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Home My WebLink About2867 VIA CONQUISTADOR; ; CB130046; Permit• City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 01-07-2013 Permit No: CB 130046 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 2867 VIA CONQUISTADOR CBAD PME Status: Parcel No: 2225920100 Lot#: 0 Applied: ISSUED 01/07/2013 SKS 01/07/2013 01/07/2013 Reference #: PC#: Project Title: Applicant: MANDICH RES -REPLACE WATER HEATER, LIKE FOR LIKE CALIFORNIA DEL TA MECHANICAL STE 155 6056 E BASELINE RD MESA AZ 85206 480-898-0007 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES Entered By: Plan Approved: Owner: MANDICH ROBERT A 5016 42ND AVES SEATTLE WA 98118 Issued: Inspect Area: $31 .00 $0.00 $0.00 $64.00 $95.00 Total Fees: $95.00 Total Payments To Date: $95.00 Balance Due: Inspector: Clearance: _____ _ $0.00 NOTICE: Please take NOTICE that approval of your project includes the "Imposition· of fees, dedications, reservations, or other exactions hereafter collecbvely 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 f / x i n f whi h vi I I ' • hi h h r • I • City of Carlsbad ij---~~ Plan Check No. 1635 Faraday Ave., Carlsbad, CA 92008 ~~~ Est. Value 760-602-2717 / 2718/ 2719 Fax: 760-602-8558 -;,·•~-• Plan Ck. pepo~it .,,,,-,__ Building Permit Application -Co.JJ Date ' /1 / / V I JOB ADDRESS SUITE#/SPACE#/UNIT# APN . --2867 Via Conquistador CT/PROJECT# I LOT # I PHASE# I # OF UNITS I# BEOROOMS # BATHROOMS r ENANT BUSINESS NAME I CONSTR. TYPE I occ. GROUP fflCRIPTION OF WORK: Include Square Feet of Affected Area(s) Replace existing like for alike water heater EXISTING USE I PROPOSED USE I GARAGE (SF) PATIOS (SF) I DECKS (SF) FIREPLACE I AIR CONDITIONING IFIRE SPRINKLERS YESC)# No[] YES □No □ YES□No□ CONTACT NAME (lfDllferentFomAppllcant) C l'f , D It M h . I I APPLICANT NAME Galina Pavlova a I ornIa e a ec anica nc. ADDRESS ADDRESS 6056 E Bseline Rd# 155 6056 E Baseline Rd# 155 CITY STATE ZIP CITY STATE ZIP Mesa AZ 85206 Mesa Az 85206 PHONE I FAX PHONE I FAX 480-898-0007 1-480-218-5645 858-361-6495 858-240-6677 EMAIL EMAIL california@,deltamechanical.com galiapavlovabg@.yahoo.com PROPERTY OWNER NAME Bob Mandich CONTRACTOR BUS. NAME California Delta Mechanical Inc. ADDRESS ADDRESS 2867 Via Conquistador 6056 E Baseline Rd# 155 CITY STATE ZIP CITY STATE ZIP Carlsbad CA 92009 Mesa AZ 85206 PHONE I FAX PHONE IFAX 760-438-6648 480-898-0007 EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS I STATE L\C. # STATE LIC.# I CLASS rTY BUS. L\C.1214281 811114 c-36 (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 lor 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 the Business and Professions Code} or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7D31.5 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 one of me follol+ing declarations: [2] I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of Ille Labor Code, for Ille performance of the work for which this pennit Is Issued. [Z] I have and will maintain worl<ers' compensation. as reoulred by Section 3700 of Ille Labor Code, for the performance of the wor1< for which this permit Is Issued. My wor1<ers' compensation Insurance carrier and policy number are: Insurance Co Policy No. 1197623 Expiration Date 07"1113 ]]igi,section need net be completed~ the permit is for one hundred dollars ($100) or less. lLJ Certificate of Exemption: I cer:lfy that In the performance of the wor1< for wllich this permit is issued, I shall not emplOy any person In any manner so as to became subject to Ille Wor1<ers' Compensation Laws of California. WARNING: Failure to secure worl<ers' 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 S ·on 3 06 o he Labor code, interest and attorney's fees. / / 25 CONTRACTOR SIGNATURE DATE / l / • 13 I hereby affirm tflat I am exempt from Contractor's License Law for the follol+ing reason: D I, as owner of the property or my emplOyees wilh wages as their sole compensation, will do the wor1< 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 lhereon, and whO does such wor1< himseff or through his own employees, provided that such improvements are not intended or offered for sale. If, however, Ille building or improvement is sold within one year of completion, the owner-builder will have Ille burden of proving that he did not build or Improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to construct Ille 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 Ille 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 or Ille proposed property improvement O ves O No 2. I (have/ have not) signed an application for a building permit for Ille proposed wor1<. 3. I have contracted with Ille following person (firm} to provide Ille proposed construction (Include name address I phone I contractors' license number}: 4. I plan to provide portions of the wor1<, but I have hired the follOwlng person to coordinate, supervise and provide Ille major wor1< (Include name I address / phone / contractors' license number}: 5. I will provide some of the wor1<, but I have contracted (hired} Ille following persons to provide the v.or1< Indicated (Include name/ address I phone I type of wor1<): 25 PROPERTY OWNER SIGNATURE DATE Is the applicant or future building occupant required to submit a business..Q!fill, acutely hazardous materials registratiOn form or risk management and prevention program under Sections 25505, 25533 or 25534 of tile Presley-Tanner Hazardous Substance Account Act? D Yes LJNo Is the applicant or future building occupant required to obtain a permit from tile air pollution control district or a~ality management district? 0 Yes O No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 Yes 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 AND THE AIR POLLUTION CONTROL DISTRICT. issued (Sec. 3097 (i) Civil Code). Lender's Address I certify that I llave read the application and state that the above Information is correct and that the infonnation on the plans Is accurate. I ag,l!e to comply with all City ordinances and State laws relating to building construction. I hereby authorize rep.-esentati..e of the City ri Car1sba:J to enter upon the alxMl mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST All LIABtUTIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUEAGAJNST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavaoons over 5'0' deep and demoition or oonstruction of structures over 3 stories in height. EXPIRATION: E..ery permit issued by the Building Official under the pro,isions of this Code shall expire by limitation and become null and IIOid ~ the bulding or work authorized by such permit is rot corrmenoed within 180 days from the date of such permit or~ the building or wor1< authorized by such permit is suspended or aba'ldoned at any time after the wor1< is corrmenoed for a period of 100 days (Section 100.4.4 Uniform Building Code). ~ ,,,, I fo LI $ _g APPLICANT'S SIGNATURE cf Inspection List Permit#: CB130046 Type: PME Date Inspection Item 01/18/2013 25 Water HeaterNents 01/18/2013 25 Water HeaterNents 01/18/2013 29 Final Plumbing Tuesday, January 22, 2013 Inspector Act PY PY RI AP AP MANDICH RES -REPLACE WATER HEATER, LIKE FOR LIKE Comments PLEASE CALL WITH TIME Page 1 of 1