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Home My WebLink About2843 VIA CONQUISTADOR; ; CB122643; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 12-11-2012 Permit No: CB122643 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 2843 VIA CONQUISTADOR CBAD PME Status: Parcel No: 2225920700 Lot #: 0 Applied: Entered By: Reference #: Plan Approved: PC#: Issued: Inspect Area: Project Title: JENKINS RES -REPLACE WATER HEATER, SAME SIZE & LOCATION. Applicant: 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 TOT AL PERMIT FEES Owner: MARTIN FAMILY TRUST 11-25-09 2843 VIA CONQU ISTADOR CARLSBAD CA 92009 ISSUED 12/11 /2012 SKS $31.00 $0.00 $0.00 $64.00 $95.00 Total Fees: $95.00 Total Payments To Date: Balance Due: Inspector: FINAL APPROVAL Date: 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 f / f whi h h v r i I N Tl E imil r hi whi h h f limi i n h r vi I h rwi Ci.ty of Carlsbad ,-.. ~ Plan Check No.~. { 7~ 2).R'-f3 t;,-~~ ji ~~ 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value 760-602-2717 / 2718 / 2719 Fax: 760-602-8558 I ~-';,--~-1 Plan Ck. Deposit ~~ Building Permit Application -Date J //I 7 / 1 _,,, I ~ JOB ADDRESS SUITE#/SPACE#/UNIT# APN 2843 Via Conquistador --- CT/PROJECT# I LOT# I PHASE# 1 • OF UNITS 1• BEOROOMS # BATHROOMS I TENANT BUSINESS NAME I CONSTR. TYPE I occ. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) Replace existing like for alike water heater EXISTING USE rROPOSED USE I GARAGE (SF) PATIOS (SF) I DECKS (SF) FIREPLACE I AIR CONDITIONING IFIRE SPRINKLERS YESO NcCJ YES □No □ YES□No□ CONTACT NAME (If Different Fom App/leant) Califronia Delta Mechanical Inc APPLICANT NAME Galina Pavlova ADDRESS ADDRESS 6056 E Baseline Rd # 155 6056 E Baseline Rd 3 155 CITY STATE ZIP CITY STATE ZIP Mesa AZ 85206 Mesa AZ 85206 PHONE PHONE I FAX I FAX 480-898-0007 1-480-218-5645 858-361-6495 858-240-6677 EMAIL EMAIL california(@,deltamechanical.com i:1alinap(@,deltamechanical .com PROPERTY OWNER NAME Mark Martin CONTRACTOR BUS. NAME California Delta Mechanical inc. ADDRESS ADDRESS 2843 Via Conquistador 6056 E Baseline Rd # 155 CITY STATE ZIP CITY STATE ZIP Carlsbad CA 92011 Mesa Az 85206 PHONE IFAX PHONE I FAX 619-247-0276 480-898-0007 EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS I STATE LIC. # STATE LIC.# !CLASS r TYBUS. LIC1214281 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 an~ 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 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)). Worlters' Compensation Declaration: I hereby affirm under penall'f of petjury one of the fol/owing declarations: 0 I have and will maintain a certificate of consent to self-insure for wor1<ers' compensation as provided by Section 3700 of the Labor Code, for the performance ol the wor1t for which this permit is issued. [Z] I have and will maintain worlters' compensation. as required by Section 3700 of the Labor Code for the performance of the work for which this permit is issued. My wor1ters' compensation Insurance carrier and policy number are: Insurance Co Policy No. 1197823 Expiration Date '"""' Jl$, section need not be completed if the permit Is for one hundred dollars ($100) or less. l.!'.'.'.J Certificate of Exemption: I certify that in the performance of the wor1< forwhleh thlS permit IS Issued, I shall not employ any person in any manner so as to become subject to the Wor1ters· Compensation Laws of California. WARNING: Failure to secure worlters' 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 i Se ion 70 f the Labor code, interest and attorney's fees. _,g CONTRACTOR SIGNATURE I hereby affirm that I am exempt from Contractor's License Law for the fol/owing reason: D 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 Contracto(s License Law does not apply to an owner of property who builds or Improves thereon, and who does such wor1< 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 the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contracto(s license Law does not apply to an owner of property who builds or improves thereon, and contracts for such prorects with contractor(s) licensed pursuant to the Contracto(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. 0 Yes 0 No 2. I (have/ have not) signed an application for a building permit for the proposed wor1<. 3. I have contracted with the following person (firm) to provide the proposed construction (include name address/ phone / 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 wor1t (include name/ address/ phone I contractors· license number): 5. I will provide some of the wor1t, but I have contracted (hired) the following persons to provide the work indleated (include name I address / phone/ type of wor1t): _,g PROPERTY OWNER SIGNATURE DATE Is the app1icant or future building occupant required to submit a business..ID2!l, acutely hazardous materials registration fonn or risk management and preventiOn program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? D Yes LJNo Is the applicant or future building occupant required to obtain a pennit from the air pollutiOn control district or a~llty management district? O Yes O No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? O 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. I certify that I have read the application and state that the above lnfonnation Is correct and that the lnfonnation on the plans is accurate. I agree to complywitll all Cityo!dinances and State laws relating to building construction. I hereby authorize representative ct the City ct Cartsba:l 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, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: AA OSHA peimt is requiroo for excavaoons (:N8f 5'0' deep and demolition or construction ct structures (:N8f 3 stories in height. EXPIRATION: Every permit issued by the Buildng Official under the pro,isions ct this Code shall expire by lirntation and become null and \Od n the building or work autrorizoo by such permit is rot coomenced witllin 180days from the date ct such pemitocn the building oc wock authorizoo by such permit is suspendoo oc abandored at any tirre after the work iscoomenced for a perm ct 180da (Section 106.4.4 Uniform Building Code) . .fiS APPLICANT'S SIGNATURE DATE