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Home My WebLink About2808 CARRILLO WAY; ; CB090099; Permit01-20-2009 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing Permit Permit No: CB090099 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: 2808 CARRILLO WY CBAD PLUM 2226621700 Lot#: Construction Type: KLEINMAN RES REPLACE WTR HTR 0 NEW Status: ISSUED Applied: 01/20/2009 Entered By: KG Plan Approved: 01/20/2009 Issued: 01/20/2009 Inspect Area: Applicant: CALIFORNIA DELTA MECHANICAL SUITE #27 12440 OAK KNOLL RD 92064 866-898-0008 Owner: KLEINMAN FAMILY TRUST 06-16-05 2808 CARRILLO WAY 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 Inspector:5 FINAL APPROVAL Date: "?-- 1 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 fees/exactions. If you protest them, you mist 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 JOB ADDRESS CT/PROJECT # 2808 Cqrrilo way PHASE # # OF UNITS * BEDROOMS DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) SUITE#/SPACE#/UNIT# # BATHROOMS I TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP replace existing like for alike water heater EXISTING USE PROPOSEDUSE GARAGE (SF) CONTACT NAME (If Different Fom Applicant) _ ... . _ ., .. , . . .California Delta Mechanical, Inc. ADDRESS 6052 e. Base CITY Mesa PHONE 480-898-0007 ine road suite #155 STATE ZIP Az 85206 FAX 1-480-218-5645 EMAIL california@deltamechanical.com PROPERTY OWNER NAME Paul Kleinman ADDRESS Same as site CITY Carlsbad PHONE 858-759-7303 STATE ZIP CA 92009 FAX EMAIL ARCH/DESIGNER NAME & ADDRESS STATE LIC. » PATIOS (SF)DECKS (SF) FIREPLACE AIR CONDITIONING YES | |# NO| [ YES | [NO | | FIRE SPRINKLERS YES | [NO| | APPLICANT NAME _ .. _ .Galma Pavlova ADDRESS CITY PHONE EMAIL 6052 E. Baseline road suite # 1 55 STATE ZIP Mesa Az 85206 FAX 480-898-0007 1-858-410-1499 galiapavlovab.g@yahoo.com CONTRACTOR BUS. NAME , .California Delta Mechanical, Inc. ADDRESS CITY PHONE 6052 E Baseline rd # 155 STATE ZIP MESA Az FAX 480-898-0007 85206 EMAIL STATE LIC.ff CLASS CITY BUS. LIC.# 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 requires theapplicant 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 theBusiness 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 acivil penalty of not more than five hundred dollars ($500)). Workers' Compensation Declaration: / hereby affirm under penalty of perjury one of the following declarations: L£j 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. LLJ 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 "a™1 This section need not be completed if the permit is for one hundred dollars ($100) or less. I/I Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (8,100,000), in addition to the cost of compensation, damages as provided for in SectionJ706 of the Labor code, interest and attorney's fees. £$ CONTRACTOR SIGNATURE n Section,?v/f^L/\ I hereby affirm that I am exempt from Contractor's License Law for the following reason: | | 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 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 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 contractors) licensed pursuant to the Contractor's License Law). I am exempt under Section Business and Professions Code for this reason: 1.1 personally plan to provide the major labor and materials for construction of (tie proposed property improvement. I |Yes |~~lNo 2.1 (have / have not) signed an application for a building permit for the proposed work. 3.1 have contracted with the following person (firm) to provide the proposed construction (include name address / phone / contractors' license number): 4.1 plan to provide portions of the work, but I nave hired the following person to coordinate, supervise and provide the major work (include name / address / phone / contractors' license number): 5.1 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): y£TpROPERTY OWNER SIGNATURE