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2557 LUCIERNAGA ST; ; VARIOUS; Permit
MODEL NO.. BUILDING PERMIT APPLICATION City of CARLSBAD, CALIFORNIA 92008 Applicant to complete numbered spaces only Phone 729-1181 Permit No ( ^ • .' / // 0 JOB ADDR ESS ASSESSOR'S PARCEL NUMBER ,LEGAL 1 DESCR A Is EE ATTACHED SHEET; OWNER 2 . /,< ,-' MAI L ADDRESS 'A AT CON TRAC TOR 3 K ' i'. WAIL ADDRESS STATEJLIC. NO. CITY LIC. NO. ARCHITECT OR DESIGNER 4 MAI L ADDRESS LICENSE NO ENGINEER MAl L ADDRESS LICENSE NO COMPENSATION INS CARRIER MAIL ADDRESS USE OF BJ ILDING NO. BORMS_ NO. BATHS. 8 Classofwork • NEW • ADDITION DALTERATiON • REPAIR • MOVE • REMOVE 9 Describe work 10 Change of use from Change of use to 11 Valuation of work $ / ' PLAN CHECK FEE $ - ~ PERMIT FEE $ i O ( SPECIAL CONDITIONS Type of Const Occupancy Grou p MICRO Fl LM FEE Type of Const Occupancy Grou p MICRO Fl LM FEE Size of Bldg (Total) Sq Ft No of Stories Max Occ Load Size of Bldg (Total) Sq Ft No of Stories Max Occ Load Fire Zone Use Zone Fire Sprinklers Required Qves DNO APPLICATION ACCEPTED BY •/ ' DATE PLANS CHECKED BY APPROVED FOR ISSUANCE BY DATE Fire Zone Use Zone Fire Sprinklers Required Qves DNO APPLICATION ACCEPTED BY •/ ' DATE PLANS CHECKED BY APPROVED FOR ISSUANCE BY DATE No of Dwelling Units OFFSTREET No, Covered PARKING SPACES INo, Sq, Ft. jOpen NOTICE SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB- ING, HEATING. VENTILATING OR Al R CON Dl TIONI NG THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM- MENCED 1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION Special Approvals Required Received Not Required NOTICE SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB- ING, HEATING. VENTILATING OR Al R CON Dl TIONI NG THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM- MENCED 1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION PLANNING OEPT, NOTICE SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB- ING, HEATING. VENTILATING OR Al R CON Dl TIONI NG THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM- MENCED 1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION HEALTH DEPT NOTICE SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB- ING, HEATING. VENTILATING OR Al R CON Dl TIONI NG THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM- MENCED 1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION FIRE DEPT NOTICE SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB- ING, HEATING. VENTILATING OR Al R CON Dl TIONI NG THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM- MENCED 1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION SOIL REPORT NOTICE SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB- ING, HEATING. VENTILATING OR Al R CON Dl TIONI NG THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM- MENCED 1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION OTHER (Specify) NOTICE SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB- ING, HEATING. VENTILATING OR Al R CON Dl TIONI NG THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM- MENCED 1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION ENGINEERING DEPT NOTICE SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB- ING, HEATING. VENTILATING OR Al R CON Dl TIONI NG THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM- MENCED 1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION WATER DEPT, NOTICE SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB- ING, HEATING. VENTILATING OR Al R CON Dl TIONI NG THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM- MENCED 1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION NOTICE SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB- ING, HEATING. VENTILATING OR Al R CON Dl TIONI NG THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM- MENCED 1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION NOTICE SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB- ING, HEATING. VENTILATING OR Al R CON Dl TIONI NG THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM- MENCED 1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION NOTICE SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB- ING, HEATING. VENTILATING OR Al R CON Dl TIONI NG THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM- MENCED 1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) / « •. '7'"- • , f f-- SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) / « •. '7'"- • , f f-- SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) / « •. '7'"- • , f f-- SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT PLAN CHECK VALIDATION CK. M.O CASH PERMIT VALIDATION CK. M.O CASH TOTAL FEES $ / / INSPECTOR PLUMBING PERMIT APPLICATION City Of CARLSBAD, CALIFORNIA 92008 / Applicant to complete numbered spaces only. PhOR© 729-1181 Permit No ; JOB ADDR ESS 2S37'a lmiQrrm]&$ireQi LEGAL DESCR. ief fJ20-7 MAIL ADDRESS Smi Diem S&at e^ilt Mmios S 4022 tHsMar^ iSmn "im^ CON TRAC TOR MAI L ADDRESS ifta^nson 5 ^obimisn €fc>sf@»-g. Ijie. ^54? Stole PHONE STATE LIC. NO. CITY LIC. NO. ^troot^ Cargotoi!^ ^3QS i5SS9 ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO EN CIN EER MAI L ADDRESS LICENSE NO. : I COMPENSATION IN S.