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Home My WebLink About1702 Blackbird Cir; ; CBR2018-1172; Permit(city of Carlsbad Print Date: 06/07/2018 Job Address: Permit Type: Parcel No: Valuation: Occupancy Group: # Dwelling Units: Bedrooms: Project Title: 1702 Blackbird Cir BLDG-Resident ia I 2156026200 $0.00 Residential Permit Work Class: P/M/E Lot#: Reference#: Construction Type: Bathrooms: Orig. Plan Check#: Plan Check II: Description: SIESEL: REPLACE SO GAL WATER HEATER, LIKE FOR LIKE Owner: Status: Applied: Issued: Permit Finaled: Inspector: Final Inspection: Contractor: Permit No: CBR2018·1172 Closed -Finaled 05/15/2018 05/15/2018 A Krog 6/7/2018 2:35:03PM TRUST SI ES EL 2010 TRUST 06-04-10 1702 Blackbird Cir CALIFORNIA DELTA MECHANICAL INC CARLSBAD, CA 92011 WATER HEATER -PLUMBING, ELECTRICAL, MECHANICAL Total Fees: $98.00 Total Payments To Date: $98.00 6056 E Baseline Rd, 155 Mesa, AZ 85206-4803 480-89 8-0007 Balance Due: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exaction." 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, ioning, 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 limitation has previously otherwise expired. $0.00 1635 Faraday Avenue, Carlsbad, CA 92008-7314 I 760-602-2700 I 760-602-8S60 f I www.carlsbadca.gov $98.00 ITHE FOLLOWlNG APPROVALS REQUIRED PRIOR TO PERMIT ISSJJ,'.INCE: 0 PLAt-!N'ING, 0 ENGINEERING 0 BUILDING O FIRE QHEALTH 0 HAZMA T/APCol ' Plan Check No{b([).0/g,_/ I 'f;;J_ {'cicyof Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value ,l L19 \ Carlsbad Ph: 760-602-2719 ,Fax: 760-602"8558 Plan Ck. Deposit ' email: building@carlsbadt.a.gov www.carlsbadea.gov Date ,~ /~-/ ~ ls-15-18 JOB ADDRESS 1702 Blackbird Cir SUITH/SPACE#/UNITJJ rPN --- : CT/PROJECT# I LOTH r·PHA.SE # I" OF UNITS Ill ~EDRODlillS II 6ATMROOMS I T!NANT BUSIN~ NAME I wNSTR. TYPE I occ. GROUP ,!• : DESCRIPTION OF WORK: Include Square Feet of Affected Area(!i) replace 50 gal gas water heater like for like : EXISTINQUSE I PROPOSED USE I GARAGE '.SF) ' ~ATIOS {SF) IDECKS(SF) FIREPLACE r lR CONDITIONING I FIRE SPRINKLERS YESD . NcC] YES0No0 YESO NoO APPLICANT NAME AJ Diaz ' '' PROPERlY OWNER NAM&: AnneSiesel D-•-Contact ADDRESS 6056 E Baseline Rd, Ste 155 ADDRtss 55 Sycamore Dr CITY STATE ZIP 852.06 CITY STATE ZIP Mesa AZ West Warwick RI 02893 PHONE : I FAX ! I PHONE I FAX 866-692-5273 866-692-5275 : 504-296-3449 EMAIL EMAIL capermits@deltamechanical.com DESIGN PROFESSIONAL CO~ACTOR BUS. NAME California Delta Mechanical , ', ADDRESS ADDRESS 6056 E Baseline Rd, Ste 155 CITY STATE ZIP CITY , ~ STATE ZIP Mesa AZ. 85206 PHONE I FAX : PHONE 'FAX ' ' . ' 480-898-0007 480-898-0005 EMAIL I EMAIL '' : ISTATEpC.# STATE LIC.# rLASS I CITY eus. uc.1214281 .. : 811114 C36 (Sec. 7031.5 Business and Professions Code: Any Cily or County which requires a permit to ·coMtrvct. altar, 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 o{ the Contractor's License Law (Chapter 9, commendinll with Section 7000 of Division 3 of the Business and Professions Code) or that he Is exem~t therefrom. and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant toe civil penally of not more than five hundred dollars {$500}). Worl<.81'8' Compensation Declaratfon: I hereby affirm underpeflll/ty of perjutyonenfthe following declaretbns: D I have and wlll maintain a certificate of consent to self-Insure for workers' ~pensation as provided by Section 3700 of the Labor Code, for the performance of the work for which thls penn~ Is Issued. [Z] I have and will malntaln wori<ers' comoensatlon, as required by Section 3700 of the Labor Code, for the performance of the work for which lhis oermtt is issued. My workers' compensation insurance carrier and policy number are: Insurance Co. American Home AHuranoe Polley No. WC 026160234 CA Expiration Date 7-1-18 Jj!m,secUon need not be completed if th& permit is for one hundred dollars ($100) or less. LJ Certificate of Exemption: I certify that in the performance of the work for wh this permit is issued, I shall not employ any per.;on in any manner so as to become subject to the WOlkers' Compensation Laws or Cafilomia. WARNING: Failure to secur workers' compensation coverage I unlawful, and shall subject an employer to criminal penaltlee and clvil fines up to one hundred thousand dollars (&100,000), In addition to the cost of compensation, d for In St 7 of the Labor code, Interest and attnmey's fees. 2! CONTRACTOR SIGNATURE I hereby affirm that I