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Home My WebLink About1369 CASSINS ST; ; CB111921; Permit09-06-2011 City of Carlsbad 1635 Faraday Av Carlsbad.CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No: CB111921 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC #: Project Title: 1369 CASSINS ST CBAD PME 2156914300 Lot #: 0 LORENTZEN RES REPLACE WTR HTR Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 09/06/2011 KG Applicant: CALIFORNIA DELTA MECHANICAL Owner: LORENTZEN SHAWN P&LAURA R SUITE #27 12440 OAK KNOLL RD 92064 866-898-0008 1369 CASSINS ST CARLSBAD CA 92011 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees $150.00 $0.00 $0.00 $0.00 TOTAL PERMIT FEES $150.00 Total Fees: $150.00 Total Payments To Date: $150.00 Balance Due: $0.00 PERMJT HAS EXPIRED IN ACCORDANCE WITH C.B.C. SECTION 106.4A AS AyEMDED BY C.M.C.18.04i)30 ^6 Inspector: FINAL APPROVAL Date: Clearance: NOTICE: Please take NOTICE that approval of your project includes the Imposition" of fees, dedications, resewations, or other exactions hereafter collectively refen'ed to as "fees/exactions." You have 90 days from the date this pennit 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 fees/exactions of which vou have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously othenwise expired. City of Carlsbad 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718 / 2719 Fax: 760-602-8558 Building Permit Application Plan Check Est. Value Plan Ck. Deposit Date JOB ADDRESS 1369 Cassins street SUITE#/SPACE#/UNIT# CT/PROJECT # LOT* # OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP DESCRIPTION OF WORK: /nc/ude Square Feet of Affected Area(s) Replace existing \\ke for aiiice water iieater EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE YESr~> AIR CONDITIONING YEsj |NO| 1 FlRESPRINKLERS YES| |NO| 1 CONTACT NAME (If [>lfferent Fom Applicant) California Delta Mechanical APPLICANT NAME Galina Pavlova ADDRESS 6056 East Baseline rd # 155 ADDRESS 6056 E. Baseline road suite # 155 CITY Mesa STATE AZ ZIP 85206 CITY Mesa STATE AZ ZIP 85206 PHONE 480-898-0007 FAX 1-480-218-5645 PHONE 858-361-6495 FAX 1-858-240-6677 EMAIL california@deltamechanical.coni EMAIL galiapavlovabg@yahoo.com PROPERTY OWNER NAME Shawn Lorentzen CONTRACTOR BUS. NAME ^^^^ /^^'^^^/^^^ ADDRESS 1369 Cassins street ADDRESS ^ ^ J j~i y CITY Carlsbad STATE ZIP CA 92011 CITY STATE ^ PHONE 760-579-8802 FAX PHONE FAX EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS STATE LIC. # STATE LIC.# _ CLASS^ '^^^ CITY BUS. LIC.# (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 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)). Workers' Compensation Declaration: / hereby affirm under penalty of perjury one ofthe foltowing declarations: IM I have and will maintain a certificate ot 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. hCi I have and will maintain worlters' compensation, as reaiiired bv Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Insurance Co PoiicyNo. mmi Expiration Date momn This section need not be completed if the permit is for one hundred dollars ($100) or less. I/I 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 attomey's fees. JS^ CONTRACTOR SIGNATURE y1^^'(>''^^r^ DATE / hereby affirm that I am exempt from Contractor's License Law for the following reason: I I 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 Contractor's License 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 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 ot sale). I I I, as owner of the properly, am exclusively contracting with licensed contractors to construct fhe projecl (Sec. 7044, Business and Professions Code: The Conlraclor's License Law does nof apply lo an owner of property who builds or improves Ihereon, and contracts for such projects wilh conlraclor(s) licensed pursuant to the Contractor's License Law). I am exempt under Section „ .Business and Professions Code for this reason: 1.1 personally plan lo provide the major labor and materials for construcfion of Ihe proposed properly improvement, QVes I iNo 2.1 (have / have not) signed an application for a building permit for the proposed work. 3.1 have contrxted with the following person (firm) to provide the proposed construction (include name address / phone / contractors' license number): 4.1 plan to provide portions of the work, but I have hired Ihe foltowing person to coordinate, supervise and provide the major work (include name / address / phone / contractors' license number): 5.1 will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone / type of work): -^S'PROPERTY OWNER SIGNATURE DATE s the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 26505, 25533 or 25534 of the ^resley-Tanner Hazardous Substance Account Act? | | Yes I iNn s the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? I hes I I No s the facility to be constructed within 1,000 feet of the outer boundary of a school site? [UlYes I I No 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 EMERGENCY 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 certilythatlhavereadthe application and state that the above information is conect and that the infomiation on the plans is accurate. I agree to complywith all City onlinances and State laws relating to building construction. hereby authorize representative of the City of Carisbad to enter upon the above mentioned property for inspection puqDoses. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD \GAINST 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 pennit is required for excavations over 5'0' deep and demolition or construction of stmctures over 3 stories in height iXPIRATION: Every permit issued by the Building Oflicial under the provisions of this Code shall expire by limitatkDn and become null and void if the building or worit authorized by such pemnit is not commenced within 80 days from the date of such perniit or if the building or worit authorized by such pemnit is suspended or abandoned at any time after the wortt is commenced for a period of 180 days {Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE