HomeMy WebLinkAbout1737 Camassia Ln; ; CBR2017-1178; PermitPrint Date: 06/18/2018
Job Address:
Permit Type:
Parcel No:
Valuation:
Occupancy Group:
# Dwelling Units:
Bedrooms:
Project Title:
1737 Camassia Ln
BLDG-Residential
2158810610
$ 0.00
Residential Permit
Work Class: P/M/E
Lot#:
Reference #:
Construction Type
Bathrooms:
Orig. Plan Check#:
Plan Check#:
Description: MINK: CHANGE OUT FURNACE, CONDENSOR & COIL
FEE
Owner:
TRUST MINK ROLAND TRUST 11-29-07
1737 Camassia Ln
CARLSBAD,CA 92011
PLUMBING, ELECTRICAL, AND MECHANICAL PERMIT
Total Fees: $ 166.00 Total Payments To Date : $ 166.00
. (cityof
Carlsbad
Permit No: CBR2017-1178
Status:
Applied:
Issued:
Permit
Finaled:
Inspector:
Final
Inspection:
Contractor:
Closed -Expired
06/01/2017
06/01/2017
BREEZE POINT HEATING AND AIR
CONDITIONING SERVICE
1518 Seabrook Ln
San Diego, CA 92139-3960
858-864-3780
AMOUNT
$166.00
Balance Due: $0.00
Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter
collectively referred to as "fees/exaction." 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 limitation has previously otherwise expired.
Building Division
1635 Faraday Avenue, Carlsbad CA 92008-7314 I 760-602-2700 I 760-602-8560 f I www.carlsbadca.gov
THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: 0PLANNING D ENGINEERING .Rf BUILDING OFIRE 0HEALTH 0HAZMATIAPCD
' {city of Building Permit Application Plan Check No.t -~.-..-,::r-J/7-K -1635 Faraday Ave., Carlsbad, CA 92008 Est. Value
Carlsbad Ph: 760-602-2719 Fax: 760-602-8558 Plan Ck. Deposit
email: building@carlsbadca.gov (A_,_,~ www.carlsbadca.gov Date
JOB ADDRESS SUITE#/SPACE#/UNIT# lAPN ---1,,-J Mrf/.u9fl.h? ~ . "}~II /737 o,frM.A ~.{'I A
CT/PROJECT# I LOT# rHASE# I# OF UNITS I* BEDROOMS # BATHROOMS I TENANT BUSINESS NAME I CONSTR. TYPE I occ. GROUP
DESCRIPTION OF WORK: Include Square Feet of Affected Area(s)
~ce-oriT ~ f-rJ PJv!rQ: I c.-0 ,Jftt?N P'bY't "t" (U) IL
EXISTING USE I PROPOSED USE I GARAGE (SF) PATIOS (SF) I DECKS (SF) FIREPLACE I AIR CO~ING I FIRE SPRINKLERS
YESO NoD YES NOD vcsONoO
APPLICANT NAME (}?nl7f3' ~,.JA PROPERTYOWNER [Z,O~ MIAJK Primary Contact
ADDRESS 1--oB ~'[WJJ( t*vrC-ADDRESS I 7 ,3 7 C4'rMA g,s I A, I,,µ
CITY o-PrJ) ruav STATE otJ-' ZIP CjL/~t/ CITY ~(J1r(? STATE ~-ZIP '}U//
PHONE( ;5(') S1,, J, '7j?/J IFAX fl 1q) 3 99J';f1N PHO/?t~)<f~ -t/1)'i_3 I FAX
EMAIL
(//r)Jl<,h,1 -Cl;?@~-
EMAIL
it-OM
DESIGN PROFESSIONAL CONTRACTOR BUS. NAME ~fT. /~"7;.it <4 lrfc
ADDRESS ADDRES}s-/; h,~)( L/pflJ'
CITY STATE ZIP CITY ~ ()1.c--{!,,,v STATE~ ZIP tjotf p'J
PHONE I FAX '",91;:>) Pt! ~7,n IF7 6 /1) 3 '1'/ .fifn> -
EMAIL EMA>e (j fJ1tiJ /Ur(/ -q,; -vJ1r1fJt!O . a.-t)M I STATE UC.# STATELIC.# C)ol/ J7J-I CLASS I CITY BUS. UC.# C -:zo
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to.construct, alter, improve, demolish or repair any_ structure, pnor to its issuance, also requires the applicant for such permit to file a si~ned statement that he 1s licensed pursuant to the provisions of the Contractor's License Law /Chapter 9, comme.nding with Section 7000 of D1vis1on 3 of the B.usiness and Professions Code} or [hat he 1s exempt therefrom, and the basis for the alleged exemption. Any violation of Section 1031.5 by any applicant for a permit subjects the applicant to a
civil penalty of not more than five hundred dollars {$500}).
