following parson (firm) to provide the proposed construction (include name / address / phone number I contractors license numbor): I plan to provide ponions of the work, but I have hired tho following person to coordinate, supervise and provide the major work (include name I address I phone I will provide some of tho work, but I have contracted (hired) the following pmons to provide the work indicated linclude name / address / phone number / type Businem and Rofeaaions Code for this raaaon: LENDERS NAME LENDER'S ADDRESS 9. APWCANTWWllhChTlON I certify that I have read the application md state that the above information is correct and that the information on the plans is accurate. I agrae to comply with all City ordinancar and State law8 relating to building construction. I hereby authorize representativon of the City of Cartsbad to enter upon the above mentioned property for inspection purposes. I 4LSO AQREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AQAINST ALL LIABILITIES, JUDQMENTS. COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AQAINST SAJD CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excevations over 6'0' deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit isauad by work authorized by such permit is or abandonad at any time after the this Code shall expin by limitation and become null and void if the building or of such permit or if the building or work authorized by such permit IS suspended 108.4.4 Uniform Building Code). DATE APPLICANT'S SIGNATURE WHITE: File YELLOW: Applicant PINK: Finance