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HomeMy WebLinkAbout1316 SHOREBIRD LN; ; CB102547; Permit' City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 12-27-2010 Plumbing Permit Permit No: CB102547 Job Address: Permit Type: Parcel No: Reference #: PC#: Project Title: Applicant: Building Inspection Request Line (760) 602-2725 1316 SHOREBIRD LN CBAD PLUM 2157910900 Lot#: 0 Construction Type: NEW HAYASHI RES REPLACE WTR HTR Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 12/27/2010 KG 12/27/2010 12/27/2010 CALIFORNIA DELTA MECHANICAL HAYASHI FAMILY REVOCABLE 2002 TRUST 08-23-02 SUITE# 27 12440 OAK KNOLL RD 92064 866-898-0008 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: Inspector: $27.00 0 0 0 0 1 0 0 1316 SHOREBIRD LN CARLSBAD CA 92011 $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 Total Payments To Date: $27.00 Balance Due: FINAL APPROVAL Date: 1/1@1 ' 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. 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 inn--f whi-.. ·-· h_.,_ -r<>vi-.. -1 .. ._ __ n niv---W'ITlr.E <>imil-"'r tn !hi<> nr --•-... hirh th · -f lim"-•i-n-._ __ -r-vi-.. -1 .. -xnir-...1 City of Carlsbad /.635 Faraday Ave .. Carlsbad, CA 92008 760-602-2717 / 2718 / 2719 Fax: 760-602-8558 Building Permit Application JOB ADDRESS 1316 Shorebird In Plan Check No. Est. Value Plan Ck. Deposit Date. SUITE#/SPACE#/UNIT# Cf/PROJECT 11 LOT II PHASE II II OF UNITS # BEDROOMS # BATHROOMS TENANT BUSINESS NAME I CONSTR-TYPJ:C~GROU, --------------~ DESCRIPTION OF WORK: ·1nClude Square Feet of Affected Area(s) Replace existing like for alike water heater EXISTING USE I PROPOSED USE !GARAGE (SF} PATIOS (SF) I DECKS (SF) I _FIREPLACE I AIR CONDITIDr-JING I FIRE 3PR!NKLERS YESO No□ vesONoD vesONoC CONTACT NAME (ff Different Fom Applicant) California Delta Mechanical APPLICANT NAME Galina Pavlova -----------------ADDRESS ADDRESS 6052 East Baseline rd # 155 6052 East 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 1-858-410-1499 -Ei-iAI' ------__ ,. ----------- EMAIL california@deltamechanical.com galiapavlovabg@yahoo.com PROPERTY OWNER NAME Rob Hayashi CONTRACTOR BUS. NAME California Delta Mechanical ADDRESS ADDRESS 1316 Shorebird In 6052 East Baseline rd # 155 CITY STATE ZIP CITY STATE ZIP Carlsbad Ca 92011 Mesa AZ 85206 PHONE I FAX PHONE IFAX 760-438-3171 480-898-0007 EMAIL EMAIL ARCH/DESIGNER NAME & ADDRESS I STATE LIC. # STATE LIC.# I CLASS I CITY BUS "'1214281 811114 c-36 (Sec: 7031.5 Busmess and Professions Code. Any City or County which requires a permtt to.construct, alter, improve, demolish or repair an}" structure, pnorto its issuance, also requires the appl!cant for such per_mtt to file a signed statement that he 1s licensed pursuant to the provisions of the Contractor's license Law {Chapter 9, commending with Section 7000 of Division 3 of the Busmess and Professions Code} or that he is exempt therefrom, a,1d 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: [Z] I have and will 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. lZJ 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. 1597823 Expiration Date 08131131 ~section need not be completed if the permit is for one hundred dollars ($100) or less. LlJ 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 upto 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. ~ CONTRACTOR SIGNATURE I hereby affirm that I am exempt from Contractor's License Law for the following reason· □ □ □ I, as owner 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 ProfessionJ Code: The Son tractor'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 am 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 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 pursuant to the Contracto(s license Law). I am exempt under Section~-___ ... __ Business and Profession~ Code for this reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property impro~ement. OYes Do 2. I (have I 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 {include name address / phone I contractors' license number): 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and pro~ide the major work {include name I 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 I phone I type of work} 2$ PROPERTY OWNER SIGNATURE DATE --------·--·---- s t~e applicant or future building occupant required to submit a business~, acutely hazardous materials registration form or risk mancJ]ernent and prevention program under Sections 25505, 25533 or 25534 of the )resley-Tanner Hazardous Substance Account Act? D Yes LJNo s the appl_icant or future building occupant required to obtain a permit from the air pollution control district or a~ality management district? [Jves D No s the lac1h!y 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 is correct and that the infonnatlon on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. hereby authorize representalive of the City of Ca1sbad to enter upoo the abcNe mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY ANO KEEP HARMLESS THE CITY OF CARLSBAD \GAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. )SHA An OSHA permit is required for excavations CNer 5'0' deep aid demolition or construction of structures CNef 3 stooes in height :XPIRATION: Every permit issued by the Buiking Official under the provisions of this Code shall expire by linitalion c¥'ld beoome null and void if the building or work authorized by such permit is not commenced lNithin 80 days from the date of such pemit or if the building or work authorized by such permit is suspended or abandoned at aiy time after the work is oorrmenced for a period of 180 days (Section 106.4.4 Uniform Building Code), fESAPPLICANT'SSIGNATURE DATE ~ #--< /o ----~-~ .. ------·---·,· I m City of Carlsbad Bldg Inspection Request For: 01/14/2011 Permit# CB102547 Title: HAYASHI RES REPLACE WTR HTR Description: Type:PLUM Sub Type: Job Address: Suite: Location: 1316 SHOREBIRD LN Lot: 0 Inspector Assignment: Phone: 6199171171 Inspector: -~(\"¼-~_ OWNER HAYASHI FAMILY REVOCABLE 2002 TRUST 08-23-02 Owner: HAYASHI FAMILY REVOCABLE 2002 TRUST 08-23-02 Remarks: late as possible Total Time: CD Description Act Comments Requested By: ROB Entered By: CHRISTINE 25 Water HeaterNents ~------~ Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# Inspection History Date Description Act lnsp Comments