WORKERS' COMPENSATION
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: D 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. D 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 perm~ is issued. My workers' compensation insurance carrier and policy
number are: Insurance Co. _____ Policy No Expiration Date-----------
~ion need not be completed if the permit is for one hundred dollars ($100) or less.
MCertificate of Exemption: I certrfy that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of
California. WARNING: Failure to secure workers' Ion coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), in
addition to the cost of compensation, dama as provided fo in Section 3706 of the Labor code, interest and attorney's fees.
,1$ CONTRACTOR SIGNATURE
I hereby affirm that I am exempt from Contractor's License Law for the following reason:
D
D
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. 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).
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).
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. 0Yes 0No
2. I (have I 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 I phone I contractors' license number):
4. I plan to provide portions of the work, but I have hired the following person lo coordinate, supervise and provide the major work (include name I address I phone I 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 I address I phone I type of work):
R! PROPERTY OWNER SIGNATURE 0AGENT DATE
I
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk mana(!ement and prevention program under Sections 25505, 25533 or 25534 of the
Presley.Tanner Hazardous Substance Account Act? [] Yes [] No
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? [] Yes D No
, Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D Yes [] No
i 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.
I certify that I have read the application and state that the above infonnation is correct and that the infonnatlon on the plans is aOOJralB. I agree to comply with all City ordinances and StalB laws relating to building cxmstruction.
I hereby au~cxize represenlative of ~e Ciy of Carlsbad to enter upon ~e above menliooed property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD
AGAINST ALL L1AB1Lrr1ES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
OSHA: AA OSHA permit is required for excavations CNf!S 5'0' deep and demolition or construction of structures over 3 stories in height.
EXPIRATION: Every permit issued by the Buik:ling · pl'CMSions of this Gode shall expire by limitation and become null and void if 1he buik:ling or'M)IK authorized by such µemit is not commenced within
180 days from the date of such permit or if Hl9 orv«>rk a · ed by such permit is suspended or abandoned at any time after the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code).
~ APPLICANT'S SIGNATURE DATE t-1-?-o!)
STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE.
Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection.
Fax (760) 602-6560, Email building@carlsbadca.gov or Mail the completed fonn to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92006.
CO#: (Office Use Only)
CONTACT NAME OCCUPANT NAME
ADDRESS BUILDING ADDRESS
CITY STATE ZIP CITY
Carlsbad
STATE
CA
PHONE FAX
EMAIL OCCUPANT'S BUS. LIC. No.
DELIVERY OPTIONS
D PICK UP: o CONTACT (Listed above) o OCCUPANT (Listed above)
o CONTRACTOR (On Pg. 1)
[] MAIL TO: o CONTACT (Listed above) o OCCUPANT (Listed above)
o CONTRACTOR (On Pg. 1)
D MAIL/ FAX TO OTHER:-----------------
AS'APPLICANT'S SIGNATURE
o ASSOCIATED CB#•------------
o NO CHANGE IN USE/ NO CONSTRUCTION
o CHANGE OF USE/ NO CONSTRUCTION
DATE
ZIP