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Home My WebLink About2607 LA GOLONDRINA ST; ; CB911324; PermitB U I L D I N G P E R M I T 09/20/91 .:.4:07 Page 1 of 1 Job Address: 2607 LA GOLONDRINA ST Str: PerMlt Type: PLUMBING Parcel No: 215-562-21-00 Vclluation: o Construction Type: NEW Occupancy Group: Class Code: ~escript1on: GAS LINE FOR BBQ Appl/Ownr : GRELL, JEFF (619) 2607 LA GOLONDRINA ST CARLSBAD, CA 9l009 *** FPec; Rf'quired *** Fees: 1 Adjustments: Total Fees: Permit N0: r·B911 124 Project No: A1101b~7 Development No: Fl: Ste: 4499 09/20/91 0001 01 02 C-PRMT 10-00 (!,Asl'- ____ £D Applied: 09/2 l/41 Apr/Issue: 09/l0/l1 Validated By: ~,BB 438-188.:i .00 .00 10.0C *"I<. Ext fee D.=tta Fee description Enter Y' for Plum Gas Piping System ue Fee ~ 7.50 Y ) 2.50 * PLUMBING TOTAL 10.00 ,-__________ __ CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad CA 92009 (619) 438-1161 PERMIT APPLICATION City of carlsbad Building Departaent 2075 Las Pal•• Dr., Carlsbad, CA 92009 (619) 438-1161 I. PEkMl I IYPE A -U COmmerctal U New Butldmg Li I enanc Improvement B -D Industrial □ New Building D Tenant Improvement C -□ Residential □ Apartment D Condo □ Single Family Dwelling □Addition/Alteration □ Duplex □ Demolition U Relocation □ Mobile Home □ Electrical □ Plumbing □Mechanical □Pool □ Spa □Retaining Wall □Solar □Other, _____ , 2. PROJECr INFORMATION ~rrsf""\7 1 "' r \ _J _ • c-L BuJJdmg or Suile No. N~ross s~ ~O t:;r,\~ 0r CHECK BEWW IF SUBMII ~ □ 2 Energy Cales □ 2 Structural Cales □ 2 Soils Report □ 1 Addressed Envelope l. WN IACI PERSON (If dnlerent from appUcant) NAME ADDRESS PLAN CHECK NO. EST.VAL. __________ _ PIAN CK DEPOSIT, ________ _ VALID.BY, __________ _ DATI! FOR OFFICE USE ONLY Omt No. Phase No. PROPOSED USE STATE ZIP CODE UAGENI FORWNIRACIOR ADDRESS wNER DAGEN I FOR OWNER ~ DAY TELEPHONE STATE ZIP CODE 5. PROPrutl Y OWNRll / NAME'1"effG ~ l) ADDRESS ZIP CODE DAYTELEP~, ')._(, 01 L ft 6 c,/ °"' ~ S--f. 9 «t2at:1 DAYTELEPHONE 6/'t-"1'3r-l gg.3 / / CITY STATE 6. WNlitACIOk NAME ADDRESS , CITY SAM& STATE STATE UC.# ZIP CODE UCENSE CLASS DAY TELEPHONE CITY BUSINESS UC. # CITY STATE ZIP CODE DAY TELEPHONE STATE UC.# 7. WUkkRRS' WMPENSAiiON Workers' Compensation Ueclarat1on: I hereby allmn that I have a cert1hcate of consent to self-msure issued by the Director of industnal 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 Cert1hcate of Exempuon: I certify that m the performance of the work for which this pemut 1s issued, I shall not employ any person m any manner so as to become subject to the Workers' Compensation Laws of California. SIGNATURE DATE 8. OWNlfit-B0liDkk Dfl!IJJtAiiuN X OWner-Buiider Deciaratton: I hereby affmn that I am exempt from the Contracto?s Lcense 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 Professions Code: The Contractor's Llcense 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.). D 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 Llcense 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 permit to construct, alter, improve, demolish, or repair any structure, prior to its i~uance, 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 the i pt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit sub th nt t ·vit penalty of not more than five hundred dollars [$5001). DATI! '1-:z.o -'i I Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration fonn or risk management and prevention program under Sections 2,@)5, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? □ YES J1!1 NO Is the applicant or future building occypant required to obtain a permit from the air pollution control district or air quality management district? □ YES l!I NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □YES □NO IF ANY OF nm ANSWERS ARE YES, A FINAL CERTIFICATI! OF oa:IJPANCY MAY Nar BE ISSIIFJ) AFIBR JULY), 1989 UNLESS nm APPLICANT HAS MET OR JS MEETING nm REQUIREMENTS OF THI! OFFICI! OF l!Ml!RGENCY SERVICl!S AND nm AIR POILU11ON <DNTROL DISllllCT. 9. WNS'IROCIION L£NDING AGENCY I hereby afurm that there 1s a construction lendmg agency for the performance of the work ior which lb1s permit 1s issued (Sec 3097(1} CIVIi Code). LENDER'S NAME LENDER'S ADDRESS 10. APPUCANI CEklfillCAliuN I certify chat I have read the apphcat1on and state that the above mformauon 1s correct. I agree to comply with all City ordinances 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 Al.50 AGREE ID SAVE INDEMNIFY AND KEEP HARMLESS nm Cf1Y OF CARI.5BAD AGAINST ALL UABlllTIES, JUDGMENTS, CDSTS AND EXPENSES WIIlCH MAY IN ANY WAY MilUJI! AGAINST SAID Cf1Y IN <DNSEQUENCI! OF TIii! GRANTING OF TIDS 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 under 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). DATI!: q -"1.D-'\ I WHITE: File YELLOW: Applicant PINK: Finance CITY OF CARLSBAD INSPECTION REQUEST PERMIT# CB911324 FOR 09/30/91 DESCRIPTION: GAS LINE FOR BBQ TYPE: PLUM JOB ADDRESS: 2607 LA GOLONDRINA ST APPLICANT: GRELL, JEFF CONTRACTOR: PHONE: PHONE: INSPECTOR AREA PY PLANCK# CB911324 OCC GRP CONSTR. TYPE NEW STR: FL: STE: (619) 438-1883 OWNER: REMARKS: MH/JEFF/AM PLEASE EARLY SPECIAL INSTRUCT: PHONE: INSPECTOR ---~1---I-'-------- TOTAL TIME: CD 52 LVL DESCRIPTION SW Underground Plumbing ------------------ ACT COMMENTS !+f__ _______ _ ------------------ ***** INSPECTION HISTORY***** DATE DESCRIPTION ACT INSP COMMENTS