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Home My WebLink About1766 COTTONWOOD AVE; ; CB130178; Permit01-23-2013 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PWIE) Permit Permit No CB130178 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # PC# Project Title 1766 COTTONWOOD AV CBAD PME 2155033722 Lot# MADISON REPLACE FURNACES CONDENSER Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 01/23/2013 JMA 01/23/2013 01/23/2013 Applicant STILLMAN HEATING AND AIR CONDITIONING SUITE A 7200 PONTO DR CARLSBAD CA 92011 760-431-3266 Owner MADISON MICHAEL E 1766 COTTONWOOD AVE CARLSBADCA 92011 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees $0 00 SO 00 $154 00 $0 00 TOTAL PERMIT FEES $154 00 Total Fees $154 00 Total Payments To Date $154 00 Balance Due-$0.00 Inspector FINAL APPR Date ^OVAL G5 Clearance NOTICE Please take NOTICE ^at approval of your project includes ttie "Imposition" of fees, dedications, reseivations, or other exactions hereafter collectively referred to as "fees/exactions" You have 90 days from Itie date ttiis permit was issued to protest imposition of these fees/exactions If you protest them, you must follow the protest procedures set forth in Govemment 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 setvice fees in connection with this project NOR DOES IT APPLY to any fees/exactions of which you have previougly been given a NOTICE similar to this, or as to which the statute of limitations has previously othenwise expired THE FOLLOWING APPROVALS REQUIRED raiORTO PERMIT ISSUANCE • PLANNING • ENGINEERiNG • BUILDING • RRE • HEALTH • HAZMAT/APCD CiTY OF Building Permit Application 1635 FaradayAve . Carlsbad, CA 92008 Pti 760-G02-2719 Fax 760-602-8558 email buldlmg@carfsbadca gov www carlsbadca gov Plan Check Uo(^jS> I 11^ Est. Value Plan Ck. Deposit SWPP JOB ADDRESS SUITE#/SPAC[:#/UN1T# CT/PROJECT # PHASE # # OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR TYPE OCC GROUP DESCRIPTION OF WORK Include Square Feet of Affected Amafs) ^ /AJ EXISTING USE PROPOSED USE JCAN^AMEZ/Pflmsry ttontact) ^ . i All c^^gj. my^hjfifU GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE YESQ # NOD AIR CONDITIONING YES • NO • FIRE SPRINKLERS YES • NO • APPLICANT NAME {Secondary Contact) ADDRESS _ ff 77 ADDRESS STATE . ZIP FAX CITY STATE ZIP PHONE. /jV 3</y oyy<^ PHONE FAX EMAIL EMAIL PROPERTY OWNER NAME ^1 CONTRACTOR BUS NAME ADDRESS ADDRESS 3 J / J /9Yr QA-^^^ j/fcl CITY STATE ZIP CITY STATE ZIP PHONE FAX PHONE FAX EMAIL 'BUS L1C# . - ^ . / ARCH/OESIGNER MAME & ADDRESS "CLASS 7^ (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 [ssuance also requires ttie applicant for sucn permit to file a signed statement that he is licensed pursuant to the provisions ofthe Contractor s License Law {Chapter 9 commendmgwith Section 7000 of Division 3 of the Business and Professions Code} or that he is exempt therefrom, and the basis for the alleged exemption Any violation of Section 7031 5 by any applicant for a permit subiects the applicant to a civil penalty of not more than five hundred dollars {$500}) Wofkers'Compensation Declaration / hereby affirm under penalty of peijury one of the following declarations n I have and will maintain a certificate of consent to self insure tor workers compensation as provided Oy Section 3700 of Ihe Labor Code for tlie perlormance of the work for which this permit is issued ^^CJ"l have and will maintain workers'compensation as required by Section 3700 of the Labor Code, forthe perfomance of the work tor which Ihis perrnins issued My workers corrpensation insurance camer and policy numberare InsuranceCo -f^ C \A f~ '(-A Policy No ^ (L^/^^ f 0 .<r3 ( ^ Expiration Date /<y ^/ This section need not be completed if the permit is for one hundred dollars (SIOO) or less n Certificate of Exemption I certify lhal in the perlomiance 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 FaHuretosecureJUQrkers' compensation coverage is unlawful, and shall subject an emjiloyer to criminal penalties and civil fines upto one hundred thousand dollars {&100,000), in addition to the cost of compensatioi/damage^as provided for in Section 3706 of the Labor code, interest and attorney's fees y€S' CONTRACTOR SIGNATURE •AGENT DATE i hereby affirm that I am exempt from Contactor s bcense Law for the following reason • I, as