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Home My WebLink About1317 VERBENA CT; ; CB153905; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 11-12-2015 Permit No: CB153905 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference#: PC#: 1317 VERBENA CT CBAD PME 2145701400 Lot#: 0 Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 11/12/2015 JMA 11/12/2015 11/12/2015 Project Title: GOLSHAN: REPLACE WTR.HTR. Applicant: ALL STAR WATER HEATERS & PLUMBING 30300 PUERTO VALLARTA WY MENIFEE CA 92584 1-800-727-0977 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES Owner: GOLSHAN BEHROKH 1317 VERBENA CT CARLSBAD CA 92011 $38.00 $0.00 $0.00 $60.00 $98.00 Total Fees: $98.00 Total Payments To Date: $98.00 Balance Due: Inspector: AL Date: -./---Jl.~=4--1....::':>=-_, Clearance: _____ _ $0.00 NOTICE: Please ta<e CE that cl~ l)'tject irdudes Ire "ln,:mtioo" cl fees, derlcatioos, reservaia,s, cr ctha-" exa:1ioos ha-"eetter cnlectively reterred to as "feesexa:1· ." Yi rave oo days frcrn tre date tlis pemit v-as issued to pretest in,:mtioo cl these feesexafuls. If you pretest them you rrust fcilON Ire pretest p-oceo.res set forth in <?o.ierma-t C.ode Sec::tioo 60020(a), .rd file Ire pretest .rd any ctha-" re:,..ired infooratioo wth tre Oty IVa,ag:ir fcr p-ocessirg in oo:x:rda-ce wth C'a1stm M..rid~ C.ode Sec::tioo 3.32.COO. PcilLre to tirrely fcilONthal p-cxl:lCire wll ta-any Sl.b;;a:µrt IEg:ll octioo to attax. review, set aside, vcid, cr aru their irrJX)Sitioo. YOJ ere herecy Fl.Rn-ER NOT1FlEDthat ~ rigt to pretest tre si;a:ified feesexoctioos cx::ES NOT .APPI..Ytov.eta-.rd sev'8"CXJTI:ldioo fees .rd~ dmges, ncr planrg, 2D"irg, gajrg cr ctha-" sinilar Wicatioo p-ocessirg cr 58'-lioa fees in CXJTI:ldioo wth tlis l)tject. t-rn cx::ES IT .APPLY to any fees ·oos cl 'l'ohch ·cus1 been ·ven a CE sinilar to tli cr to 'llolich u cl linitatioos res ·cus1 • ~ Plan Check No. r.PJ ,s--2-f1 n ~ «., Building Permit Application ~ 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value C ITY 0 F 760-602-2717 / 2718 / 2719 CARLSBAD Fax 760-602-8558 Plan Ck. Deposit www.carlsbadca.gov Date I\,\ 7 __ I { l~wppp ... JOB ADDRESS 1317 Verbena Ct. SUITE#/SPACE#/UNI It IAPN . . - ··-·-. f°TI IP"""c II 1 • Of UNIIS I ' BEDRVVMO #tsA1tttn,vMS j TENANT ouslNEss .. ..,,. 1~=,,R. ,,,_-,DCTTlioUP DESCRIPTION OF WORK: Include Squans Feet of Affected Area(s) Replace existing water heater. Same size and location. EXISTING USE I PROPOSED USE I GARAGE (SF) PATIOS (SF) I DECKS (SF) FIREPLACE I AIR CONDITIONING 'FIRE SPRINKLERS YES[]# No0 YES □No□ YES□No□ CONTACT NAME (II Olfror•nt Fom Appl/cant) APPLICANT NAME Sierra Sprague ADDRESS ADDRESS 30300 Puerto Vallarta CITY STATE ZIP CITY STATE ZlP Menifee CA 92584 PHONE IFAX PHONE IFAX 951-301-0067 EMAIL EMAIL PROPERTY OWNER NAME Brook Golshan CONTRACTOR BUS. NAME All Sfar w~tPr t I . ··-"' ADDRESS ADDRESS Sa~asiob 30300 Puerto Vallarta CllY STATE ZIP CITY STATE ZIP Cartc:h=irl CA 92011 Menifee CA 92584 PHONE (AX PHONE I FAX 760-518-9983 951-301-0067 EMAIL EMAIL A AACli/DESIGNER NAME & AO DRESS I STATE UC.# STATE UC,# rlASc 36 l0rv)tJrA I Y 1% 812894 (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 the applicant for such permit to file a signed statement ttiat he Is licensed pursuant to the provisions of the Contractor's License Law (Chapter 9, commending with Section 7000 of Division 3 or the Business and Professions Code} or !hat he is exempt therefrom, and the basis for the alleged exemption. My 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)). Worl<ers' Compensation Declaration: I hereby affirm under penalty of perjury ooe of the lotlowfng declarslions: 0 I have and will maintain a certJficate of consent to self-Insure for workers' compensation as provided by Section 3700 of the Labor Code, for lhe performance of the worn for which this permit is issued. 0 I have and wUI maintain workers' compensation, as reQuired by Section 3700 of the Labor Code, for the performance ol tlie worn for which this permit is Issued My worners' compensation insurance carrier and policy number aro: Insurance Co American Insurance Company Pot,cy No. C4809630A Expiration Date 8/01116 ]l!!