HomeMy WebLinkAbout2505 LA GOLONDRINA ST; ; CB930580; PermitPERMIT APPLICATION PLAN CHECK NO. 9'?-5~0
City of Carlsbad Building Department
2075 Las Pal..,s Dr., Carlsbad, CA 92009 (619) 438-1161 ESr. VAL:-=-'"d"'"'===--~--· ---
PIJ\N CK DEPOSIT_-,-______ _
VAUD.BY ____ b~,,____.-~~-~-~~-
DATE 4,//ft /¢ -3
D New BUJldmg D I enant Improvement
B -O Industrial D New Building D Tenant Improvement
C -0 Residential D Apartment D Condo D Single Family Dwelling D Addition/ Alteration
D Duplex O Demolition D Relocation O Mobile Home D Electrical D Plumbing
D Mechanical D Pool D Spa D Retaining Wall D Solar D Other
2. PRQJECT INFORMATION FOR OFFICE USE ONLY
ress u1 mg or u1te o.
Nearest Cross Street ta 01~h11tf n nc;i.-
LEGAL DESCHIP I ION Lot No. Sulx11V1s1on Name/Number OmtNo. Phase No.
I~/ -r~ r3-Z'f
D 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report □ 1 Addressed Envelope
ASSESSOR'S PARCEi, EXISTING USE
DESCRIPTION OF WORK f4Z, $GF1_ /).e_f,t_ PROPOSED USE
sQ. FT. 1 oro '9i'BI f-ibR1E;· /::>cul-,o Co't'-er
3. WN iACI PERSON (LI dnlereni from appJlcan()
NAME ADDRESS
ZIP CODE Cl1Y STATE DAY TELEPHONE
4. APPUCANI
NAME
UCONIRACIUR OAC,ENI FORCONIRACIOR DOWNER □AGENi FOR OWNER
ADDRESS
CITI STATE ZIP CODE DAY TELEPHONE
5
· ~ERA;/~ //WwiJ /11lf~ ADDRESS ,Z.t,;c,$ U\_ n(?fbfttfl7"1,::{_
CrIY tar-1,;,bavf STATE(II"' ZIPCODE qt/X)q DAYTELEPHONE 43b-5~2"1
NAME
CllY STATE
STATE UC.#
ADDRESS
ZIP CODE
UCENSE CLASS
DAY TELEPHONE
CITI BUSINESS UC. #
cnY STATE ZIP CODE DAY TELEPHONE STATE UC.#
7. WOltRiltS' UJMPRNSAllON
Workers Compensation L>eclarat1on I hereby all1rm that I have a cert1l1cate of consent to self-insure issued by the Director of lndustnal
Relations, or a certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified
by the Director of the insurer thereof filed with the Building Inspection Department (Section 3800, Lab. C).
INSURANCE COMPANY POUCY NO. EXPIRATION DATE
Ceruhcate of Exemption: I ccrlify that m the performance of the work !or which this penn1t 1s issued, i shall not employ any person m any manner
so as co become subject to the Workers' Compensation Laws of California.
SIGNATURE DATE
8. OWNmt-Bonnm DFl!LAkA:IIUN
Owner-Builder Declaration: I hereby affirm that I am exempt from the Contracto?s License Law for the loilowmg reason:
'f/, 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 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 exclusively contracting with licensed con1ractors 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 Contractor's License Law).
□ I am exempt under Section ________ Business and Professions Code for this reason:
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a pennit 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, commencing 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 ci · a\ty of ot more than five hundred dollars [$500]).
SIGNATURE DATE
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and
prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act?
□ 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 ANVOF TIIE ANSWERS AIIE YF_s, A HNAI. CERllFICA"ll! OFOO'.:UPANCY MAYNar BE ISSUED AFTER JULY 1, 1989 UNLF.SS TIIE APPIJCANT
HAS MET Oil IS MEK!lNG TIIE REQUIREMENTS OF TIIE OFFICE OF EMERGENCY SERVICES AND THE A11l POU.lfTION OONTROL DISTillCT.
9. WNSIR0C.IION llffiDlNG AGENC.'r
] hereby allirm that there 1s a construction lending agency lor the perl()rmance of the work for which this permit 1s issued (Sec 3097(1} C1vH C&ie).
LENDER'S NAME LENDER'S ADDRESS
10. APPIJCAN I crutl1FlCAlkJN
I certify that I have read the apphcat10n and state that the alxwe mlormat1on 1s correct. 1 agree to comply with ail City ordmances 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 lU SAVE INDEMNIFY AND KEEP IIARMLF.SS TIIE CTIY OF c.ARISBAD AGAINST All UABIIITIF...c;, JUDGMENTS. CDSTS
AND EXPENSES wrna1 MAY IN ANV WAY A(x:JUJE AGAINSf SAID CTIY IN CDNSEQUENCE OF TIIE GIIAN"llNG OF 1111S PERMIT.
OSHA: An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height.
Expiration. Every permit issued by the Building Official undt'r 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 365 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 303(d) Uniform Building Code).
APPUCANT's s1GNP.ruR~~;{b DATE, w/!b/113
WHITE: File YELl.OW: Applicant PINK: Finance
PERMIT# CB930580
DESCRIPTION: 702 SF
SPECS
TYPE: PATIO
JOB ADDRESS:
PATIO+
CITY OF CARLSBAD
INSPECTION REQUEST
FOR 05/20/94
142 SF DECK PER
STE:
INSPECTOR AREA TP
PLANCK# CB930580
OCC GRP
CONSTR. TYPE NEW
LOT:
APPLICANT:
2505 LA GOLONDRINA ST
MCNAMARA, MICHAEL PHONE: 619 438-5627
CONTRACTOR:
OWNER:
REMARKS: MW/MIKE/534-5084
SPECIAL INSTRUCT: RES. 619-438-5627
TOTAL TIME:
CD LVL DESCRIPTION
PHONE: 12 PHONE:
INSPECTOR--'-~'--~~-'---=____./~.,..--
ACT COMMENTS
19 ST Final Structural v ______________ _
29 PL Final Plumbing w C 39 EL Final Electrical we ______________ _
~1'. ME -F~i~~n~~M-e~~-::5'=a=n~i_c_a_1 _______ d---------------
--------~---------------------------
***** INSPECTION HISTORY*****
DATE DESCRIPTION
081293 Ftg/Foundation/Piers
ACT INSP
AP TP
COMMENTS
3 28X28Xl2