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Home My WebLink About2852 VIA CONQUISTADOR; ; CB111918; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 09-06-2011 Permit No: CB111918 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 2852 VIA CONQUISTADOR CBAD PME Status: Parcel No: 2225922300 Lot #: 0 Applied: ISSUED 09/06/2011 KG Reference #: PC#: Project Title: HOFFMAN RES REPLACE WTR HTR Applicant: CALIFORNIA DEL TA MECHANICAL SUITE# 27 12440 OAK KNOLL RD 92064 866-898-0008 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES Entered By: Plan Approved: Issued: Inspect Area: Owner: HOFFMANEDWARDT&BRENDA 2852 VIA CONQUISTADOR CARLSBAD CA 92009 $150.00 $0.00 $0.00 $0.00 $150.00 Total Fees: $150.00 Total Payments To Date: $150.00 Balance Due: rv;,,~~"'\. t'l>r;,- Inspector: Date: Clearance: _____ _ $0.00 NOTICE: Please take NOTICE th:Jt 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 ser1ice fees in connection with this project. NOR DOES IT APPLY to any City of Carlsbad 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718 / 2719 • Fax: 760-602-8558 Building Permit Application JOB ADDRESS 2852 Via Conquistador Plan Check N Est. Value SUITE#/SPACE#/UNIT# CT/PROJECT# LOT# PHASE# # OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP DESCRIPTION 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) I FIREPLACE I AIR CONDITIONING IFIRE SPRINKLERS YES[]# NO□ YES□No□ YES□No□ CONTACT NAME (If Different Fom App/leant) California Delta Mechanical APPLICANT NAME Galina Pavlova --ADDRESS ADDRESS 6056 East Baseline rd # 155 6056 E. Baseline road suite# 155 CITY STATE ZIP CITY STATE ZIP Mesa AZ 85206 Mesa AZ 85206 PHONE I FAX PHONE 1 FAX 480-898-0007 1-480-218-5645 858-361-6495 1-858-240-6677 --EMAIL EMAIL california@deltamechanical .com galiapavlovabg@yahoo.com PROPERTY OWNER NAME Brenda hoffman CONTa CTO/R BUS2"E½0 ~ 1/7, / ~ , ~ '.:./'. ~/..?/c;>~ ADDRESS ADDRESS ',?/ 2852 Via Conquistador o~56 c; 5c>-~ '/?J? fd* /...;:53"" CITY STATE ZIP CITY STATE ZJ;'~c-b Carlsbad CA 92009 /U'aa A2 PHONE I FAX PHONE I FAX 760-685-3017 4c?tl -J?'9c?-t:7?1t7.? EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS I STATE LIC. # STATE LIC.# r~YG i2k/~-<'cr'/ cf////'-/ (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 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 1031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)). .. Workers' Compensation Declaration: I hereby affirm under penafty of perjury one of the following declarations: 0 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. [ZJ I have and will maintain workers' compensation, as reouired by Section 3700 of the Labor Code. for the performance of lhe work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Insurance Co Policy No. 1697823 Expiration Date ""112012 ~section need not be completed ~the permit is for one hundred dollars ($100) or less. liJ 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. JiS CONTRACTOR SIGNATURE ,a?!~ DATE 9 ,//' ~ / I hereby affirm that I am exempt from Contractor's License Law for the following reason: □ □ □ 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 sate (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 himse~ 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, as owner of lhe 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 lo 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. O Yes O No 2. I (have/ have not) signed an application for a building permit for the proposed work. 3. I have contracted with lhe following person (firm) to provide the proposed construction (include name address I phone / contractors' license number): 4. I plan lo provide portions of the work. but I have hired the following person to coordinate, supervise and provide the major work {include name f address/ phone / contractors' license number): 5 I will provide some of the work. but I have conlracted (hired) the following persons to provide the work indicated (include name f address / phone / type of work): .JiS PROPERTY OWNER SIGNATURE DATE s the applicant or future building occupant required to submit a business...ll!IDl, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the 'resley-Tanner HazardOU§ Substance Account Act? D Yes LJNo s the applicant or future building occupant required to obtain a permit from the air pollution control district or a~ality management district? [Jy es D No s the facility to~ constructed within 1,000 feet of the outer boundary of a school site? O Yes LJNo F 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 :MERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code), .ender's Name Lender's Address certify that I have read the application and state that the above infonnation Is correct and that the infonnation on the plans is accurate. I agree to comply with all City ordinances and State laws relating to bulldlng construction. hereby authorize representalive of the City of Ca1sbad to enter upon the ab<Ne mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD IGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. )SHA: An OSHA perrrit is required for excavations over 5'0' deep aid demolition or construction of structures over 3 stones in height. :XPIRATION: Eveiy permit issued by the Building Official under the provisions of this Code shall expire by linitation aid become null and void if the building or work authorized by such permit is not commenced llrithin 80 days from the date of such pernit or if the building or work authorized by such pemlit is suspended or abandoned at any time after the work is commenced for a penod of 180 days (Section 106.4.4 Unifoon Building Code). _g APPLICANT'S SIGNATURE DATE