The URL can be used to link to this page

Home My WebLink About2864 CAMINO SERBAL; ; CB082254; Permit12-19-2008 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No CB082254 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # PC# Project Title 2864 CAMINO SERBAL CBAD PLUM 2552812800 Lot# Construction Type SUTTON RES-REPLACE WTR HTR 0 NEW Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 12/19/2008 LSM 12/19/2008 12/19/2008 Applicant CALIFORNIA DELTA MECHANICAL SUITE #27 12440 OAK KNOLL RD 92064 866-898-0008 Owner SUTTON TIMOTHY G TRUST 01-31-97 2864 CAMINO SERBAL 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 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 fee\'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 City of Carlsbad 1635 Faraday Ave , Carlsbad, CA 92008 760-602-2717/2718/2719 Fax 760-602-8558 Building Permit Application Plan Check No Est Value Plan Ck Deposit Date lo* JOB ADDRESS 2864 GattiTmlu Serbal CT/PROJECTI * BEDROOMS SUITE#/SPACE#/UNIT# TENANT BUSINESS NAME DESCRIPTION OF WORK Include Square Feet of Affected Area(s) replace existing like for alike water heater EXISTING USE P ROPOSEDUSE GARAGE (SF) CONTACT NAME (If Different Font Applicant) _ . - _ .. _ . . .California Delta Dechamcal, Inc ADDRESS 6052 E Baseline road suite #155 CITY Mesa PHONE 480-898-0007 STATE ZIP AZ 85206 I FAX 1-480-218-5645 EMAIL califorma(5)deltamechanical com PROPERTY OWNER NAME Jenmffer Sutton ADDRESS 2864 Camimto Serbal CITY Carlsbad PHONE 760-634-8474 STATE ZIP CA 92009 FAX EMAIL ARCH/DESIGNtR NAME & ADDRESS STATE LIC * PATIOS (SF)DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS YES | |# N0| | YES^NOQ YES | [ N0| | APPLICANT NAME _ . _ .Galma Pavlova ADDRESS CITY PHONE EMAIL 6052 E. Baseline road suite # 155 STATE ZIP Mesa AZ 85206 FAX 480-898-0007 1-858-410-1499 qahapavlovabq(8>yanoo com CONTRACTOR BUS NAME California Delta Mechanical ADDRESS CITY PHONE 6052 E Baseline rd # 155 STATE ZIP Mesa AZ 85206 FAX 480-898-0007 EMAIL STATE LIC «CLASS CITY BUS LIC « 811114 c-36 (Sec 70315 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 70315 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)) Workers' Compensation Declaration / hereby affirm under penalty of perjury one of the following declarations L£] 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 blJ I have and will maintain workers compensation as required by 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 Dale °mm This section need not be completed if the permit is for one hundred dollars (S100) or less f/1 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 j California WARNING Failure to secure workers' compensation coverage is unlawful, and shall subject an employer.to cnmmal penalties and civil fines up to one hundred thousand dollars (&100.000), m addition to the cost of compensation, damages as provided form Section 3706 of the Labor code, interest and attorney's fees ^ CONTRACTOR SIGNATURE ./>//^\ DATE / hereby affirm that I am exempt from Contractors License Law for the following reason | | I as owner of the property or my employees with wages as their sole compensation will do the wort 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) | | 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)1 i I _| 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 I lYes I IMP 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 / 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 / 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 / type of work) ^"PROPERTY OWNER SIGNATURE DATE Is the applicant or future building occupant required to submit a business plan acutely hazardous materials registration form or nsk management and prevention program under Sections 25505 25533 or 25534 of the Presley Tanner Hazardous Substance Account Act? P^Yes I iNo Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air_guality management distnct7 LJYes I I No Is the facility to be constructed within 1 000 feet of the outer boundary of a school site' PHves FlNo IF ANY OF THE ANSWERS ARE YES,/ EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec 3097 (i) Civil Code) Lenders 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 authonze representative 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 for excavations over 5 0 deep and demolition or construction of structures over 3 stones 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 penod of 180 days (Section 106 4 4 Uniform Building Code) ^APPLICANT'S SIGNATURE City of Carlsbad Bldg Inspection Request For 01/29/2009 Permit# CB082254 Title SUTTON RES-REPLACE WTR HTR Description Sub Type 2864 CAMINO SERBAL Lot 0 Type PLUM Job Address Suite Location OWNER SUTTON TIMOTHY G TRUST 01-31-97 Owner SUTTON TIMOTHY G TRUST 01 -31 -97 Remarks PM PLEASE 2 -4 Inspector Assignment Phone 7606348474 Inspector Total Time CD Description 25 Water Heater/Vents 29 Final Plumbing Act Comments ft? Requested By JENNIFER Entered By JANEAN Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act Insp Comments Storm Water Compliance Exemption Form am applying tp the City of Carlsbad for the following type(s) of construction permit Building Permit D Right-of-Way Permit E]My project is categorically EXEMPT from theTetjuirement to prepare a storm water pollution prevention plan (SWPPP) because it only requires issuance of one or more of the following permit types Electrical Fire Additional Fire Alarm Fixed Systems Mechanical Mobile