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Home My WebLink About2812 NEW CASTLE WAY; MULTI-PERMIT FILE; CB091995; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 11-30-2009 Plumbing Permit Permit No: CB091995 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 2812 NEW CASTLE WY CBAD PLUM Status: Parcel No: 167 4801929 Lot #: 0 Applied: Construction Type: NEW Entered By: Reference #: Plan Approved: PC#: Issued: Project Title: GERO RES REPLACE WTR HTR Inspect Area: Applicant: CALIFORNIA DELTA 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: GERO DANIEL J&PATRICIA L 2812 NEW CASTLE WAY CARLSBAD CA 92010 ISSUED 11/30/2009 KG 11/30/2009 11/30/2009 $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: FINAL APPROVAL Date: 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 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 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 applica~·on processing or service fees in connection with this project. NOR DOES IT APPLY to any f x ·on f whi h h v r vi I N Tl i ii r hi r hi h h of i ha r vi I h rwi City of Carlsbad 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718 / 2719 Fax: 760-602-8558 Building Permit Application (i • ' . • ' Plan Check N Est. Value Date JOB ADDRESS 2812 New Castle way SUITE#/SPAC #/UNIT# CT/PROJECT# PHASE# # OF UNITS # BEDROOMS # BATH QOM TENANT BUSlNESS NAME DESCRIPTION OF WORK: Include Square Feet of Affected Area(-,)~--~----~-----~-------~------- Replace existing like for alike water heater EXISTING USE I PROPOSED USE I GARAGE (SF) PATIOS {SF) I DECKS (SF) I FIREPLACE !AIR CONDITIONING I FiRE SPRINKLERS v,so N<Q v,s □No0 vcsONoO CONTACT NAME (lfDI .. NntFomApplk,nt) California Delta Mechanical Inc. APPLICANT NAME Galina Pavlova ADDRESS ADDRESS 6052 E. Baseline road suite# 155 6052 E. Baseline road suite# 155 ---------CITY STATE ZIP CITY STATE ZIP Mesa AZ. 85206 Mesa AZ. 85206 PHONE I FAX PHONE IFAX 480-898-0007 1-480-218-5645 480-898-0007 1-858-410-1499 EMAIL EMAIL california@.deltamechanical.com galiapavlovabg@.yahoo.com PROPERTY OWNER NAME Patt/ Gero CONTRACTOR BUS. NAME California Delta Mechanical Inc. ADDRESS ADDRESS 2812 New Castle wav 6052 E. Baseline road suite# 155 CITY STATE ZIP CITY STATE ZIP Carlsbad Ca 92010 Mesa Az i.5206 PHONE I FAX PHONE I FAX 760-803-0362 480-898-0007 EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS I STATE UC.# STATE LIC.# I CLASS l"1..z1 -/2.~ I 811114 c-36 {Sec: 7031.5 Busmess and Professions Code: Any City or County which requires a permit to construct, alter, improve, demohsh or repair any structure, pnor to its issuance, also requires the applicant for such permit to file a siro,ed 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)). Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations· [ZJ I have and will maintain a certificate of consent to self-Insure for workers' compensation as provided by Section 3700 of the Lat>or Code, for the perfomiance of the work for wt'lich this permit is issued ·- [{J i have and will maintain workers' compensation. as reQuired by Section 3700 of the Lat>or Code, for the performance Of the work for wt'lich this permit is issued. My workers' compensallon insurance carrier and policy number are: Insurance Co Policy No. 169782! Expiration Date 01113m1 ~section need not be completed if the permit is for one hundred dollars ($100) or less. L{J Certificate of Exemption: I certify that in the performance of the 'Mlrk for which this permit iS issued, I shall not employ any person in any manner so as to become subject to the Worl(ers' Compensa~on 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, damages as provided for ~ion 3706 of the Labor code, Interest and attorney's fees. KS CONTRACTOR SIGNATURE t I hereby affirm that I am exempt from Contractor's License Law for the following reason: □ I, as owner of the property or my empiOyees with wages as their so~ 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 tlmseH or through his own employees, provided that such improvements are not lntended or offered for sale. If, tnwe...er, the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that he did not btrild or improve for the purpose of sa~) 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 pursL1ant 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 