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Home My WebLink About2630 LEWIS LN; ; CB112099; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/Electrical (PME) Permit 09-29-2011 Permit No: CB112099 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference #: PC#: 2630 LEWIS LN CBAD PME 1552722100 Status: Lot#: 0 Applied: Entered By: Plan Approved: Issued: Project Title: WILLIAMS RES-REPLACE WTR HTR Inspect Area: Applicant: CALIFORNIA DEL TA MECHANICAL SUITE# 27 12440 OAK KNOLL RD 92064 866-898-0008 Plumbing Fees Electrical Fees Mechanical Fees Other PME Fees TOTAL PERMIT FEES Owner: WILLIAMS JOSHUA A&VERONICA C 2630 LEWIS LN CARLSBAD CA 92008 ISSUED 09/29/2011 LSM 09/29/2011 09/29/2011 $150.00 $0.00 $0.00 $0.00 $150.00 Total Fees: $150.00 Total Payments To Date: $150.00 Balance Due: Inspector: FINAL APPROVAL Date /0 · f'J · I( 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. 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. City of Carlsbad 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718/ 2719 Fax: 760-602-8558 Building Permit Application JOB ADDRESS 2630 Lewis Ln ,, ' Plan Check No. ~ f I ,.;).f)q Est. Value Plan Ck. Deposit Date q SUITE#/SPACE#/UNIT# APN -CT/PROJECT# LOT# PHASE# # OF UNITS # BEDROOMS TENANT BUSINESS NAME CONSTR. TYPE DCC. GROUP DESCRIPTION OF WORK:· Include Square Feet of Affected Area(s) Replace existing like for alike water heater 50 gal gas EXISTING USE I PROPOSED USE I GARAGE (SF) PATIOS (SF) T DECKS (SF) I ·FIREPLACE IAIR CONDITIONING I FIRE SPRINKLERS v,so NO□ YES □No □ YES □No□ CONTACT NAME (If Different Fom App/leant) California Delta Mechanical APPLICANT NAME Galina Pavlova ADDRESS ADDRESS 6056 East Baseline rd# 155 6056 E. Baseline road suite# 155 CITY STATE ZIP CITY STATE ZIP Mesa AZ 85206 Mesa AZ 85206 ---- PHONE IFAX ·-I FAX PHONE 480-898-0007 1-480-218-5645 858-361-6495 858-240-6677 -· EMAIL EMAIL california@,deltamechanical.com galiapavlovabg@,yal1oo.com PROPERTY OWNER NAME Veronica Willimas CONTRACTOR BUS. NAME California Delta Mechanical ADDRESS ADDRESS 2630 Lewis Ln 6056 East Baseline rd# 155 CITY STATE ZIP CITY STATE ZIP Carlsbad CA 92008 Mesa AZ 85206 PHONE I FAX PHONE IFAX 760-213-6256 480-898-0007 EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS I STATE UC.# STATE UC.# I CLASS ICITYBUS LIC.1214281 811114 c36 (Sec: 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or ;epaIr any structure, prior to its issuance, also requires the applicant for such permItto 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 7031.5 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 declarations: [ZJ I have and will maintain a certificate of consent to self-insure for workers' compensa~on 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 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.--~ 1697823 Expiration Date 011111121i12 ___ _ This section need not be completed ii the permit is for one hundred dollars ($100) or less. [Z] Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. ,jj'$ CONTRACTOR SIGNATURE I hereby affirm /hat I am exempt from Contracfor's License Law for the following reason· □ □ □ I, as ow11er 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, as ow11er of the property, am exclusively contracti11g with licensed contractors to construct the project (Sec. 7044, Busi11ess and Professio11s 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 pursua11t lo the Contractor's Lice11se 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 improveme11t. OYes Oo 2. I (have I have not) signed an applicatio11 for a building permit for the proposed work 3, I have contracted with the following perso11 (firm) to provide the proposed construction (include name address/ phone I contractors' license number): 4. I pla11 to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include 11ame / address I phone/ 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)· £f PROPERTY OWNER SIGNATURE DATE s the applicant or future building occupant required to submit a business~, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Jresley-Tanner Hazardous Substance Account Act? D Yes LJNo s the appl_icant or future building_occupant required lo obtain a permit from the air pollution control district or a~ality management district? [Jves 0No s the facility to be constructed within 1,000 feet of the outer boundary of a school site? Oves LJNo F 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 :MERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. certify that I have read the application and state that the above information ls correct and that the infonnation on the plans is accurate. I agree to comply with all City ordinances and State l."WS relating to building construction. hereby authorize representative of the City of Carlsbad to enter upon the aoo/e mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD \GAIN ST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMl"I. )SHA: An OSHA permt is required for excavations over 5'0' deep a,d demolition or construction of structures CNer 3 stories in height. :XPlRATlON: Every pemiit 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 eoo1menced within 80 days from the date of such perrrit ocifthe building ocwork authorized by such permit is suspended or .bandoned at any time after the work is commenced for a period of ~80 days (Section 100.4.4 Uniform Building Code). 2S APPLICANT'S SIGNATURE DATE 9 A 1-)/ m . . City of Carlsbad Bldg Inspection Request For: 10/18/2011 . Permit# CB112099 Title: WILLIAMS RES-REPLACE WTR HTR Description: Type:PME Sub Type: Job Address: 2630 LEWIS LN Suite: location: lot: 0 APPLICANT CALIFORNIA DELTA MECHANICAL Owner: WILLIAMS JOSHUA A&VERONICA C Remarks: Total Time: CD Description 25 Water HeaterNents ~ Comments Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# Inspection History Date Description Act lnsp Comments Inspector Assignment: Phone: 7607292116 lnspecto{) ;C Requested By: VERONICA Entered By: CHRISTINE