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Home My WebLink About2352 ALTISMA WAY; 5; CB080607; Permit04-04-2008 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No CB080607 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # Project Title 2352 ALTISMA WY CBAD St 05 PLUM 2152402001 Lot# 0 Construction Type NEW LEE RES- REPLACE WTR HTR Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 04/04/2008 LSM 04/04/2008 04/04/2008 Applicant CALIFORNIA DELTA MECHANICAL SUITE # 27 12440 OAK KNOLL RD 92064 866-898-0008 Owner WEST VIRGINIA 2352 ALTISMA WAY #1 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:$0.00 Inspector Clearance NOTICE Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, o- 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 ?nd 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. PROJECT «a=Of»IAT!ON 2352 Altisma way Unit 5 FOR OFFICE USE ONLY PLAN CHECK NO £•& EST VAL Plan Ck Deposit Validated By Address (mdude Bldg/Suite #) Legal Description Lot No Assessor's Parcel # Replace standard water heater like for like Description of Work Business Name (at this address) Subdivision Name/Number Unit No Existing Use SQ FT # of Stones Phase No Proposed Use # of Bedrooms Total # of units # of Bathrooms 2. CONTACT PIRStm {if ttiferont California Delta mechanical, Inc 6052 East Baseline rd # 155 Mesa Name 3. APPUCAlW 13 Contra Gahna Pavlova Name 4. PROPERTY OWNER Kavm Lee Name Address 6052 East Baseline rd # Address Same Address City 155 MESA City Carlsbad City AZ 85206 (480) 898-0007 (480) 898-0005 State/Zip AZ 85206 State/Zip CA 92009 State/Zip Telephone # Fax # 480-898-0007 Telephone # " ' " '" •^•^Mll^ ' ' " "•"''•«'*'&•' - ' 760-602-6979 Telephone # (Sec 7031 5 Business and Professions Code Any City or County which requires a permit to construct alter 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 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 6052 East Bseline rd # 155 Mesa 85206 (480) 898-0007 Name Address City State/Zip Telephone # State License* 811114 License Class C-36 Citv Business License # 1214281 Designer Name Address State License # City State/Zip 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 QD 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 07/01/08 (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($100,000), in addition to the cost of compensation, damages ar&pnKded for in Section 3706 of the Labor Code, interest and attorney's fees SIGNATURE Gahna Pavlova /$["/ DATE 04/01/08 I 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 contractors) 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 P 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 materials registration for or nsk management and prevention program under Sections 25505 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? D YES 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 O 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 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 . 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 OSMA permit ,s 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 for a period of 180 days (Section 106 4 4 Uniform Building Code) APPLICANT s SIGNATURE Galma Pavlova DATE 04/01/08 (77 WHITE File YELLOW Applicant PINK Finance City of Carlsbad Bldg Inspection Request For 04/24/2008 Permit* CB080607 Title LEE RES- REPLACE WTR HTR Description 2352 ALTISMA WY 05 Lot Type PLUM Job Address Suite Location OWNER WEST VIRGINIA Owner Remarks Sub Type Inspector Assignment Phone 3108729044 Inspector Total Time CD Description 25 Water Heater/Vents Act Comments ££._._ - Requested By KEVIN LEE Entered By CHRISTINE Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act Insp Comments PDLICYHOLDf* COPY PO 3OX 120807 SAM FnAMriSfO,CA 94142-0807 . , TtON. u m A i _. CRRTIFICATE OP WORKERS' COMPBNSATION INSURANCE GROI^- POLICY NUMBER 1«7M!l-!»007 CERTIFICATE IP: 8 CFRTiriCATE EXPIRES' 07-O1-200807-01-2007/OT HOW DBWJT I*coiWLiANoe nenwnniw 107R f IIPMXAl. HWY KTK 10O l* .- 10 ominy tint M«(\ h«wn liiu*rt n .miid WorMr*' <"omp«nB«lnn Insurwo* policy trj a form approved by ' - to thn i»mf>ICMiBi n»nftn-" bftlnw fot th«i pollrv f>ar)ort « pollr^ K not ,ut>|n<t in rimr»H«lftn hy th* fund i»»r«pt »ipot» 1O riavf artv^nce wrltton notlow to th* r wall iHf> iil\-r> vim )n rlsyt jirlvnnrr- nnilrs shmilrl lln-t patloy bft nnnrfillart prlnr 10 it* normal ftxplrntlo ls cnrrlflrM* (,f inn<>mnrA if not in Insurwirfl nollry »ri1 dft** not *n«™i oxt#ncl or altw the novwagft r fhn policy lintnrt hardn Nrttwlthitunrtlnfl «ny requfrmmrt, f«rin or <-nnrlitlon of any «ntr»ct or other dooum«nt «i i<"!p»ri tn wrhlrh thin r^rtlCtrstft of miurmca nwy hfl Isnuflrt or to which It ir\#v p«rt»ift the insuranr** fnirfivl hy HIT. poiiiv i(n».c[ihrtft heioin K iuh|*rt 10 nit ihn trrrw oxrluwlans, anrt condHlons, of stirh policy PRESIDENT '«: fTARTiTTY HMrT TNCLUDXNB OErfMSF RnSTS $1,000 000 PER i iY!"l> RAI tFBMJIA ne« TA MCCMAHICAI ^MC n»A NfWJfflili Will !•»»,