HomeMy WebLinkAbout2372 ALTISMA WAY; STE C; CB100065; Permit01-11-2010
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Mechanical Permit Permit No: CB100065
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Valuation:
Reference #:
PC#:
Project Title:
2372 ALTISMA WY CBAD St: C
MECH
2152403415
$0.00
Lot#:
WARDLOW RES REPLACE FURNACE
Status: ISSUED
Applied: 01/11/2010
Entered By: KG
Plan Approved: 01/11/2010
Issued: 01/11/2010
Inspect Area:
Applicant:
WARDLOW CONNIE
STEC
2372ALTISMAWY
CARLSBAD CA 92009
760-930-0488
Owner:
WARDLOW CONNIE
STEC
2372ALTISMAWY
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
1
0
0
0
0
0
$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:$24.00 Balance Due:$0.00
Inspector:
FINAL APPRQVAL
Date: 2-J Clearance:
NOTICE: Please take NOTICE thappproval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively
referred to as "fees/exactions." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must
follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for
prxessing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack,
review, set aside, void, or annul their imposition.
You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity
changes, nor planning, zoning, grading or other similar application prxessing or service fees in connection with this project. NOR DOES IT APPLY to any
fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired.
'V* Building Permit A|
v\^, 1635 Faraday Ave., Carlsbai
^5r ChTY OF 760-602-2717/2718
r"* A n i CD A n* Fax: 76°-602-85
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d, CA 92008 Est. Value
/ 2ciy58 Plan Ck. Deposit
>ov ^ , > / / / - y'^XV—/1I \ L_»_Ji~J/\L/ — — uate /•~//-~/(J ^tf
JOB ADDRESS , v i
CT/PROJECT* LOT* PHASE* \ OF UNITS * BEDROOMS
SUITE«/SPACE*/UNIT# APN J
(L. //
8 BATHROOMS TENANT BUSINESS NAME CONSTR. TYPt" OCC. GROUP
DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) -
EXISTING USE PROPOSED USE GARAGE (SF)
CONTACT NAME (If Different Fom Applicant)
ADDRESS
CITY STATE ZIP
PHONE FAX
EMAIL
PROPERTY OWNE.R NAME
" C^£)Y\V\.\^ L ' \AJ$./"£U0K3
ADDRESS
<2H>73L-C A-lTiSm^c U)^w
CITY STATE ' ZIP
PHONE FAX
EMAIL
ARCH/DESIGNER NAME & ADDRESS STATE LIC. 8
PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS
YES D # NO D YES Q NO D YES D NO D
APPLICANT NAME
ADDRESS
J)tf( vw^€-^
CITY STATE ZIP
PHONE FAX
EMAIL
CONTRACTOR BUS. NAME
ADDRESS
CITY STATE ZIP
PHONE FAX
EMAIL
STATE LIC.# CLASS CITY BUS. LIC.#
(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 issuance, also requires theapplicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9, commending with Section 7000 of Division 3 of theBusiness 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 acivil penalty of not more than five hundred dollars {$500}).
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
O 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.
PI 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 issued. My workers' compensation insurance carrier and policy
number are: Insurance Co. Policy No. Expiration Date
This section need not be completed if the permit is for one hundred dollars ($100) or less.
O Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of
California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), in
addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees.
JS$ CONTRACTOR SIGNATURE OAGENT DATE
/ hereby affirm that I am exempt from Contractor's License Law for the following reason:
n 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).
\rf 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).
O I am exempt under Section Business and Professions Code for this reason:
1.1 personally plan to provide the major labor and materials for construction of the proposed property improvement, n Yes 3 No
2.1 (have / have not) signed an application for a building permit for the proposed work.
3.1 have contracted with the following person (firm) to provide the proposed construction (include name address / phone / contractors' license number):
4.1 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):
5.1 will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone / type of work):
^PROPERTY OWNER SIGNATURE CJAGENT DATE / — \ | _ j A
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? d Yes S. No
Is the applicants future building occupant required to obtain a permit from the air pollution control district or air quality management district? n Yes SS\No
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? O Yes CJ No
IF ANY OF THE ANSWERS ARE YES, /
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
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 com ply with all City ordinances and State laws relating to build ing tanstruction.
I hereby authorize representative of the City of Carlsbad to enter upon the above mentioned properly 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 not commenced within
^APPLICANT'S SIGNATUR DATE }-)l-ld
City of Carlsbad Bldg Inspection Request
For: 02/05/2010
Permit# CB100065
Title: WARDLOW RES REPLACE FURNACE
Description:
f\
Inspector Assignment://
2372 ALTISMAWY
C Lot:
Type: MECH Sub Type:
Job Address:
Suite:
Location:
OWNER WARDLOW CONNIE
Owner:
Remarks:
Phone: 6196886923
Inspector:
Total Time:
CD Description
43 AirCond/Furnace Set
Act Comments
Requested By: CONNIE WARLOW
Entered By: CHRISTINE
Comments/Notices/Holds
Associated PCRs/CVs Original PC#
Inspection History
Date Description Act Insp Comments