HomeMy WebLinkAbout1771 BLACKBIRD CIR; ; CB051914; PermitCity of Carlsbad
You are hereby FURTHER NOTIFIED that your tight to protest the specified feedexactions 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
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1635 Faraday Av Carlsbad, CA 92008
Building inspection Request Line (760) 602-2725
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05-26-2005 Mechanical Permit Permit No: CB051914
Job Address: Permit Type: MECH Status: ISSUED
Parcel No: 2156023700 Lot #: 0 Applied: 05/26/2005
Valuation: $0.00 Entered By: KG
Plan Approved: 05/26/2005 Issued: 05/26/2005
1771 BLACKBIRD CR CBAD
CAHILL RES REPLACE CONDENSER & Inspect Area:
ON A/C UNIT
Applicant:
GLENN JONES
Owner:
CAHILL DENNIS J&WALKER KAREN M
1771 BLACKBIRD CIR
CARLSBAD CA 92009
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 $9.00
$0.00
$0.00 $0.00
$0.00
$0.00 $0.00 $0.00
$24.00
Total Fees: $24.00 Total Payments To Date: $0.00 Balance Due: $24.00
Inspector: ll . Date: Clearance:
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPAR
1635 Faraday Ave., Carlsbad, CA 92008
MENT
FOR OFFICE
PLAN CHECK N
EST. VAL.
Plan Ck. Deposit
Validated B
Date
1. PROJECT INFORMATION
Unit No. ' ' PhaseNo. Total # of units Legal Description Lot No. Subdihsion NameINumber
Existing Use Proposed Use Assessor's Parcel #
# of Bathrooms
Telephone # Fax #
Sa. FT. #of Stories
2.
Name
3. APPLICANT 0 Contractor 0 Agent for Contractor 0 Owner 0 Agent for Owner
CONTACT PERSON (if different from applicant)
Address city StateIZip
Address city Statelzip Telephone # . Name
IC L Telephone # Name Address city Statelzip iW-1
ONTRACTOR - COMPANY NAME
(Set. 7031.5 Business and Professions Code: Any City or County
issuance, also requires the applicant for such permit to file a sig
[Chapter 9, commending with Section 7000 of Division 3 of the
exemption. Any violation of ection 7031.5 by any applicant for a
fLJ-&t-JL co
Address
State License 3 b 57 C-3 License Class <"LO City Business License #
Designer Name Address city StateIZip Telephone
State License #
6. WORKERS' COMPENSATION
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
0 of the work for which this permit is issued.
0 issued. My worker's compensation insurance carrier and policy number are:
Insurance Company Policy No. Expiration Date
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS IS1001 OR LESS)
%Name do r-lw
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
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
(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).
0 The
Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractorb) licensed
pursuant to the Contractor's License Law).
0
1, as Owner of the property. am exclusively contracting with licensed contractors to construct the project (Sec 7044, Business and Professions Code
I am exempt under Section Business and Professions Code for this reason:
1.
2.
3.
I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES
I (have / have not) signed an application for a building permit for the proposed work.
I have contracted with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors license number):
ON0
4. number / contractors license number):
5.
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
I will provide some of the work, but I have contracted (hired) the following persons to Drovide the work indicated (include name / address I phone number / tvDe -. of work):
PROPERTY OWNER SIGNATURE DATE
COMPLETE THIS SECTION FOR NON-RFS/D&NT/Af BUILDING PERMITS ONLY
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? 0 YES 0 NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 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.
0 YES 0 NO
c] YES
NSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097Li) Civil Code)
NAME LENDER'S ADDRESS
ICANT CERTlFlCATlON
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 Citt 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 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 if the building or work
authorized by such permit is k authorized by such permit is suspended or abandoned at any time after the work is
APPLICANT'S SIGNATURE DATE C/~&J (UT ,
WHITE: File YELLOW: Applicant PINK Finance \
City of Carlsbad Bldg Inspection Request
For: 06/10/2005
Permit# CB051914 Inspector Assignment:
Title: CAHILL RES REPLACE CONDENSER &
Description: COIL ON NC UNIT
Type: MECH Sub Type:
Job Address: 1771 BLACKBIRD CR
Suite: Lot 0
Location :
OWNER CAHILL DENNIS J&WALKER KAREN M
Owner: CAHILL DENNIS J&WALKER KAREN M
Remarks:
Phone: 7607457670
Inspector:
Total Time: Requested By: DENNIS
Entered By: CHRISTINE
CD Description
43 AirCondFurnace Set
Associated PCRs/CVs
Inspection Historv Date Description Act lnsp Comments