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HomeMy WebLinkAbout2835 UNICORNIO ST; A; CB053384; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 09-26-2005 Plumbing Permit Permit No: CB053384 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 2835 UNICORNIO ST CBAD St: A PLUM Status: Parcel No: 2153602603 Lot #: 0 Applied: Construction Type: NEW Entered By: Reference #: Project Title: Applicant: VAYNSHTEYN RESIDENCE WATER HEATER REPLACEMENT CALIFORNIA DELTA MECHANICAL SUITE# 27 12440 OAK KNOLL RD 92064 866-898-0008 Plumbing Issue Fee Fixture or Trap Building Sewer Roof Drain Install/Repair Water Line Water Heater and/or Vent Gas Piping System Vacuum Breaker Other Plumbing Fees Master Drainage Fee Sewer Fee Additional Fees TOTAL PERMIT FEES 0 0 0 0 1 0 0 Plan Approved: Issued: Inspect Area: Owner: VAYNSHTEYN LEONID&ANNA 1263 MARIPOSA RD CARLSBAD CA 92009 ISSUED 09/26/2005 MDP 09/26/2005 09/26/2005 $20.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $27.00 Total Fees: $27.00 Total Payments To Date: $27.00 Balance Due: Inspector: .:.;zj[tl\ FIN Clearance: ------- $0.00 NOTICE: Please take NOTICE that approval 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 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 • • • T • ii f • ' • h I FOR OFFICE USE ONLY PLAN CHECK NO. ______ _ PERMIT APPLICATION EST. VAL. __________ _ Plan Ck. Deposit ________ _ CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 Validated By _________ _ Date ____________ _ 1. PROJECT!~ 2835 UNICIORNIO STREET UNIT A CARLSBAD, CA 92009 Address (include Bldg/Suite #) Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # Existing Use Proposed Use Replace standard water heater like for like Description of WOl1( SQ. FT. # of Stories # of Bedrooms # of Bathrooms California Delta mechanical, Inc. 2500 S. Power Rd. Suite I 120 Mesa AZ 85209 (480) 898-0007 (480) 898-0005 Name Address City State/Zip Telephone# Fax# 3. APPLICANT ©...._Conlraclor C Agent fer Conlraclor C Owner C Agent fer Owner RO MEL 2500 S. POWER RD # 120 MESA AZ 480-898-0007 Name Address City Sta1e/Zip Telephone# OWNER ----- LENNY VA YNSHTEYN 2835 UNICIORNIO STREET UNIT A CARLSBAD, CA 92009 760-212-3689 Name Address City Sta1e/Zip Telephone# I , CONTIW:TOR • COIIPANY NAME (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any s1ruciure, prior to its issuance, also requires the applicant for such pennlt 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 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 pennit subjects the applicant to a civil penalty of not more than five hundred dollars [$500]). California Delta Mechanical, lnc. 2500 S. Power Rd. Suite# 120 Mesa 85209 ( 480) 898-0007 Name Address City State/Zip Telephone# State License# ~8_1 _11_1 __ 4 ____ _ License Class _C_-_3_6 _______ _ City Business License # --=1-=2:...:1 .... 4:..:2:..:8:...;1=------- Designer Name Address City State/Zip Telephone# State License# _______ _ I. WORKER'SCOIIPalA110N Workers' Compensation Dedara1ion: I hereby affinn under penalty of perjury one of the following dedaralions: □ I have and will maintain a certificate of consent to self~nsure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this pennit is Issued. [El I have and will maintain worker's compensation, as required by Section 3700 of the labor Code, for the performance of the work for which this pennit is Issued. My worker's compensation insurance carrier and policy number are: insurance company State Compensation Insurance Fund Policy No. 1697823 Expiralion Date . ...,0"-'7'-'-/0"'-'-'l/-"'0_,.6 _____ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100) OR LESS) □ CERTIFICATE OF EXEMPTION: I certify that in the performance 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' Cornpensalion Laws of • • dollars($100,000), In addition to the cost of compensatlo , SIGNATURE Rome) Maru 7. OWNER-BUILDER DECLARA110N d shall subject an employer to criminal penalties and clvll fines up to one hundred thousand