HomeMy WebLinkAbout2415 LA COSTA AVE; B; CB071205; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
05-01-2007 Plumbing Permit Permit No: CB071205
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
2415 LA COSTA AV CBAD St: B
PLUM Status: Parcel No: 21624055)1 .3ol. Lot#: 0 Applied:
Reference #:
Construction Type: NEW Entered By:
Plan Approved:
Issued: Project Title: KENNEY RES REPLACE WTR HTR Inspect Area:
Applicant:
CALIFORNIA DEL TA MECHANICAL
SUITE# 27
12440 OAK KNOLL RD 92064
866-898-0008
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
TOTAL PERMIT FEES
0
0
0
0
1
0
0
Owner:
KENNEY JOHN E&YOLANDA P
2419 LA COSTA AVE #A
CARLSBAD CA 92009
ISSUED
05/01/2007
KG
$20.00
$0.00
$0.00
$0.00
$0.00
$7.00
$0.00
$0.00
$0.00
$0.00
$0.00
$0.00
$27.00
Total Fees: $27.00 Total Payments To Date: $27.00 Balance Due:
Inspector:
PERr~1n ;utS t:)tP11~E(, m :\r·:·:,r:;c~~:\NCE 1¥1TH C.B.Ca
.Si::CT.H)i1i iCE/,t~A AS hJff' lJY C.M,C.10.04.UJ.')
FINAL APPROVAL
Date: Clearance:
$0.00
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
f wh h f Ii i n h h 1
FOR OFFICE USE :~ ~
PLAN CHECK N&.i.7!,:2_{):)
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad CA 92008
EST. VAL. ----.....,C..------
Plan Ck. Deposit ~"::,;''r---------
Validated By -~-A~...:::=-:-+~-v"q....-
Date -----ff'----"---L---'--,<---
1. PROJECT INFORMATION
2415 Lacosta ave. unit B
Address (indude Bldg/Suite #) Business Name (at this address)
Legal Description Lot No. Subdivision Name/Number Unit No. Phase No.
Assesso(s Parcel# Existing Use Proposed Use
Replace standard water heater like for like
Description of Work SQ.FT. # of Stories # of Bedrooms
2. CONTACT PERSON (If different from appllcant)
California Delta mechanical, Inc. 2500 S. Power Rd. Suite# 120 Mesa AZ. 85209 (480) 898-0007
Name Address City State/Zip Telephone#
3. APPLICANT GI Contractor D Agent for Contractor □ Owner □ Agent for Owner
Galina 2500 S. POWER RD# 120 MESA AZ 85209 480-898-0007
Name Address City State/Zip Telephone#
4. PROPERTY OWNER
Sherri Beher 2415 La Costa ave.# B Carlsbad CA 92009 760-493-9533
Name Address City State/Zip Telephone#
5. CONTRACTOR • COMPANY NAME
Total t. of untts
# of Bathrooms
(480) 898-0005
Fax #
(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 Contracto(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 ($5001).
Cal i forni a D e lta Mechanical, Inc . 2500 S. Pow er Rd. Suite # 120 Mesa 85209 (480) 898-0007
Name Address City State/Zip Telephone#
State License# ~8_1 _I _I _14 _____ _ License Class _C_-_3_6 _______ _ City Business License# __:.l.;;;2;...;1_4..c:2:...c8:...l;:__ ____ _
Designer Name Address City State/Zip Telephone#
State License# ________ _
6. WORKER'S COMPENSATION
Workers' Compensation Dedaration: I hereby affirm under penalty of perjury one of the following dedarations:
□ 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.
1EJ I have and will maintain worke(s compensation, as required by Section 3700 of the labor Code, for the performance of the work for which this permit is issued. My
worke(s compensation insurance carrier and policy number are:
Insurance Company State Compensation Insurance Fund Policy No. 1697823 Expiration Date . ...,0,.,7.,_/O=I /'""0'--'-7 ______ _
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100) OR LESS)
□ 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, da .,...,....,....,ued for in Section 3706 of the Labor Code, interest and attorney's fees.
SIGNATURE Gal ina Pavlova DATE 04/26/07
7. OWNER-BUILDER DECLARATION ------=====;__~
I hereby affirm that I am exempt from the Contracto(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 wi•hin 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 exdusively contracting with licensed contractors to construct the project (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 contracts for such projects with contractor(s) licensed pursuant to the Contracio(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. □ 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 construciion (indude name / address I phone number/ contr~ors 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 (indude name/ address / phone number I
/ontractors license number): ----------------------------------------------
5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (indude name / address/ phone number I 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
COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY
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 the Presley-Tanner Hazardous Substance Account Act? □ YES □ NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? □ YES □ NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ YES □ 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. CONSTRUC'liONCE"NDING 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. APPLICANT CERTIFICATION
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, JUDGEMENT!';, COSTS AND
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
OSHA: An OSHA 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 Official under the provisions of this Code shall expire by limitation and hecome 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 Galina Pavlova ~ 0
DATE_04_/_2 _6 /_0_7 _______ _
WHITE: File YELLOW: Applicant PINK: Finance