> C A R R'l E R , ./\ , MAIL ADDRESS USE OF BUIIDING 8 Classofwork- •rNEW'' •ADDITIO'N DALTERATION • REPAIR 9 Describe work PERMIT FEES No Type of Fixture or Item Fee SPECIAL CONDITIONS WATER CLOSET (TOILET) 5'oa BATHTUB LAVATORY (WASH BASIN) • I SHOWER IKITCHEN SINK & DISP DISHWASHER -'O APPLICATION ACCEPTED BY PLANS CHECKED BY 'ISSUANCE BY LAUNDRY TRAY CLOTHES WASHER iWATER HEATER NOTICE URINAL THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM- MENCED I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION DRINKING FOUNTAIN FLOOR—SINK OR DRAIN SLOP SINK GAS SYSTEMS NO OUTLETS (WATER PIPING & TREATING EQUIP WASTE INTERCEPTOR VACUUM BREAKERS LAWN SPRINKLER SYSTEM SEWER NUMBER CLEANOUTS, CESSPOOL STGNATURE-OF CONTRACTOR OR^-AU-tHO R I 2 E D-AG EN T A' SEPTIC TANK & PIT ROOF DRAINS _ ISSUANCE FEE SIGNATURE OF OWNER (LF OWNER BUILDER) TOTAL FEES CO- CO WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK M O INSPECTOR UCENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provi- sions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profes- sions Code, and my license is in full force and ef- fect OWNER-BUILDER DECLARATION Dl hereby affirm lhal I am exempi from the Con- tractor's License Lav* for the following reason (Sec 7031 5 Business and Professions Code), Any city or county which requires a permit to con- struct, alter, improve, demolish, or repair any structure, prior to its Issuance also requires the applicant for such permit to file a signed state- ment that he IS licensed pursuant to the provi- sions of the Contractor's License Law (Chapter 9 commencing with Section 7000 of Division 3 of the Business and Professions Code) or that is ex- empt therefrom and the basis for the alleged ex- emption Any violation of Section 7031 5 by an ap- plicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500) • 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 of- fered for sale (Sec 7044, Business and Profes- sions 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 of- fered for sale If, however, the building or improve- ment 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) QI, as owner of the property, am exclusively con- tracting with licensed contractors to construct the project (Sec 7044, Business end Professions Code The Contractor's License Law does not ap- ply to an owner of property \.ho builds or im- proves thereon, and who contracts for such pro- jects with a contractor(s) license pursuant to the contractor's License Law) I am exempt under Sec , B&PC for this reason Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certiticate of con- sent to self-insure, or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec 3800, Labor Code) POUCY NO COMPANY • Copy IS filed with the city • Certified copy is hereby furnished CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the per- mit is for one hundred dollars ($100) or less) 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 NOTICE TO APPLICANT If, after making this Cer- tificate of Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked USE BALL POINT PEN ONLY CITY OF CARL.SBAD-BUIUDING DEPARTMENT APPLICATION & PERMIT 1200 ELM AVENUE (714) 438-5525 APPLICANT TO FILL IN INFOR- MATION WITHIN RED LINES. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction len- ding agency for the performance of the work for I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION ANO PERMIT, AND DO HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED; TO COMPLY WITH ALL CITY, COUNTY ANO STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER SPECIFIED HEREIN OR NOT l,ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY I N CONSEQUENCE OF THE GRANTING OF THIS PERMIT OWNERQ CONTRACTORQ JSS^ BY PHONE • 1200 ELM AVENUE CARLSBAD, CALIFORNIA 92008 TELEPHONE: (714) 438-5621 Cit? of €avl^hah May 27, 1980 TO WHOM IT MAY CONCERN: Subject: Foundation Design The founciation for the building located at 2557 and 2559 Luciernaga Street, Lot 201, La Costa Meadows #1, was de- signed in accordance to the soils report by Benton Engineering and inspected to coinply with the founidation design. If you need further infonnation, please contact this department. RM/E. GREEN AcVing Building Director REG/gl 1200 ELM AVENUE • CARLSBAD, CALIFORNIA 92008 Citp of Carlsibab TELEPHONE: (714)729-1181 San Diego Gas Sf ETectric Company P. 0. Box 1831 San Diego, California 92120 Attention; Gentlemen; Subdivision Coordinator SUBJECT (ABC Condominiums) (Address) In accordance with Sections 301, 505 and (1301 or 1401) of the Uniform Building Code, this agency has de- termined that there are buildings in subject project and will issue separate building permits to cover these group (H or I) occupancies. 