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Home My WebLink About2563 LUCIERNAGA ST; ; CB081596; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 08-19-2008 Plumbing Permit Permit No: CB081596 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: Building Inspection Request Line (760) 602-2725 2563 LUCIERNAGA ST CBAD PLUM 2153000901 Lot#: 0 Construction Type: NEW HOLT RES REPLACE WTR HTR Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 08/19/2008 KG 08/19/2008 08/19/2008 Applicant: CALIFORNIA DELTA MECHANICAL HOLT DANIELE FAMILYTRU.ST06-12-03 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: $27.00 0 0 0 0 1 0 0 2563 LUCIERNAGA ST CARLSBAD CA 92009 $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: Inspector: #1, ~ FINAL AP,ROVAL Date: 0 9 1° [ Ob 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 feesiexactions. lf 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 !nformation 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 proj,act. NOR DOES IT APPLY to any . n f 1 I i r h Ii =Jl!!IJ<W:t!JILI&!l!IJ!!RJO!l!l=--...J PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 2563 Lucierna a street Address (include Bldg/Suite#) Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Assessor's Parcel# Existing Use Replace standard water heater like for like Description of Work SQ. FT. #of Stories ~r.ii•i~~i-/18;il!!!ji!!i(~ff;). FOR OFFICE USE ~N_!;,)'~ ~,b PLAN CHECK No(..@ll:;, '7' EST.VAL. ; Plan Ck. Deposit~ Validated By ~ ~ _ / Date___ _,, ~Y Phase No Total # of units Proposed Use # of Bedrooms # of Bathrooms California Delta mechanical, Inc. 2500 S. Power Rd. Suite# 120 Mesa AZ. 85209 (480) 898-0007 (480) 898-0005 Name Address City State/Zip Telephone# Fax# 11;. Ei~ ,!l!l!i~IE(;f.iiii/~lfl(!i~fr •r.-.;a.;~r.• ''jJL~,~~;.J,,,;:~!,;,,·[;:LJ ~'fjf, :y,<J '<·.-_·o;·<''.',}:.',t~!ii!,),'; i?C<':'r.'f:; <-:, · Galina Pavlova 6052 E Baseline rd# 155 MESA AZ 85206 480-898-0007 City State/Zip Telephone# Carlsbad CA 92009 760-815-6500 Name Address City State/Zip Telephone# ,,~;,. i:¢9M~ .• -¥.~~1Jf::TJ;/i;i;':.,.;,\ ~ 1 "L;i[b!:;•:_sr:.: '.:~-,. , ,, ... ,, .. ,.. .. " .. ·. ,,, '., , ' .... ,." : .. :uii,> -i:;>;:'.'.']f[J 1f:.i >. ·,.,,:., 'Llix .,;;11 {d;'.;;·'!'-L:::,,;· (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 E Baseline rd# 155 Mesa 85206 (480) 898-0007 Name Address C\ty State/Zip Telephone# State License # ~8~1 ~I ~I ~14~-----License Class _C~-~3~6'-----------City Business License# ~1~2~1~4~2~8=1 _____ _ Designer Name Address City State/Zip TelephOne # State License# ________ _ ;~i!ihtL~~~;;J,:;1U!JiJ1;iiiJ;:,umm:~ k1ff ~ 1" · 1.-, .1;'i;Jit '··"'!L':.)/,.< " .. ',j,J!/JNJX.:z:;" Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: □ 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.1•Ie 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-~0~7~/~0~l~/0~9~------ (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 comp.,.,..,.,...J,•mages are provided for in Section 3706 of the Labor Code, interest and SIGNATURE Galina Pavlova t•7 ~;Ill!~~~ I hereby affim, that I am exempt from the reason: □ 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). □ 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 contractor(s) licensed pursuant to the Contractor's License Law) □ I am exempt under Sedion _________ Business and Professions Code for this reason: I personally plan to provide the major labor and materials for construction of the proposed property improvement □ YES □ 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 I address I 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 I /ontractorslicense number): ---------------------------___________________ _ 5. I will provide some of the work, but I have contracted (hired) the following persons to proVide the work indicated (include name I address I phone number/ type of work): PROPERTY OWNER SIGNATURE ___________________________ DATE __________ _ WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For 09/10/2008 Permit# CB081596 Title: HOLT RES REPLACE WTR HTR Description: Type:PLUM Sub Type: Job Address: Suite: Location: 2563 LUCIERNAGA ST Lot: 0 OWNER HOLT DANIELE FAMILY TRUST 06-12-03 Owner: HOLT DANIELE FAMILY TRUST 06-12-03 Remarks: Total Time: Description Act Comments Inspector Assignment: Phone: 7608156500 Inspector: Mv ---<--- Requested By: DAN Entered By: JANEAN CD 25 29 Water HeaterNents Final Plumbing ~ 6. Xl.6-rt,J.ia j,...oc.,A:t:1,0.J. , "'>~6b-1l L. I Date a ~-$Q?Af>~~~s~~_e.._. W.~-~~-_D_"'-~· ~ND~- ....Joe. <oll<eo O•\L -6L$-. Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Description Act lnsp Comments 'P"--54.:Sta. ~ ~P'( c,~ ~~~L-~...er -to ~. ~ It-~.