HomeMy WebLinkAbout2506 La Golondrina St; ; 83-80-176; Permit"' z 0 ;:: .. ,. ..
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' D I here!;!v affirm that I am l(cens&d under
provls!on&~f Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Professions Code, and my license is in
full force and effect.
Lie No __ _ Cass
I hernby affirm that I am e~emDt l'Ofll the Contrac tors License Law tor the f8llow1ng reason (Sec 7031 5
Business and P•ofess1ons Code: Ari city er county which re-
quires a perm,: to construct, aIter. ,fllprJve derno.ish, or
·eoaIr any structure pnor to ,ts Issua~ce also requ,•es lhe ap
pl1cant for such permit to file a s,goed statement that he rs
1 :ensed pJrsuant lo the prov1s1ons of tre Cortractor s
L.cense Law ,er.apter 9 commen~rng with Section 7,'.)00 of
D1,,s1G1 3 81 '.he Business ard Pro1ess1c's Coce1 or tt,at ,sex-
emot :neref0cm and the basis for the alleged exempt,on Any
vI0,atIan of Section 7831 5 by an app',cant 'or a oerm1t sub-
1ects the appl,cdnt to a c1v1I penalli of not ."lore than five run•
d:ed dollars i$5JO
I as owner of the orooerty. or my e~p'oyees with wages
as their sole compensation. will do t~e work. ard lhe s:ruc·
ture ,s no! Inlended or offered for sale (Sec 7044. B,s,ness
and Proless1om, Code The Contractor's L,ceise Law does
not apply to an owner of oroper'.y whO builds or improves
thereon and who does such work himself or through his own
employees. orov1ded that such improvements are not intend-
ed or oflered for sale If. however. the bu1ld1ng or 1mprove-
"lent Is solo wrth,n one year of completion, the owner-bu,ICer
will have the burden o1 proving that he drd not build or ,,n
prove tor the purpose of sale)
::... I, as owner of the property. am exclus1vsly contracting
with licensed contr~ctors to construc1 the project (Sec 7044. Business and Professions Code The Contractor's License
Law does not apply to an owner of property who builds or ·im-proves thereon, and who contracts for each pro1ects with a
contractor(s) license pursuant to 1t1e Contractor's License
Law)
c.:; As a homeowner I am improving my home, and the follow-
ing cond1l1ons exist
1 Th€ work is being per1ormed prior to sale 2 I have lrved rn my home for twelve months
pnor to completion al this work
I have not claimed this exemption during 1he
last three years
_J I am exempt under Sec ______ , B & P C
for this reason
O I hereby a!f>rm tha! I ha•e a cert,t,cate of consen1
to self-insure, or a certif,cate of Workers
Cornpensa.t1on Insurance. or a cert1f1ed cooy thereof
(Sec 3800. Labor Code)
POUCYNO __ _8_2W:-l-13656D
COMPANY Mission I:nsurance
0 Copy ,s f,led wilh 1he crty
0 Cen,f,ed copy ,s hereby turn,shed
CERTIFICATE. OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section nee<:1 no1 be completed .J me ;,ermI!
,s tor one hundred dollars 1$100) o, lessJ
0 I cert,fy that ,n the performance ol the work for
which this perm,1 ,s ,ssued I shall not employ any
pe•son ,n any manner so as lo become sub1ec1 10
lhe Workers· Compensation Laws 01 Cali1orn,a
NOTICE TO APPLICANT 11. atte, mak,n~ th,s Cer1,
t,cate of Exempt,on you should oecome subIect 10
1he Workers Compensat,on pro.is,ons of lhe Labo•
Code you must iorthw1th comply with Suen
prov,s,ons or th,s perm,1 shall be aee..-,·,ed ,e"okea
0 I he,eby aJt,rm lhat !here ,s a cons1ruc1,o~
1end,ng agency •o, !hP perlurman, e v• the ..,ork lor
whrch Th,s pe<mIT ,s ,ssued 1Sec 3097 Civil Code1
Lenae, s Name Ponderosa Ibmes
Lenders Address __________ _
USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS
CARLSBAD BUILDING DEPARTMENT
1200 Elm, Carlsbad, Califo!nia 92008-1989 (619) 438-5525 APPLICATION & PERMIT
JOB ADDRESS
2506 La Gol~~ St:t'eet !?llA$El
AV. ST.I DATE OF APPLICATION! RO.