71 INTERDEPARTMENTAL INFORMATION SHEET -BUILDING DEPARTMENT BUILDING ADDRESS: RECEIVED DATE: C;EP2 61977 ITY 01^ CARLSBAD Building Departnnent PLANNING DEPARTMENT ZONE A LOT SIZE .01 WIDTH ^ly* ^^^^''Y^^^ UNITS ALLOWED UNITS PROVIDED PARKING SPACES REQUIRED % COVERAGE ALLOWED BUILDING HEIGHT ALLOWED FRONT SETBACK: ALLOWED PROVIDED INTRUSIONS PROVIDED_ PROVIDED PROVIDED LANDSCAPE & IRRIGATION PLAiJ-^tOMMENTS : REAR SETBACK: ENVIRONMENTAL PROTECTION REQ ADDITIONAL COMMENTS \U\A;l^ (MtM r^^\ OK TO ISS UEg^i4uAA/^"DA^:E VO\y|)\;Ty 'K TO FINAL DAT ENGINEERING DEPARTMENT R NDUSTRIAL WASTE IMPROVEMENTS SEWER CONNECTION <^ (A^HJ> DRIVEWAY LOCATIONS GRADING PERMIT AU&^ ^ EASEMENTS /^o^t"^- DRAINAGE^o«»,fc/^ $ciCi/e> LEGAL DESCRIPTION f^g^y*" ^«g> ^ j C^, 'S&U':^ cO AJ ^ / ADDITIONAL CO DATE ''17-77 PWI OK TO FINAL DATE ^-^7^ FIRE DEPARTMENT SPRINKLING SYSTEM FIRE ALARMS FIRE PROTECTION EQUIP EXITS FIRE HYDRANTS LOCATION ADDITIONAL COMMENTS INSULATION CERTIFICATION This is to certify that insulation has been installed in conformance with the current energy regulations, California Administrative Code, Title 25, State of California, in the building located at: SITE ADDRESS Duplex @ 2557 & 2559 Luciernega St., La Costa, CA Thickness/Type EXTERIOR WALLS ^ ^ Johns-Manville Manufacturer Dwens-Corning CEILINGS -r V, --,1 Johns-Manville Batts: Manufacturer Owens-Corning Thickness/Type Blown: Manufacturer Thickness/Type Wt./Bag Sq. Ft. Covered FLOORS Manufacturer SLAB ON GRADE >- '-'anufacturer Width of Insulation FOUNDATION WALLS Manufacturer Thickness/Type Thickness/Type Inches Thickness/Type Sh" 6" R-Value il 19 R-Value 15 R-Value R-Value R-Value R-Value R-Value GENERAL CONTRACTOR San Diego Best Builders BY TITLE RACTO^^S^ INC. -C -I ^^L^ ^-'^ . TITLE y y/L LICENSE # DATE LICENSE # 221517 C-2 / '7 AA C BENTON ENGINEERING, INC. APPLIED SOIL. MECHANICS FOUNDATIONS BS40 RUFFIN ROAD SAN DIEGO, CALIFORNIA 92123 PHILIP HENKiNG BENTON Februory 20, 1979 PRESIDENT - CIVIL ENGINEER San Diego Best Builders 4022 Highland Avenue San Diego, California 92105 Subject: Project No. 79-2-13M Moisture Contents in Subgrade Soils Lots 201 and 212 of La Costa Meadows Unit No. 1 Carlsbad, California Gentlemen: TELEPHONE (714) 868-1955 This is to report the results of tests to determine the moisture contents of the soils in the upper three feet below finished grade in the proposed building areas at the subject sites in Carlsbad, California. The soil samples were obtained on February 16, 1979 and the results of the moisture detennin- ations are presented as follows: Depth of Sample Moisture Lot Approximate Belov/ Existing Grade Content No. Location of Samples (in feet) (% dry wt) 201 Northerly portion of proposed 1.0 16. 1 building area 2.0 15.6 3.0 16.3 Southerly portion of proposed 1.0 16.6 building area 2.0 16.8 3.0 16.3 212 Southerly portion of proposed 1.0 22. 1 building area 2.0 16.8 Encountered rock at 2.2 feet Northerly portion of proposed 1.0 22.4 building area 2.0 20.6 Encountered rock at 2. 5 feet project No. 79-2-13M •San Diego Best Builders -2-February 20, 1979 It is concluded from the field observations of the various soil types and the final results of the moisture determinations that the soils in the upper three feet below finished grade at the locations sampled on Lot 201 and in the upper 2.2 to 2.5 feet on Lot 212 have been sufficiently moistened to minimize the potential expansion of the soils as recommended in our report under Project No. 70-10-28D dated October 12, 1971. Respectfully submitted, BENTON ENGINEERING, INC. By -t^ AZ^ -^^ii>«^ R. C. Remer Reviewed by Phili^ST^Bent/^n"/Civil Engineer^ RCE No. 10332 Distribution: (2) Addressee (1) City of Carlsbad, Building Department, Attention: Mr. Ray Green BENTON ENGINEERING, INC. MODULAR FIXTURES CORPORATION 638 WEST 17TH STFIEET, COSTA MESA, CALIFORNIA 92627 • (714) 631-2272 MAILING ADDRESS P.O. BOX 1028 COSTA MESA, CA 92627 CERTIFIED ]>JAIL RE 27 Septen±ier 1978 **• ^w, . OCT 2 l3;s Mr. Richard Osbum —mi. City Of Carlsbad ^PtiMng Deoartn, . 1200 Elm Avenue * "^P^nment Carlsbad, "Califomia 92008 Dear Mr. Osbum: THIS letter is being written to you in reference to Modular's simulated roof- ing panels installed on the Wheeler job for Ca].lin Construction (Cal Laken) ty Bear State Roofing. I saw the letter you wtrote to Mr. Chuck Ramani at the I.C.B.C. Office requesting clarification of the fire rating and was of the opinion Mr. Rairiani responded to your letter several v;eeks ago. ~ approximately a year ago f/bdular manufactured its product from 2 different materials. One was a fire retardant material t±iat has been accepted by I.C.B.O. for Class "C" and "B" fire ratings and the other material VTas a standard non fire retardant material that .did not meet any fire classification — the same as wood shakes does not meet a fire classification. We have not manufactured with the non fire retardant material for the past year. Both types of material ware identified on our literaiture and price page and in fact priced differently. As I believe you know we supplied the material direct to Bear State Roofing and had no contract with Collin Construction. The material we supplied to Bear State Roofing was all fire retardant material with the exception that we leamed later that in error a few pieces of the old non fire retardant material was supplied as ridge cap. To the best of oixr knowledge that material was retumed to Modular (our records will substantiate this) and fire retardant material was given in exchange. I understand that a couple of scrap pieces of the non fire retardant material was fomd on the Wheeler job. Perhaps it was on Bear State's truck and fell off or v\Aiatever but I can say Bear State only had fire retardant material and therefore that must be viiat v/as installed on the Wheeler job. I believe you found that the other material scraps on the job v;ere self extinguishing v^ich si±istantiate iry comments above. CERTIFIED MML Richard Osbum Page -2- 27 September 1978 I herewith respectively request that you honor the I.C.B.O. fire rating acceptance of our product and in particular on the subject job so that Mr. Laken can complete his financial responsibilities. If there is any additional information that you require please feel free to call me collect at your convenience. Thank you for your considerations. Very truly yours, MODULAR FIXTURES CORPORATION I Willia^U. PRESIDENT Hoofe, WJH/maf cc: Bear State Roofing P.O. Box 1099 Rialto, California Mr. Laken Coronado Pools 3705 So. Cordova Spring Valley, Califomia 92077 'SI .V. A .Z^ZAAAAAAAAAA.