Home Plumbing Patio/Deck Re-Roofing Sign Spa-Factory Spnnkler Water Discharge Project Storm Water Threat Assessment Criteria* No Threat Assessment Criteria n My project qualifies as NO THREAT and is exempt from the requirement to prepare a storm water pollution prevention plan (SWPPP) because it meets the "no threat" assessment criteria on the City's Project Threat Assessment Worksheet for Determination of Construction SWPPP Tier Level My project does not meet any of the High, Moderate or Low Threat criteria described below Tierl - Low Threat Assessment Criteria Q My project does not meet any of the Significant or Moderate Threat criteria, is not an exempt permit type (See list above) and the project meets one or more of the following criteria • Results in some soil disturbance, and/or • Includes outdoor construction activities (such as roofing, saw cutting, equipment washing, material stockpiling, vehicle fueling, waste stockpiling) Tier 2 • Moderate Threat Assessment Criteria [~~| My project does not meet any of the Significant Threat assessment Criteria described below and meets one or more of the following criteria • Project requires a grading plan pursuant to the Carlsbad Grading Ordinance (Chapter 1516 of the Carlsbad Municipal Code), or, • Project will result in 2,500 square feet or more of soils disturbance including any associated construction staging, stockpiling, pavement removal, equipment storage, refueling and maintenance areas and project meets one or more of the additional following criteria • Located within 200 feet of an environmentally sensitive area or the Pacific Ocean, and/or • Disturbed area is located on a slope with a grade at or exceeding 5 horizontal to 1 vertical, and/or • Disturbed area is located along or within 30 feet of a storm dram inlet, an open drainage channel or watercourse, and/or • Construction will be initiated during the rainy season or will extend into the rainy season (Oct 1 through April 30) Tier 3 - Significant Threat Assessment Criteria \_] My project includes clearing, grading or other disturbances to the ground resulting in soil disturbance totaling one or more acres including any associated construction staging, equipment storage, stockpiling, pavement removal, refueling and maintenance areas and/or Q My project is part of a phased development plan that will cumulatively result in soil disturbance totaling one or more acres including any associated construction staging, equipment storage, refueling and maintenance areas or, LJ My project is located inside or within 200 feet of an environmentally sensitive area (see City ESA Proximity map) and has a significant potential for contributing pollutants to nearby receiving waters by way of storm water runoff or non-storm water discharge(s) / certify to the best of my knowledge that the above checked statements are true and correct I understand and acknowledge that even though this project does not require preparation of a construction SWPP, I must still adhere to, and at all times during construction activities for the permit type(s) check above comply with the storm water best management practices pursuant to Title 15 of the Carlsbad Municipal Code and to City Standards *The City Engineer may authorize minor variances from the Storm Water Threat Assessment Criteria in special circumstances where it can be shown that a lesser or highte Construction SWPPP Tier Level is warranted Project Address Assessor Parcel No Owner/Owner's Authorized Agent Name Owner/Owner's Authorized Agent Signature City Concurrence SElJES Q NO . Date Title Date Project ID I»] 3 ?008 11 i>$/No. 7535 P. 1 POLICYHOLDER COPY COMPENSATION I N SURANCB FUND PO, BOX 420807, SAN r"RANCISCO,CA 94142-0807- C6RTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE BATE O7 01-2008 CONTRACTORS STATf LICENSE BOARD WORKERS COMPENSATION UNIT PO BOX 28000 SACRAMENTO CA 9SH28-002B NF GROUP POLICY NUMBER 1607823-2008 CERTIFICATE ID. 70 CERTIFICATE EXPIRES. 07-01-2009 07-01-2008/07-01-2008 THIS CERTIFICATE SUPERSEDES AND CORRECTS CERTIFICATE » 2 PATED 07-01-2008 LIC PERMITS. 81ftU INCEPTION DATE:07-M-2008 DO-NF Tins is to certify ttut we have issued a valid Workers' Compensation Insurance policy In a term arjprov«d by the* California Imuianra Commissioner to the employer named Mow tar th« policy period indicated, This nollcy is not rubject to cancallstion fay th« Fund except upon 90 days advance wiitten nntu e to the employer ^A/e will at^o give you 30 duv-s advanea notice should Al« policy be cancelled prior to Us nori™1 axplratlon. This cartifientB nf insi-r«nc« is not an insurance policy and doeD not amend, extend or allsi- the :csver«ge by the paiiry h'ted hciein Notwlthitanding any requirement, wrm or condition of any contract or other document with respect to which itiis certificate of insurance may be issued or to which tt may pertain, the insurance afforded hy tho polky described nerain Is subject to all the terms, exclusions and conditions of such policy. P\W/YAfl>£_ Vyjg^/t*j/ N^UTHORIZeD REPRESHNTATIV&J PRESIDENT EMPLOYER'S I-TABILITY LIMIT INCLUDING DEFENSE COSTS' $1.000,000 PER OCCURRENCE. ENDORSEMENT 11800 TODOR KtTCHULKOV P S T - EXCLUDED ENDORSEMENT #2088 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 07-01-20fiS IS ATTACHED TO AND FORMS A PART OF THIS POLICY EMPLOYER CALIFORNIA DELTA MECHANICAL. BJU E BASELINE RB STE 1SS MtSA AZ 8B20S INC NF (REV 2 [CAM.CS] PRINTED 07-01-2008