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Home My WebLink About2535 JEFFERSON ST; 09; CB091564; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 09-25-2009 Plumbing Permit Permit No: CB091564 Job Address: Permit Type: Parcel No: Reference #: PC #: Project Title: Applicant: Building Inspection Request Line (760) 602-2725 2535 JEFFERSON ST CBAD St: 09 PLUM 1551704509 Lot#: 0 Construction Type: NEW CUSIMANO RES-REPLACE WTR HTR Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 09/23/2009 LSM 09/25/2009 09/25/2009 CALIFORNIA DEL TA MECHANICAL CUSIMANO JOSEPH N TRUST 04-06-99 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 Total Fees: Inspector: $27.00 0 0 0 0 1 0 0 2535 JEFFERSON ST #9 CARLSBAD CA 92008 $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 Payments To Date: $27.00 Balance Due: 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 ·tees/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. " . City of Carlsbad ......... ..., ...... ~ ~'l r si:,<..p ~~ ~ ~~ Plan Check No. ~·t 1635 Fa raday Ave., Carlsbad, CA 92008 .. ~:. 760--602-2717 / 2718/ 2719 1 • Est. Value Fax: 760-602-8558 ~ ~-+.;,~, Plan Ck. Deposit ~.,'.'!.~~ Building Permit Application --q/~r0q I Date JOB ADDRESS ~,, .... -.. SUITE#/SPACE#/UNIT# IAPISS -1-,0 -1..f5 51/J ~ Jefferson street ~er CT/PROJECT# I LOT# rHASE # r OF UNITS 1 # BEOROOMS # BATHROOMS I TENANT BUSINESS NAME I CONSTR. TYPE I ocs. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) Replace existing like for alike water heater EXISTING USE I PROPOSED USE I GARAGE (SF) PATIOS (SF) I DECKS (SF) FIREPLACE I AIR CONDITIONING I FIRE SPRINKLER~ YESQI NcCJ YEs 0 No 0 YESO NoO CONTACT NAME (If Different Fom Applicant) C rf . D It M h . I I APPLICANT NAME Galina Pavlova a I orn1a e a ec amca nc. ADDRESS ADDRESS 6052 E. Baseline road suite # 155 6052 E. Baseline road suite# 155 CITY STATE ZIP CITY STATE ZIP Mesa Az 85206 Mesa AZ 85206 PHONE I FAX PHONE I FAX 480-898-0007 1-480-218-5645 480-898-0007 1-858-410-1499 EMAIL EMAIL california(@,deltamechanical.com galiapavlovabg@yahoo.com PROPERTY OWNER NAME ~ Shirley Perry CONTRACTOR BUS. NAME California Delta Mechanical Inc. ~ Jefferson street.J.11( .#y' ADDRESS ADDRESS 6052 E. Baseline road suite# 155 CITY STATE ZIP CITY STATE ZIP Carlsbad CA 92008 Mesa Az 85206 PHONE I FAX PHONE I FAX 760-729-3089 480-898-0007 EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS I STATE LIC. # STATE UC.# rcLASS 1c1TY;us;·; l.{ d-4'1 J 811114 c36 (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 !hat 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]). Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 1 have and will maintain a certificate of consent to self-insure for v.or1<ers' compensation as provided by Section 3700 of the Labor Code, for lhe perfOITTiance of the v.or1< for which this permit is issued. 0 I have and will maintain workers' compensation, as required bv Section 3700 of lhe Labor Code, for the performance of the v.or1< for which this permit is issued. My workers' compensation Insurance carrier and policy number are: Insurance Co Policy No. 1697823 Expiration Date ""'"" ~section need not be completed if the permit is for one hundred dollars ($100) or less. lLJ Certificate of Exemption: I certify that in the performance of the v.ork for which this permit is issued, I shall not empioy any person in any manner so as to become subject to the Wor1<ers' 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 as provided or i ection 3706 of the Labor code, interest and attorney's fees. 25 CONTRACTOR SIGNATURE I hereby affirm that I am exempt from Contractor's Ucense Law for the following reason: D D D I, as owner of the property or my employees with wages as their sole compensation, will do the wor1< and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of property who builds or improves !hereon, and who does such wor1< himsett 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). I, as owner of the property, am exclusively contracting with licensed contractors to construct Uie project (Sec. 7044, Business and Professions Code: The Contractors 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 lhe Contractors 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 0 Yes []No 2. I (have I have not) signed an application for a building permit for lhe proposed wor1<. 3. I have contracted with the following person (firm) to provide the proposed construction (include name address I phone I contractors' license number): 4. I plan to provide portions of the wor1<, but I have hired the fellowing person to coordinate, supervise and provide tile major v.or1< (Include name I address I phone I contractors' license number): 5. I will provide some of the v.or1<. but I have contracted (hired) the following persons to provide the v.or1< Indicated (include name I address I phone I type of wor1<): 25 PROPERTY OWNER SIGNATURE DATE Is the applicant or future building occupant required to submit a business~. acutely hazardous materials registration fonn or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? D Yes LJNo Is the applicant or future building occupant required to obtain a pennit from the air pollution control district or a~ality management district? 