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Home My WebLink About2814 AVENIDA VALERA; 128; CB063128; Permit10-30-2006 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No: CB063128 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: Project Title: 2814 AVENIDA VALERA CBAD PLUM 2164600900 Lot#: 0 Construction Type: NEW SOLOMON RES- REPLACE WTR HTR Status: ISSUED Applied: 10/30/2006 LSMEntered By: Plan Approved: Issued: Inspect Area: Applicant: CALIFORNIA DELTA MECHANICAL SUITE #27 12440 OAK KNOLL RD 92064 866-898-0008 Owner: SOLOMON FAMILY REVOCABLE TRUST 03-29-02 2814 AVENIDA VALERA CARLSBAD CA 92009 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 0 0 0 0 1 0 0 $20.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 TOTAL PERMIT FEES $27.00 Total Fees:$27.00 Total Payments To Date:$27.00 Balance Due:$0.00 PERMIT HAS EXPIRED IN ACCORDANCE WITH C B C SECTION 106,4.4 AS AMENDED BY C.y.C.18.04.030 £Z SIGNATURED Inspector: FINAL APPROVAL Date:Clearance: NOTICE: Please take NOTICE that approval of your project includes the.lmposition" 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 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 1. PROJECT INFORMATION 2814 Avenida Valera FOR OFFICE USE ONLY PLAN CHECK NO. EST. VAL. Plan Ck. Deposit . Validated By _ Date _ 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 SQ. FT.# of Stories # of Bedrooms # of Bathrooms California Delta mechanical, Inc. 2500 S. Power Rd. Suite* 120 Mesa AZ 85209 (480)898-0007 Name Address City State/Zip Telephone* 3. APPLICANT 03 Contractor O Agent for Contractor a Owner a Agent for Owner Galina Pavlova 8949 Lombard pl.#4 13 San Diego CA 92122 858-361-6495 (480) 898-0005 Fax* Name Address ' City State/Zip Telephone* 4. PROPERTYOWNER .... Neil Solomon 2814 Avenida Valera Carlsbad CA 92009 760-476-9588 Name City State/Zip Telephone #Address 5. 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, 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. 2500 S. Power Rd. Suite # 120 Mesa 85209 (480) 898-0007 Name Address . • City State/Zip Telephone* State License # 811114 License Class C-36 City Business License # 1214281 Designer Name • Address State License # City State/Zip Telephone* 6. WORKER'S COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: D 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. 13 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 carrier 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 dollars($100,000), in addition to the cost of compensatioj^damarfs are provided for in Section 3706 of the Labor Code, interest and attorney's fees. SIGNATURE Galina Pavlova ' ,/^fx^j DATE 10/26/06 [ 7. OWNER-BUILDER DECLARATION $*'*'/ I hereby affirm that I am exempt from the Contracto£s>jtense Law for the following reason: D 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 contractor(s) 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. D YES 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 1 635 Faraday Ave.,1 Carlsbad CA 92008 Page 2 of 2 COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY ', 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? DYES D NO Is 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 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 REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. 8. CONSTRUCTION LENDING AGENCY \ 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, 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). APPLICANT'S SIGNATURE Galina Pavlova x?0I^S . _ DATE 10/26/06 _ ' . WHITE: File YELLOW: Applicant PINK: Finance POLICYHOLDER COPY P.O. BOX 420807, SAN FRANCISCQ,CA 34142-0807 * »^l •*» •fc* w» *•% w» «tBt B F"UND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE COMPENSATION I NSURAMCE ISSUE DATE: 07-01-2006 GROUP; POLICY NUMBER: 16878*3-2003 CERTIFICATE IDs 6 CERTIFICATE EXWBES: 07-01-2007 07-01-3008/07-01-2007 HOME DEPOT COMPLIANCE DEPARTMEWr 3078 B IMPERIAL HHY STE 1OO 8RBA CA 92821-67B2 NP This Is to certify that wa hava issued 8 valid Workers' Compensation Insurant* policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to ft* employer. We will also gfva you 1Q days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter tha 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 herein is subject to all tha terms, exclusions, and conditions, of such policy. "^^X JTHORIZED REPRESENTATIV8LJ ' PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: 91,000,000 PER OCCURRENCE, EMPLOYER CALIFORNIA DELTA MECHANICAL, CALIFORNIA DELTA MECHANICAL, 2BOO S POWER TO STE 120MESA AZ eeao» INC INC (RCV.2-OB) PRINTED : 08-18-2008 51799812081? Ll' (40*09 , 900Z/t>T/i0