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Home My WebLink About2821 LUCIERNAGA ST; ; CB053966; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 11-16-2005 Plumbing Permit Permit No: CB053966 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: 2821 LUCIERNAGA ST CBAD PLUM 2153101901 Lot#: 0 Construction Type: NEW Status: Applied: Entered By: Reference #: Plan Approved: Issued: Project Title: SHEPARD RES REPLACE H2O HEATER 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: SHEPARD ROBERT E&DIANE B 2821 LUCIERNAGA ST CARLSBAD CA 92009 ISSUED 11/16/2005 KG 11/16/2005 11/16/2005 $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: EXPIRED PERMIT $0.00 PERMIT HAS EXPIRED IN ACCORDANCE WITH C;B.C. SECTION 106.4.4 AS AMENDED BY C.M.C.18.04.u30 Inspector: DATE u\·, \bc.s1GNATURE_g!?J("',1""A"""'>'----- 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 pe11T1il 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 infom,ation 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 i I Tl ii r h' h fl' i i h i 1 h FOR OFFICE USE ONLY PLAN CHECK NoC~39&v PERMIT APPLICATION EST. VAL _________ _ Plan Ck. Deposit _____ l,,c'--- CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 Validated By .-r-r7--=~::;,c.....-- Date 2821 LUCIERNAGA ST. CARLSBAD, CA 92009 Address (indude 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 Proposed Use Replace standard water heater like for like Description of Work SQ. FT. # of Stories # of Bedrooms # of Bathrooms California Delta mechanical, Inc. 2500 s. Power Rd. Suite fl 120 Mesa AZ 85209 (480) 898·0007 (480) 898-0005 Name Address City State/Zip Telephone# Fax# lllisRIDll:(:"l!'l~'.~.:f'l:!;:,1.-ili'Yi\':t~:xJ: ... 7:\l:/~.s:•ji:i:'l';':+!fr!i~~M!:llit~~•ji:i:,:~/Jl'~$t,~~~ ROMEL 2500 S. POWER RD. #120 MESA AZ 85209 (480)898-0007 Name Address City State/Zip Telephone# ROBERT SHEPARD 2821 LUCIERNAGA ST. CARLSBAD CA 92009 (760)918-1620 Name Address City State/Zip Telephone# lit!WrllW!iCilliflllw~ji:!f,';~~'.!1~~;~0·•s:, •. •~t.:::.··::,~;:.•;~.···~·:;i'.t~;:·~.•~-w-ciri:i~;r~l'!~~ll\\l;J:;¥11Ji\J~ (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demoish 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 fo< the alleged exemption. Any violatioo of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$5001). California Delta Mechanical, Inc. 2500 S. Power Rd. Suite# 120 Mesa 85209 (480) 898-0007 Name Address City State/Zip Telephone# State License# __.e,8:,_l :,_l l"'lc:4,_ ___ _ License Class ---'C'--.::3,;;6 _______ _ City Business License# _...,1"2~1'-4"2~8=! _____ _ Designer Name Address City State/Zip Telephone# State License# _______ _ :t:'~~MlllJll~llff ~~t%');f~;~:~-1;1J·-);iyt ifi\;".~f:i~~~~:s;c, .~f{L~-:;;ii0'if7i~:s~0~-~~~ ,¢.;;J~faij;~~~~fu:&~~ii~~~ Workers' Compensation Dedaratlon: 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. ~ 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,~0"7~/0"-"l/~0~6'------- (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 pertormance of the work for which this pennit is issued, I shall not employ any person in any manner so as to becOme subjed to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage Is unlawful, and shall subject an employer to crimlnal penalUH and clvll fines up to one hundred thousand dollars($100,000), In addition to the cost of compensation, damages are provkled for in Section 3706 of the Labor Code, Interest and attorney's fees. SIGNATURE Rome! Mam DATE,_;lc,l'-/l,__4:c/0,c5'------ " ,''lll!l"lllil! •. ~l~'l!W'+'vii,, 11ft, .•~0 .. ~+',t.~•"±~~.l/ti::t::ic·•0r·"••:i:, '0ji:lf~~1,,:;•.,;,:/f•z,/':ll\\l;z;lffl'~irilf,4i'.7'~~~~ I hereby affirm that I am exempt from the Contractor's License Law for the following reeson: 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 ov.m 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 contrador(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. □ 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 (finn) to provide the proposed construction (include name I address/ phone number f 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 (indude name/ address/ phone number/ fontractorslicense number): ------------------------------------------- 5, I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (indude name /address/ phone number/ type of work): PROPERTY OWNER SIGNATURE __________________________ OATIS __________ _ WHITE: File YELLOW: Applicant PINK: Finance PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 Page 2 of 2 ~,~fl!!tf«';!lfl'l!l~~~~-Vo0 '';",,;:;clg; -~-;:,,.;. ; ,, ~~' . , Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials Ngi•ra.ion t,r or ri1k m1nagem1nl ■nd p.........tion program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Ad? D YES 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? □ 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. 1:J:~~----~:,,-~0::~~i'{~<,:½~;:.~:{·:,;} .·.'"'.!'~~',,::~"'M!~.>t-:•f::;,~"~.;;~;:~'.'.···~'i~f'f~~,f:.;,.~ . .,:~4_7: .. :·:¥A:~-~~~(:~:U~!.'.~ I hereby affirm that there is a construction lending agency for the performance r:J th• worll for whidi thi• permit i■ i•u•d (S.O. 3097(1) Civil Code). LENDER'S NAME _________________ _ LENDER'S ADDRESS __________________ _ 1-;C;fM r:MltOIBdl.l.:';AD:>tt '. ,,,::;:;,,:,}i~+ ,.;/'?,"¢' ·it'\' ''3:,~ ' ' ,, ~~~.. ' ':·:,": '_lLl' qr ' ,.,.·:_:•¥fr:.+·. --~, ''I'. ,'. --;;:~~-.t•~:_:.~~~:t{~?l~1nlii·,·;,i.' I certify that I have read the application and state that the above irtormllion is correct and that the information on the pl•n• i■ ax:ur••· I agree kl complif wl:h 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 ANO 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 Rome! Maru DATE I 1/14/05 ---------------------- WHITE: File YELLOW: Applicant PINK: Finance