HomeMy WebLinkAbout2748 ARGONAUTA ST; ; CB062668; Permit09 18-2006'
City of Carlsbad
1635 Faraday Av Carlsbad CA 92008
Plumbing Permit Permit No CB062668
Building Inspection Request Line (760) 602-2725
Job Address
Permit Type
Parcel No
Reference #
Project Title
2748 ARGONAUTA ST CBAD
PLUM
2154001902 Lot#
Construction Type
WINTER RES REPLACE WTR HTR
0
NEW
Status
Applied
Entered By
Plan Approved
Issued
Inspect Area
ISSUED
09/18/2006
LSM
Applicant
CALIFORNIA DELTA MECHANICAL
SUITE #27
12440 OAK KNOLL RD 92064
866 898 0008
Owner
WINTER GARY
2748 ARGONAUTA ST
CARLSBAD CA 92009
Plumbing Issue Fee
Fixture or Trap
Building Sewer
Roof Dram
Install/Repair Water Line
Water Heater and/or Vent
Gas Piping System
Vacuum Breaker
Other Plumbing Fees
Master Drainage Fee
Sewer Fee
Additional Fees
0
0
0
0
1
0
0
$2000
$000
$000
$000
$000
$700
$000
$000
$000
$000
$000
$000
TOTAL PERMIT FEES $2700
Total Fees $27 00 Total Payments To Date $27 00 Balance Due $000
HAS Hi ^O^DAHCE WITH G B C
* VU -10 BY C H L 18 04 030
DAT!SIGNATURC -Ofctf-
Inspector
FINAL APPROVAL
Date 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 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 theinmposition
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
fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave Carlsbad CA 92008
FOR OFFICE USE ONLY
PLAN CHECK NO
EST VAL
Plan Ck Deposit.
Validated By
Date
LI PROJECT INFORMATION
2748 Argonauta street
Address (include Bldg/Suite #)Business Name (at this address)
Legal Description Lot No Subdivision Name/Number Unit No Phase No Total # of units
Assessor's Parcel # Existing Use
Replace standard water heater like for like
Proposed Use
Description of Work SOFT # of Stones # of Bedrooms # of Bathrooms
|2 CONTACT PERSON (if different from applicant)
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#
|3 APPLICANT D Contractor Q .Agent for Contractor D Owner D Agent for Owner
Galina Pavlova 8949 Lombard pi apt3 413 San Diego ca 92122 858 361 6495
Name Address City State/Zip Telephone #
|4 PROPERTY OWNER
Gary Winter 2748 Argonauta street Carlsbad CA 92009 7608311702
Name Address City State/Zip Telephone #
CONTRACTOR COMPANY NAME
(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
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 2500 S Power Rd Suite # 120 Mesa 85209 (480) 898 0007
Name Address City State/Zip Telephone*
State License # 811114 LicenseClass C 36 Citv Business License # 1214281
Designer Name Address
State License #
City State/Zip Telephone #
WORKER S COMPENSATION'
Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations
O 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
0 I have 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 earner and policy number are
Insurance Company State Compensation Insurance Fund Policy No 1697823 Expiration Date 07/01/07
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS)
D 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
doll rs($100000) n add tlon t th o tof omp tlon damag re pro Id df IS tion 3706 of the Labo Code Int re t nd ttorney1 fees
SIGNATURE Galina Pavlova DATE 09/14/06
e:OWNER BUILDER DECLARATION"
I hereby affirm that I am exempt from the Contractor's License Law for the following reason
0 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)
D 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 contractors) licensed pursuant to the Contractor's
License Law)
D 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 DYES D 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 / address / 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 /
/ontractors 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 / 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
J
Is the applicant or future building occupant required to submit a business plan acutely hazardous materials registration for or nsk management and prevention program under
Sections 25505 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act' DYES D NO
Is the facility to be constructed within 1 000 feet of the outer boundary of a school site? D YES D 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
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(1) Civil Code)
LENDER S NAME LENDER S ADDRESS
I certify that I have read the application and state that the above information 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 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 CpSTS AND
OSHA An OSHA permit is required for excavations of 5 0 deep and demolition or construction of structures over 3 stones in height
by such permit is not commenced within 1 80 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)
APPLICANT s SIGNATURE Galma Pavlova DATE 09/14/06
WHITE File YELLOW Applicant PINK Finance
COMPENSATION
INS URAMCE
FUND
POLICYHOLDER COPY
PO BOX 420807 SAN FRANCISCO CA 94142-0807
CERTIFICATE OF WORKERS COMPENSATION INSURANCE
ISSUE DATE Q7-Q1-2006 GROUP-
POLICY NUMBER 1697823-2008
CERTIPICATE ID 6
CERTIFICATE EXP««S 07-01-2007
07-01-2008/07-01-2O07
HOME DEPOT
COMPLIANCE DEPARTMENT
3075 e IMPERIAL HWY STE 100
BREA CA 92821-6762
This is to certify that we have issued a valid Worths Compensation insurance policy m a form approved by the
California Insurance Commissioner to the employer named below for the policy period indicated.
Thia policy is not subject to cancellation by the Fund except upon 10 days advance written notice to ths employer
We will also give you 10 days advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance 13 not an insurance policy and does not amend, extend or alter the coverage afforded
by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document
with respect to which this certificate of insurance may be issued or to which it may pertain the insurance
afforded by the policy described herem IB subject to all the terms, exclusions and conditions of such policy
•fORlZBD REPRESENTATlVtJ PRESIDENT
EMPLOYER S LIABILITY LIMIT INCtUDlNB DEFENSE COSTS $1 000 000 PER OCCURRENCE
EWOT.OYER
CALIFORNIA DELTA MECHANICAL INC DBA
CALIFORNIA DELTA MECHANICAL, INC
2500 S POWER 00 STE 120
MESA AZ 85209
NF
(REV2 OB)PRINTED 08-18 2006
M0409
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