^JAAAA. Z AAAkA,Z ,:t4AAAAA..^.MvAAAAAAAX i CiTY OF CARLSBAD i ^ This Certificotc issued pursuant to the requirements of Section 306 of the Uniform Building Code certifies that at the time of issuance <^ this structure complies with appSicable ordinances of the City ^ regulating building construction use. > Hi>- Clnsnfirntion DuplSX ^ Hrniip ^ 3/M1 Type Construction. VN Bldg. P>,.,>M. 78-5984/78-59851, .Use Zone. R-2 ? Occupant Load- Owner of Building G?^^! jrgb/LUCe Building Address. <l _ .. . ="2557/2559-Luciernaga . , Carlsbad, CA. 92008 :Address 2564 Navarra .Locality NOTE: Allftrotions, changes, addilions or chongas of occupancy nul\tfio5 this certiticota. (Post in corrspicuous ploco) 11/23/^999, City of Carlsbad Plumbing Permit Permit No:CB994365 Building Inspection Request Line (760) 438-3101 Job Address: Permit Type. Parcel No. Reference # Project Title. 2557 LUCIERNAGA ST CBAD PLUM 2153000802 Lot#: 0 Construction Type: NEW WALDEN RES-REPLACE WATR HEATR Status- Applied Entered By. Plan Approved: Issued' Inspect Area. ISSUED 11/23/1999 RMA 11/23/1999 11/23/1999 Applicant A&J FOSTER, INC. STE B 13706 HWY 8 BUS EL CAJON CA 92021 619-390-4477 ^,,.^t|iX||^HEEL€BW^^^^^ D&VIOLA E TRS Total Fees $27 00 #f|f f'Tstalfpayments f dl3atej%;" $0 00 %ftcl-<fy'Balapce Due •''S'-tA % AAiAi $27.00 Plumbing Issue Fee • Fixture or Trap ' Building Sewer Roof Drain Install/Repair Water Line Water Heater and/or Vent Gas Piping System Vacuum Breaker Ottier Plumbing Fees Master Drainage Fee Sewer Fee €>jCkZZt&?i 0 0 0 0~ ^ 1 ^ '- l«pooo Af/ f:ZAZmi4o.oo ' m' /Z'zA:Mi^o-oo /<f1#;&;?ff $0 00 AZA'lAZAvA $7.00 A'A:-^'A&-jy $o.oo $0.00 $0 00 $0 00 $0.00 TOTAL PERMIT FEES $27.00 Inspector FINAL APPROVAL Date: Z^-?-^? Clearance. NOTICE Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions" You have 90 days from the date this permit was issued to protest imposition of these fees/exactions If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3 32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capactiy changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously othenwise expired CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 ! -PERMIT APPUCATION , CITY-OF CARLSBAD BUILDING DEPARTMENT ; 2075 Las Palmas Dr., Carlsbad CA 92009 1 (1519) 438-1161 1 ii^jmxcii^WJiaMms^^ 2557 Luciernaga St FOR OFFICE USE ONLY PLA'N CHECK NO ECT. VAL. ONLY , plan Ck. Deposit Validated By Date » - - s rAbdrjis* lincludt Bidg/Suit* f) il ' " {fi ^ t(la<!|''Oucriptian BuslniH Ntmii (tt this/addrau) Lot No. g^l^bdivlsJon Nimi/Numb«r Unit No. Ftiasa No Total I ol units iMsof'i Pa'rcai # Existing UM Propoaad Uaa i ';0«|«iption of Work SQ. FT. lot Storif* t of Bedrooms V-A ' WATER HEATER REPLACEiyiENT ts:^rcQNi^cTi'En$o.(i(irdi(itmtj^^^^ ' 1 Walden, Alex 2b57'LpiC H of Bathrooms Sa^.'>i^77v68,43 ,.h(arni Address 1. • 4 c;ViF.T,r.,Y JOHNSON/KRISTY FOS' City State/Zip Telephone t Fax t 3^-.'Am9Sa?0-4477 ViNamv Address t-H fei^Pn, A1^^ 2557 Luciernaga city Stats/2lp Telephone C Address Qty ^I l.. Stste/Zip Telephone » iBssaaaiBMgSiiiflB^^ ' j (Sjec.'^'7031.6 Business snd Professions Coda: Any City or County which rsqulras • psrmit to construct, titer,'Improvt, demolish or repair any structure, prior to Its ' ^ jisuance, also requires ths applicant (or such permit to (lit t signed slitemant thtt ht Is Uctnttd pursuantj\to tht provisions of the Contractor's Ucense Law 1 'iCihipter 9, commending with Section 7000 of Division 3 of tha Business end Profasilons Cods] or thet h'e'ls: exempt therefrom, and the basis for tha alle^ ' exemption. Any violation of Section 7031.5 by eny epDlieant (or JU>srjnlLsuhlsct« tht tppllcant tAjS ctwiKptnelty of not nraie thargg6@ibdr^i^^)si$ibei 1 A&J FOSTER PLUMBING Ii706-B HWY 8 ^DS^. EE, vjwv^ ^ . Nam* r 'S'lattUctrua \ : 630120 Addiess Uctnat CIsss, C-36 City State/Zip • , * ^' > . City Business Ucense I ¥ f I .Designer Nama M f,^ ,'%tata'Uctiue f N/A Address City ., Stete/Zip Telephone ^IR^i^pnWORKEHSl'COMPENSAtldHi^^ '.'^ rS!'