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Home My WebLink About2873 SEGOVIA WAY; ; CB151957; Permit• City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 06-24-2015 Permit No: CB151957 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC#: 2873 SEGOVIA WY CBAD PME 2552804100 Status: Lot#: 0 Applied: Entered By: Plan Approved: Issued: Inspect Area: Project Title: TWARDOWSKI RES: REPLACE 75 GAL WATER HEATER Applicant: CALIFORNIA DELTA MECHANICAL STE 155 6056 E BASELINE RD MESA AZ. 85206 480-898-0007/866-6925273 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES Owner: KOLE VERA A 2007 TRUST 11-08-07 2873 SEGOVIA WAY CARLSBAD CA 92009 ISSUED 06/24/2015 SLE 06/24/2015 06/24/2015 $35.00 $0.00 $0.00 $60.00 $95.00 Total Fees: $95.00 Total Payments To Date: $95.00 Balance Due: Inspector: FINAL t PPR OVAL Date: /i · Zo · IS: Clearance: $0.00 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. lf 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 lo 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 f ~ THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: □PLANNING 0 ENGINEERING 0 BUILDING □FIRE □HEALTH 0 HAZMATIAPCD {'city of Building Permit Application Plan Check No. c_.e, \""'-I . IC\':) 7- 1635 Faraday Ave., Carlsbad, CA 92008 Est. Value Carlsbad Ph: 760-602-2719 Fax: 760-602-8558 Plan Ck. Deposit email: building@carlsbadca.gov www.carlsbadca.gov Date \.0-2~·\S' iswPPP JOB ADDRESS 2873 SEGOVIA WAY SUlIEf/SPACEf/UNITf IAPN --- CT/PROJECT# I LOT# I PHASE# I# OF UNITS I# BEDROOMS # BATHROOMS I TENANT BUSINESS NAME ICONSTR. TYPE I occ. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) Replace 75 Gallon gas water heater EXISTING USE I PROPOSED USE I GARAGE {SF) PATIOS (SF) I DECKS (SF) FIREPLACE !AIR CONDITIONING' I FIRE SPRINKLERS YESO "'° YES □No □ YES□No□ APPLICANT NAME Aaron Franz PROPERTY OWNER NAME JOHN TWARDOWSKI Pffll, ... Contllct ADDRESS ADDRESS 6056 E Baseline Rd Mesa Az 85206 2873 SEGOVIA WAY CITY STATE ZIP CITY STATE ZIP Mesa AZ 85206 Carlsbad CA 92009 PHONE I) FAX PHONE I FAX 866-692-5273 Ext 208:; 866-692-5275 905-718-2429 EMAIL EMAIL Capermits@deltamechanical.com DESIGN PROFESSIONAL CONTRACTOR BUS. NAME California Delta Mechanical ADDRESS ADDRESS 6056 E Baseline Rd #155 CITY STATE ZIP CITY STATE ZIP Mesa AZ 85206 PHONE rAX PHONE IFAX 866-692-5273 866-692-5275 EMAIL EMAIL Capermits@deltamechanical.com I STATE LIC. # STATE UC.# l'LA5c:36 I CllY BUS. "'·; 21481 811114 {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 JChapter 9, commending with Section 70_00 of Division 3 of the B_usmess and Professions Code} or that he Is exempt therefrom, and the basis for the alleged exemption. Any vIolatIon of Section 031.5 by any applicant for a permit subJects the applicant to a civil penalty of not more than five hundred dollars ($500}). WORKERS' COMPENSATION 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 WJrkers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 0 I have and will maintain workers' compensation, as reQllired 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 Twin City Fire Policy No. 34WEQI0120 Expiration Date 4121116 ~section need not be completed if the permit is for one hundred dollars ($100) or less. LJ Certificate of Exemption: I certify that in the perfonnance 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, dans as_provid~ for In S on 3706 of the Labor code, Interest and attorney's fees. ~ CONTRACTOR SIGNATURE ~ 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 saK! (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 wt,o 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 prop:>sed property improvement. 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/ phone/ contractors' license number) 4. I plan to provide portions of the wof'K, but I have hired the following person to coordinate, supervise and provide the major work (include name /address/ phOne I 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 I address/ phone I type of work): ,6$ PROPERTY OWNER SIGNATURE □AGENT DATE I ' . Inspection List Permit#: CB151957 Type: PME Date lnspection_ltem 1112012015 25 Water HeaterNents 1112012015 25 Water HeaterNents 11 /2012015 29 Final Plumbing 11120/2015 29 Final Plumbing 1111212015 25 Water HeaterNents 11112/2015 25 Water HeaterNents 11/12/2015 29 Final Plumbing Friday, November 20, 2015 Inspector PD PD PD Act RI AP RI AP RI co RI TWARDOWSKI RES: REPLACE 75 GAL WATER HEATER Comments AM PLEASE No access AM PLEASE Page 1 of 1