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Home My WebLink About2760 OLYMPIA DR; ; CB060469; Permit... City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 02-22-2006 Plumbing Permit Permit No: CB060469 Job Address: Permit Type: Parcel No: Reference #: Project Title: Applicant: Building Inspection Request Line (760) 602-2725 2760 OLYMPIA DR CBAD PLUM 1674315000 Lot#: 0 Construction Type: NEW VELTMAN RES-REPLACE WATER HTR Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: CALIFORNIA DELTA MECHANICAL CLOVER HOMES INC C/O JOHAN A VELTMAN 2560 BELLEVUE AVE SUITE# 27 ISSUED 02/22/2006 LSM 12440 OAK KNOLL RD 92064 866-898-0008 WEST VANCOUVER BC V7V1 E4 00000 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 TOTAL PERMIT FEES Total Fees: $27.00 0 0 0 0 1 0 0 Total Payments To Date: $20.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $0.00 $0.00 $0.00 $0.00 $0.00 $27.00 $27.00 Balance Due: EXPIRED PERMIT $0.00 PERMIT HAS EXPIRED IN ACCORDANCE WITH C.B.C. SECTION 106.4.4 AS AMENDED BY C.M.C.18.04.030 Inspector: DATE 7 \\ sl Q'J SIGNATURE _,c£.~lt\!l.{L----- FINAL APPROVAL Date: 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. Jf 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 1T APPLY to any f,.,,.,,.J,_x . _, hl,.h .,,.,,, hi:!V" """Vi"""I hn"'n niv"'n" ~1nT1r.E !=:imil::ir tn lhi.<1 nr .,,., t" which th-_, . i'"'i"n" h---r-vj-··-1---·h----j---xni---'. ,.. PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 ...,__..._ .•• -ECT INFORMATION 2760 OLYMPIA DRIVE CARLSBAD, CA 92010 Address (include Bldg/Suite #) Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Assesso(s Parcel # Existing Use Replace standard water heater like fo r like Description of Work SQ. FT. #of Stones 2. ~NTACT PERSON (If different from appllcant) FOR OFFICE USE ONLY PLAN CHECK NO. Q{;,Q~ Oi..l <D.-'1 EST. VAL. _________ _ Plan Ck. Deposit--,-,,------- Validated By ___ _;~:::...,_=------ Date ___ "';iJ:'-}+-'<2..e...?T/=-t"""''.'Qfe'--""--- Phase No. Total# of units Proposed Use # of Bedrooms # 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# 3. APPLICANT 0 Contractor □ Agent for Contl'lldor □ Owi1ii □ ~for ROM EL 2500 S. POWER RD #120 MESA AZ 480-898·0007 Name Address City State/Zip Telephone# 4. PROPERTY OWNER JOHA VELTMAN 2760 OLYMPIA DRIVE CARLSBAD CA 92010 760-729-6206 Name Address City State/Zip Telephone# 11. CONTRACTOR -COMPANY NAME Fax# (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 Contracto(s License Law [Chapter 9, oornmending with Section 7000 of Div1s1on 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 [$5001). California D elta Mechanical, Inc. 2500 S. Power Rd. Suite# 120 Mesa 85209 (480) 898-0007 Name Address City State/Zip Telephone# State License# .....c..8_I _11_1_4 ____ _ License Class _C_-3_6 _______ _ City Business License # ....,;lc.::2c..:l=-4:..:;;2::c8;;..l=------- Designer Name Address City State/Zip Telephone# State License# _______ _ 8. WORKER'S COMPENSA TlON Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: □ I have and will maintain a certificate of consent to self-insure for workers' oornpensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued IE] I have and will maintain worke(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 earlier and policy number are: Insurance Company State Compensation In surance Fund Policy No. 1697823 Expiration Date,_,0,.7'-'-/.,._0_..l/~0"'6'-------- (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100) OR LESS) □ 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 subje<.1 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 R ome! Maru DATE 02/15/06 -:.:..:..:..::.-----====--. 7. OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contracto(s License Law for the following reason: □ I. as owner of the property or my employees with wages as their sole oornpensation, will d the work and the structure is not intended or offered for sale (Sac. 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 owner of the property, am exdusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contracto(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 Contracto(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. □ YES □ 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 (indude 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 (indude name /address/ phone number/ type of work): PROPERTY OWNER SIGNATURE ___________________________ DATE __________ _ W HITE: File YELLOW: Applicant PINK: Finance >- PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad CA 92008 Page 2 of 2 COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY 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 Ad? □ YES □ NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? □ YES □ NO Is the facility to be constructed within 1.000 feet of the outer boundary of a school site? □ YES □ 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. CONSTRUCTION LENDING AGENCY 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 ___________________ _ 9. APPLICANT CERTIFICATION 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 Cartsbad 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 EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavations of 5'0" deep and demolition or construciion of structures over 3 stories in height. EXPIRATION: Every permit issued by the building Official under the provisions of this Code hall expire by limitation and become null and void if the building or work authorized by such permit ,s not commenced within 180 days from the date of such permit or jj-the build. g or work authorized by such permit is suspended or abandoned at any time after the work is commencec for a period of 180 days (Section 106.4.4 un· or Buildi WHITE: File YELLOW: Applicant PINK: Finance