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Home My WebLink About2622 LA COSTA AVE; ; CB131380; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 06-04-2013 Permit No: CB131380 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC#: 2622 LA COSTA AV CBAD PME 2162800400 Lot#: Status: 0 Applied: Entered By: Plan Approved: Issued: Inspect Area: Project Title: COLER RES= REPLACE WTR HTR Applicant: CALIFORNIA DELTA MECHANICAL STE 155 6056 E BASELINE RD MESA AZ 85206 480-898-0007 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES Owner: COLER SIEGLINDE P 2622 LA COSTA AVE CARLSBAD CA 92009 ISSUED 06/04/2013 LSM 06/04/2013 06/04/2013 $31.00 $0.00 $0.00 $64.00 $95.00 Total Fees: $95.00 Total Payments To Date: $95.00 Balance Due: 1 Inspector: 3 Clearance: $0.00 I 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 f x i n f whi h h v i I TICE imil r hi r hi h h imi i n h I h City of Carlsbad .. Plan Check No. (!B 1 ~ t '3 ~ • 1635 Faraday Ave., Carlsbad, CA 92008 ~--; Est. Value 760-602-2717 / 2718 / 2719 Fax: 760-602-8558 Plan Ck. Deposit .. Building Permit Application Date ~/ Lf1 13 I I JOB ADDRESS SUITE#/SPACE#/UNIT# IAPN i 2622 La Costa Ave . --- I CT/PROJECT# rOT# I PHASE# l#OFUNITS .!#BEDROOMS # BATHROOMS I TENANT BUSINESS NAME I CONSTR. TYPE I occ. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) Replace existing like for alike water heater EXlSTING USE I PROPOSED USE I GARAGE (SF) PATIOS (SF) I DECKS {SF) FIREPLACE IAIR CONDITIONING I FIRE SPRINKLERS v,so NO v,s □NoD v,s□NoO CONTACTNAME (lfDltferentFomAppllcant) C l'f , D Ii M h , I I APPLICANT NAME Galina Pavlova a I ornIa e a ec amca nc. 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 480-898-0007 IFAX 1-480-218-5645 858-361-6495 I FAX 858-240-6677 It.MAIL EMAIL california(@.deltamechanical.com galinap(@.deltamechanical.com PROPERTY OWNER NAIIIIE Sieglinde Coler CONTRACTOR BUS. NAME California Delta Mechanical Inc. ADDRESS ADDRESS 2622 La Costa Ave . 6056 E Baseline Rd 3 155 CITY STATE ZIP CITY STATE ZIP Carlsbad CA 92009 Mesa AZ 85206 PHONE I FAX PHONE IFAX 760-942-9779 480-898-0007 EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS I STATE UC.# STATE UC.# I CLASS I CITY BUS uc.1214281 811114 c-36 (Sec. 7031.5 Business and Professions Code: Any City or Coun_ty which requires a permit to. construct, alter, improve, demolish or repair any structure, pnor to its issuance, also requires the applicant for such per_mIt to file a s1~ned statement that he Is licensed pursuant to the provisions of the Contractor's License LawJChapter 9, comme_nding with Section 7000 of D1vis1on 3 of the Business 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 Declaration: I hereby affirm under penalty of perjury one of the following dedarations: [Z] I have and will maintain a certificate of consent to self-insure for mr1(ers' compensation as provided by Section 3700 of the Labor Code, for the performance of the wor1( for which this permit is issued 0 I have and will maintain workers' compensation, as required bv Section 3700 of the Labor Code, for the performance of the worlr. for which this permit is issued. My worlr.ers' compensaton insurance caITT:lr and policy number are: lnsura~ce Co Polk::y No 1697823 Expiration Date 0110112013 "P1iAsection need nol be completed if the 1)8rmit is for one hundred dollars ($100) or ,~ . ..s. l{J Certificate of Exemption: I certify that In the performance of the 'NIJrlr. for wl't,ch this permit is issued, I shall not empluy any per.;on in any rrianner so as to become subject to the Worlr.ers' 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 oi' compensation, damages as provided for in Section 3706 of h La or cod , interest and attorney's fees. / K! CONTRACTOR SIGNATURE 7 C /'/ I hereby affirm that I am exempt from Contractor's Ucense Law for the following reason □ □ □ I, as owner of 111e property or my employees with wages as their sole compensalkm, will do the wort( and the structure IS not intended or offered for sale (Sec. 7044, Business and Professions Code: The Contractor's Lieense 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. 11, however, the building or improvement is sold within one year of completion, the o'Mler-builder wW 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 who builds or improves thereon, and contracts for such projects with contractor(s) licensed pur.;uant to the Contractor's License Law). I am exempt under Section ____ .Business and Professions Code for this reason: 1. I personally plan to proVlde the major labor and materials for construction of the proposed property improvement. □Yes ONo 2. I (have/ have not) si;Jned an application for a building permit for the proposed work. 3. I have contracted with the followlng 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 foliowing person to coordinate, supervise and provide the major worlr. (include name I address/ phone I contractors' license number): 5. I will provide some of the worlr., but I have contracted (hired) the following persons to provide the wor'K indicated (include name/ address/ phone I type of worlr.): ~ PROPERTY OWNER SIGNATURE DATE ' ' Is the applicant or future building occupant required to submit a business a, acutely hazar!ous materials registration form 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? Oves D No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Oves LJNo 1 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 SERVl~ES AND THE AIR POLLUTION CONTROL DISTRICT. I certify that I haw read the application and state that the above lnfonnatlon Is correct and that the information on the plans is accurate. I agree to oomply with all Ci!¥ oldlnances and State :.iws relating to building construction. I hereby authorize representative of the City of Carlsboc! to enter up::m the atx:M3 mentioned property for ins~on purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL UABIUTIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY INANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: AA OSHA permit is required for excavatbns over 5'0' deep and demolition or constru:;tion of structures over 3 stories in height EXPIRATION: Every permit issued by the Building Official under the provisions of this Code shall expire by limltalion and become null and ',(lid iflhe building or work authorized by suet, permit is oot oommenced within 180 days from ~e date of Wch psm1I or I !he btli"ing or wo~ autholizro by st<h 2 is wspended or abandoned at any tin,, atte, ti'e WOO< is oomn,,nced ft" a peOJd of 100 days rn 100.4.4 Unloon Bui"ing Code). NfAPPLICANT'SSIGNATURE ~"LLf DATE 5/stJ/8 Inspection List Permit#: CB131380 Type: PME Date Inspection Item 06/20/2013 25 Water HeaterNents 06/20/2013 25 Water HeaterNents 06/20/2013 29 Final Plumbing 06/20/2013 29 Final Plumbing Inspector PY PY COLER RES= REPLACE WTR HTR Act Comments RI FIRST AM PLS AP RI AP Friday, June 21, 2013 Page 1 of 1