}, sec~on need not be compleled If the permit is for one hundred dollars ($100) or less. LJ Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject lo the Workers' Compensation Laws of Caifomla. WARNING: Failure to secure workers' compensation coverage Is unlawful, and shall subject an employer lo criminal penalties and civil fines up to one hundred thousand dollars (&100,000), In addition to the cost of compensation, damages as provided for In Section 3706 of the Labor code, interest and attorney's foes. / / 2S CONTRACTOR SIGNATURE DATE ///II/I$' I hereby affirm that I am exempt from CMlrtlctor's Ucense Law for the following reason: □ □ □ I, as owner of the property or my employees with wages as their sole compensation, will do the worn and the structure Is not inlended or offered for sale (Sec. 7044, Business and Professions Code: The Contracto(s Lk:ense 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 mtended or offered for sale. If, however, the buUding or improvement is sold within one year of compleUon, the owner-builder will have the burden of proving that he did not build or Improve for the purpose of sale). I, as owner ol the property, am exclusively contracting with Ncensed contractors lo construct the project (Sec. 7044, Business and Professions Code: The Contraclofs Ucense Law does not apply to an owner of property who builds or Improves thereon, and oontracts for sudl projects with contractor(s} licensed pursuant to the Conlractor's License Law). I am exempt under Section ____ ,Business and Professions Code for lhls reason: 1. I personally plan to provide the major labor and materials for C011struclion of the proposed property improvement. 0 Yes 0 No 2. I (have I have not) signed an applicalion for a building permit for the proposed wor11. 3. I have contracted with the following person (firm) to provide the proposed oonstruction (include name address I phone/ contractors' license number): 4. I plan lo provide portions of the work, but I have hired the following person lo coordinate, supervise and provide the major work (include name/ address I phone I contractors' license number): 5. I will provide some of the worn, but I have contracted (hired) the following persons to provide tlie worn Indicated (include name/ address I phone I type of work): £5 PROPERTY OWNER SIGNATURE DATE I 'Is the applicant or future building OCOJpant required to submit a business~. acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance ACCO\Jl1t Act? D Yes LJNo Is the applicant or future building OCOJpant required to obtain a permit from the air pollution control~trict or aiL9l!allty management district? O Yes O No Is the facility to be constl\Jcted within 1,000 feet of the outer boundary of a school site? LJYes LJNo 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 AHO 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 theapplCcltlon and stats that the above lnfonnatlonlscorreaand tllatltlelnformatfon on the plans Is accurate. I agree to comply \\Ith all City ordinances and State laws relatfngto buildlngconstrudlon. I hereby authOlize representative of the City of Gallsbad to enter ul)(Jl the above mentioned ~rty l:lr inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABlUTIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEO.JENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA pennit is ~uired to' eIDlV8tioos O\'ef' 5'0' deep ll!d demo:ition or CO/lSIIIX:OOn of structures ove< 3 stooes in height. EXPIRATION: Every permit issued by the Buikfing Offidal under the pro'lisitlls of this Code shaff exp re by lirritatk>n ard become nun ard ..oo if the buildlrg orwa11 authorized by such pennit is not corr.nenced ~trio 180days from the date of such permit or iflhe buildif'El or WOik authorized by such permit is suspendoo or abardoned at any time after the won< is oornmenred to-a i;eood of 180days (Section 100.4.4 lklibm aJikling Code). ,€S APPLICANT'S SIGNATURE .L.,,,,r;;..,.,...s.c-9 ._ DATE // /2 / / $ Inspection List Permit#: C8153905 Type: PME Date Inspection Item 12/04/2015 25 Water HeaterNents 12/04/2015 25 Water HeaterNents 12/04/2015 29 Final Plumbing 12/04/2015 29 Final Plumbing Friday, December 04, 2015 GOLSHAN: REPLACE WTR.HTR. Inspector Act Comments RI PY AP RI PY AP Page 1 of 1