lat>or and materials for constt'l£tion of the proposed property lmprov-ement. Oves Oo 2. I (have I have not) signed an application for a building permit for the proposed work. 3. I have contracted with the followlrg person (firm) to provide the proposed construction (include name address I phone/ contractors' license number): 4. I plan to provide portions of the worl(, but I have hired the following person to coordinate, supervise and provide the majOr work (include name I address/ phone I contractors' license number): 5. I will provide some of the work, but I have contracted (hired) the fol'Qw!ng persons to provide the work indicated (include name I address I phOne / type of work): .JiS PROPERTY OWNER SIGNATURE DATE -~ -------·----------- Is the applicant or future building occupant required to submit a business_Qtfill, acutely hazardous materials registration form or risk management and prevention program under SecUons 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? D Yes L..JNo Is the applicant or future building occupant required to obtain a permit from the air pollution control district or a~ality management distr'cl? Oves 0No Is the facil;(y to be constructed within 1,000 feet of the outer boundary of a school site? Oves LJNo 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. I certify that I ha\'e read the application and state that the above infonnation Is coned: and that the infonnatlon on the plans Is accurate. I agree to compl!,rwllh all City oldinanc:es and State laws relating to buildlng construction. I hereby authorize represenlatMl of the City of Carlsba:l to enteruJX)ll the aboYe mentiooed property for insl):lciico purp:,ses. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, 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 requira:l for excavaOCms over 5'0' deep and demoh'tion or crnstruction of structures over 3 stories in height. EXPIRATION: Every permit issued by the Buildflg a!icial urder the l)'C)Visions of this Ccx:le shall expire by liflltalion OOJ bocome null .n-:1 '-00 if the buikling or work authorized by such permit is rot oommenced within 180 days from the date of sudl permit or if the lx.Jikling or work authorized by such pemit is suSj):lnded or abandoned at anytirre aftef the work is oomrrenced for a perbd of 100day.; (Secoon 100.4.4 Uniform Buik:ling Cooe) ..@S' APPLICANT'S SIGNATURE _J April 16, 2010 DANIEL & PATRICIA GERO 2812 NEW CASTLE WAY CARLSBAD CA 92010 City RE: BUILDING PERMIT EXPIRATION PERMIT TYPE: WATER HEATER of Carlsbad I :.j •II GI I,,. I •14 •EI I I,, 14 ,I I Permit Number: CB091995 Issue Date: 11/30/2009 ADDRESS: 2812 NEW CASTLE WY PLEASE CALL FOR AN INSPECTION IF WORK IS COMPLETE Our records indicate that your building permit will expire by limitation of time on 05/29/2010. The provisions of UBC, Section 106.4.4 as amended by the Carlsbad Municipal Code state: "EXPIRATION. Every permit issued by the Building Official under the provisions of this code shall expire by limitation and become nul I 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 stopped at any time after the work is commenced for a period of 180 days or if the building or work authorized by such permit exceeds three calendar years from the issuance date of permit. Work shall be presumed to have commenced if the permittee has obtained a required inspection approval of work authorized by the permit by the Building Official within 180 days of the date of permit issuance. Work shall be presumed to be stopped if the permittee has not obtained a required inspection approval of work by the Building Official within each 180 day period upon the initial commencement of work authorized by such permit. Before such work can be recommenced, a new permit shall be obtained to do so, and the fee, therefore, shall be one-half the amount required for a new permit for such work, and provided that no changes have been made or will be made in the original plans and specifications for such work, and provided further that such suspension or abandonment has not exceeded one year. In order to renew action on a permit after expiration, the permittee shall pay a new permit fee. Any person holding an unexpired permit may apply for an extension of the time within which work may commence under that permit when the