HomeMy WebLinkAbout2870 ENGLEWOOD WAY; ; CB121286; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Plumbing/Mechanical/Electrical (PME) Permit
07-09-2012 Permit No: CB121286
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
2870 ENGLEWOOD WY CBAD
PME Status:
Parcel No: 1674802018 Lot#: 0 Applied:
Reference #:
PC#:
Project Title: WALKER RES= REPLACE WTR HTR
Applicant:
CALIFORNIA DELTA MECHANICAL
SUITE# 27
12440 OAK KNOLL RD 92064
866-898-0008
Plumbing Fees
Electrical Fees
Mechanical Fees
Other PME Fees
TOTAL PERMIT FEES
Entered By:
Plan Approved:
Issued:
Inspect Area:
Owner:
WALKER FAMILY TRUST 05-02-89
4381 SHASTA PL
CARLSBAD CA 92010
ISSUED
07/09/2012
LSM
07/09/2012
07/09/2012
$30.00
$0.00
$0.00
$65.00
$95.00
Total Fees: $95.00 Total Payments To Date: $95.00 Balance Due:
Inspector:
FINAL APPROVAL
Date: IZ·//~12,: Clearance:
$0.00
NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reseivations, 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
· n f hi h h v vi I n i n N Tl E i ii r
CitY' of Carlsbad
1635 Faraday Ave., Carlsbad, CA 92008
760-602-2717 / 2718 / 2719
Fax: 760-602-8558
Building Permit Application
JOB ADDRESS 2870 Englewood Way
CT/PROJECT# LOT# PHASE# # OF UNITS
DESCRIPTION OF WORK: Include Square Feet of Affected Area(s)
Plan Check No. C.& l;;I., l ~
Est. Value
Plan Ck. Deposit
Date I q I "2.-
SUITE#/SPACE#/UNIT# APN
# BEDROOMS # BATHROOMS TENANT BUSINESS NAME I CONSTR. TYPE I occ GROUP
Replace existing like for alike water heater
EXISTING USE l PROPOSED USE -r GARAGE (SF) PATIOS (SF) l DECKS (SF) l FIREPLACE I AIR CONDITIONING I FIRE SPRINKLERS
YES(]# NoCJ YES0No0 vESONoD
CONTACT NAME (If Different Fom App/leant) California Delta Mechanical APPLICANT NAME Galina Pavlova
ADDRESS ADDRESS 6052 E. Baseline road suite# 155 6056 E.Baseline rd# 155 CITY STATE ZIP CITY STATE ZIP
Mesa AZ. 85206 Mesa AZ. 85206
PHONE PHONE
480-898-0007 I FAX 1-480-218-5645 858-361-6495 I FAX 1-858-240-6677
EMAIL EMAIL
california@deltamechanical.com galinap@deltamechanical.com
PROPERTY OWNER NAME Rd Walker CONTRACTOR BUS. NAME California Delta Mechanical
ADDRESS ADDRESS
2870 Enqlewood Wav 6056 East Baseline rd # 155
CITY STATE ZIP CITY STATE ZIP
Carlsbad Ca 92010 Mesa AZ. 85206
PHONE l FAX PHONE IFAX 760-729-6034 480-898-0007
EMAIL EMAIL
ARCH/DESIGNER NAME & ADDRESS l STATE LIC. # STATE LIC.# I CLASS ICllY BUS. LIC1214281 811114 c-36
(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 reqi,iires 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 D1v1s1on 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 fhe following declarations·
[Z] l 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 wnich this permit is issued.
0 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 Date-----··· 01101/201~ __ ··-·e
This section need not be completed if the permit is for one hundred dollars ($100) or less.
[Z] 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 compensation, damages as provided for In Section 370 of the lab cod , Interest and attorney's fees.
~ CONTRACTOR SIGNATURE
I hereby affirm fhat I am exempt from Contracto(s License Law for fhe following reason:
0
D
D
I, as owner of the property or my employees with wages as their sole 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 himse~ 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 impro~ement. 0Yes 0No
2. I (have I 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 I phone I 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 I address I phone I contractors· license number):
5. I will provide some of the worll, but I have contracted (hired) the following persons to provide the work indicated (include name I address I phone/ type of work):
~ PROPERTY OWNER SIGNATURE DATE
Ol!IIP'i ETI!, TIU S S 11~1'10 Ill l'OR 1110 l\l•R 11$1011111'.d!'AI'""ll '11 t IHI\IG 11'11 RM IT$ 0 Ill tY ~ j ~ ~ = '"
s the applicant or future building occupant required to submit a business~, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the
Jresley-Tanner Hazardous Substance Account Act? D Yes LJNo
s the applicant or future building occupant required to obtain a permit from the air pollution control district or a~ality management district? [Jves D No
s the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0Yes LJNo
F 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
:MERGENCY SERVICES ANO THE AIR POLLUTION CONTROL DISTRICT.
certify that I have read the application and state that the above information iscorrectand that the infonnatlon on the plans ls accurate. I agree to comply with all City ordinances and State laws relating to building construction.
hereby authorize representative of the City of Ca1SMI to enter upon the atxNe mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD
\GA INST All LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT,
)SHA: An OSHA pemil is required for excavations over 5'0' deep cr,d demolition or construction of structures wer 3 stories in height.
:XPIRATION: Evef)' permit issued by the Building Official under the provisions of this Code shall expire by !irritation cr,d become null ood void if the building or work authorized by such permit is not commenced within
80 days from the date of such pemit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced for a periOO of 180 days (Sec.'.ion 106.4.4 Uniform Building Code).
~APPLICANT'SSIGNATURE DATE i116 /;-..,.e
. .
Inspection List
Permit#: CB121286
Date Inspection Item
12/10/2012 29 Final Plumbing
12110/2012 29 Final Plumbing
Tuesday, December 11, 2012
Type: PME WALKER RES= REPLACE WTR HTR
Inspector Act Comments
RI PM PLS CALL 1 ST
PB AP
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