am exempt from Contractol's License Law for the following relJS(){I; 0 I, as owner of the property or my employees with wages as their sole CQmpensation, 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 work himself or through his own employees, provided that such Improvements are not intended or offered for sale. If, however, the buiding or improvement is sold within one year of completion, the owner-builder wiD have !he 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 ricensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contraclo(s License Law does not apply to an owner or property who builds or improves thereon, and contracts for such projects with ~ntractor(s) icensed pursuant lo the Contracto(s Llcense Law). D I am exempt under Section Business and Professions Code for this raason: 1. I personaHy plan to provide the major labor and materials for construction of the proposed property improvement. Q Yes O o 2. I (have I have not) signed an epplication for a bullding permn for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction (indude name address I phone I contraclors' license number): 4. I plan to provide portions of the work, but I have hired the foUowing person to coordinate, supervise and provide the ~r wOlk (include name I address I phone I contractors' license number): 5. I will provide some of the work, but I have contracted (hirad) the following persons to provide the work indicated Qnclude name I address I phone I type of work): Ji!S PROPERTY OWNER SIGNATURE 0AGENT DATE -~,-• .,.. ,, -'• • ' ' • --' .~,.., • ' • \ -T ..;,, I ,\,•;• 0 <" ._ ~ -• ~ ' •• • ,, > • ' O • _, ~ ~ • -r • ~ • f" :,_C.:·,~-~-~ L ~ T _E: __ rf;t i S s .. E.<:_! ION t~~~ __ N., 0 N -. RES_~.~ E_ J'!_! ~AL BU IL D) !".~ __ PERMIT~ 0 NL _Y . . Is 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 25605, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? D Yes D No Is the applicant or Mure ooilding 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 Alff 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 ha...e read the application and stilte thattheaboYe fnfonna11on ls<XlffllCt'and that the Information on the plans Is acmate. I agreetoaimplywlth a.II Cityon:llnancesand Slate laws relatlnglDbuidlngconslnlClfon. I hereby autiorize representative of fle City cJ Carlsbad kl enter l4)(l1 the above mentialed property for Inspection purpooes. I ALSO AGREE TO SA VE, INDEMIIFY AND KEEP HARM.ESS Tl-£ CITY OF CARLSBAD AGAINST ALL LlABllrrlES, JUOOMENTS, COSTS AND EXPENSES Vv'HICH MAY JN ANY WAY ACCRUE AGAINST SAID CfTY.IN CONSEQUENCE OF THE GRANTtlG OF THIS PERMIT. OSHA: An OSHA permit Is required for ex<:a'JOOOnS <:Nef 5'0' deep and demolklon or construction of shictures CNeT 3 stones In h~ht EXPIRATION: Eve!y permit issued by the Blilding Offdal under1he provisions of tis Code shal elq)ire by~ and become l"ltjl i;Wld VOid f 1he buikling orv.m author1zed by such penritis rxtcoornenced 'Mlhil 180 dcl'fS from the date of such permit or if the buidi or · such pennt lssuspendec! or abandoned ct anytime after1hew011ciS oomienced for a period at 180 days (Sedion 106.4.4 Unifoon Butt,g Code). _A$ APPLICANT'S SIGNATURE . DATE ~ \ ~ .:_ \ 4l ,. ':. "' "or ',",~,;~~-: I • , ~f~\1":-i" ' ;'.1-;s"' !''\~" , ' ,;;l ,,,o,'..c,: ,~~;ts"".' { ~::{-!'If • \,.,I~ 1,,,.,/~/.",(..,) ( ""' '~ · · .. / ·;:· ~·*:': \,_.; '"'' w •• !T INSREqJl~ltH~~tb~Y,.,§POijT (Q~~~~187'~.~1f1!) . · . · Permit fypc: BLDO-Residential Application Date: 05/15/2018 Owner: TRUST SIESEL 2010 TRUST 06-04-10 Work Class: P/M/E Issue Date: 05/15/2018 Subdivision: PARCEL MAP NO 16228 Statu•,: Closed -Finaled Ex pi ration Date: 12/0412018 Address: 1702 Blackbrrd Cir Carlsbad. CA 92011-5008 IVR Number: 11370 ,,,,--------·--·-------·--------------------- Actual Scheduled Date Start Date Inspection Type Inspection No. 06/04/2018 06/04/2018 06107/2018 06/0712018 June 07, 2018 BLDG-25 Water HeaterNents 059849-2018 BLDG-Final Inspection Checklist Item BLDG-Building Deficiency 059850-2018 Checklist Item BLDG-Plumbing Final BLDG-25 Water HeaterNents 060283-2018 BLDG-Final Inspection 060284-2018 Checklist ltcm BLDG-Plumbing Final Inspection Status Primary Inspector Reinspection Complete Failed Andy Krogh Reinspection Complete COMMENTS Passed Relocate sediment trap No Failed Andy Krogh Reinspection Complete COMMENTS Passed Relocate sediment trap No Passed Andy Krogh Complete Passed Andy Krogh Complete COMMENTS Passed Yes Page 1 of 1