permittee is unable to commence work within the time period required by this section for good and satisfactory reasons. The Building Official may extend the time for action by the permittee for a period not exceeding 180 days on written request by the permittee showing that circumstances beyond the control of the permittee have prevented action from being taken. No permit shall be extended more than once. Please check below indicating your intentions and return this letter to us. Project abandoned. A new permit will be obtained prior to commencing work. No fee extension requested for 180 days. (attach a letter of explanation) Renewal permit requested. If the project has been completed and only a final inspection is needed, please call the inspection request line at (760) 602-2725. ~,,. If you have any questions, please contact the Building Inspection Department at (760) 602-2700. Christine Wauschek Office Specialist 1635 Faraday Avenue• Carlsbad, CA 92008-7314 • (760) 602-2700 • FAX (760) 602-8560 @ City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 12-05-2005 Plumbing Permit Permit No: CB054137 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 2812 NEW CASTLE WY CBAD PLUM Status: Parcel No: 1674801929 Lot#: 0 Applied: Construction Type: NEW Entered By: Reference #: Project Tille: GERO RES-INSTALL NEW WATER HEATER Applicant: ALL STAR WATER HEATERS & PLUMBING 17886 LAKESHORE DR 92530 1-800-727-0977 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 Plan Approved: Issued: Inspect Area: Owner: GERO DANIEL J&PATRICIA L 2812 NEW CASTLE WAY CARLSBAD CA 92010 ISSUED 12/05/2005 LSM 12/05/2005 12/05/2005 $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: Clearance: $0.00 TICE hat 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 Car1sbad 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 fwhi h vi I Tl i ii r hi h h limi i h r i I PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Assessor's Parcel # Description of Work #of Stories Name Address City State/Zip Name Address City State/Zip ,<>,:rT l Name FOR OFFICE USE ONLY 051../-t31 PLAN CHECK NO. (f:8 05 4 I 3-1- EST. VAL. _________ _ Plan Ck. Deposit_~~------ Validated By __ _,~"-~'------ Date -------'1-"ili@'-+-'S':.+-"D-l:..:::... __ _ Phase No. Total# of units Proposed Use # of Bedrooms # of Bathrooms Telephone# Fax# Telephone# (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 provislons 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 [$50Ql}. A 1 t ,STJ<>..~ ,tN'~ 11:EA"TC4S sO~@ (/ut:.?-TO VAUA,tt.9!)4 f7/,aJ1ffrC-/Z-.f8Y Name 8 V , J Address C? City State/Zip lfelephone# (/ev7Z,.]of State License #' Vu "I Cf License Class I, City Business License#___________ 77 Designer Name Address City State/Zip Telephone# State License# _______ _ Workers' Compensation Declaration: I hereby affirm under penr-1lty of perjury one of tr.e following declarations: □ r 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. --15" 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 workerscompensationinsurancecarriJltan~numberare: . j--.l/!· // ~ ,,.-. _ 0_7,._or/ Insurance Company ..$1:TA,-e-I-, ~ Polley No. _ -----10-t? Y F (J L___ Expiration Date, __ -'--7~..>"-~---1.. ____ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) □ CERTIFICATE OF EXEMPTION· I ce tfy 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' Com sa · n L of WARNING: Fallure to secure worke dollan.($100,000), In addition to the c SIGNATURE ge Is unlawful, and shall subject an employer to criminal penalties and civil fines up lo one hundred lhouaand , damages are provided for In Section 3706 of lhe Labor Code, Interest and attorney's fees. .L -DATE IL--/-.. e p erty or my employees with wages as their sole compensation, will d the wori< and the structure is not intended or offered for sale (Sec. 7044, Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and who does such wori< 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 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 work. 3. I have contracted with the following person (firm) to provide tho proposed construction (include name I address / phone number I ,ontra~ors 1icer.tC3 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 / phone number I /o'ltractors 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 