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HomeMy WebLinkAbout1616 CORMORANT DR; ; CB070368; Permit02-12-2007 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No CB070368 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 1616 CORMORANT DR CBAD PLUM 2156500405 Lot# 0 Construction Type NEW ALEXANDER RES- REPLACE WTR HTR Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 02/12/2007 LSM Applicant CALIFORNIA DELTA MECHANICAL SUITE #27 12440 OAK KNOLL RD 92064 866-898-0008 Owner ALEXANDER ELAINE LIVING TRUST 06-21-04 1616 CORMORANT DR CARLSBAD CA 92011 Plumbing Issue Fee Fixture or Trap Building Sewer Roof Dram Install/Repair Water Line Water Heater and/or Vent Gas Piping System Vacuum Breaker Other Plumbing Fees Master Drainage Fee Sewer Fee Additional Fees 0 0 0 0 1 0 0 $2000 $000 $000 $000 $000 $700 $000 $000 $000 $000 $000 $000 TOTAL PERMIT FEES $2700 Total Fees $27 00 Total Payments To Date $27 00 Balance Due $000 Inspector Jw\.FINAL A AL 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 of limitations has previously otherwise expired PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad CA 92008 1. PRpj¥cmiTORIViA'TS'" 1616 Cormorant dr FOR OFFICE USE ONLY 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 Assessor's Parcel # Existing Use Replace standard water heater like for like Proposed Use Descnption of Work SQ FT # of Stones # of Bedrooms # of Bathrooms Califomia Delta mechanical, Inc 2500 S Power Rd Suite #120 Mesa AZ85209 ~,*k,-~; (480) 898-0007 (480) 898-0005 Name ' 3 Galma Pavlova Address City State/Zip 8949 Lombard pi #413 San Diego CA92122 Telephone # """""*,; ss-^. 858-361-1495" Fax* Name 4'""'" PROPECTYOWNER Elaine Alexander Address 1616 Cormorant dr City Carlsbad State/Zip ra'*a^*^f^ .: CA 92011 Telephone # 760-889-5904 Name Address City State/Zip Telephone # 1.5.^.. cprrrRAqTo^^MPAM^ME^^,;, .;,.'._. '•..... SflPSlsl:, ;,-'.,,Jt-,iili3.."::;."":-"""""" ^:^™''':^^;JSs:^^"™^^^ (Sec 7031 5 Business and Professions Code Any City or County which requires a permit to construct alter improve demolish or repair any structure pnor 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 [$500]) California Delta Mechanical, Inc 2500 S Power Rd Suite # 120 Mesa 85209 (480) 898-0007 Name State License # 811114 Designer Name State License # ,6~ WORkERJCONIPENSATK Address License Class Address iSiL- ....,..-..^2 'f^E':-5Spyii "$si-. C-36 . _,. .._.,..,£„„_„ City City State/Zip City Business License # State/Zip "" ' Telephone # 1214281 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 E 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 insurance earner and policy number are Insurance Company State Compensation Insurance Fund Policy No 1697823 Expiration Date 07/01/07 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] 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 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 compensatioiv/lajpages are provided for in Section 3706 of the Labor Code, interest and attorney's fees SIGNATURE Galma Pavlova .d&S* DATE^ 02/07/07 7"; 1 hereby affirm that I am exempt from 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 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 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 contractor(s) licensed pursuant to the Contractor's License Law) D I am exempt under Section Business and Professions Code for this reason 1 I personally plan to provide the major labor and matenals 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 FaradayAve, Carlsbad CA 92008 Page 2 of 2 COMPLETE THIS ||CT10NFq|NON-R£S|§N™L BUILDING PERMimpNLY "^ ..'