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Home My WebLink About2875 SANFORD LN; ; CB100883; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 05-19-2010 Plumbing Permit Permit No: CB100883 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: Applicant: Building Inspection Request Line (760) 602-2725 2875 SANFORD LN CBAD PLUM 1674724200 Lot#: 0 Construction Type: NEW BENICKY RES-REPLACE WTR HTR Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 05/19/2010 LSM 05/19/2010 05/19/2010 CALIFORNIA DELTA MECHANICAL BRIGHT LEE A FAMILY TRUST 01-22-98 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 Total Fees: Inspector: $27.00 1 KORITE RANCHO SANTA MARGARITA CA 92688 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 $27.00 Total Payments To Date: $27. 00 Balance Due: FINAL APPROV L D Date: l-~ 1,.,0 I Clearance $0.00 NOTICE: Please take NOTICE that a proval of your project includes the 'Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as 'fees/exactions." You h ve 90 days from the date this pennit 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, zonirg, graditig or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any f ired. City of Carlsbad .. ~,ovc;rs-3 • Plan Check No. ~-; 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value 760-602-2717 / 2718/ 2719 Fax: 760-602-8558 ., .. ,, .... Plan Ck. Deposit .. Building Permit Application Date SI tC\ { IU LJ::.)~ ,, .. - JOB ADDRESS SUITE#/SPACE# /UNIT# !'"" 2875 Sanford Ln. --- CT/PROJECT# I LOT# I PHASE# I# OF UNITS I# BEDROOMS # BATHROOMS I TENANT BUSINESS NAME 1 CONSTR. TYP~ locc. GROUP ---DESCRIPTION OF WORK: Include Square Feet of Affected Atea(S) -----·-- Replace existing like for alike water heater EXISTING USE I PROPOSED USE !GARAGE (SF) PATIOS (SF) I DECKS (SF) ,,FIREPLACE rR CONDITIONING i I FIRE SPRINKLERS YES[], N<O vcsONoD vcsONoD CONTACT NAME (ff Different Fom AppllcantJ California Delta Mechanical APPLICANT NAME Galina Pavlova ADDRESS ADDRESS 6052 East Baseline rd # 155 6052 E. Baseline road suite# 155 ---CllY STATE ZIP CITY STATE ZIP Mesa AZ 85206 Mesa AZ 85206 PHONE PHONE 480-898-0007 !FAX 1-480-218-5645 858-361-6495 I FAX 1-858-410-1499 EMAIL EMAIL california@.deltamechanical.com 9aliapavlovab9@.yahoo.com PROPERTY OWNER NAME Lee Anne Benicky CONTRACTOR BUS. NAME ADDRESS ----California Delta Mechanical -----ADDRESS Same as site 6052 East Baseline rd # 155 CITY STATE ZIP CITY STATE ZIP Carlsbad CA 92010 Mesa AZ 85206 PHONE I FAX PHONE I FAX 949-456-5187 480-898-0007 1-480-218-5645 EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS I STATE LIC. # STATE UC.# 'CLASS lcirrsus uc.1214281 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 the applicant for such per_mit 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 fuat he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 1031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars {$500)). Workera' Compensation Declaration: / hereby affirm under penalty of petjury one of the following dedarations: [Z] I have and WIii maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the pertormance of the work for which ltlis permit is issued. [Z] I have and will maintain workers' compensation, as reciuired bv 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 07101110 ~secijon need not be comp~ted if the permit is for one hundred dollars ($100) or klss Lll 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 lawful, 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 of the Labor code, interest and attorney's fees. -/ 2S CONTRACTOR SIGNATURE 1/6 // 0 I herefy affirm lhat I am exempt from Contractor's Ucense Law for the following reason: 1 1 0 I, as owner of the property or my employees with wages_ as their sole compensat_ ion, will do the work and the structure is not intend_ed 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 orie year of completion, the owner-buiider will have the burden of proving that he did not build or iITl)rove for the purpose of sale). 0 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 Ymo builds or improves thereon, arrd contracts for such projects with contractor(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 improvemenl 0Yes Oo 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 followir.g person lo coordinate, supervise and provide the majOr mrk (include name I address I phone/ contractors' license number)· 5. I will provide some of the work, but I have contracted (hired) the follOWing persons lo provide the work indicated (include name/ address I phone/ type of work): ! ..@S" PROPERTY OWNER SIGNATURE -------------- DATE I certify that I have reed the application and sta\11 that the above infonnation Is conect and that the information on the i>lans is accurate. I agree to comply with all City oldinances and State laws relating to building construction. I hereby authorize representative of the City of Cartsba'.l to enterup::in the aoove menlloned propertyfct ins~ pur!X)ses. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP 1-1.A.RMLfSS THE CITY OF CARLSMD A GA.INST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN Atff WAY ACCRUE AGAINST SA\D CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSI-I.A. perm! ~ requil'OO fC1 excavati:lns OV8f 5'0' deep and demoitK:ln or construclx'.ln of structums over 3 stories in height. EXPlRA TION: E~ pemiit issued by the Building Ofooal under the pro,,isions of this Code shalt expire by linitation and become null and \00 It the building or work authorized by such permit is rot commerce:! within 65 APPLICANT'S SIGNATURE DATE 6 /4 _µ i:) 180days frcrTI the date of sud1 penm cr It the building crwork authoo~zed by such permi · nded or abandoned at anytill'B after the work is oorrmenced for a ~riod of 100 days (SEdion 100.4.4 Uniform Building Code). ------------------,c,--~------------------------------------------___ J ~ .. ·~ CITY OF CARLSBAD PERMIT#: \C>o Q &~ 1.,i16' UNSCHEDULED BUILDING INSPECTION B-44 Development Services Building Division 1635 Faraday Avenue Carlsbad CA 92008 760-602-2700 INSPECTOR: _____ _ CONTACT: -~-=Q(!\=-'-.__ __ _ PHONE #: ::i, qi') -~;;t \-~ 1,8,. JOB ADDRESS: ----J....,~◊=&..,,s:::~S:~oa-~~ r,...u:,._.l'""'-'Y~cr,,""'-c,--------- DESCRIPTION: __ ..,._ .. ___ ~ ___ \) __ ~_-_""_. _______ _ CODE ~.s;:: Bldg Inspection Form DESCRIPTION \.; )q:j:-g;, \.l.qa::Rn;;> Page 1 of 1 ACT ~ COM~ r Rev. 06/09