PE~MIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 Page 2 of 2 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? D YES O NO 1s the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? D YES D NO Is the facility to be oonstructed within 1,000 feet of the outer boundary of a school site? □ 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 REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. I hereby affirm that there Is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3007(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 LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGEMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY AC RUE A NST SAi Cl IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required fore EXPIRATION: Every permit issued by by such permit is not commenced withi the work is commenced for a period I u r the rovisions of this Code shall expire by limitation and become null and void if the bu fl ding or work authorized ate of ch permit or if the building or work authorized by such permit Is suspended or abandoned at any time after 06.4.4 iform Building Code). WHITE: FIie YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For 12/16/2005 Permit# CB054137 Title: GERO RES-INSTALL NEW WATER Description: HEATER Type: PLUM Sub Type: Job Address: 2812 NEW CASTLE WY Suite: Lot 0 Location: APPLICANT ALL STAR WATER HEATERS & PLUMBING Owner: GERO DANIEL J&PATRICIA L Remarks: OR EXT. 3195 AT CITY OF CARLSBAD Total Time: Inspector Assignment: Phone: 7607200362 Inspector: ---- Requested By: PATTI Entered By: CHRISTINE CD 25 Description Water HeaterNents Act Comment !} .. l+f ~he~ Comments/Notices/Hold Associated PCRs/CVs Inspection History Date Description Act lnsp Comments ... PERMIT APPLICATION CJTV OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (619) 438-1161 FOR OFFICE USE ONLY PLAN CHECK NO. q 7[J b IS":. EST. VAL. ________ _ Validated By._,.. _ _,_.,,_:c_:__ ____ _ Plan Ck. D. eposit . f1i .. Date J/rq( Address (include Bldg/Suite I) Business Name (at this eddressl Leg■I Description Lot No. SFR Subdivision Name/Number Unit No. Phase No. Total I of units Assessor's Parcel I Existing Use Proposed Use Description of Work SO. FT. lof StorlH I of Bedrooms # of Bathrooms WATER HFATER REPLACEMENT ;2..."' CONTACT PERSbu Ill dlfle19oi tron\,eoail ... tlt~i<ii. ,,,,·,;i.:'"i";l::;f' :,,.,,,,v,,,,,1.._~,;•t.""'~"'•-"cC,!.\\·72J)~Q362 GerO, Patt'i ··ztH.'L. NeW ~t....te!!·'·vvo:/''"A'1JJ7.,._r,:~~ • .. ~,W'.-.W ...... <1.I,,, ,,.,,.. ' Name Address City !&.'1>l[CPNTAAC'.fOlli!,COlo1"\llY.lHAMliillle a a #It½ Ml#Siilii :mrtrt J State/Zip T elaphone # 6 ,..,-,~t!ii!l'ev':', .. ,. State/Zip Telephone# .J!i!!il~i'~i:ft~t-· (Sec. 7031.5 Business and Professions Code: Any City or County which r11qulres I permit to construct, eltw, 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'• License Lew !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 blan_y aJ!Plicant__!!)tf pjt,rm.i1..21bJects the ep. pl\~ t~enaltv of~!l'ore<J128t)~l• hun'8~til~OO)I. A & J FOSTER PLUMBING 3 /Ob-B liWY tl BUb. Nama 630120 Address C-36 City Stote/Zlpl2003'i41ephone # Stata License I __________ License Class__________ City Business License I _______ _ Designer Name Address City State/Zip Telephone State License I _ _cN~/'--"A"------- :i~( ,ii,wo.RKERSt COMPENSATIONi[j.{i:f.~~:l·::·:1:1iv~:::'.1'i,~r2~~JkT ff[( ({!'.'.!t~ti,';:: "'.;Jt?,lttt:£11k!i/j:;r~!~~:'~~~Bi~fl~:\f~"}!;:i' ,i:t~~.1\· ' !;'.·_ :t., -~::.,;. ,,.,_ Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declaratlone: O I have and will maintain a certificate of consent to self-insure for workere' compensation H provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. }O I have and will maintain workers' compensation, as required by Section 3700 of tha Labor Code, for the performance of the work for which this permit Is issued. My worker's compensation insurance carrier and policy number ere: N2007-56-51 5-1-97 Insurance Company FARMER INSURANCE Policy No. Expiration Date, _______ _ !THIS SECTION NEED NOT BE COMPLETEO IF THE PERMIT IS FOR ONE HUNDREO COLLARS [♦100I OR LESSI 0 CERTIFICATE OF EXEMPTION: I certify that in the perfurmance of thi, work for which thi1 permit is l11ued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to aecure·workers' compen1atlon