_ 4/22£83_
OWNEA"S NAME
l'ONDEROS"\ Hl'lF,$ I OWNE R·s PHONE
619/560-8555
CONTRACTC!R
l'QND~I01ES
PERMWMBEA
3587 I 113,113 I c. 2 _ "IO . 71. I CONTRACTORS PHONE It ZONE ~ r; -I (Cl
BUSINESS LICENSE#
619/560,-8555
VALUATION
OWNER'S MAI LI NG ADDA ESS
ll300 Son-ento Valley I¾'!,, Suite ioo, S,D. 92l2l
CONTRACTOR"S AOORESS
Sama as O,,mer
LICENSE NO.
343456
PLAN 1.0_ #
83-80
~ODE
'l DESIGNER LICENSE,, STANDARD PLAN# BUILDING SO. FOOTAGE
---'-'-'-----L.~+1 1\;r"am Basseni<ln & A.ssociates c-8395 2255
DESCA1PT!ON OF WORK
, -Sin,µ,a-E;;l,ll);iJ;¥-.W:ith..Ql,:tlagre-----=P~L!\N~\!'!___:2~2"'5~5'--..!BX~'------I OEj?_lGNER"S ADDRE!'i;'i DESIGNER'S PHONE ~ 3~90 Westeriy Pl., Suite 170
LOT
}7/;
BLOCK I SUBDIVISION r_,,,...,;· 1 lo -L ASSESSOR PARCEL NO
L ~--Tlnit Nn.2
41-l!;./8311&6
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CeNSUS TRAC, I oe LAND use I 'AR;;; S>ACE RES;N'TS I GRADING P_EAMIT ISSUED
~ D N □ I REDEVELOPMENT AREA , □ ,ex
TYPE
CONST
VN
OCC LOAD FIRE SPR
YON@ Not Valid Unless Machine Certified
OTY. PLUMBING PERMIT -ISSUE 7.50 QTY. MECHANICAL PERMIT -ISSUE 3.00 SUMMARY/ACCOUNT NUMBER
I .1 EACH FIXTURE TRAP ~+~ ___)_ l'NSTA_L__L_F_URN ou_m ce T~ ooo BTU__ 4 •. 00 BUILDING PERMIT 01-oo-oo-a220 _4_68~0_
EACH BUllDING SEWER OVER 100,000 BTU SIGN PERMIT 01·00-00-8221
,-~~-+--E_A_C_H WATER H~irn ~N □-□-~_yEN~ 1 ~--~~!LER,..C□~~~ss-?~P2_~3 H~ =--=---.----PLAN c-HEcK _______ ~~o-oo-aso6 304. 20
WACH GAS_ SYSTE~ __!__.T~ 4 _OUTLE_T_S -t ----l ~:Q_l_~ER iCOM~~~~-□R_~_15_HP_ -------TOTA~UM~ ___9_1·00-00-8222 51 50
--+~ACH GAS SYSTEM 5 OR MORE t , META_L FIR~~AC~ _ ELECTRICAL 01-00-00-8223 __}Q.....Q_Q _
I-E.ACH·.·1NSr.AC-A.LTER:REPA1RWATERP1PE _ __i__ _iliv~_N~-Ns_~~-~ouCT ___ ---~------~'-"LU __ MECHANIC~ _____ _Q]___:_oo-oo-a224 ____ .lLQQ__
i EACH VACUUM BREAKER , . , MECH EXHAUST HO□□·oucrs MOBILEHOME 01-00-00-8225
L l ~A~:':o~~~:~,~R~s,os,-~ +------~□:~~ :~~A~~N,~E~R-=----'-;;i~:H:::1::RK INSJ__-__ ~:~{::!:: -7. 96~
~~~~~Tc;.QT~A~L~P~L-UMBING . . _ _l__ __ -,---__ 5l. 50 ___ -~-_ ~-~-11. 00 FIRE SPRINKLERS 01-00-00-8227 ____::_ -=--=
tY I __:LECT~ICA_L:_ PE~M_IT~ issuE =_{ s. ooµ,, [ so~o ,AAoc . ___ _,___ ____ --4, ;;:~;~ ::~1,1T1Es FEE __3200000923
NEW CONS.T E~_AMP SWT ~ __ _J.Q_O___ __ 251-_QO ---~ECT~-_ _ _______ _,_________ ~HOOL_£~E -Q!_§_TRICT_ _ ~
~ _ _ __ _ _ 2 PH_ ___ _ ST_2_RA~TANKS __ .__'_ ---~--___ Carlsbad 80-92-21-0519 r=t EXIST BLO~A!MP_!~WT B_~R-___ _ ----J--ROCK STORA~ __ /~ -~~ _ _,__ ____ ____,. -~ncinitas _J!0-92-22-~19 _ ~-=
1 PH 3 PH . PLJMP / • ---'=f-San O1eguito 80-92-23-0519
TEMP OCCUPANCY iJQ DAYSI . -1 ---~----------
j :AL 1 30. 0 --~<ITAL SOIA' -i .
