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1373 CASSINS ST; ; CB052293; Permit
City of Carlsbad , , , 1635 Faraday Av Carlsbad, CA 92008 06-21-2005 Plumbing Permit Permit No: CB052293 Building Inspection Request Line (760) 602-2725 Job Address: 1373 CASSINS ST CBAD Permit Type: PLUM Status: ISSUED Parcel No: 2156914400 Lot*: 0 Applied: 06/21/2005 Construction Type: NEW Entered By: KQ Reference #: Plan Approved: 06/21/2005 Issued: 06/21/2005 Project Title: ROSE RES REPLACE H2O HEATER Inspect Area: Applicant: Owner CALIFORNIA DELTA MECHANICAL ROSE GHiGORY A&AMY SUITE #27 1373 CASSINS ST 12440 OAK KNOLL RD 92064 CARLSBAD CA 92009 866-898-0008 Plumbing Issue Fee $20.00 Fixture or Trap 0 $0.00 Building Sewer 0 $0.00 Roof Drain 0 $0.00 Install/Repair Water Line 0 $0.00 Water Heater and/or Vent 1 $7.00 Gas Piping System 0 $0.00 Vacuum Breaker 0 $0.00 Other Plumbing Fees ' $0.00 Master Drainage Fee $0.00 Sewer Fee $6.00 Additional Fees $0.00 TOTAL PERMIT FEES $27.00 Total Fees: $27.00 Total Payments To Date: $0.00 Balance Due: $27.00 06/21/05 0002 01 Q9CGR ^ 27.00 FINAL APPROVAL \f-l~1a I rInspector: ^ _L. Date: a I r U-*L. _ Clearance: 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 fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute erf limitations has previously otherwise expired. PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 1. PROJECT INFORMATION FOR OFFICE USE PLAN CHECK NO.' EST. VAL. Plan Ck. Deposit Validated By Date Address (include Bldg/Suite #)Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No.Phase No.Total # of units Proposed Use Description of Work # of Bathrooms 2. CONTACT PERSON (If dffferent from applicant) 2 £ 0 0 Name Address City 3. APPLICANT tf Contractor D Agent for Contractor D Owner State/Zip Telephone D AgentforOwner J P Name 4. PROPERTY OWNER Address City State/Zip Telephone * Name ' ' f v Address City State/Zip Teli 5: ':•" CONTRACTOR • COMPANY N*ME^^V-VU:,:/^. ';'•:' V?:.;'-"" '. .:, v ":•'"' -.--•• "' •• (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/or a permit subjects the-applicant to a civil penalty of not more than five hundred dollars ($500]). Name / State License # Designer Name State License # S #f( M4- *I4U4- Address License Class Cr1""" CP fa Address City / City State/Zip City Business License # [_i State/Zip TelesphonertT. ?&{ Telephone # Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: D 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. Jl, I have and will maintain worker's compensation, as required by Section 3700 of the labor Code, for the performance of the work for which this permit is issued. My worker's compensation iosurajce carrier and policy, number to: i > rt^> >Tiii-vc>Insurance Company.Policy No.Expiration Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [J100] OR LESS) D 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 Ubws of California. WARNING: Failure to V4Mre workenr^MnpensUlon coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollara($100,000), in adiit&rAta^rfewSf^pmpAisatlon, damages are provided for in Section 3706 of the Labor Code, interest and attorney's fees. SIGNATURE IW\S/V^-'—f"^ : DATE 7, OWNER-BUILD^ted^Tlfyi -' ( , ~~ I hereby affirm thayfanVeXSmpt f rdjn the Contractor's License Law for the following reason: D I, as owner of the property or my employees with wages as their sole compensation, will d the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: me 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 of sale). D I, as owner of the 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 contractors) licensed pursuant to the Contractor's License Law). O 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. D YES D NO 2. I (have/have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction (include name / address / phone number / 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 work (include name / address / phone number / /ontractors license number): 5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type of work): PROPERTY OWNER SIGNATURE DATE WHITE: File YELLOW: Applicant PINK: Finance PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 Page 2 of 2 " >i "•, Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration for or risk management and prevention program under Sections 25505,25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? DYES D NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? D YES D NO IslhefacilrtytobeconstructBdwithinl.OOOfeetoflheouterboundaryofaschoolsrte? D YES D NO 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 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(1) Civil Code). LENDER'S NAME LENDER'S ADDRESS. I certify that I have read the application and state that the above information is correct and that the information on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the City of Carlsbad 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, JUDGEMENTS, COSTS AND OSHA: An OSHA permit is required for excavations of 5'0' deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the building Official i by such permit is not commenced with n the work is commenced for a period <i 1£ > APPLICANTS SIGNATURE provisions of this Code shall expire by limitation and become null and void if the building or work authorized such permit or if the building or work authorized by such permit is suspended or abandoned at any time after Building Code). DATE WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For 08/11/2005 Permit* CB052293 Title: ROSE RES REPLACE H2O HEATER Description: Inspector Assignment: 1373 CASSINS ST Lot Type: PLUM Sub Type: Job Address: Suite: Location: APPLICANT CALIFORNIA DELTA MECHANICAL Owner: ROSE GREGORY A&AMY Remarks: Phone: 7604380266 Total Time:Requested By: AMY ROSE Entered By: CHRISTINE Act CommentCD Description 25 Water Heater/Vents Associated PCRs/CVs Inspection History Date Description Act Insp Comments License Detail Page 1 of2 California Home License Detail Contractor License #811114 CALIFORNIA CONTRACTORS STATE LICEN DISCLAIMER A license status check provides information taken from the CSLB license data base. Before on this information, you should be aware of the following limitations: • CSLB complaint disclosure is restricted by law (B&P7124.6). If this entity is subject tc complaint disclosure, a link for complaint disclosure will appear below. Click on the lin button to obtain complaint and/or legal action information. • Per B&P 7071.17. only construction related civil judgments reported to the CSLB are disclosed. • Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration. • Due to workload, there may be relevant information that has not yet been entered ont Board's license data base. Extract Date: 06/21/2005 * * * Business Information * * * CALIFORNIA DELTA MECHANICAL INC 2500 S POWER ROAD #120 MESA, AZ 85208 Business Phone Number: (480) 898-0007 Entity: Corporation Issue Date: 08/01/2002 Expire Date: 08/31/2006 * * * License Status * * * This license is current and active. All information below should be reviewed. * * *Classifications * * Class (Description C36 IPLUMBING * * *Bonding Information * * * CONTRACTOR'S BOND: This license filed Contractor's Bond number 6060003 in the air $10,000 with the bonding company http://www2.cslb.ca.gov/CSLB_LIBRARY/License+Detail.asp 06/21/2005 License Detail Page 2 of 2 SURETY COMPANY OF THE PACIFIC. Effective Date: 03/25/2004 Contractor's Bonding History BOND OF QUALIFYING INDIVIDUAL(I): This license filed Bond of Qualifying Individual i 161627 for ANTON DIMITROV TCHAKAROV in the amount of $7,500 with the bonding cc AMERICAN CONTRACTORS INDEMNITY COMPANY. Effective Date: 07/10/2002 *'* * Workers Compensation Information * * * This license has workers compensation insurance with the STATE COMPENSATION INSURANCE FUND Policy Number: 1697823 Effective Date: 07/01/2002 Expire Date: 07/01/2006 ' Personnel List License Number Request [Contractor Name Request [Personnel Name Request Salesperson Request [salesperson Name Request © 2005 State of California. Conditions of Use Privacy Policy http://www2.cslb.ca.gov/CSLB_LIBRARY/License+Detail.asp 06/21/2005