^ rvWorltera' Compensalion Daderstlon: t heieby affirm under penalty of perjury one of the following dacleretlons: ' > - ' mss •» ^ have and will maintain a certlficete of consent to self-insure for workere' compensstion ss provided by Ssctioii ,3700 of the Lebor Code, for the perlormance ' ,brj the work for which this permit le Issued. J, I jEj^'l have er>d will msintein workers' compensation, as required by Section 3700 of the Labor Code, (orithtipertormance ol tha work tor which this permit Is Issued. My worker's comperuetlon Insurence Mrrler iH^ N2007-^5,6'-51 CONTIMJOUS iRSuifsnce Coinpany FAE^MER INSURANCE PoUey No._ Expiration Oate f (THIS SECTIOH NEED HOT BE COMPLETEO IF THE PEtUUrT 18 FOR ONE HUNDRED DOLLARS l»100) OR LeSS);;{' ' 0}' ' CERTIFICATE OF EXEMPTION: I certify that In the performence of the work (or which this parmit Is lssued,''>l;siisii not employ eny person In any manner so as to become subject to the Workers' Compensetlon Laws o( Cslllornia. :i'' I WAHNINQ: Faltuia to sacucf workers' compensatton coyejMie Is unlew(ul, and thaU subject an employer to'ctlmlnal' ptnalttet and civil fines up to one hundred lOCOQJUrinSUdition to tiak^ott o( i> thou'saivl dollars {(100 , SIGNATURE ^ '^-bWNEB-BUiLDWDeclAHATIONi*®ij,f>'; >' i^liereby affirm thai I am exempt from the Contri amages at provldad (or In Section 370S o( DATE ' lytco^e, Inteituit end attorney's (tea. lor's Uceiue Lew for the following reeeon: ; ^UlT'lVi i • >• es owner of the property or my employees with wages es their sole compensstion, will do the work';,ancl the, structure Is not inlended or offered for sale i iSsc. 7044. Business and Professioiu Code: The Contrectot'e Uceiue Law does not sppty to an owner of propert'y who builda or Improves thereon, end who does svjch work hirnsell or through hit own employees, provided thet euch Improvements sre not Intended or offeied^pr eele., If, however, the building or Improvement is si^d'.vilthln one year ol completion, the owner-builder wlU hava the burden of proving that he did not bulid orlinp'irova'ior the purpoae ol sale). \ ;;L<< ea owner of the property, em exclusively contreeting with licensed contractore to construct'ttie project (Sec. 7044, Business and Professions Cods: The r. CehtVector't Ucense Lew does net epply to en owner o( property who bullde or Improves thsreon, end cpntfecte (or euch projactt with contractorls) licensed pursusnt to the Contrector't Ucense Lewj. > Q I am exempt under Section Business end Piotetilons Code (or this retson: ; 1: I personally plan to provide the meJor labor end meteriats (or consuucUon o( the propoeed property improvement. O YES QNO ' 2;| I (have / have not) signed sn sppllcetlon (or e building permit (or the proposed work; ^: 'A.\ I 3.' I have contracted with the (ollowing person KIrm) to provide the proposed construction (Include neme./;eddress / phone number / contractors license numberl: , 4;j I plan to provide portioi« o( ths woik, but I have hired the (ollowing person to cooidinttt, tuperviie tnd'proyide tht major work linclude name / address / phone i number / conuactots license number): , ,>'• ••• \ S:i I wilt provide some o( the work, but I have contracted (hired) tha foiiowing persons lo provide the work Indicated (include name / address / phone number / type 5 oljwork):. ',!?•':-. S*i'» OAT& PltOPEBTY OWNER SIGNATURE Isftheiappticant or future building occupent required to submit a butlnoM plan, acutely hazardoua meterlels reglstretlon form or riak management and prevention program under Sections 26605. 25633 or 26634 ol the Presley-Tenner Hezsrdous Substance Account Act? .KCD' YES • NO I tojithe epplicant or future buildtng occupant required to obtain a permit (rom the elr poUution eonuol dlsuict of'^^^ • YES • NO I ls<|the fecility to be constnjcted within 1,000 (eet ofthe outer boundery o(e school slte7 • YES • N0.!jj^''^7 ' i lfi'ANY OF THE ANSWERS ARE YES. A FINAL CERTIFICATE OF OCCUPANCY MAY NOT RE ISSUED UNLESS THE APPUCANT HAS MET OR IS MEETING THE I REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES ANO THE AIR POUUTION CONTROL DISTRICT.':' [. jahlCOHSTRUCTIOHLENDlHQ'AOENCY^'fe^^^fflSMMM^^ i i ' . I hereby sffirm that there Is s conslruction lending agency for the performence of the work for which thle permit it'issued ISac. 3097(11 Civil Cods) ' LENDER'S NAME LENDER'S ADDRESS ' - Ws:'iAWlCANT,cERT^Flc^T^o^.w^fe"^^m'^w£ '-ms^w^^Mmmmmmm^m^sw^^u^w^i^ii-, i-, z - 4-} pertlfy thet I have reed the epplicetlon and stete that the above information it coirect and that the Inlormatlon dn the plans Is accurate 1 agree to comply with all t 'jCitV'Oftfinencet tnd Stale laws Itltting to building construction. I hereby authotUe lepreeentelivee o( theECity of Carisbad to enter upon the above mentioned ptopehy.(or mspection puiposes. I ALSO AQREE TO SAVE. INDEMNIFY AND KEEP .HARMLESS THEfplTV, OF CARLSBAD AQAINST ALL LIABILITIES, •fij|ip^MHlTS, COSTS AHD EXPENSES WHICH MAY IN ANY WAY ACCRUE AQAINST SAID CITY IN CONSEQUENCE OF THE GRANTINQ OF THIS PERMIT. !''^!sHA: An OSHA permit is required (or excevetlons over 6,'J3" deep end demolition or consuuctlon o( sUuctures^oyer 3 stories In height. UWIHRATION: Every peimit issued by the Building Otfldei under the provisions of this Code shsll expire byi^l'lmltellon end become null and void il the building or I''work tuthoriied by such permit Is not commeneed within 386 deys (rom the dite o( tuch permit or II the bulii^lng or work authorized by such permit Is suspended i (^ abendonetJ at eny tlmt »(lBi the woikIscommenced(of ijerlod o^J^dey* (Section 108.4.4 Unilorm Biiilding Codel, ^^^ ^ ^ ^APaiCANT'S SIGNATURE hs woik Is commsnced for i p« yZ;AlJA. City ofCarlsbad Inspection F^equest For 12/7/1999 Permit# CB994365 Title: WALDEN RES-REPLACE WATR HEATR Description: Inspector Assignment DM Type PLUM Sub Type. Job Address: 2557 LUCIERNAGA ST Suite. Lot 0 Location. APPLICANT A&J FOSTER, INC. Owner: WALDMAN ALEXANDER JR&THERESE Remarl<s' Phone. OOOOOOOOOO Inspector' Total Time. CD Description 