0 Yes D No Is the facility to be ccnstructed within 1,000 feet of the outer boundary of a school site? 0 Yes LJNo 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 this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address I certify that I have read the application and state that the aboYe infonnation is conectand that the infonnation on the plans is accurate. I agree to comply with all City ordinances and State~ relating to building construction. I hereby authorize rei:ra,entative of the City of Car1sbOO to enter upon the above mentioned property fa insi:ecoon purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA pemit is requiroo fa excavatx:>ns over 5'0' deep and demoition or construction of structures over 3 stolies in height. EXPIRATION: Every permit issued by the Buildng Official under the pro'visions of this Cooe shall expire by lirritation and become null and loid [ the b\.ilding or work authorizoo by such permit is rot corrmenred within 180 days from the date of such penrit ex [ the building ex work authorized by such pemit is suspendOO ex abandoned at any tifre after the work is oormenced for a pericxl of 180 days (Sroion 1~.4. 4 Unifoml Building Cooe). ,,i'$ APPLICANT'S SIGNATURE DATE ;i?' ~d ,,/t:J ~ I Storm Water Compliance Exemption Form I am applying to the City of Carlsbad for the following type(s) of construction permit: D Building Permit D Right-of-Way Permit D My project is categorically EXEMPT from the requirement to prepare a storm water pollution prevention plan (SWPPP) because it only requires issuance of one or more of the following permit types: Electrical Fire Additional Fire Alarm Fixed Systems Mechanical Mobile Home Plumbing Project Storm Water Threat Assessment Criteria* No Threat Assessment Criteria Patio/Deck Re-Roofing Sign Spa-Factory Sprinkler Water Discharge D My project qualifies as NO THREAT and is exempt from the requirement to prepare a storm water pollution prevention plan (SWPPP) because it meets the 'no threat' assessment criteria on the City's Project Threat Assessment Worksheet for Determination of Construction SWPPP Tier Level. My project does not meet any of the High, Moderate or Low Threat criteria described below. Tier 1 -Low Threat Assessment Criteria D My project does not meet any of the Significant or Moderate Threat criteria, is not an exempt permit type (See list above) and the project meets one or more of the following criteria: • Results in some soil disturbance; and/or • Includes outdoor construction activities (such as roofing, saw cutting, equipment washing, material stockpiling, vehicle fueling, waste stockpiling). Tier 2 -Moderate Threat Assessment Criteria D My project does not meet any of the Significant Threat assessment Criteria described below and meets one or more of the following criteria: • Project requires a grading plan pursuant to the Carlsbad Grading Ordinance (Chapter 15.16 of the Carlsbad Municipal Code); or, • Project will result in 2,500 square feet or more of soils disturbance including any associated construction staging, stockpiling, pavement removal, equipment storage, refueling and maintenance areas and project meets one or more of the additional following criteria: • Located within 200 feet of an environmentally sensitive area or the Pacific Ocean, and/or • Disturbed area is located on a slope with a grade at or exceeding 5 horizontal to 1 vertical, and/or • Disturbed area is located along or within 30 feet of a storm drain inlet, an open drainage channel or watercourse, and/or • Construction will be initiated during the rainy season or will extend into the rainy season (Oct. 1 through April 30). Tier 3 -Significant Threat Assessment Criteria D My project includes clearing, grading or other disturbances to the ground resulting in soil disturbance totaling one or more acres including any associated construction staging, equipment storage, stor,kpiling, pavement removal, refueling and maintenance areas: and/or D My project is part of a phased development plan that will cumulatively result in soil disturbance totaling one or more acres including any associated construction staging, equipment storage, refueling and maintenance areas: or, D My project is located inside or within 200 feet of an environmentally sensitive area (see City ESA Proximity map) and has a significant potential for contributing pollutants to nearby receiving waters by way of storm water runoff or non-storm water discharge(s). I certify to the best of my knowledge that the above checked statements are true and co"ect. I understand and acknowledge that even though this project does not require preparation of a construction SWPP, I must still adhere to, and at all times during construction activities for the permit type(s) check above comply with the storm water best management practices pursuant to Title 15 of the Carlsbad Municipal Code and to City Standards. ·The City Engineer may authorize minor variances from the Storm Water Threat Assessment Criteria in special circumstances where it can be shown that a lesser or highte Construction SWPPP Tier Level is warranted. Assessor Parcel N~ 'P? ,rt??? s:r: .;p' ~ . . City of Carlsbad Bldg Inspection Request For: 10/26/2009 Permit# CB091564 Title: CUSIMANO RES-REPLACE WTR HTR ~'., Inspector Assignment: \j ! Description: Type: PLUM Sub Type: Phone: 7607293089 Job Address: 2535 JEFFERSON ST Suite: 09 Lot: 0 Location: Inspector: ---- OWNER CUSIMANO JOSEPH N TRUST 04-06-99 Owner: Remarks: Total Time: Requested By: SHIRLEY CD Description 25 Water HeaterNents Act Commentse .. · E:tered. Boy: ~HRISTINE .:::___ V""\__ ~ Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act lnsp Comments