DATE Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? | |Yes I iNo Is the applicant or future building occupant required to obtain a permit from the air pollution control district or airjjuality management district? I lYes I I No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Hires 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). Lender's Name Lender's Address 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 stories in height. EXPI RATION: 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 commem w) 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 Unfiorm Building Code). ^APPLICANT'S SIGNATURE S/ S/LX DATE Storm Water Compliance Exemption Form I am applying to the City of Carlsbad for the following type(s) of construction permit: D Building Permit d Right-of-Way Permit QlVly project is categorically EXEMPT from the requirement 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 Sprinkler Water Discharge Project Storm Water Threat Assessment Criteria* Wo Threat Assessment Criteria I | 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 | | 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 15.16 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 drain 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). TierS - Significant Threat Assessment Criteria I I 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 I | 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, I I 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: Citvptfficurrence: JflYES Q NO f Title: City of Carlsbad Bldg Inspection Request For: 07/06/2009 Permit* CB090099 Title: KLEINMAN RES REPLACE WTR HTR Description: Inspector Assignment: TP 2808 CARRILLO WY Lot: 0 Type: PLUM Sub Type: Job Address: Suite: Location: OWNER KLEINMAN FAMILY TRUST 06-16-05 Owner: KLEINMAN FAMILY TRUST 06-16-05 Remark^^PteASE PM Total Time: CD Description 25 Water Heater/Vents 29 Final Plumbing Act ^Comments ft? I Phone: 8582457162 Inspector: Requested By: PAUL Entered By: JANEAN Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description Act Insp Comments 01/27/2009 25 Water Heater/Vents NR TP NO RESPONSE Jul. 3. 2000 i!:08/No. 753b POLICYHOLDER COPY P.O. BOX 420807, SAN FRANC1SCO.CA 94142-0807 F»LJND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE COMPENSATIONI N SURANCfi ISSUE DATE; O7-01-900B CONTRACTORS STATE LICENSE BOARD WORKERS COMPILATION UNIT PO BOX 90000 SACRAMENTO CA 95036-0028 NF GROUP: POLICY NUMBER: 1607823-2008 CERTIFICATE IP; 70 CERTIFICATE EXPIRES: 07-01-2008o? -o 1 -2008/07-01 -aoo« THIS CERTIFICATE SUPERSEDES AND CORRECTS CERTIFICATE # 2 DATED 07-01-2008 LIC PERMIT*; 011114 INCEPTION DATC:07~ci-200* DO:NF NF [his h to certify that w« have issued « valid Workers' Compensation Insurance policy In a fprm acprovad by theuutfnrni* lnsur*iwf> Commissioner to the employer named below for the policy period indicated, This policy in not subject to cancellation ijy tha Fund axcppt upon 30 days advance written notice <o the employer, Wo will also give you 30 days advance notie* should this: policy 0« cancelled prior to its normal expiration. rws ssrti|i<s/rtB of insurance is not an insurance policy and does not amend, extend or *H» the 3ov*r»g* afforded wrth mS?Br7fnS^hiilhl'S1'1' N0^1,*11^"*"? *"y requirement, term or condition of any contract or oth«r documenty^r* HPhC , h,fih 'i115 cartifteat« of Insurance may be issuecf or to which it may pertain, the Insurantartorciea hy thn policy described Herein Is subject to ail the terms, exclusions, and condition*, of such policy. VfCy^JV <^ULv^>Lx' PRESIDENT it ABILITY LIMIT INCLUDING DEFENSE COSTS-- $1,000,000 PER OCCURRENCE. ENDORSEMENT jH806 - TODQR KITCHULKOV P S T - EXCLUDED. A™ WOeB ENT1Tt-BD CERTIFICATE HOLDERS' NOTICE EFFECTIVE 07-01-20rtS IS• ATTACHED Tfl AND FORMS A PART OF THIS POLICE. FMPl.OYEq CALIFORNIA DELTA MECHANICAL, INC BOSS E BASELINE RD STF 1B5 MESA AZ 88208 NF [CAM.CS] PRINTER . 07-01-2008