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Home My WebLink About2165 CORTE ACEBO; ; CB062665; Permit09-18-2006 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No CB062665 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 2165 CORTE ACEBO CBAD PLUM 2552600800 Lot # Construction Type GELLER RES- REPLACE WTR HTR 0 NEW Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 09/18/2006 LSM 09/18/2006 09/18/2006 Applicant CALIFORNIA DELTA MECHANICAL SUITE # 27 12440 OAK KNOLL RD 92064 866-898-0008 Owner GELLER FAMILY TRUST 01-23-01 2165 CORTE ACEBO CARLSBAD CA 92009 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 FINAL 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 FOR OFFICE USE ONLY PLAN CHECK NO EST VAL Plan Ck Deposit Validated By Date 1 PROJECT INFORMATION 2165 Corte Acebo 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 Description of Work SQ FT # of Stories # of Bedrooms n of Bathrooms [2 CONTACT PERSON (if different from applicant) Call forma Delia Mechanical, Inc 2500 S Power Rd Suite #120 Mesa AZ 85209 (480) 898-0007 (480) 898-0005 Name [IT APPLICANT Address City State/Zip Telephone #Fax* ED Contractor El Agent for Contractor D Owner D Agent for Owner Galma Pavlova 8949 Lombard pi apt3 413 San Diego ca92122 858-361-6495 Name Address City State/Zip Telephone # PROPERTY OWNER Michael Geller 2165Corte Acebo Carlsbad CA 92009 760-518-8300 Name Address City State/Zip Telephone # CONTRACTOR - COMPANY NAME (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 Delia Mechanical. Inc 2500 S Power Rd Suite # 120 Mesa 85209 (480) 898-0007 Name State License #811114 Address License Class C-36 City State/Zip City Business License # _ Telephone # 1214281 Designer Name State License # [6 WORKER'S"COMPENSATlON~ Address City State/Zip Telephone # Workers Compensation Declaration I hereby affirm under penalty of penury 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 El 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 Dale 07/0 1/0 7 _ (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($1 00 000) in addition to the cost of compensation damages are provided for in Section 3706 of the Labor Code interest and attorney's fees SIGNATURE Gahna Pavlova _ DATE 09/14/06 _ OWNER-BUILDER'DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason 0 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 Faraday Ave, Carlsbad CA 92008 Page 2 of 2 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 Act' D YES O 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 tENplNG'AGENCY ' ~~~ [ 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 [9. APPi:iCANT'CERTIF!CATIQN~ I 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 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 the work is commenced for a period of 180 days (Section 106 4 4 Uniform Building Code) APPLICANTS SIGNATURE _GalmaPavlova DATE 09/14/06 WHITE File YELLOW Applicant PINK Finance City of Carlsbad Bldg Inspection Request For 09/25/2006 Permit* CB062665 Title GELLER RES- REPLACE WTR HTR Description Inspector Assignment 2165 CORTEACEBO Lot 0 Type PLUM Sub Type Job Address Suite Location APPLICANT CALIFORNIA DELTA MECHANICAL Owner GELLER FAMILY TRUST 01-23-01 Remarks Phone 7605188300 Inspector Total Time CD Description 25 Water Heater/Vents Act Comment Comments/Notices/Hold Requested By MICHAEL GELLER Entered By KAREN Associated PCRs/CVs Original PC# Inspection History Date Description Act Insp Comments COMPENSATION IN S URANCe FUND POL1CYHOLDER COPY PO BOX 420607, SAN FRANDSCO.CA 94142-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE 07-01-2006 HOME DEPOT COMPLIANCE DEPARTMENT 3079 E IMPERIAL HWY STE 100 BREA CA 92821-6752 KIP GROUP- POLICY NUMBER 1697823-2006 CERTIPICATE ID- 6 CERTIFICATE EXPIRES- 07-01-2O07 07-01 -4008/07-01-2007 NF This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to the employer We will also give you 10 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage a1 forded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document wflth respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. 3RIZED REPRESENTATIVE^) PRESIDENT EMPLOYER'S IIABILITY LIMIT INCtUDINa DEFENSE COSTS: $1,000,000 PER OCCURRENCE EMPLOYER CALIFORNIA DELTA MECHANICAL, INC DBA CALIFORNIA DELTA MECHANICAL, INC2500 s POWER RO STE 120 MESA AZ 8S209 NF REV 2-08)PRINTED : 08-18*2008 N040S fTM ciurmnw