HomeMy WebLinkAbout2606 Galicia Way; ; 81-441; PermitIll z 0 ~ Cl: ~ u Ill D
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O I ller9by affirm that I am licensed under I
provlalona of Chapter 9 (commencing with I
Section 7000) of Division 3 of the Business I
and PT01"8lona Code, and my license Is In .
lull force and effect. I Lie No. _______ Cl,ss _____ _
I hef90y affirm that I am exempt from the Con·
~~~·~:= ;!,· ~'~~i~1:Wc!J.~~l~~
county which requires a pennit to conslruct alter. improve, demoHsh. or repair any structure,
prior to it1 issuance atso requires the applicant tor
such permit to file • signed statement that he is licensed pursuant to the provisions of the Con-
lrac:to,'s License Law (Cllaplef 9 commencing With
Section 7000 of Oiv1st0n 3 of the Business and Pro. tessions Code) °' lhal ,s uempl ,,_.from and the
t>uis for the alleged exemption. Any viola.hon of Section 1031.5 by an applicant lo, a permit subjecll
tne applicant to a civil penalty of not more than five
hundr-«I dollOB ($!i()(ll.
C I, • owner ot the property, 0< my emptoyees ,.,th wages as their sofe compensation, will do the
WOftil.. and the structure is not intended or offered for
safe (Sec. 70U, Business and Professiotis Code:
The Contractor's License Uw does not apply to an
owner or p«>perty who builds or improves thereon .-10 who does such WOB him,elt Of through his own
empk)yees. provtded thal such improvemei'lts ..
not intende1 o, otte,ed 10< -· If, -er. the buikting or imp,ovetMOI 1s 50kS within one ., .. of
comptet.Jon, the OwtMtf-builoef will have the burden
of proving that he did not build °' improve ror the
purpooe of sate).
Q I, as owner ot the property, am exclusively
contrachn9 with licensed contr~to,s to construct the pro;.e-t (Sec. 7044. Business and Professions
Code: The Contractor's License Uw does not apply
to an owner ot property who builds o, improves ~'.:=i~':, ~~c=~~!~ ~:~:C:\~~;:.;
License Law).
C I am uempt under Sec. _____ , 8. & PC.
fo,this reason ___________ _
• I hereby affirm t~t I have a certificate of consent
to self-insure, or a certificate of Workers·
Compensation Insurance. o, a certified copy thereof
(Sec. J800, Labo< Code(
POLICY NO. ______ _
COMPANY
• Copy 1S filed Wllh the city.
C Cenified copy ,s hereby furnished.
CERTIFICATl OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE
(This section need not be completed 1t the permit
1s to, one hundred dollars ($1001 or less)
• I certify that in lhe performance of the wortc; '°'
wruch this permit 1s issued, I shall not employ any
person 1n any manner so as to beCome sub,ecl to
the WC>fkers· Compensation Laws ot Calltorma.
NOTICE TO APPI.ICANT· If, alter malun~ 1n1s Cen1, tiute of Exemption. you sl'\OUld become subject ,.,
the Won(ers' Compensation provisions of the ubcH
Code. you must forthwith comply with such
pr0¥1s1ons or this perm,1 shall be deemed revoked
D I hereby attum that there 1s a cons11uct1on
1end1no agency for 1ne perlOf'mance of the work lor
which this permll •s issued tSec 3097. C1v11 Godel
Lender·s Name ___________ _
Lender's Address __________ _
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USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
CARLSBAD BUILDING DEPARTMENT
1200 Elm, Carlsbad, Callfornla 92008 (714) 438-5525
APPLICATION & PERMIT
PERMIT NUMIER
-~
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CONTIIACTOR°I AOQtUU -
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DESIGNEII -:--:.
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UCINIING.
