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