-I ---_____ l
l HAVE CAREFULLY E*.AMINED THE COMPLETED "APPUCAT!ON AND PERMIT"' AND DO HEREBY * AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE ·5' 0"' DEEP AHO OEMOLITK>N OR CONSTRUCTION OF
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS STRUCTURES OVER J STORIES IN HEIGHT
ISSUED: TO COMPLY WITH ALL C!TY, COUNTY AND STATE LAWS GOVERNING BUILDING CON-
STRUCTION. WHETHER SPECIFIEO HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND %0VEO BY ~-DATE
KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABIUTJES, JUDGMENTS, COSTS AND 4
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE BY PHONE Q -AA,,.~,, 1 ,n I 1 7lj_Q7
GRANTINGOFTHISPEAMIT. ,:;:~.,.;.;.,;.,_,._,..c: 'fl.O:r,r.., i'VV~ 1 1(..,£ (j::)
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INSPECTION TYPE DATE INSPECTOR
BUILDING·,
FOUNDATION "'-"
REINFORCED STEEL "-Jf_,__,3 T
MASONRY
GUNITE OR GROUT
FLOOR & CEILING SUB FRAME .
SHEATHING 9-L1-l'! I'~
A
FRAME ·-..,,._I Al•'f.n,
,,
EXTERIOR LATH lNSULAllON ' A
INTERIOR LATH & DRYWALL "' ,,,.__,.~~ 17"
PLUMBING
SEWER AND BL/CO /J.J/~f/1 ,.p
PLUMBING UNDERGROUND 7.1,.H .. ..
PLUMBING TOP OUT ,.,._7..yz "
TUB AND ~HOWER PAN ,.
GAS TEST M•~-JrJ +1
ELECTRICAL I
TEMPORARY POWER
ELECTRIC UNDERGROUND ,.
ROUGH ELECTRIC /d•'/•r.1 1-r
ELECTRIC SERVICE
BONDING
G. F. L -SMOKE DETECTOR
MECHANICAL "
DUCT & PLEM., REF. PIPING /4•1l~l ,,,
HEAT -AIR COND. -SOLAR SYSTEMS
VENTILATING SYSTEMS
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE BEEN APPROVED.
JOB SITE FINAL
PLUMBING .
ELECTRICAL "--
MECHANICAL " I/ .
GAS ' I •/rl, I
BUILDING ' '""' 'L I
SPECIAL CONDITIONS
CERT OF @IPANCY ISSUED
-I
-
-
-
-
-
-
~ ~3 «) -l , j.,
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
lNSPECTION REO IF INSPECTOR'S DATE CHECKED APPROVAL --
'.:C-" C' ,---r,.,r,, A.,,---,-
F
F
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C THIS IS TO C.ERTIFY THAT INSUJ •,TION l'.AS BEEN INSTAI.l.EO IN ,.....
F CONFORMANCE WITH TIL.. CURRENT ENERGY REGULATIONS, CALIFORNIA C ,-ADMINISTRATIVE CODE, TITLE 25, STATE OF CALI FORNI/, IN TUE F
C BUILDING LOCATED AT: >-
F
',
SITE ADDRESS: 11ot L 9. C 12.IP hdt. L ~(J_ S'7t: Lq Co.'i/9 E ,-
Number Street ' ity ,-
>-EXTERIOR WALLS
I
0//11 ½ II r-
Manufacturer /) Thickness/Type ,f R/Value r-J
r-CEILINGS
r-
Batts: Manufacturer (r/m /2 /;; // 19 Thickness ,z R/Value ,.....
...., GENERAL CONTRACTOR: LIC./f
,.....
BY TITLE DATE r-
-INSULATION CONTRACTOR: APOLLO l NSlJLAT ION LIC./f !i\6015 ~
r-c}-fu ~ . TI 11,!t.131"27 /t;&c;;;/281 BY_ ____y/7 ~_.,-,"' DATE ,....
I-
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