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Home My WebLink About2550 CHESTNUT AVE; ; CB122014; Permit10-04-2012 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/IVIechanical/Electrical (PIVIE) Permit Permit No:CB122014 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: 2550 CHESTNUT AV CBAD PME 1672703300 Lot#: SIECZKOWSKI RES - REPLACE H20 HEATER, SAME SIZE, SAME LOCATION. Applicant: ALL STAR WATER HEATERS & PLUMBING Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: Owner: SIECZKOWSKI BARBARA C ISSUED 10/04/2012 SKS 10/04/2012 10/04/2012 30300 PUERTO VALLARTA WY MENIFEE CA 92584 1-800-727-0977 2550 CHESTNUT AVE CARLSBAD CA 92010 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees $31.00 $0.00 $0.00 $64.00 TOTAL PERMIT FEES $95.00 Total Fees: $95.00 Total Payments To Date: $95.00 Balance Due: $0.00 Inspector: FINAL APPROVAL Date: /ff'/p /'Z^ 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 pemiit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Govemment Code Section 66020(a), and file the protest and any other required infonmatlon 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 Imposltbn. 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 seivice fees in connectton 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 oreviouslv othenwise expired. ^ CITY OF CARLSBAD Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717/2718/2719 Fax 760-602-8558 www.carlsbadca.gov ^j^^ Plan Check No. Est. Value Pian Ck. Deposit Date /W/jg^ SWPPP JOB ADDRESS 2550 Chestnut Ave. PHASE# I # OF UNrrs I« BEDROOMS sflft#/SPACE#/UNIT# CT/PROJECT # # BATHROOMS I TENANT BUSINESS NAtklE CONSTR. TVPE I 0C& GROUP DESCRIPTION OF WORK: Indude Sqinra Faat ofAttecfd Ana(t, Replace existing water heater. Same size and location. EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE YESQ NOj I AIR CONDmONING YES I |NO| I FIRE SPRINKLERS YESQ] NOj I CONTACTNAME (HOHfenntFomAppKemt) APPLICANT NAME Robert Block ADDRESS ADDRESS 30300 Puerto Vallarta CITY STATE ZIP cmr Menifee STATE CA ZIP 92584 PHONE FAX PHONE 951-345-4083 FAX EMAIL EMAIL PROPERTY OWNER NAME Barbara Sieczkowski CONTRACTOR BUS. NAME All Star Water Heaters ADDRESS ADDRESS Same as lob 30300 Puerto Vallarta crrY STATE ZIP Carlsbad _CA. 92008 CITY STATE ZIP Menifee 92584 PHONE 780-729-8850 FAX PHONE 951-345-4083 FAX EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS 812894 CLASS C36 cnv BUS. uc.# (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 LawfChapter 9, commending with Section TOOOof 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 appllcantfor a permit subjects the applicant to a civil penalty of not more than fwe hundred dollars ($500)). WORKERS' COMPENSATION Workers' Compantatlon Daclantlon: f hereby affirm under penalty of peijury one of the foSoviIng declarations: BI hive and will maintain a certificate of coniant to telMnture for workers' compensation as provkled by Section 3700 of the Labor Code, fbr the performance of the work for which this pemiit is issued. I have and will maintain worken' compantatlon, as required bv Sectbn 3700 of the Labor Code, fbr the perfonnance of the work fbr whk^i this pennit Is issued. My workers' compensatnn insurance canier and polk;y number are: Insurance Co Oak Rhrer Int. Co. Polfcy No. 2200062086121 Expiratton Date This section need not be completed If Ihe pennit Is for one hundred doiiars ($100) or less. n Cartlflcata of Exemption: I certify that in the perfomiance of the work Ibr whtoh this pemiit is issued, I shall not emptoy any person in any manner so as to become subject to the Workers' Compensatton Laws of Califomia. WARNING: Fallura to sscura workers' compentitlon coverage It unlawful, and shall subjact an smployer to criminal panaltlat and civil Unas up to ont hundrtd thouiand dollars (&100,000), In addition to the cott of rnmpimtinn ri«ii|ngii« || |iiwiiiiiii|H)i jn Section 3706 of tht i |^rnH«, inhiiMt and tttomty't