HomeMy WebLinkAbout2866 AVENIDA CEREZA; ; CB071321; Permit05-11-2007
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Plumbing Permit Permit No CB071321
Building Inspection Request Line (760) 602-2725
Job Address
Permit Type
Parcel No
Reference #
Project Title
2866 AVENIDA CEREZA CBAD
PLUM
2552824300 Lot # 0
Construction Type NEW
RICE RES-REPLACE WTR HTR
Status
Applied
Entered By
Plan Approved
Issued
Inspect Area
ISSUED
05/11/2007
LSM
05/11/2007
05/11/2007
Applicant
CALIFORNIA DELTA MECHANICAL
SUITE # 27
12440 OAK KNOLL RD 92064
866-898-0008
Owner
RICE FAMILY TRUST 07-19-96
2866 AVENIDA CEREZA
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 03 Balance Due $000
Inspector 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 Ihese 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 '""''
2866 Avcnida Cereza
FOR OFFICE USE ONLY
PLAN CHECK NO £& O") \
EST VAL
Plan Ck Deposit.
Validated By
Date
Address (include Bldg/Suite #)
Legal Description Lot No
Assessor's Parcel #
Replace standard water heater like for like
Description of Work
Business Name (at this address)
Subdivision Name/Number Unit No
Existing Use
SQ FT # of Stories
Phase No
Proposed Use
# of Bedrooms
Total # of units
# of Bathrooms
California Delta mechanical. Inc 2500 S Power Rd Suite #120 Mesa
Name Address City
j3 APPLICANT 0 Contractor D Agent for Contractor D Owner
Galma Pavlova 2500 S POWER RD # 120 MESA
Name Address
'4.- PROPERTY OWNER" , ''•— ??!li
Charles Rice 2866 Avenida Ccrcza
Name Address
5. CONTRACXOJif- CbMPANY;NAME
City
lis^-,*,, ., • ' " '
Carlsbad
City
AZ 85209 (480) 898-0007 (480) 898-0005
State/Zip Telephone* Fax#
''•'•-•:-,'is.:. •• ••••-•'«- !Q Agent for Owner •• 'SilfS!;?"''' .A-- S" :i'
"" AZ 85209 480-898-0007
State/Zip
CA 92009
State/Zip
Telephone #
760-944-8972
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 provision > 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 [S500])
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'"- •>$&?• '•". .j$ .,„
:&•... • •!••&£....,... . v....-v. • -.^fix '. : -^.' ;;,?$
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
El 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)
O 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 compensatipn^Mmdges are provided form Section 3706 of the Laboi Code, interest and attorney's fees
SIGNATURE Galma Pavlova jt^^Z. DATE 5/8/07
7^g - OWNER-BUILDER DECLARATION'
I hereby affirm that I am exempt from the Contracto>sTicense 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 howsver 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 Scile)
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 Contractors
License Law)
D I am exempt under Section Business and Professions Code for this reason
1
2
3
I personally plan to provide the major labor and materials for construction of the proposed property improvement D YES D NO
I (have/have not) signed an application for a building permit for the proposed work
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
COMPLETE THIS SECTION FOR WOW-RESraeNTMiggUILDING PERMITS ONLY "^ ''^. ^ :J|H '':I%> ::|
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 D NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district9 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 ''W- •';''• '' "f* ^ '"*'
• 'iJ&W,;.1:.- • i ••.'. • • ••:• ••'••$.* • :*X
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)
LENDERS NAME _ LENDER S ADDRESS
9 APPLICANT CERTIFICATION "'"J^SaL.- .?HiliI;L '"''VK.,.,, ::Jki:. "3S*1I liiS- lift ' •. ii
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 authorised by such permit is suspended or abandoned at any time after
the work is commenced for a period of 180 days (Section 10644 Uniform Building Code)
APPLICANT S SIGNATURE GallM Pavlova J%0£'T DATE 5/8/07
WHITE File YELLOW Applicant PINK France
City of Carlsbad Bldg Inspection Request
For 04/29/2008
Perrvttf CB071321
Ti!:e RICE RES-REPLACE WTR HTR
Descnotion
Inspector Assignment
2866 AVENIDA CEREZA
Lot 0
"lype PLUM Sub Typo
Jen Address
Suite-
Location
OWNER RICE FAMILY TRUST 07-19-96
Owner RICE FAMILY TRUST 07-19-96
Remarks FIRST AM PLEASE
Phone 7608225131
Inspector
CD Descr;pt:on
25 Water Heater/Vents
29 Final Plumbing
Comments
Requested 3y CHARLES
Entered 3y JANEAN
Comments/Not'ces/Holds
JS'.C
Associated P_CRs_/C Vs O rig i n a I P C#
Inspection History
Descr:c!ion Act !nsp Comments
PQJJCWOUDER COPY
STATE PO BOX 420607, SAN FRAIMCISCOCA 94142-0807
CGRTIFICATS OP WORKERS' COMPENSATION INSURANT
»MR CM 01 -won P^ICY NUMBER
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