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Home My WebLink About2322 LA COSTA AVE; B; CB111983; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 09-14-2011 Permit No: CB111983 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: 2322 LA COSTA AV CBAD St: B PME 21631014045" Lot#: HARRIS RES-REPLACE WTR HTR 0 Applicant: Owner: CALIFORNIA DEL TA MECHANICAL SUITE# 27 12440 OAK KNOLL RD 92064 866-898-0008 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES Total Fees: $150.00 Total Payments To Date: Inspector: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 09/14/2011 LSM 09/14/2011 09/14/2011 $150.00 $0.00 $0.00 $0.00 $150.00 $150.00 Balance Due: Clearance: $0.00 NOTICE: Please take NOTICE th . approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions." Ycu have 90 days from the date this permit was issued to protest imposition of these tees/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. City of Carlsbad 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718/ 2719 Fax: 760-602-8558 Building Permit Application JOB ADDRESS 2322 La costa CT/PRO.JECT # LOT# PHASE# DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) Plan Check No. Q.B{J Est. Value Plan Ck. Deposit Date q r SUITE#/SPACE#/UNIT# APN # OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP Replace existing like for alike water heater EXISTING USE I PROPOSED USE I GARAGE (SF) PATIOS (SF) I DECKS (SF) I FIREPLACE IAIR CONDITIONING I FIRE SPRINKLERS vesO No□ ves0NoD ves0No0 CONTACT NAME (If Different Fom Applicant) California Delta Mechanical APPLICANT NAME Galina Pavlova --- ADDRESS ADDRESS 6056 East Baseline rd# 155 6056 E. Baseline road suite# 155 CITY STATE ZIP CITY STATE ZIP Mesa AZ. 85206 Mesa AZ. 85206 PHONE I FAX PHONE IFAX 480-898-0007 1-480-218-5645 480-898-0007 1-8:i8-410-1499 EMAIL EMAIL california@deltamechanical.com galiapavlovabg@yahoo.com PROPERTY OWNEit NAME Manny Harris CONTRACTOR BUS. NAME California Delta Mechanical ADDRESS ADDRESS 2322 La costa 6056 East Baseline rd # 155 CIT'.' STATE ZIP CITY STATE ZIP Carlsbad Ca 92009 Mesa AZ. 85206 PHONE I FAX PHONE I FAX 858-344-1465 480-898-0007 EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS I STATE UC.# STATE UC.# I CLASS I CITY BUS LIC1214281 811114 c36 (Sec: 7031.5 Busmess and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its :ssuance, 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 1031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars {$500}). Workers' Compensation Declaration: I hereby affirm under penally of perjury one of the following declarations: [Z] 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 tt,;.; permit is issued. 0 I have and will maintain workers' compensation, as reouired bv Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Insurance Co Policy No, 1697823 Expiration Date 07111112G12 This sectk>n need not be completed if the permit is for one hundred dollars ($100) or less. [ZJ Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensatio11 Laws of California. WARNING: Failure to secure workeni' compe11sation coverage is unlawful. and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), in addition to the cost of compensation, damages as provided for In Section 3706 of the Labor code, interest and attorney's fees. ,t!$ CONTRACTOR SIGNATURE I hereby affirm that I am exempt from Contractor's License Law for the following reason: □ □ □ I, as owner of the property or my employees with wages as their sole compensation, will do 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 i11tended 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). I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business a11d 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). 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. 0Yes Oo 2. I (have I 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 constructio11 (i11clude name address I phone I contractors' license number): 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provkle the major work (include name I address/ phone / contractors' 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 I address/ phone I type of work): ,t!$ PROPERTY CWNER SIGNATURE DATE -~e, ~ -- ,,<UII PL loiT;II THIS SIICTION !'OR NON•RloiStOloiNTfA:tt. 9"Wt.OfNG PIIRMITS ONLY s the applicant or future building occupant required to submit a business., acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Jresley-Tanner Hazardous Substance Account Act? D Yes LJNo s the applicant or future building _oCCtJpant required to obtain a permit from the air pollution control district or a~ality management district? []ves D No s the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0Yes LJNo F 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 :MERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. 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. hereby authorize representative of the City of Carlsbad to enter upon the al:xJ.le mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY Of CARLSBAD \GAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. )SHA: An OSHA pennil is required for excavatioos CN8f 5'0' deep c11d demolition or oonstruction of slrudures CNef 3 stories in height. :XPlRATION: Every pennit issued by the Building Official undef the provisions of this Ccxle shall expire by limitation c11d become null and 'vtid if the building or work authorized by such pen nit is not commenced v.;thin 80 days from the date of such pemit orif the building or work a.ithorized by such permit is suspended or al:landoned at any time after the work is commenced for a pefiod of 180 days {Section 106.4.4 Uniform Building Code). 2$ APPLICANT'S SIGNATURE Mv<-'\ DATE 9 /7 /4 •• «~ ~ CITY OF CARLSBAD DATE: I O 1/4 (7 _ __,,, PERMIT#: .1 I -19'l':> Unscheduled Building Inspection CONTACT: PHONE#: Building Department 1635 Faraday Avenue Carlsbad CA 92008 760-602-2700 ------- ------- JOB ADDRESS: _L_o_Z_1-__ L4-'-------.::.w--=-=c..sn---'-tt-1------'-__:__-- DESCRIPTION: __________________ _ CODE ACT COMMENTS i,5 -+ Bldg Inspection Form Page 1 of 1 · Rev. 06/09