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Home My WebLink About2626 LEWIS LN; ; CB111982; Permit09-14-2011 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: Applicant: City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No: CB111982 Building Inspection Request Line (760) 602-2725 2626 LEWIS LN CBAD PME 1552722200 Lot#: 0 BERMAN RES-REPLACE WTR HTR Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 09/14/2011 LSM 09/14/2011 09/14/2011 CALIFORNIA DEL TA MECHANICAL BERMAN ARLENE S SUITE# 27 12440 OAK KNOLL RD 92064 866-898-0008 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES 2626 LEWIS LN CARLSBAD CA 92008 $150.00 $0.00 $0.00 $0.00 $150.00 Total Fees: $150.00 Total Payments To Date: $150.00 Balance Due: Inspector: FINAL APPROVAL Date: ..2 . ..l-J r I 2.., Clearance: $0.00 NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reseivations, or other exactions hereafter cOltectively referred to as "fees/exactions." You have 90 days from the date this permit was issued to protest imposition ot these fees/exactions JI 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 informatior, 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 hih hv rvi Tl imilr hi rs whi fli in h xir City of Carlsbad ''1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718 / 2719 Fax: 760-602-8558 Building Permit Application JOB ADDRESS Plan Check No.ffi l I I 0i. 'l' ~ Est. Value Plan Ck. Deposit Date 9 f4. f( SUITE#/SPACE#/UNIT# APN .). <, -:J1/) CT/PR6J"E'CT'#~----'---'-",~O"T"•-----=,H"AS"E~,-~.~a~,~u~N~1T~s~,~B"E'"D~RO~O"M"S~-1.,~,"AT~H"R~D~OM~s~~'TE~N~A"NT'B~U"S~IN"E~ss~N~A"M ... ,--------~,C~DN~S~T"R'TY~P"E~"o=cc."GROUP -aP.t-LewisLn DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) Replace existing like for alike water heater EXISTING USE I PROPOSED USE rARAGE (SF) PATIOS (SF) I DECKS (SF) I FIREPLACE 1 IAIR CONDITIONING I I FIRE SPRINKLERS v,so NO□ v,s □No □ YES□No□ CONTACT NAME (ff Different Fom App/leant) California Delta Mechanical APPLICANT NAME Galina Pavlova -----~---·· ADDRESS ADDRESS 6056 East Baseline rd# 155 6056 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@2deltamechanical.com galiapavlovabg@2yahoo.com PROPERTY OWNER NAME Arlene Berman CONTRACTOR BUS. NAME California Delta Mechanical ADDRESS ADDRESS 2626 Lewis Ln 6056 East Baseline rd # 155 CITY STATE ZIP CITY STATE ZIP Carlsbad Ca 92008 -Mesa AZ. 85206 PHONE I FAX PHONE IFAX 760-729-8020 480-898-0007 EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS I STATE UC.# STATE UC.# I CL.ASS I CITY BUS. LIC1214281 811114 c36 (Sec: 7031.5 Business and P,rofess1ons 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 per_mit 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 apphcant to a civil penalty of not more than five hundred dollars {$500}). Workers' Compensation Declaratlon: I hereby affinn under penalty of perjury one of the following declarations: [Z] 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 pertonnance of the work for which !hie; permit is issued 0 I have and wlll maintain workers' compensation, as reauired bv Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are: Insurance Co Policy No. 1697823 Expiration Date 01111112012 J.b..ip,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 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 civlt fines up to one hundred thousand dollars (&100,000), in addition to the cost of compensation, damages as provided for In Section 3706 of the Labor code, Interest and attorney's fees. 25 CONTRACTOR SIGNATURE ~_.? I hereby affirm that I am exempt from Contractor's License Law for the following reason: D I, _as owner of the property or my employees with wages as their sole compensation, will do 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 himseW or through his own employees, provided that such improvements are not intended or offered for sale. If, however, !he 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 pro.jects 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 ttie proposed property improvement. 0Yes 0No 2. I (have I 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 address I phone 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 I contractors' license 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/ phone I type of work) 25 PROPERTY OWNER SIGNATURE DATE • s the applicant or future building occupant required to submit a business,.Q!fill, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the )resley-Tanner Hazardous Substance Account Act? D Yes LJNo s the applicant or future buikling occupant required to obtain a permit from the air pollution control district or a~ality management district? Oves D No s the facility to be constructed within 1,000 feet of the outer boundary of a school site? Oves L..JNo F At.IV 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 ~MERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. certify that I have read the application and state that the above infonnatlon 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 construciion. hereby authorize represeotative of the Qty of Ca1sbad to enter upon the above meotioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD \GAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. )SHA: An OSHA pemit is required for excavations over 5'0' deep and derr'Kllition or construction of structures CNer 3 stories in height :XPIRA TION: Every perm!: issued by the Building Official under the provisions of this Code shall expire by limitation aid b~me null and void if the building or work authorized by such pen .,it is not oomrnenced within 80 days from lhe date of sudl pemit or if the buildirv;i or work authorized by such permit is suspended or ;tiandoned at any time after the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). ~ APPLICANT'S SIGNATURE ~ DATE ,9 ?.~/ &1 City of Carlsbad Bldg Inspection Request ' For: 02/22/2012 . Permit# CB111982 Title: BERMAN RES-REPLACE WTR HTR Description: Type:PME Sub Type: Job Address: 2626 LEWIS LN Suite: Lot: Location: OWNER BERMAN ARLENE S Owner: BERMAN ARLENE S Remarks: 10-12 PLEASE Total Time: 0 Act Comments Inspector Assignment: Phone: 7607298020 Inspector~ Requested By: ARLENE Entered By: JANEAN CD Description 25 Water HeaterNents 29 Final Plumbing i------ .. ---~-·-------·-~ ---··-------·--- Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# Inspection History Date Description Act lnsp Comments