fast. . ^ ''=^>s^ DAGENT DATE <9 / -^"^ / ^ ^ >ef CONTRACTOR SIGNATURE ] OWNER-BUiLDER OECLARA TlO N I hereby affimi that I am exempt fiom Conlracfor's Ucense Law fbr the following reason: I I I, as owner of the property or my emptoyees with wages as their sole compensatton, will do the work and the stmcture is not intended or offered for sale (Sec. 7044, Business and Pmfesstons Code: The Contractor's • • Ltoense Law does not apply to an owner of property who buikis or impreves thereon, and who does such work himself or through his own emptoyees, provided that such improvements are not Intended or offered fbr sale. If, however, the buikling or imprevement is sou within one year of rompletton, the owner-bulkier will have the burden of proving that he dkj not build or improve for the purpose of sale). I, as owner of the property, am exclusively contracting with licensed contractors to constnict the project (Sec. 7044, Business and Professtons Code: The Contractors Ltoense Law does not apply to an owner of property who buiMs or improves thereon, and contracts for such projects with contractor(s) Itoensed pursuant to the Contractor's Ucense Law). I am exempt under Sectton Business and Professions Code tor this reason: 1.1 personally plan to provide the makir labor and materials for constmctton of the proposed property improvement I lYes I INO 2.1 (have / have not) signed an appltoatkin for a buikling penult for the proposed work. 3.1 have contracted with the foliowing person (flmi) to provide the proposed constmctton (include name address / phone / contractors' Itoense number): 4. i plan to provide porttons of the work, but I have hired the foltowing person to coordinate, supenrlse and provkje the major work (Inciude name / address / phone / contractors' itoense number): 5.1 will provide some of the work, but I have contracted (hired) the foltowing persons to provide the work indtoated (inciude name / address / phone / type of work): ^PROPERTY OWNER SIGNATURE •AGENT DATE COMPLETE THIS SECTION FOR N O N - R E S I D E N T I A L B U I L O I N Ci PERMITS ONLY Is the appltoant or future buitoing occupant required to submit a business o|an, acutely hazardous materials reglstratton fomi or risk management and preventton program under Secttons 2SS05,25533 or 25534 of the Prestey-Tanner Hazardous Substance Account Act? t^Yes LjNo Is the appltoant or future buitoing occupant required to obtain a pennit from the air poliutton conttol distrtot or airoualitv management distrtot? I Ives I I No Is the facility to be constmcted within 1,000 feet of the outer boundary of a school site? FlYes FlNo 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 CONSTRUCTION LENDING AGENCV I hereby affimi that there Is a construction lending agency fbr the peiformance of the worit this permit is Issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address APPLICANT CERTIFICATION Iceitifythatlhave read the appllcaUan and slate thet the above Infbiinatlon Is corred and that the InfbmiaOon on the ^ I hereby authorize representafive of the aty of Carlsbad toenter upon the above menlkxiedpn^ AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT OSMA: An OSHA pennit is required for excavafions over S'O deep and demofifion or constnKtxxi of sfit^ EXPIRATION: Every pemiit Iskjed by the BuikJing Oflkaal under the provistons of this Code shal ISOdaysfromthedateofsuch ft™'''^'"hBbuiM»iaofwori( authorized ^.sydipemiit is suspended or abandoned at any time after the work is commenced for a period of 180 days (Secfion 106.4.4 Unifomi Building Code). vefAPPLICANT'S SIGNATURE DATE Inspection List Permlti^: CB122014 Type: PME SIECZKOWSKI RES - REPLACE H20 HEATER, SAME SIZE, SAME LOCATION. Date Inspection Item Inspector Act Comments 10/16/2012 25 Water Heater/Vents - RI 10/16/2012 25 Water HeaterA/ents PB AP 10/16/2012 29 Final Plumbing - RI 10/16/2012 29 Final Plumbing PB AP Tuesday, October 16,2012 Page 1 of 1