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Home My WebLink About1779 BLACKBIRD CiR; ; CB143602; Permit12-24-2014 City of Carlsbad 1635 Faraday Av Carlsbad.CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No: CBI43602 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC #: Project Title: 1779 BLACKBIRD CR CBAD PME 2156027200 POZNAK RESIDENCE REPLACE 90K BTU FURNACE Lot#: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 12/24/2014 MDP 12/24/2014 12/24/2014 Applicant: SHERLOCK HEATING & AIR CONDITIONING INC STE 104 2880 SCOTT ST VISTA CA 92081-8560 760-295-5014 Owner: RIPSTEIN PROPERTIES LLC C/O DEBORAH BELL 7919 W 137TH ST OVERLAND PARK KS 66223 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees $0.00 $0.00 $160.00 $0.00 TOTAL PERMIT FEES $160.00 Total Fees: $160.00 Total Payments To Date: $160.00 Balance Due: $0.00 Inspector: FINAL Date PPRQVA^ Clearance: NOTICE: Please tal<e NOTICE that approval of your project includes the "Impqsition" of feet, dedications, reservations, or other exactions hereafter collectively refen-ed 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 Uanager for processing in accordance with Carisbad 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 ave hereby FURTHER NOTIFIED tt^at 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 vou have previouslv been given a NOTICE similar to this, or as to which the statute of limitations has previouslv othenA/ise expired. THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: nPLANNING •ENGINEERING • BUILDING •FIRE • HEALTH nHAZMAT/APCD Ccityof Carlsbad Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Ph: 760-602-2719 Fax:760-602-8558 email: building@carlsbadca.gov www.carlsbadca.gov Plan Check No. Est. Value Plan Ck. Deposit Date SWPPP JOB ADDRESS ^ SUITE*/SPACE«/UNIT* APN - CT/PROJECT # LOT# PH/!SE# # OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP DESCRIPTION OF WORK: /nclude Square Feet of Affected Areafs; EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE YESQ# NOj I AIR CONDITIONING YES I I NO I I FlRESPRINKLERS YES I |NO| I APPLICANT NAME Prima :ANT NAIVIE \ \ w \ - A ry Contact ^V\fcr\OC-V- He<^.TVY\3 ^ AjC- PROPERTY OWNER ADDRESS CITY STATE ADDRESS rcAc. PHONE E I FAX ZIP CITY STATE ZIP PHONE EMAIL EMAIL DESIGN PROFESSIONAL CONTRACTOR BUS. NAME . ADDRESS ADDRESS CITY STATE ZIP CITY CA STATE ZIP PHONE PHONE ' FAX EMAIL EMAIL CLASS CZO CITY BUS. LIC.# (Sec. 7031.5 Business and Proressions 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 pursuantto the provisions ofthe Contractor's License Law (Chapter 9, commending with Section 7000 of Division 3 ofthe 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 subjects the applicant to a civil penalty of not more than five hundred dollars {$500}). WORKERS' COMPEMSATION Workers' Compensation Declaration: / hereby affinn under penalty ri perjury one ofthe following declarations: L_j I have and will maintain a cettificate of consent to selMnsure for workers' compensation as provided by Section 37(X) of the Labor Code, for the perfomiance of the worl< for which this pennit is issued. Jf>l I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the perfornijQce of the worit for which this permit Is issued. My worlters' compensation|insurance earner and policy A *^ A W>gT ^ C.Ci,V\ Policy No K**^^^ ^ ^ I Oi 7.2-1 Expiration Date | IS number are: Insurance Co._ This section need not be completed if the permit is for one hundred dollars ($100) or less. I I Certificate of Exemption: I certify that in the perfomiance of the worit for which this pemiit is issued, I shall not employ any person in any manner so as to become subject to the Worlters' Compensation Laws of Califomia. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred ttiousand dollars (&100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attomey's fees. ygT CONTRACTOR SIGNATURE ^^[jCCc^^ <^^^^^^^ ^^-g^ENT DATE 2^1 ii^ Mr N e R - B U I L O E R ID E C i. A ll A TI O N / heretty affirm that I am exempt from Contractor's Ucense Law for the fotlowing reason: I I I, as owner of the property or my employees with wages as their sole compensation, will do the worit and the stnicture 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 v»ho 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 I I, as owner of the praperty, 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 I I am exempt under Section Business and Prafessions Code for this reason: 1.1 personally plan to provide the major labor and materials for construction of the proposed property impravement. OYes I INO 2.1 (have / have not) signed an application for a building pemiit for the proposed work. 3.1 have contracted with the following person (fimi) to provide the proposed construction (include name address / phone / contractors' license number): 4.1 plan to provide portions of the worit, but I have hired the following person to coordinate, supervise and provide the major worit (include name / address / phone / contractors' license number): 5.1 will provide some of the work, but I have contracted (hired) the following persons to provide the worit indicated (include name / address / phone / type of work): >6S'PR0PERTY OWNER SIGNATURE •AGENT DATE Ic O WI P LETB THIS SECTION F O R N O M - R E $ I O E N T 1 PERA* ITS ONtY "7'^ Is the appiicant or future building occupanl required to submit a business plan, xutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Acf? 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 No Is the fxility to be constmcted within 1,000 feet of the outer boundary of a school site? Yes 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. CO N ST RUCTION LENDING AGENCY I liereby affimi that ttiere is a construction lending agency for tlie performance of ttie wttf. this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address , ? P L I C ANT C B R T I F I C A T | O N I ceitlfy that I have read the appiteation and state thatthe above information is conect and that the Inforniation on Uie plans Is accurate. I agiee to comply witti all Clly ordinances and State laws relating to building consbuction. I hereby authorize representative ofthe City of Carlsbad to enter upon the above mentioned property Ibr inspection purposes. I ALSO AGFEE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CfTY OF CARLSBAD AGAINST Aa 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 pemnit is required fbr excavations over 5'0' deep and demolition or constmction of stmctures over 3 stories in height. EXPIRATION: Every pennit issued by the Building Oflicial under the provisbns of this Code shall expire by limitation and become null and void if the building or work authorized by such pemnit is not commenced within 180 days from the date of such pemiit or if Ihe building or work authorized by such pennit te suspeniJed or abandoned at any time alter the viork is commenced Ibr a period of 180 days (Section 106.4.4 Unfomi Building Code). vfilfAPPLICANT'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. Fax (760) 602-8560, Email buildinq(S)car1sbadca.qov or Mail the completed form to City of Carisbad, Building Division 1635 Faraday Avenue, Carisbad, Califomia 92008. C0#: (Office Use Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDING ADDRESS STATE ZIP CITY STATE Carlsbad CA PHONE FAX EMAIL OCCUPANT'S BUS. LIC. No. DELIVERY OPnONS PICK UP: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) MAILTO: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) MAIL / FAX TO OTHER: ASSOCIATED CB#- NO CHANGE IN USE / NO CONSTRUCTION CHANGE OF USE / NO CONSTRUCTION ^APPLICANT'S SIGNATURE DATE Inspection List Permit#: CB143602 Type: PME POZNAK RESIDENCE REPLACE SOK BTU FURNACE Date Inspection Item Inspector Act Comments 02/24/2015 43 AirCond/Furnace Set - Rl 02/24/2015 43 AirCond/Furnace Set SP AP 02/24/2015 49 FinalMechanical - Rl 02/24/2015 49 FinalMechanical SP Fl Tuesday, February 24, 2015 Page 1 of 1