owner of the property or my employees with wages as their sole compensation will do the work and the stmcture is not intended or offered for sale (Sec 7044, Business and Pnjfessions Code The Contractor's License Law does not apply Io an owner ol property who builds or improves thereon and who does such work himself or through his own emfrioyees, 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 Ihat he did not build or improve for Ihe purpose ol sale) • I, as owner of the property, am exclusively conlracting with licensed contractors to construct the praject (Sec 7044 Business and Prafessions Code The Cantrxtot s License LBVJ (Joes not apply to an owner of property 'Who buiWs or improves thereon, and contracts for such projects v^ith contrxtor[s) licensed pursuant to the Contractor s bcense Law) • I am exempt under Section Business and Professions Code tor this reason 1 I personally plan to provide the major labor and materials for constuction of the proposed property imfwovement • Yes O No 2 I (have/have not) signed an ?pplication for a building permitfor ihe proposed work 3 I have contracted with the followmg person (firm) to provide the proposed construction (include name address / phone / 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 / contractors' license number) 5 I will provide some of the vrark, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone / type of vwrk) ^gfpROPERTY OWNER SIGNATURE •AGENT DATE Is the apphcant or future building occupant required to submit a business plan acutely hazandous matenals registration form or nsk management and prevention program under Sections 25505 25533 or 25534 of Ihe Presley Tanner Hazardous Substance Account Acf • Yes O No Is ihe applicant or future building occupant required to obtain a pennit from the air pollution control distnct or air quality management distncf • Yes • No Is tfie facility to be constructed within 1,000 feet of the outer boundary of a school sile'> • Yes • No !F ANY QF 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 hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec 3097 (i) Civil Code) Lender's Name Lender's Address Icerti^thatlhaveteadtheapplkationandstatethattheaboveinfomnationiscon^aFKjttiattheinforn^ I agree tocomplywith all Cityofifinancesand State laws relating to buildmg construction I hereby autonze representative of Sie City of Catistad lo enter upon Uie atwve mentioned property for inspection purposes I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CfTY OF CARLSBAD AGAINST ALL LIABILITIES JUDGMENTS, COSTS AND EXPENSES WHICH IVlAY IN Am WAY ACCRUE AGAINST SAID CEfY IN CONSEQUENCE OF THE GRANTING OF THIS PERMfT OSHA An OSHA pemiit is required for excavations over 5'0' deep and demolition or caistaictcn of stnjctures over 3 stones in height EXPIRATION Every permit issued by the Building Offoal under the pfovisons of this Code shall expire by limitation and become null and void if the building or work autfiorized by such permit is not commenced wthin 180 days from thedateofsuc^i pemiit or if the building or wrk authonzed by such permit is suspended or abandoned at any time after ihe vwik is commenced {braperodofia)days (Section 106 4 4 Unffonn Building Code) ^fiS"APPLICANT'S SIGNATURE DATE STOP- THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. CERTIFICATE OF OCCUPANCY [Commercial Projects OnlyJ Fax (760) 602-8560, Email www buildinqtajcarisbadca gov or Mail the completed form to City of Carlsbad, Building Diwsion 1635 Faraday Avenue, Carlsbad, California 92008 C0# (OfHce Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS CITY STATE ZIP CITY STATE ZIP Carlsbad CA PHONE FAX EMAIL OCCUPANTS BUS LIC No DELIVERY OPTIONS • PICKUP • CONTACT (Listed above) • OCCUPANT (Listed above) • CONTRACTOR (On Pg 1) n MAIL TO • CONTACT (Listed above) • OCCUPANT (Listed above) • CONTRACTOR (On Pg 1) • MAIL/FAXTOOTHER • ASSOCIATED CB#- • NO CHANGE IN USE/NO CONSTRUCTION • CHANGE OF USE / NO CONSTRUCTION ^eS" APPLICANT'S SIGNATURE DATE Inspection List Permit# CB130178 Type PME MADISON REPLACE FURNACE & CONDENSER Date Inspection Item Inspector Act Comments 02/14/2013 43 AirCond/Furnace Set - Rl GATE CODE KEY KEY9511 02/14/2013 43 AirCond/Furnace Set PD AP 02/14/2013 49 Final Mechanical - Rl 02/14/2013 49 Final Mechanical PD AP Friday, February 15, 2013 Page 1 of 1