coverage Is unlawful, and shall subject an employer to crlmlnal penaltiea and civil fines up to one hu11dred thousand dollara 1$100,000), In addition to the colt of compantalion, damnges H provided for In Section 3706 of the Lab(II' coda, lntereat and attorney's fees. SIGNATURE _______________________ ~------DATE _________ _ 7. OWNER•BUIWER DECLARATION :>t .: ' c';.;:[t.'l~m.i~t~'tifii:it~j~fiL~::i:.1::Jf;.,\::ii,i:S{t.J:)·' I hereby affirm that I am exempt from the Contractor's Llcenso Law for the following reason: 0 I. as owner of the property or my employees with wages es their sole compensation, wlll 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. himself or through hie 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 havo the burden of proving that he did not build or Improve for the purpose of eale). 0 I, as owner of the property, am exclusively contracting with licensed contrectors to construct' th• project (Sec. 7044, Business and ProfeHlons Code: The Contractor's License Law does not apply to an owner of property who bullde or Improves thereon, end contracts for such projects with contractorts) licensed pursuant to the Contractor's License Law). 0 I am exempt under Section ______ Business and Professions Coda for this re111on: 1 . I personally plan to provide the major labor and meteriels for construction of the proposed property Improvement. 0 YES ONO 2. I !have/ have notl signed an application for• building permit for the proposed work: 3. I have contracted with the following person !firm) to provide the proposed construction !include name / address f 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 / phona number/ 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 / address / phone number / type ol workl .. ·_ ------------------------------------------------------- PROPERTY OWNER SIGNATURE_______________________ DATE _________ _ COMl'LEtE.THIS SEC'f'ION. FOR N_O~MS/0.EN~B~ll.l!INO ~~111,illiliPN~ '(;iBli/lli3lla~Di,,~)il~,;i,;;;;•;.f!::•,)IT';·~ ,,,: 'c• ;·, 'li'. ;. Is the applicant or future building occupant required to submit • business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25605, 25533 or 26534 of the Presl11y-Tanner Ha2.ardou1 Substance Account Actl O YES O NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district Of air quality management district? D YES O NO ls the facility to be constructed within 1,000 feet of the outer boundary of a school site1 D YES O 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. 8._ :, CONSTRUCTION LENDING AGENCY,, ,<J,V'•,>,-,; ,., ?•; :-:~\:',:.'_:,··::.·;;,:;:i;;J';;rir.}~~f{~ti!f~!it-;~1JpJfJ4fl~~~~,J'.h~:::,~,\f~¾tU''. .. I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is iHued (Sec. 309701 Civil Code). LENDER'S NAME _____________ _ LENDER'S ADDRESS, ________________________ _ ,9;, ' APPLICANT CERTIFICATION. 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 Citv 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, JUDGMENTS, 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 tor excavations over 610• deep and demolition or construction of atructures over 3 1tories in height. EXP1RATION: Every permit issued by the Building Official under the provlr.ions of this Code shall expire by limitation and become null and void if the building or work authorized by such permit Is no commenced within 366 days from the date of such permit or If the building or work authorized by uch permit is suspended or abandoned at any time after the rk is c mmenced for I od of 180 days tSecti 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE 4dr.J.Ll.4/.:Ld~'L-.-l,,J.d..'5!:±~~~~-"------DATE ..:.._4--1-'-_,_+--'--'------ YELLOW: Applicant PINK: Finance PERMIT# CB970615 DESCRIPTION: REPLACE WATER TYPE: PLUM CITY OF CARLSBAD INSPECTION REQUEST FOR 04/11/97 HEATER INSPECTOR AREA DC PLANCK# CB970615 OCC GRP CONSTR. TYPE NEW JOB ADDRESS: 2812 NEW APPLICANT: GERO, PATTY CONTRACTOR: CASTLE WY STE: LOT: OWNER: REMARKS: RS/PATTY SPECIAL INSTRUCT: TOTAL TIME: GER0/720-0362 DORIS -~ CALL HER FOR THE~ PHONE: 619 720-0362 PHONE: PHONE: INSPECTOR ~'t\.,_ _________ _ (OR SEE HERifERE) TO ARRANGE A TIME CD 25 LVL DESCRIPTION / s -(0.c5 .. cf~NTS PL Water Heater/Vents .:di? ,,, I (A./,! C..· ***** INSPECTION HISTORY***** DATE DESCRIPTION ACT INSP COMMENTS