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Home My WebLink About1709 BLACKBIRD CIR; ; CB102109; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 11-09-2010 Plumbing Permit Permit No: CB102109 Building Inspection Request Line (760) 602-2725 Job Address: 1709 BLACKBIRD CR CBAD Permit Type: PLUM Status: ISSUED Parcel No: 2156028100 Lot#: 0 Applied: 11/09/2010 Construction Type: NEW Entered By: KG Reference #: Plan Approved: 11/09/2010 PC#: Issued: 11/09/2010 Project Title: GARDNER RES REPLACE WTR HTR Inspect Area: Applicant: Owner: CALIFORNIA DELTA MECHANICAL GARDNER BRUCE S&JILL V SUITE #27 1709 BLACKBIRD CIR 12440 OAK KNOLL RD 92064 CARLSBAD CA 92011 866-898-0008 Plumbing Issue Fee $20.00 Fixture or Trap 0 $0.00 Building Sewer 0 $0.00 Roof Drain :*•• 0 $0.00 Install/Repair Water Line 0 $0:00 Water Heater and/or Vent 1 $f{00 Gas Piping System 0 $j}.00 Vacuum Breaker : 0 .§0.00 Other Plumbing Fees $0.00 Master Drainage Fee $0.00 Sewer Fee $0.00 Additional Fees ; •*, : $0.00 TOTAL PERMIT FEES ; v $27.00 Total Fees: $27.00 Total Payments To Date: $27.00 Balance Due: $0.00 4 FINAL APPROVAL V"*- Date: \\/l£/to/t> 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 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. City of Carlsbad 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718 / 2719 Fax: 760-602-8558 Building Permit Application Plan Est. Value Plan Ck. DepositmDate JOB ADDRESS 1709 Blackbird cir. SUITE#/SPACE#/UNIT# CT/PROJECT #PHASE # # OF UNITS # BEDROOMS # BATHROOMS I TENANT BUSINESS NAME CONSTR. TYPE I OCC. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) Replace existing like for alike water heater EXISTING USE P CONTACT NAME (If Different Fom Applicant) ADDRESS 6052 East CITY Mesa PHONE 480-898-0007 ROPOSED USE GARAGE (SF) California Delta Mechanical Baseline rd STATE AZ #155 ZIP 85206 FAX 1-480-218-5645 EMAIL california@deltamechanical.com PROPERTY OWNER NAME Bruce Gardner ADDRESS 1709 Blackbird cir. CITY Carlsbad PHONE 760-804-9881 EMAIL STATE ZIP CA 92011 FAX ARCH/DESIGNER NAME & ADDRESS STATE LIC. # PATIOS (SF)DECKS (SF) APPLICANT NAME ADDRESS CITY PHONE EMAIL FIREPLACE YES[~~|# N0[ | AIR CONDITIONING YESQNOQ FIRE SPRINKLERS YESQNO[^] Galina Pavlova 6052 E Baseline rd# 155 Mesa STATE 858-361-6495 FAX AZ ZIP 85206 1-858-410-1499 galiapavlovabg@yahoo.com CONTRACTOR BUS. NAME ADDRESS CITY PHONE California Delta Mechanical 6052 East Baseline rd # 155 Mesa STATE 480-898-0007 AZ ZIP 85206 FAX EMAIL STATE LIC.# 811114 CLASS c-36 CITY BUS. LIC.# 1214281 (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: I hereby affirm under penalty of perjury one of the following declaratbns: b£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. liJ 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. I*"823 Expiration Date ™ym 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 (&100,000), in addition to the cost of compensation, damages as provided for in Sectiort,37IUr ojfjtie^abor code, interest and attorney's fees. ^CONTRACTOR SIGNATURE M^/^C DATE //'/£? 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 contractor(s) 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 the proposed property improvement. I lYes I~~|NO 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 have 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): > ^PROPERTY OWNER SIGNATURE DATE s the applicant or fuMre building occupant required to submit a business clan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Lesley-Tanner Hazardous Substance Account Act? QYes llNo s 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 s the facility to be constructed within 1,000 feet of the outer boundary of a school site? Fives IJNo F ANY OF THE ANSWERS ARE YES,/ EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code), .ender's Name Lender's Address 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 Cilyordinances and State laws relatingto building construction. hereby authorize representative of the City of Carlsbad to enter upon the above mentioned properly for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD \GAINST 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 permit is required for excavations over 5'G" 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 ^APPLICANT'S SIGNATURE DATE City of Carlsbad Bldg Inspection Request For: 11/16/2010 Permit* CB102109 Title: GARDNER RES REPLACE WTR HTR Description: Sub Type: 1709 BLACKBIRD CR Lot: 0 Type: PLUM Job Address: Suite: Location: OWNER GARDNER BRUCE S&JILLV Owner: GARDNER BRUCE S&JILL V Remarks: AFTER 9AM Total Time: CD Description 25 Water Heater/Vents Comments Inspector Assignment: Phone: 7602075312 Inspector: Requested By: JILL Entered By: CHRISTINE Comments/Notices/Holds Associated PGRs/CVs/SWPPPs Original PC# Inspection History Date Description Act Insp Comments