HomeMy WebLinkAbout2623 LA GOLONDRINA ST; ; CB070640; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
03-0~200o/ Plumbing Permit Permit No: CB070640
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
2623 LA GOLONDRINA ST CBAD
PLUM Status:
Parcel No: 2155621300 Lot#: 0 Applied:
Construction Type: NEW Entered By:
Reference #: Plan Approved:
Issued:
Project Title: EWASKIW 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:
EWASKIW FAMILY TRUST 3 04-19-01
2623 LA GOLONDRINA ST
CARLSBAD CA 92009
ISSUED
03/07/2007
LSM
03/07/2007
03/07/2007
$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:
FINA
Date:
PROV~ -0, U 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 pennit 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 infonnation 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 lo 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 hi h h v r I iv n N Tl E imil r hi r wh' h h f limi ati n h I oh
FOR OFFICE USE ONLY
PLAN CHECK NO. ce,o700 YD
• PERMIT APPLICATION
EST. VAL. _________ _
Plan Ck. Deposit ----r-,,--,----s:-
~:::•_te_d_B_y __________ _,,o':,~r!_s~w~~::~~~~~-= CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad CA 92008
2623 La Golondima
Address (include Bldg/Suite#) Business Name (at this address)
Legal Description Lot No. Subdivision Name/Number Unit No. Phase No.
Assessor's Parcel # Existing Use Proposed Use
Replace standard water heater like for like
Description of Work SQ.FT. # of Stories # of Bedrooms
i.. --•-•·• I •'-c.2:''!~ii:i~i!!iiii~iii~:::,,2:!!~Di;,),:,:::w::,~:,•·0::;:1!lii ...... ;;.-,,::.
California Delta mechanical, Inc. 2500 S. Power Rd. Suite# 120 Mesa AZ 85209 (480) 898-0007
Name Address City State/Zip Telerhone #
3; ::~~ ~;eJ•11··1'/i~Pr;±:!±11mi~•••1·11•rr:;mt1hllilil~im i:1:1e~?t1,:""?; 1Hlmiiii/~ifa~L
Galina Pavlova 8949 Lombard p\. # 413 San Diego CA 92122
Name Address City State/Zip
.4.
William Awaskiw 2623 La Golondima Carlsbad CA 92009 760-803-5552
Name Address City State/Zip Telephone#
Total# of units
# of Bathrooms
(480) 898-0005
Fax#
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{Seo. 7031.15 Bullim,H and Prof-ion• Code: Any City or County which require, a permit to conlllrud, alter, improve, demolieh or repair any lllrudure, prior to it, i•u•nca,
al.:. requires the applicant for such permit to file a 1ignm::l lllat1meri that he is lican,«t pursuant to the provisions of the Contractor's license Law [Chapter 9, commending with
Section 7000 of Division 3 of the Business and Pn:Naaion, 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 Address City State/Zip Telephone#
State license # ...c8e.l,clecleclc:4c_ ___ _ License Class _.:C:c-_:3:c6:_ _______ _ City Business License # _,l'-'2'-l'-4'-'2"8=1 _____ _
Designer Name Address City State/Zip Telephone#
State License# ________ _
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Work1r9' Compenllltion Dedal"aion: I hereby ,nm, under panalty c:I perjury on• c:I th, following dmarlllllon,:
□ 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.
(!I I have and will maintain worker's compensation, as required by Section 3700 of the labor Code, for the perform.mce 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,._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 provided for in Section 3706 of the Labor Code, interest and
SIGNATURE Galina Pavlova ~-~~~~~mim1mr_ .1iHjii011fiF
l hereby affirm that I am exempt from the Contractor's License 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 'Nithin 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 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 □ NO
2. I (have/have not) signed an application for a building permit for the proposed WO(k.
3 I have contracted with the following person (firm) to provide the proposed construction {include name/ address I phone number I 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 I address I phone number/
/ontractors license number): -----------------------------------------------
5. I will provide some of the work, but l have contracted {hired) the following persons to provide the work indicated (include name I 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
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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.
l,':'!Y</--i--■~,1~~•»~;-,-~!-lf-~:~llrJ!:i'"'i;~~,.•;~•1ati'!•~.-JiW!•~:i:~;;#li!J'.~.'-•·:x·_:~-~iliti;i(i~!d!,!~!j:,;::;lilt'.ir"1'~.'ii1_;_~;;;;;:n;ij1i1: :~i)~!Eii
I hereby •rm that th•r• i• a conatrudion lending agency for th• performanca of the work for which this permit is issued (6.:. 3097(1) Ci\il Code).
LENDER'S NAME ___________________ _ LENDER'S ADDRESS __________________ _
,~,, ·' ,~..,~•......_1~~111:mmnmr.11111J~r,;:~11~i1m1;;1itnmet~ir~ii~HmiH'.iiIT~~•11111::11!1!i!ii!iiim:i~s:1!:!~Jmir;mgist~1i¥2m::!1;,+ ·"'':'!L1,:~··;.:~_:::_::.•,m; 1r1Jff!Hi:t'·--: __ .. 11_' ,, , :
I cartify that I haw read th• application end atate that the aboYe irlormation is con.ct and that the inklrmation on the plan■ ia acx:urate. I agree to com?,y 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
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 become 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).
APPLICANTS SIGNATURE Galina Pavlova ~ □ATE _0_3/_0_5_/_0_7 ________ _
WHITE: File YELLOW: Applicant PINK: Finance
City of Carlsbad Bldg Inspection Request
For 04/09/2007
Permit# CB070640
Title: EWASKIW RES-REPLACE WTR HTR
Description:
Type:PLUM Sub Type:
Job Address: 2623 LA GOLONDRINA ST
Suite: Lot: 0
Location:
APPLICANT CALIFORNIA DELTA MECHANICAL
Owner: EWASKIW FAMILY TRUST 3 04-19-01
Remarks: PLEASE INSPECT 9AM -NOON
Total Time:
CD Description Act Comments
25 Water HeaterNents
1''1 FIWftL
Comments/Notices/Holds
Associated PCRs/CVs Original PC#
Inspection History
Date Description
04104/2007 24 Rough/Topout
Act lnsp Comments
WC JM
Inspector Assignment:
Phone:
Inspector:
Requested By: NA
Entered By: CHRISTINE
04/04/2007 25 Water HeaterNents CO JM NO ONE HOME -NOTIFIED