25 Water HeaterA/ents Act Comments AR. Requested By TERESA Entered By CHRISTINE Associated PCRs Inspection History Date Description Act Insp Comments 12/1/1999 25 Water Heater/Vents CA DM 03-06-2009 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Mechanical Permit Permit No: CB090359 Building Inspection Request Line (760) 602-2725 Job Address Permil Type Parcel No Valuation Reference # PC# Project Title 2557 LUCIERNAGA ST CBAD MECH 2153000802 $0 00 WALDMAN RES REPLACE FAU Lot# Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 03/06/2009 KG 03/06/2009 03/06/2009 Applicant ASI HASTINGS Owner WALDMAN ALEXANDER JR&THERESE M 1250 GREENFIELD DR EL CAJON, CA 92167 619-223-9016 2557 LUCIERNAGA ST CARLSBADCA 92009 Mechanical Issue Fee $15 00 Install/Furn/Ducts/Heat Pumps Fee 1 $9 00 Fireplace Installation Fee 0 $0 00 Exhaust Fan Fee 0 $0.00 Installation/Relocation Vent Fee 0 $0 00 Hood Fee 0 $0 00 Boiler/Compressor to 15HP Fee 0 $0 00 Other $0 00 Additional Fees $0 00 TOTAL PERMIT FEES $24 00 Total Fees $24 00 Total Payments To Date $24 00 Balance Due: $0.00 Inspector' FINAL APPROVAL Date: "^/^M Clearance NOTICE Please lake 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 fiom the date this pemiit w/as 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 nght to protest the specified fees/exactions DOES NOT APPL Y 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 fees/exactions of which vou have previouslv been given a NOTICE similar to this, or as to which the statute ol limitations has previously othenwise expired City of Carlsbad 1635 Faraday Ave., Carlsbad, CA 92008 , 760-602-2717/2718/ 2719 Fax- 760-602-8558 Building Permit Application Plan Check No C3A03AA Est. Value Plan Ck. Deposit A- JOB ADDRESS •» SUITEK/SPACEK/UNlTd CT/PROJECT « ,HASE » » Of UMITS If BEDROOMS It BATHROOMS TENANT BUSINESS NAME CONSTR TYPE OCC GROUP DESCRIPTION OF WORK. Include Square Feet af Affected Areafs) EXISTING USE 2i PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPUVCE YESfn* N0| I AIR CONDITIONING YES I |NO|^ FIRE SPRINKLERS YES I [NO| I CONTACT NAME (ir Different AomlApp/lcant) APPLICANT NAME - )DRESS ADDRESS A^ ADDRESS STAT4 CITY STATE X ZIP PHONE PHONE FAX EMAIL EMAIL PROPEirrV OWNER NAME v y \ ADDRESS CONTRACTOR BUS NAME (ESS • \ :i ~ STATECA ADDRESS ZIP ^ ZIP CITY STATE PHONE FAX PHONE EMAIL ARCH/DESIGNER NAME 4 ADDRESS CLASS CITY BUS LIC » (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 Contractor's License Law IChapter 9, commending with Section 7000 of Division 3 of the Business and Professions Codel 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|) *J ""LJS, Worker?' Compensation Declaration / hereby affirm under penalty of perjury one ofthe lollowing declarations I have and will maintain a certificate of consent to self.insure for workers' compensation as provided by Seciion 3700 ol Ihe Labcr Code, for the perfomiance of Ihe work for which this permit is issued •qal have and will maintain wc>rl<ers' compensation as reauired bv Section 3700 of lhe Labor Code, for the performance of Ihe work foe which this pennil is issued My vwrkers' compensation insurance earner and policy number are Insurance Co Policy No V<vjf> '^jb '''''X^^'SM \>^-II^I^ Expiration Date \0 \ 0*^ ThL".section need nol be completed if lhe permit is for one hundred dollars ($100) or less *^'^^O0 O"^^ ^'AO 0 _ j_,artificate of Exemption' I certify lhal in the perfomiance ol Ihe work for which lhis permit is issued, I shall nol employ any person in any manner so as lo become subject lo Ihe Workers' Compensation Laws of California WARNING Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalhes and civil fines up to one hundred thousand dollars (&10O,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attomey's fees JSS CONTRACTOR SIGNATURE DATE I hereby affirm that I am exempt Irom Contractor's License Law for Ihe following reason I I I, as owner of Ihe property or my employees with wages as their sole compensation, will do Ihe work and the stmcture is nol intendeij or offered for sale (Sec 7044, Business and Professions Code The Contractor's License Law dees not apply to an owner of property who builds or improves Ihereon, and who does such work himsell or Ihrough his own employees, provided lhat such improvemenls are nol intended or offered for sale If, however, Ihe building or improvement is sold within one year of completion, Ihe owner-builder will have lhe burden ol proving lhal he did not build or improve for the purpose of sale) "I I I, as owner of lhe property, am exclusively contracling with licensed contractors lo conslnict Ihe project (Sec 7044, Business and Professions Code The Conlraclor's License Law does nol apply to an owner of property who builds or improves Ihereon, and contracts for such projects wilh contraclor(s) licensed pursuani lo Ihe Contractor's License Law) I I 1 am exempi under Section Business and Professions Code for lhis reason 1 1 personally plan to provide the major labor and maienals for construction of Ihe proposed property improvement QYes j |NO 2 I (have I have not) signed an application lor a building permit lor the proposed work 3 I have conlracled with the lollowing person (firm) lo provide Ihe proposed construction (include name address / phone / contractors' license