ITATI L.ICINM (I
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• 11 .,.. ........ '-.• ~-"!-~c,; ':f '; r ... -STORIES
PLAV,O~~ :-/ ILOG USE CODE
STANDARD PLAN# BUtLOING SQ. FOOTAGE
• I·.-I : I I /7 ,. !.J . f',
CENSUS TRACT r·LANO USE PARKING SPACE RES UNITS GRADING J'.ERMIT ISSUED
YO N D
vO NO
l REDEV ELOPMENT AREA TYPE
CONST
occ LOAD I FIRE SPR ,l I I 17 7 I / n. I . I ~.t .. \1
vO NO vO NO Nor Valid Unlm M«hiM t:.rrifi«I
QTY. PLUMBING PERMIT · ISSUE ? <{)j QTY. MECHANICAL PERMIT· ISSUE -~• C'\c1 SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP I -I I INSTALL FURN. DUCTS i.JP TO 100.000 BTU I I BUILDING PERMIT ·-·
EACH BUILDING SEWER I OVER 100,000 BTU SIGN PERMIT
EACHWATERHEATERANOIORVENT BOILER/COMPRESSOR UPT0 3HP PLANCHECK 10 /. ·-/•., f:~,)
EACH GAS SYSTEM 1 TO 4 OUTLETS I I I BOILER/COMPRESSOR 3-15 HP I I TOTAL PLUMBING
EACH GAS SYSTEM 5 OR MORE I I I METAL FIREPLACE I I ELECTRICAL
EACH INSTAL .. ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL
EACH VACUUM BREAKER I I I MECH EXHAUST -HOOD/DUCTS MOBILEHOME
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOMEPARKINSP
EACH flMDRAIN (INSIDE) I II I I I SOLAR
TOTJ;L MECHANICAL STRONG.MOTION
TOTAL PLUMBING l FIRE SPRINKLERS
IQTY. ELECTRICAL PERMIT -ISSUE _.,. I
,.,(, Q() QTY. SOLAR -ISSUE
PUBLIC FACILITIES FEE
BRIDGE FEE
NEW CONST EA AMP/SWT IBKR COLLECTORS SCHOOL FEE • DISTRICT
1 PH 3 PH STORAGE TANKS Carlsbad
EXIST BLOG EA AMP/SWT/BKR ROCK STORAGE Encinitas
1 PH 3 PH PUMP San Dieguito
REMODE L/ALTER PER CIRCUIT PLAN CHECK FEE San Marcos
TEMP PO LE 200 AMPS
OVER 200 AMPS
TEMP OCCUPANCY 130 DAYSI
TOTAL ELECTRICAL l TOTAL SOLAR TOTAL FEES PAYABLE l C ., .r ·+ ,\:J ..,
-;-
l~'VI CAMl'Ul.[TOAMINEDTHtC0MIUTIDM~TION-ftAMn'" ANO DO HEREBY
~
PEIW.TY 01'. PEMIIIY THAt. AU, INfOMIATIOM HEA&ON INCLUDING TME
~
-OORIIECT Ale I PUll'rtt8'GIR1'1P'IAND MAIi IF A PERMIT IS
CtTf, COUNTY ANG 8TAT! LAWS GOV&ANING BUILDING CON-HEREIN Oft NO't. I ALSO AGAEI! TO SAVE INDEMNIFY AND tlAALSIIAD ~ ALL UAIILITIU, JUDGMENTS, C08l8 AND
1XPEN1D WHICH MAY IN ANY WAY ACCRUi AGAIHSI' SAID cm' IN CONSeQuacE OF THI
GIWfTIN8 01' TMIS PERMIT.
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~TUM .. •. CZ i . ~0 ~~~· APPROVED BY DATE
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INSPECTION TYPE DATE INSPECTOR
BUILDING
FOUNDATION
REINFORCED STEEL
MASONRY
GUNITE OR GR"UT
FLOOR & CEILING SUB FRAME
SHEATHING
FRAME
EXTERIOR LATH INSULATION
INTERIOR LATH & DRYWALL
PLUMBING
SEWER AND BL/CO
PLUMBING UNDERGROUND
PLUMBING TOP OUT
TUB AND ~HOWER PAN -GAS TEST
ELECTRICAL
TEMPORARY POWER
ELECTRIC UNDERGROUND
ROUGH ELECTRIC
ELECTRIC SERVICE
BONDING A
G. F. I. -SMOKE DETECTOR.
MECHANICAL
DUCT & PLEM., REF. PIPING
HEAT -AIR COND. -SOLAR SYSTEMS
VENTILATING SYSTEMS
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HA VE BEEN APPROVED.
JOB SITE FINAL
PLUMBING
.ELECTRICAL • I
MECHANICAL /YJ,J, GAS /a ~ I
-BUILDING ~ J .,-r-
SPECIAL CONDITIONS ---CERT OF OCCUPANCY ISSUED
Y\-4'-1 (
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS ' INSPECTOR"S NOTES
INSPECTION REQ. IF INSPECTOR'S DATE CHECKED APPROVAL
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRESTRESSEO
CONCRETE
POST TENSIONED
CONCRETE
FIELD WELDING
HIGH STRENGTH
BOLTS
SPECIAL MASONRY
PILES·CAISSONS
.
