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Home My WebLink About1766 BLACKBIRD CIR; ; CB060041; Permit01-10-2006 City of Carlsbad 1635 Faraday Av Carlsbad, C A 92008 Plumbing Permit Permit No: CB060041 Building Inspection Request Line (760) 602-2725 c/ Job Address: Permit Type: Parcel No: Reference #: Project Title: 1766 BLACKBIRD CR CBAD PLUM 2156020600 Lot#: 0 Construction Type: NEW BELLOFF RES- REPLACE WATER HTR Status: ISSUED Applied: 01/05/2006 Entered By: LSM Plan Approved: 01/05/2006 Issued: 01/05/2006 Inspect Area: Applicant: CALIFORNIA DELTA MECHANICAL SUITE # 27 12440 OAK KNOLL RD 92064 866-898-0008 Owner: BELLOFF RICHARD F&BOSTWICK PEMELA R TRS 1766 BLACKBIRD CIR CARLSBAD CA 92011 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 $20.00 $0.00 $0.00 $0.00 $7.00 $0.00 $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: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 previousJv been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise exDirecL PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 FOR OFFICE USE ONLY PLAN CHECK NO. EST. VAL. Plan Ck. Deposit _ Validated By Date 1 1766 BLACKBIRD CIRCLE CARLSBAD, CA 92009 Address (indude Bldg/Suitetf) Legal Description Lot No. Assessor's Parcel # Replace standard water heater like for like Description of Work Business Name (at this address) Subdivision Name/Number Unit No. Existing Use SQ. FT- # of Stories Phase No. Proposed Use # of Bedrooms Total # of units # of Bathrooms California Delta mechanical, Inc. 2500 s. Power Rd. Suite #120 Mesa AZ 85209 (480) 898-0007 (480) 898-0005 Name Address City State/Zip Telephone #Fax# ROMEL 2500 S. POWER RD #120 MESA AZ 85209 480-898-0007 Name Address City State/Zip Telephone # RICHARD AND PAM BELLOFF 1766 BLACKBIRD CIRCLE CARLSBAD. CA 92009 760-431-7327 Name Address City State/Zip Telephone # (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 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 the Business and Professions Code] or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 70315 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500]). California Delta Mechanical, Inc. 2500 S. Power Rd. Suite # 120 Mesa 852Q9 (480) 898-0007 Name Address City State/Zip Telephone # State License # 811114 LicenseClass C-36 Citv Business License # 1214281 Designer Name Address State License # City State/Zip Telephone # 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 serf-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. [HI I have and will maintain worker's compensation, as required by Section 3700 of the labor Code, for the performance of the work for which this permit is issued. My worker's compensation insurance carrier and policy number are: Insurance Company State Compensation Insurance Fund Policy No. J697823 Expiration Date j)7/0_l_/Q6 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) D CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars($ 100,000), In addition to the cost of compensation, damages are provided for In Section 3706 of the Labor Code, interest and attorney's fees. SIGNATURE Romel Maru DATE 12/26/05 I hereby affirm that I am exempt from the Contractor's License Law for the following reason: D I, as owner of the property or my employees with wages as their sole compensation, will d 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). D 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). 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 improvement. D YES D NO 2. I (have/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 (indude name / address / phone number / contractors license number): 4. I 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 number/ /ontractors 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 / address / phone number / type of work): PROPERTY OWNER SIGNATURE DATE WHITE: File YELLOW: Applicant PINK: Finance PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 Page 2 of 2 Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration for or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? D YES D NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? D YES D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES D NO 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 REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(1) Civil Code). LENDER'S NAME LENDER'S ADDRESS I 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 City ordinances and State laws relating to building construction. I hereby authorize representatives of the City of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGEMENTS, COSTS AND OSHA: An OSHA permit is required for excavations of 5'0" 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 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 Uniform Building Code). APPLICANTS SIGNATURE DATE.12/26/05 WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For 02/02/2006 Permit* CB060041 Inspector Assignment: Title: BELLOFF RES- REPLACE WATER HTR Description: Type: PLUM Sub Type: Phone: 7605227327 Job Address: 1766 BLACKBIRD CR Suite: Lot 0 fif Location: Inspector: |C ^ APPLICANT CALIFORNIA DELTA MECHANICAL Owner: BELLOFF RICHARD F&BOSTWICK PEMELA R TRS Remarks: Total Time: Requested By: RICHARD Entered By: JANEAN CD Description Act A Comment 25 Water Heater/Vents 29 Final Plumbing Comments/Notices/Hold Associated PCRs/CVs Original PC# Inspection History Date Description Act Insp Comments License Detail Page 1 of2 California. Home .Welcome to Thursday, Janu License Detail Contractor License #811114 CALIFORNIA CONTRACTORS STATE LICEN DISCLAIMER A license status check provides information taken from the CSLB license data base. Before on this information, you should be aware of the following limitations: • CSLB complaint disclosure is restricted by law (B&P 71.24-6). If this entity is subject tc complaint disclosure, a link for complaint disclosure will appear below. Click on the lin button to obtain complaint and/or legal action information. • Per B&P.707.1.17, only construction related civil judgments reported to the CSLB are disclosed. • Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration. • Due to workload, there may be relevant information that has not yet been entered ont Board's license data base. A A A Extract Date: 01/05/2006 Business Information * * * CALIFORNIA DELTA MECHANICAL INC 2500 S POWER ROAD #120 MESA, AZ 85208 Business Phone Number: (480) 898-0007 Entity: Corporation Issue Date: 08/01/2002 Expire Date: 08/31/2006 * * * License Status * * * This license is current and active. All information below should be reviewed. A A A Classifications * A Class Description C36 PLUMBING * * ABonding Information A A A CONTRACTOR'S BOND: This license filed Contractor's Bond number 6060003 in the arr $10,000 with the bonding company http://www2.cslb.ca.gov/CSLB_LIBRARY/License+Detail.asp 01/05/2006 License Detail Page 2 of2 SURETY COMPANY OF THE PACIFIC. Effective Date: 03/25/2004 Contractor's Bonding History BOND OF QUALIFYING INDIVIDUAL(I): This license filed Bond of Qualifying Individual i 161627 for ANTON DIMITROV TCHAKAROV in the amount of $7,500 with the bonding cc AMERICAN CONTRACTORS INDEMNITY COMPANY. Effective Date: 07/10/2002 * * *Workers Compensation Information * * * This license has workers compensation insurance with the STATE COMPENSATION INSURANCE FUND Policy Number: 1697823 Effective Date: 07/01/2002 Expire Date: 07/01/2006 Personnel List • License Number Request • Contractor Name Request •Personnel Name Request ISalesperson Request • Salesperson Name Request 2005 Slate of California. Cpndjtipns of Use Privacy Policy http://www2.cs!b.ca.gov/CSLB_LIBRARY/License+Detail.asp 01/05/2006