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Home My WebLink About175 MAPLE AVE; 09; CB142001; Permit08-14-2014 Job Address: Permit Type: Parcel No: Reference#: PC#: Project Title: Applicant: City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit Permit No: CB142001 Building Inspection Request Line (760) 602-2725 175 MAPLE AV CBAD St: 09 PME 20423321@1 Lot#: 0 oq KNIPSTEIN RES: REPLACE WATER HEATER, SAME LOCATION Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 08/12/2014 SKS 08/14/2014 08/14/2014 CALIFORNIA DEL TA MECHANICAL STE 155 KNIPSTEIN THOMAS W & NANCY J LIVING TRUST 09-26- UNIT 9 6056 E BASELINE RD MESA AZ 85206 480-898-0007/866-6925273 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES 175 MAPLE AVE CARLSBAD CA 92008-3232 $33.00 $0.00 $0.00 $62.00 $95.00 Total Fees: $95.00 Total Payments To Date: $95.00 Balance Due: Inspector: :52 Date: Clearance: $0.00 NOTICE: Please take NOTICE that approval of your project includes the "Imp ition" 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 ttiat procedure will bar any subsequent legal action to attack, review, set aside, void, or annul ttieir imposition. City of Carlsbad .. • Plan Check No. 1635 Faraday Ave., Carlsbad, CA 92008 M,f: Est. Value 760-602-2717 I 2718/ 2719 Fax: 760-602-8558 •H'1]1•" ~ Plan Ck. Deposit •• Building Permit Application r~ Date K} 12//J I JOB ADDRESS SUITE#/SPACE#/'t -ltPN ---175 Maple Ave. 9(..r w,--.r, CT/PROJECT# I LOT# I PHASE# l # OF UNITS I# BEDROOMS # BATHROOMS ENANT BUSINESS NAME I CONSTR me I occ csoul -DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) - Replace water heater like for alike. Same location EXISTING USE I PROPOSED USE I GARAGE (SF) PATIOS (SF) I DECKS (SF) FIREP!..ACE !AIR CONDITIONING l FIRE SPRINKLERS YES[), No0 YES □No □ YES□No□ CONTACTNAME (ffDHferentFomAppllcantJ C l'f . D I M h . I I a I orma e ta ec amca nc. APPLICANT NAME Galina Pavlova ADDRESS ADDRESS 6056 E Baseline Rd # 155 6056 E Baseline Rd # 155 --CITY STATE ZIP CITY STATE ZIP Mesa AZ. 85206 Mesa AZ. 85206 PHONE PHONE I FAX 7-FAX 480-898-0007 1-480-218-5645 858-361-6495 858-240-6677 EMAIL EMAIL california@ldeltamechanical.com galinap@ldeltamechanical.com PROPERTY OWNER NAME Tom Knipstein CONTRACTOR BUS. NAME California Delta Mechanical Inc. ----- ADDRESS ADDRESS 6056 E Baseline Rd-1,155 175 Maple Ave . CITY STATE ZIP CITY STATE llP Carlsbad CA 92008 Mesa AZ. 85206 PHONE I FAX PHONE I FAX 760-7 47-4868 480-898-0007 EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS -I STATE LIC. # STATE LIC.# I CLASS I CITY ,us. uc.1214281 811114 c-36 (Sec: 7031.5 Business and P_rofess1ons Code: Any City or County which requires a permit to_construct. alter, improve, demolish or repair any s'crl.,ctL.ri,, prior to its issuance, also requires the applicant for such per_mit to file a signed statement that he is licensed pursuant to the prov1s1ons of the Contractor's License LawJChapter 9. ccmmend1ng with Section 7000 of D1v1s1on 3 of the B_usiness and Professions Code} or fhat he is exempt therefrom, and the basis for the alleged exemption. Any v1olat1on of Section 031.:3 b:1 any ,,p~l:cant for c: permit subJects the applicant to a c1v1I penalty of not more than five hundred dollars {$500}). I Workers' Compensation Declaration: I hereby affirm under penally of perjury one of the following declarations [Z] I have and wi!I 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 [Z] I have and will maintain workers' compensation, as required bv Section 3700 of the Labor Code, for the performance of the work for which this permd is issui,d. My workers' compensation insurance canier and policy number are: Insurance Co Wesco Insurance company Policy No. C2SBBJ07 Expiration Date 06/02115 This section need not be completed if the permit is for one hundred dollars ($100) or less (Z] Certificate of Exemption: I certify that m the perfo!lTlance of the work for which !hi; 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 thou&and dollars (&100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor o , t st and attorney's fees. _ /. _,€S CONTRACTOR SIGNATURE TliA,,<..-'( J7 (5; / lf I hereby affirm that I am exempt from Contractor's License Law for the following rem;on: I, as O'Nller 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 Cootractor's License Law does not apply to an owner of property who builds or improves thereon, and who does sucli work himselt" 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 P1ofessions 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 improvement. Oves ONo 2. I (have I have not) signed an applicatkln 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. ! plan to provide portions of the WOl'k, but I have hired the following person to coordinate, supervise and provide the major work (include name I 11cldress I phone I contractors' license number): 5. I wHI provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (indude name I address I phone I fype of work): l_ ~PROPERTY OWNER SIGNATURE DATE COMPLtiTE",THIS SECTION FOR NON•REs'IDENTIAL BUILDING PERMITS ONLY Is the applicant or future building occupant ,equired to submrt a busines~, acutely hazardous materlals regis1ralion fonn or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? D Yes LJNo Is the applicant or future building occupant required to obtain a permit from the air pollution control district or a~ality management district? Des O Ne, ls the factlity to be constructed within 1,000 feet of the outer boundary of a school site? 0Yes LJNo IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REC:UIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. I certify that I have read the application and state that the above infonnation iscorrectandthatthe information on the plans is accurate. I agree to comply'Mth all Cityon:lir.an:::.esand State laws relating to building construction. I hereby authorize representative oflhe City of Carlsbad to enter upon the above mentiooed property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY ANO KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA pem,it is required for excavations over 5'0' deep aid demolitioo or construction of structures over 3 stories in height EXPIRATION: Every pennlt issued by the Building Official under the provisions of this Code shall expire by limitation and become null aid void if the building or w::irk authorized by such pennit is not commenced within 180 days from the date of such pemit or if the b.Jilding or work authorized by such pennit is suspended or abandoned at anytime after the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). _g APPLICANT'S SIGNATURE DATE J' Is/; t'.( Inspection List Permit#: CB142001 Type: PME Date Inspection Item 09/08/2014 25 Water HeaterNents 09/08/2014 25 Water HeaterNents 09/08/2014 29 Final Plumbing 09/08/2014 29 Final Plumbing Tuesday, September 09, 2014 Inspector SP SP Act RI AP RI Fl KNIPSTEIN RES: REPLACE WATER HEATER, SAME LOCATION Comments KNIPSTEIN RES, CALL WETA Page 1 of 1