.
.. City o ~arlsbad MISCELLANEOUS . • 120!) ELM, C. ,dAD, CA 92008 • TEL. (714) 438-5525 RECEIPT I / I / 11
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, ~~~r:J. (-; (J (c, 6t:JL/C:.11} 'I w '--t MISCELLANEOUS FEE RECEIPT f O It J-. Owner ~ TE/2 /I.~ r'__o LL1,,J.f' I • • PLAN CHECK FEE
Mailing 5~ • VALUATION ~ j-._,_, l/, -Address
f c2: f111 LS 8 4..b I Zip Tel. • DEMOLITION
Con~lor j ,_ ,{ JFI , .A /JooL~ 7-A/ ct. • HOUSE MOVING
Ad,ss -• PARKS AND RECREATION FEE '-I -...( ~. W t4 ';!--Ir ',,JJ -ro;...,, ~
c~}' -. 1 ~tnb'¥P 7 1-<) l ~-?'11-sooo • PUBLIC FACILITIES FEE
• SCHOOL FEE · DISTRICT State Lie. ), <'2,1./(J City
s. Clas~J"'i\ ~ e--:r i Lie. No. • Carlsbad
COMPµTE FOR PLAN CHECK ONLY ' • Encinitas
• San Diego
LEGAL DESCRIPTION ;
• San Marcos I
n
ASSESSORS PARCEL NO ;}_J6-JJ>11 -J~ n
n
DESCRIPTION OF WORK -n
?JJ () Jd r o-vJL n
n
J• n
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Jt-YY / • .
PLAN ID NO. •
DESIGNER ADDRESS • ,·
• PHONE
$4 (1 .(. ~--)~,r.r'-' f1ri? TOTAL FEE
CONTACT PERSW *WARNING: PLAN CHECK FEES. WHERE NO ACTION IS TAKEN BY THE ( ~i>-~r,-r) \ APPLICANT IN 180 DAYS AND NO BUILDING PERMIT IS ISSUED, FEE ARE
I FORFEITED TO THE CITY.
~'-___..,/ COMMENTS: .
Signature of Appllca-:YJ_ ),,,_ -~ Date lol.20/ ;~/ ' ~ v ' ~
White -Applicant Yellow -File Pink -(1) Finance (2) Data Process Gold -Assessor
INTERDEPARTMENTAL INFORMATION SHEET
BUILDING DEPARTMENT DATE:
ECEIVED
BUILDING ADDRESS~ bcrrt 0~~ lv~ __ o_c_r_1_')_1_ss_1 __
CITY OF CARLSBAD
Building Dcoartment
PLANNING DEPARTMENT
i ZONE __________ LOT SIZE _________ LOT WIDTH _________ _
UNITS ALLOWED ____________ UNITS PROVIDED ____________ _
PARKING SPACES REQUIRED PROVIDED ------------
% COVERAGE ALLOWED _____________ PROVIDED __________ _
BUILDING HEIGHT ALLOWED PROVIDED
FRONT SETBACK: SIDE SETBACK: REAR SETBACK:
ALLOWED
PROVIDED ______ _
, INTRUSIONS
LANDSCAPE & IRRIGATION PLAN COMMENTS:
ENVIRONMENTAL PROTECTION REQ:
OK TO ISSUE: ________ DATE ____ _
ENGINEERING DEPARTMEN
"1
R.O.W. ______ IND WASTE _______ IMPROVEMENTS _______ _
... SEWER CONNECTION ________ DRIVEWAY LOCATIONS ____________ _
GRADING PERMIT _______ EASEMENTS _________ DRAINAGE ____ _
LEGAL DESCRIPTION __ --,-__________________________ _
ADDITIONAL COMMENTS ____________________________ _
OK TO ISSUE:Jt&-e DAT/})~7/-t?l PWI ____ OK TO FINAL ____ DATE ___ _
FIRE DEPARTMENT
SPRiliKLING SYSTEM ____________ FIRE PROTECTION EQUIP. _______ _
FIRE ALARMS EXITS ________________ _
FIRE HYDRANTS LOCATION __________________ _
ADDITIONAL COMMENTS
OK TO ISSUE: _____ DATE _______ OK TO FINAL ______ DATE ____ _
WATER DEPARTMENT
REQUIREMENTS OF APPROPRIATE DISTRICTS MET ________ DATE ________ _
8/-YY/