for In Section 3706 of tht Labor Code, lnteru t and attorney's fees. DATE 09/20/05 I hereby affinn thal I am exempt from the Contract fo the following reason: D I, as owner of the property or my emplo ees with age as th ir sole compensa1ion, will d the work and the s1ructure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's License Law oes 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 r not intended or offered for sale. ~-however, the building 0< improvement is sold within one year al completion, the owner-builder will have the burden of proving tha1 he did not build or improve for the purpose of sale). □ I, as owner of the property, am exdusively contracting with licensed contractors to construct the projed (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. □ YES □ NO 2. I (have/have not) signed an application for a building pennit for the proposed work. 3. I have contracted with the following person (finn) to provide the proposed cons1ruction (indude name / address / phone number I 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 (indude name/ address/ phone number I /ontradors license number): ------------------------------------------ 5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work Indicated (indude name /address / phone number/ type of work): PROPERTY OWNER SIGNATURE __________________________ DATE __________ _ WHITE: File YELLOW: Applicant PINK: Finance PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 Page 2 of 2 COIIPLE1E 'ntll 8EC110N FOR IIOIUfSIDBfflAI 8llLDINO PERaTS ONLY Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration for or risk management and prevention program under Sections 25505, 25533 or 25534 cl the Presley-Tanner Hazardous Substance Account Ad.? □ 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 facility to be constructed 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. I. CONSTRUC1l0N LENDING AGENCY --- 1 hereby affirm that there Is a construct.ion lending agency for the performance of the work for which this permit is Issued (Sec. 3097(1) Civil Code). LENDER'S NAME _________________ _ APPLICANT CER11PICA110N 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 City of Car1sbad 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, JUDGEMENTS, 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 of 5'0" deep and demolition or canst ct.ion of structures over 3 stories in height. EXPIRATION: Every permit issued by the building Official u the provisions this C e shall expire by limitation and become null and void if the building or work authorized by such permit is not commenced within 180 days from the d e such per ilding or work authorized by such permit is suspended or abandoned at any time after the work is commenced for a period of 180 days (Section 1 4.4 ni,rprr!J,tl!IIMlllllgyQa• WHITE: File YELLOW: Applicant PINK: Finance . ,. . . UNSCHEDULED BUILDING INSPECTION DATE 3-~~Q\D C ~~ INSPECTOR ____ _ PERMIT # QS:7)':)7;~ • PLAN CHECK# ___ _ JOB ADDRESS @:GS I tD,CDci.u) ~ -- DESCRIPTION CODE DESCRIPTION ACT COMMENTS ;?b lk~\r\~, _J_ c:)9\ ~ :CC\a~ 8:- License Detail Page 2 of 2 ~ '~------------------------------------SURETY COMPANY OF THE PACIFIC. Effective Date: 03/25/2004 Contractor's Bonding_ History BOND OF QUALIFYING INDIVIDUAL(1 ): This license filed Bond of Qualifying Individual 1 161627 for ANTON DIMITROV TCHAKAROV in the amount of $7,500 with the bonding cc AMERICAN CO)flRACTORS INDEMNITY COMPANY. Effective Date: 07/10/2002 ***Workers Compensation Information * * * This license has workers compensation insurance with the STATE COMPENSATION INSURANCE FUND Policy Number: 1697823 Effective Date: 07/01/2002 Expire Date: 07/01/2006 ~sonnel Listi I L._ic_imse_ N!,IJ:!lber RJLquest 11 Contractor Name Re uest 11 Personn_el Name Req_ue~t a.=::::::::==:::==::::::::::=:==-. _ __JI Isales erson Name Re uest © 2005 State of California. Conditions of Use ~Y.£.oli.cy. http://www2.cslb.ca.gov/CSLB _LIBRARY /License+Detail.asp 09/26/2005