number) 4 I plan to provide portions of the work, bul I have hired the following person to coordinate, supeivise and provide the major work (include name / address / phone / contractors' license number) 5 I will provide some of Ihe work, but I have contracted (hired) the lollowing persons lo provide Ihe work indicated (include name / address / phone / lype of work) yfifpROPERTY OWNER SIGNATURE DATE is the applicant or future building occupant required lo submit a business plan, acutely hazardous matenals registration lorm or nsk management and prevention program under Sedions 25505, 25533 or 25534 of lhe Presley-Tanner Hazardous Substance Account Acf j j Yes I iNn Is the applicant or luture building occupant required lo obtain a permit from lhe air pollulion conttol dislnct or air quality management distncP I lYes I j No Is Ihe facility to be constructed wilhin 1,000 feet ol the outer boundary of a school site'' r^Yes flNo 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 I certfy that I have read the application and state thatthe above infomiation is correct and thatthe infomiation on the plans is accurate. I agree to comply with ali City ordinances and State laws relatingto building constnicton 1 hereby aulhonze represenlative of Ihe City of Carlsbad lo enter upon the above mentioned property for inspecton purposes 1 ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITC OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT OSHA An OSHA perniit is requiiEd for excavatons over S'C deep and demoliton or conslnjcton of slniclunes over 3 stones in heighl EXPIRATION Every pennit issued by Ihe Building Ofliaal under lhe jKitii^ions of Ihis Code shall expire by iinnilation and become null and void if Ihe building or work authonzed by such permit is nol commenced wilhin 180 days from lhe dale of such permil pi^yhe building or work aulhoni^ bS^such pemnit is suspended or abandoned al any time after the work is commenced lor a penod of 180 days (Section 106 4 4 Uniform Building Code) APPLICANT'S SIGNATURE DATE City ofCarlsbad Bldg Inspection Request For 03/24/2009 Permit# CB090359 Title WALDMAN RES REPLACE FAU Descnption Inspector Assignment. 2557 LUCIERNAGA ST Lot 0 Type MECH Sub Type. Job Address Suite Location. OWNER WALDMAN ALEXANDER JR&THERESE M Owner WALDMAN ALEXANDER JR&THERESE M Remarks AM PLEASE Phone 7604389060 Inspector Totai Time CD Descnption 49 Final Mechanical Act Comments Comments/Notices/iHolds Requested By. MR. WALDMAN Entered By: KATHY Associated PCRs/CVs Original PC# inspection History Date Description Act Insp Comments 05-30-2013 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Plumbing/Mechanical/EleGtrical (PME) Permit Permit No: CBI 31349 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Reference # PC# Project Title 2557 LUCIERNAGA ST CBAD PME 2153000802 Lot# WALDMAN REPLACE WTR HTR Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 05/30/2013 JMA 05/30/2013 05/30/2013 Applicant Owner ARS AMERICAN RESIDENTIAL SERVICES OF CALIFORNI WALDMAN ALEXANDER JR&THERESE M STE A 9895 OLSON DR 2557 LUCIERNAGA ST SAN DIEGO CA 92121 CARLSBAD CA 92009 858-457-6572 Plumbing Fees Electrical Fees Mectianical Fees Other PME Fees $31 00 $0 00 $0 00 $64 00 TOTAL PERMIT FEES $95 00 Total Fees $95 00 Total Payments To Date $95 00 Balance Due: $0.00 inspector FINAL APPROVAL Date ^^11-^(3 Clearance NOTICE Please take NOTICE that approval of your project includes the "Innposition" of fees, dedications, reservations, or other exactions hereafter collectively refen'ed to as "fees/exactions" You have 90 days Irom the date this permit was issued to protest imposition of these fees/exactions If you protest them, you must lollow 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 lo 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 lees/exactions of which vou have previouslv been given a NOTICE similar to this, or as to which the statute of limitations has previously othenwise expired A CITY OF CARLSBAD Building Permit Application 1635 Faraday Ave , Carlsbad, CA 92008 760-602-2717/ 2718/ 2719 Fax 760-602-8558 wwrw.cailsbarJca gov Plan Check No. Est. Value Plan Ck. Deposit Date I JOB ADDRESS suiTe«/sPAcafi/uNiT» CT/PROIECT S PHASE It H OF UNlTSLi » BEDROOMS # BATHROOMS TENANT BUSINESS NAME CONSTR TYPE occ GROUP DESCRIPTION OF WORK Include Square Feet of Affected Aiea(s) EXISTING USE PROPOSED USE GARAGE (SF) PATIOS ISF) DECKS (SF| FIREPLACE YES • # NO O AIR CONDITIONING YES • NOD FIRE SPRINKLERS YES • NOD CONTACT NAIVIE (If Difterent Fom AppllcantI APPLICANT NAME ADDRESS ADDRESS , _ of? ZZ ZT STATE ZIP CITY jC PHONE FAX PHONE FAX _ PROPERTY OWN 1^^^^^^^%c uJo^lA mcAn CONTRACTOR BUS. NAME fiRS Son Ore ADDRESS CITY ; STATE O ADDRESS OL-Savn Dr. CITY_ _ STATE STATE PHONE PHONE _ FAX EMAIL ARCH/DESIGNER NAME & ADDRESS CITY BUS UCH (Sec 7031 5 Bus mess and Prolessions Code Any City or Counly which requires a permit lo construci. alter improve, demolish or repair any structure, prior to its issuance, also requires the applicant lor such permit to file a signed statement lhat 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 inal he is exempt therefrom, and the basis for the alleged exemplion Any violation of Section 703i 5 by any applicant for a permit subjects the applicant lo a civil penalty of not