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HomeMy WebLinkAbout2415 BURGOS CT; ; CB053376; Permit09-26-2005 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No: CB053376 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: Project Title: 2415 BURGOS CTCBAD PLUM 2162403702 Lot#: 0 Construction Type: NEW FOX RESIDENCE WATER HEATER REPLACEMENT Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 09/26/2005 MDP 09/26/2005 09/26/2005 Applicant: CALIFORNIA DELTA MECHANICAL SUITE # 27 12440 OAK KNOLL RD 92064 866-898-0008 Owner: FOX FAMILY TRUST 06-11-99 2415 BURGOS CT CARLSBAD CA 92009 Plumbing Issue Fee Fixture or Trap Building Sewer Roof Drain 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 $20.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL PERMIT FEES $27.00 Total Fees:$27.00 Total Payments To Date:$27.00 Balance Due:$0.00 PERMIT HAS EXPIRED. IN ACCORDANCE W!TN C.B.C. SECTION 106.4.4 AS AMENDED BY C.M.C. 18.04.030 IGNATURE Inspector: FINAL APPROVAL Date:Clearance: 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 tile 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 vou 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 2415 BOURGOF COURT CARLSBAD, CA 92009 Address (include 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 SO. FT. # of Stories Phase No. Total # of units Proposed Use # of Bedrooms # of Bathrooms California Delta mechanical, Inc. 2500S. Power Rd. Suite #120 Mesa AZ 85209 (480) 898-0007 (480) 898-0005 _ Name Address City State/Zip Telephone #Fax* ROMEL MARU 2500 S. POWER R0# 120 MESA AZ 480-898-0007 Name Address City State/Zip Telephone # GERALD FOX 2415 BOURGOF COURT CARLSBAD CA 92009 760-944-6478 Name Address City State/Zip 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. 2500 S. Power Rd. Suite # 120 Mesa 85209 (480) 898-0007 Name State License#...811114 Address License Class C-36 City State/Zip Telephone # City Business License # 1214281 Designer Name State License # Address 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. 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 carrier and policy number are: Insurance Company State Compensation Insurance Fund Policy No, 1697823 Expiration Date 07/01/06 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS (5100) OR LESS) D CERTIFICATE OF EXEMPTION: I certify that in the performancebf 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' compensaticti cov0rafy3*-UR|awful,und shall subject an employer to criminal penalties and civil fines up to one hundred thousand doMars(S100,000), In addition to the cost of compe/isajtlofL damgesftfif prbvkked for in Section 3706 of the Labor Code, interest and attorney's fees. SIGNATURE Romel Mani A \X^\^^—X DATE 09/20/05 I hereby affirm that I am exempt from the CortrantoVi^ensi LaWfor 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 Uaw does not apply to an owner of property who builds or improves thereon, and who does such work himseff or through his own employees, provided that such improvements are not intended or offered for sale, tf, 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). P 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 contrador(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 materials 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 materials registration for or risk management and prevention program under Sections 25505, 25533 or 25534 of trie Presley-Tanner Hazardous Substance Account Act? O 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? G YES n 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 OS HA: An OS HA permit is required for excavations of 5'0" deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the building Offi( by such permit is not commenced within 180 days from the date of such permit or ifjthe building or work authorized by such permit is suspended or abandoned at anytime after the work is commenced for a period of 180 days (Section 1 APPLICANT'S SIGNATURE DATE.09/20/05 WHITE: File YELLOW: Applicant PINK: Finance License Detail Page 2 of 2 SURETY COMPANY OF THE PACIFIC. Effective Date: 03/25/2004 Contractor's BondingJHistory BOND OF QUALIFYING INDIVIDUAL(I): This license filed Bond of Qualifying Individual i 161627 for ANTON DIMITROV TCHAKAROV in the amount of $7,500 with the bonding cc AMERICAN CONTRACTORS INDEMNITY COMPANY. Effective Date: 07/10/2002 * * *Workers Compensation Information * * * This license has workers compensation insurance with the STATE COMPENSATION INSURANCE FUND Policy Number: 1697823 Effective Date: 07/01/2002 "Expire Date: 07/01/2006 PersonnelList •License Number Request mContractor Name Request B Personnel Name Request"~ — .!. ..! '. ...! .' "~' .!.""'. ' _""" ".'""" ^m-"- - . . ^B_ ' _. •Salesperson Request.^^TTT,,:,,:.1 y^rrr:Salesperson Name Request © 2005 State of California. Conditions of Use Privacy Policy http://www2.cslb.ca.gov/CSLB_LIBRARY/License+Detail.asp 09/26/2005