^ """SK '.._. : "fg ^ . ''il"1"' 3 Is the applicant or future building occupant required to submit a business plan acutely hazardous matenals registration for or nsk management and prevention program under Sections 25505 25533 or 25534 of the Presley-Tanner Hazardous Substance Account AcP 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 Is the facility to be constructed within 1 000 feet of the outer boundary of a school site? 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 '8 CONSTRUCTION-LENDING AGENCY ' •Tvifw^risp*"" ...', • '.viSF-'~^^ff •". ii*1"; 4^7'. v^'" w::;. - "m-' >B? ';'v S»'::-W~ • •: ^•.•#S:ij!^i^ .. :• :^^V .:^W^ . '^ cthK^.v ' •'.. ivi-:**, ...'..':> ' i*:»«sgj&..-' .... ^isS^A ^ ; . ,v^v^S^ •• • •'•. A'.v\ . -.-.'.:•• ,.*&•'.,.< \-.J"' ..^i-SSiS^ •• .- f'^S^v-~:.. .X^\v ^.•.•••^ 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) LENDERS NAME LENDER S ADDRESS 9. APPLICANT CERTIFICATION^ "S5tL ' '"^;. • • '^ife '-K. •• V- • 'm:. "^' • • -^m.m. " \ -^ 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 authonze 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 EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT OSHA An OSHA permit is required for excavations of 5 0 deep and demolition or construction of structures over 3 stones in height EXPIRATION Every permit issued by the building Official under the provisions of this Code shall expire by limitation and become null and void if the building or work authorized by such permit is not commenced within 180 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced fora period of 180 days (Section 106 4 4 Uniform Building Code) APPLICANT s SIGNATURE Galma Pavlova s&fc^J DATE 02/07/07- WHITE File YELLOW Applicant PINK Finance City of Carlsbad Bldg Inspection Request For 02/22/2007 Permit* CB070368 Title ALEXANDER RES- REPLACE WTR HTR Description Inspector Assignment 1616 CORMORANT DR Lot 0 Type PLUM Sub Type Job Address Suite Location APPLICANT CALIFORNIA DELTA MECHANICAL Owner ALEXANDER ELAINE LIVING TRUST 06-21-04 Remarks AM PLEASE Phone 7608895904 Inspector Total Time Requested By ELAINE Entered By CHRISTINE CD Description 25 Water Heater/Vents Act Comment Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act Insp Comments COMPENSATION INS U K A N C • POLICVHOUKR COPY NP PO BOX 420307, SAN FRANOSCO.CA 94142-0807 CERTIFICATE OP WORKERS' COMPENSATION INSURANCE ISSUE DATE 07 qi 20O8 GROUP: POLICY NUMBER- T007ftt*-200e CERTIPICAU ID: « CERTIFICATE EXPireS: 07-OI-M0707-01-3000/07-01-2007 HOME DEPOT NFCONPUANCII DtPAWMwrr *»7S e IMPERIAL HNY STE 100 MIA CA 0ZBZ1-B7BX I* to certify that w* have ls«ued B valid Workeri1 Compcnution wwuranc* policy in A form approved by t*i« mi* Ihsuranc* Comml«i«ion«r to the amployar named bolow for fhfl policy period indlcitsd policy Ig not lubject to nano0ll*tion bv the Fund except upon ^ day« aoVane* written notice to the •mployer glv» you 10 d«ys idvinee notJOo should thli policy be emeelled prior to tti nornul «ypir«tioa This csrtlflen* of injurwice it not an Insurance policy and doe* not emend, extend or altar the covereae afforded try the policy listed herein. Netwt«h«tmdfng «ny requir«n«nt, term or condition of any contract or other document with reapoet to which this certificate of Inauraice may be latued or to which it may pertain, the trauma* Afforded by ttio policy rtwcnbad herein Is subject to all ttw t«rm*, «cclusfom. and condttlont, of such pollOV- \dUTHOWZBD HEPHESENTATIVO PHESBHtfT LIABILITY LIMIT XNCUK»*M OCrCNSI CdSTS- $1,OOO,OOO PER GMPLOYER DELTA MCCHANICAL, INC tAA NT PtLTA MfCHANICAL, INC *BOO $ POWBR HO STB 12OAZ «s«o» WKJfTIO . M-18-20M