more than five hundred dollars ($500}) m MM Workers' Compensation Declaralion / hereby aftirm under penalty ol perjury one of the following declarations O yf have and will maintain a certificate ol consent to self-msure for worlters' compensation as provided by Seciion 3700 ol the Labor Code, lor lhe performance of the work for which (his permit is issued ^^1 have and will maintain workers' / number are Insurance Co skompensation, as required by V^>TVprS'L4 J dol'a Sedion 3700 ol lhe Laboi Code for Ihe performance of Ihe work for which this permit is issued My workers compensalion inaliranctf earner and polic Policy No ^ (.QS I 50^CP3 i Q I i ExDiralion Dale 1 O / I / / "Z. This seclion need not be completed if Ihe permit is (or one hundred dollars ($100) or less n Certificate of Exemption' I certify lhal in Ihe perlormance of Ihe work for which Ihis permit is issued, (shall no( emp(oy any person in any manner so as (o become subjecl to Ihe Workers' Compensalion Laws of California WARNING Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil hnes up lo one hundred thousand dollars (&100,000), m GENT DATE / heretiy affirm that lam exempt from Contractors License Lav/for the following reason 3 I as owner ol Ihe properly or my employees with wages as their sole compensation will do the work and Ihe structure is nol inlended or offered for sale (Sec 7044. Business and Professions Code The Conlraclor's License Law does not appiy to an owner ol property who builds or improves Ihereon, and who does such work himsell or Ihrough his own employees, provided thai such improvemenls are nol intended or offered for sale If however, lhe building or improvemenl is sold within one year of compielion, Ihe owner-builder will have Ihe burden of proving lhal he did not build or improve lot Ihe purpose ol sale) 3 I, as owner oi Ihe property am exclusively conlracling with licensed coniractors to construct the projecl (Sec 7044, Business and Professions Code The Contractor s License Law does not apply lo an owner of properly ivh o Puilds or improves Ihereon, and conlracis (or such projects wilh con(raclor(s) licensed pursuani lo Ihe Conlractor s License Law) 3 1 am exempt under Seclion Business and Professions Code lor Ihis reason 1 I personally plan lo provide Ihe major labor and maienals lor construclion of the proposed property improvemenl 3 Yes 3 No 2 I (have / have nol) signed an application lor a building permit for Ihe proposed work 3 I have conlracled with Ihe following person (firm) to provide Ihe proposed construction (include name address / phone / contractors' license number) 4 I pian to provide portions of the work, bul I have hired the following person to coordinate, supen/ise and provide the major work (include name / address / phone / contractors license number) 5 I will provide some ol Ihe work, bul I have conlracled (hired) the following persons to provide Ihe work indicated (include name / address / phone / type ol work) jS^PROPmr OWNER SIGNATURE • AGENT OATE •Z"AA^ is Ihe applicant or iulure building occupant required to submit a business plan, acutely hazardous materials registration form or risk managemeni and prevention program under Sections 25505. 25533 or 25534 of lhe Presley-Tanner Hazardous Substance Accouni Acf D Yes • No Is lhe applicant or future building occupant required to obtain a permit from the air pollution control distnct or air quality management distiicl'^ 3 Yes • No Is Ihe facility to be constructed within 1.000 leet ol lhe outer boundary ol a school site'' D Yes 3 No IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS I^E^ OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT I hereby affirm lhal there is a construclion lending agency for Ihe performance of Ihe work lhis permil is issued (Sec 3097 (i) Civil Code) Lender's Name Lender's Address 1 certify that 1 have read the application and state that tJie above infomialion is conect and that the infoimation on the plans is accurate I agree to complywith all City oidinances and State laws relating to building constmction I hereby aulhonze representative ol lhe City ol Cailsbad lo enter upon the above mentioned properly for inspeclion purposes I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CiTY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CiTY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT OSHA An OSHA pemiii is required for excavations over 5 0' deep and demoliton or consliudion of sliuclures over 3 stones in height EXPIRATION Every permil issued by lhe Building Official under lhe provisions ol Ihis Code shall expire by limitation and become null and void if the building or woil( authorized by such pennil is nol commenced within 180 days from the dale ol such pennil or if Ihe building or work authorized by such permil is^yspended or abandoned al any lime after the work is commenced lor a pefod ol 180 days (Seclion 106 4 4 Unilomi Building Code) ^gS"APPLICANT'S SIGNATURE ^ ^^J^^^;;;;^^ DATE 5 Bo Inspection List Permit#: CB131349 Type: PME WALDMAN: REPLACE WTR. HTR. Date Inspection Item Inspector Act Commeirits 06/11/2013 25 Water Heater/Vents - Ri 06/11/2013 25 Water HeaterA/ents MC AP EXISTING LOCATION 06/11/2013 29 Final Plumbing - Ri 06/11/2013 29 Final Plumbing MC Fi Wednesday, June 12, 2013 Page 1 of 1