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Home My WebLink About2612 LA GOLONDRINA ST; ; CB050529; PermitCity of Carlsbad -1635 Faraday Av Carlsbad, CA 92008 02-18-2005 Plumbing Permit Permit No: CB050529 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Reference#: Project Title: Applicant: 2612 LA GOLONDRINA ST CBAD PLUM 2155620300 Lot#: 0 Construction Type: NEW CONWAY RES-REPLACE GAS&ELECT TO POOL EQUIPMENT Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: CONWAY DAVID W&DENISE CONWAY DAVID W&DENISE 2612 LA GOLONDRINA ST CARLSBAD CA 92009 Plumbing Issue Fee Fixture or Trap Building Sewer Roof Drain Install/Repair Water Line Water Heater and/or Vent Gas Piping System Vacuum Breaker Other Plumbing Fees Master Drainage Fee Sewer Fee Additional Fees TOTAL PERMIT FEES 0 0 0 0 0 1 0 2612 LA GOLONDRINA ST CARLSBAD CA 92009 ISSUED 02/18/2005 AMA 02/18/2005 02/18/2005 $20.00 $0.00 $0.00 $0.00 $0.00 $0.00 $7.00 $0.00 $20.00 $0.00 $0.00 $0.00 $47.00 Total Fees: $47.00 Total Payments To Date: $0.00 Balance Due: $47.00 2277 02/18/05 0002 01 CGP Inspector: FINAL AP(ROVAL Date 1.,,, ~-0~ Clearance: NOTICE· Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications. reservations, or other exactions hereatter collect1vely referred to as "fees/exactions." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or seruice fees in connection with this project. NOR DOES IT APPLY to any fees/exactions of which "OU have nreviouslv been civen a NOTICE similar to this or as to which the statute of limitations has nreviousl11 otherwise exnired. 02 47-00 y PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 1. PRQJECTINEORl\'!ATION :2.'-I<-l,a Go lo nd,. ,' VI.CA Swee..+ FOR OFFICE USE ONLY PLAN CHECK NO. C/)o5rJ5 ;}__Cf EST. VAL. __________ _ ~:~:~t:dD::o•~ l I rl!P= Address (include Bldg/Suite #) Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Proposed Use s. # of Bedrooms It of Bathrooms i. ,. <C'C)f.11A_CT: PERSON,'(lf-dlffari,0t from ·•ppllcantl Name Address -~; , /ll(PLICANf O· Corltraµtor: Q: A,Q8nt, for Contrae.tor '?i( Owner Name Address 4, PRi!PEUV·OWNER Name DAv I o C.<>..,.., A'f Address '$C. ',, i),()NYR4C!l'OR•i. C!>Jl'l~AN\' NAl\'!li' City 0 AgenOor Owner City City State/Zip Telephone# Fax# State/Zip Telephone# State/Zip Telephone # (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 ls 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 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 ($50011. Name Address City State/Zip Telephone# State License # _________ _ License Class _________ _ City Business License # _______ _ Designer Name Address City State/Zip Telephone State License # _________ _ ;e, ,WQRkERS/.'COI\IPENSATl!lN Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: D I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. D I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My worker's compensation insurance carrier and policy number are: Insurance Company______________________ Policy No. ____________ _ Expiration Date _______ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS) D CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not employ any parson in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), In addition to the cost of compensation, damages as provided for In Section 3706 of the Labor code, Interest and attorney's fees. SIGNATURE.______________________________ DATE _________ _ 'i)( •.i. •;; C>Y/NER\~(ljlipeR'ci~¢U1.l!ATlilN · . .· , , . . I hej.llbY affirm that I am exempt from the Contractor's License Law for the following reason: M"' 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). 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 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: □ 1. 2, 3. l~nally plan to provide the major labor and materials for construction of the proposed property improvement. ~ES D NO ~ / have not) signed an application for a building permit for the proposed work. I have contracted with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors license number): 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise end provide the major work (include name / address / phone !lumber/ contractors license number):. ________________________________________________ _ 6. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated !include name/ address/ phone number/ type of work): __________ --,ac--ic_""~'""--,------------------------------------- OATE _~I .!!,~F£_'2~o~s~-- PERMITS ONL V 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? D YES D NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? D YES O NO 1s the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES D NO 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. ta; !C!lNSTRUCTl!>N L~NDING.I\GE~CY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code). LENDER'S NAME _____________ _ LENDER'S ADDRESS. ________________________ _ '9,Y' ;,,APPtlCANl' CERTIFl,CA TION I certify that l have read the application and state that the above information is correct and that the information on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the Cjtt of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY ANO 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 _,ERMIT. 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 wit 180 da s 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 comma d for perio 18 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE \\1., 7 City of Carlsbad Bldg Inspection Request For: 03/15/2005 Permit# CB050529 Title: CONWAY RES-REPLACE GAS&ELECT Description: TO POOL EQUIPMENT Type: PLUM Sub Type: Job Address: 2612 LA GOLONDRINA ST Suite: Lot O Location: OWNER CONWAY DAVID W&DENISE Owner: CONWAY DAVID W&DENISE Remarks: Total Time: CD Description Act Comment 2ik 51 'Tesh pairs 29 Final Plumbing Associated PCRs/CVs lns12ection Histo!Y Date Description Act lnsp Comments Inspector Assignment: PC --- Phone: Inspector: ...k Requested By: DAVID Entered By: CHRISTINE 03/02/2005 23 Gas/Test/Repairs 03/02/2005 52 Underground Plumbing AP AP PC ALL FOR FINAL WHEN CONNECTED TO EQUPT PC 03/02/2005 53 Electric/ConduiVWiring AP PC "' d "' ,. rl" I _jJ \. '-'-I\ ..JJ O '5 ~ r-t '-9 1 -a rt j i ,fig 1-:l:! i "--l .. ~i □. .. ~ .. ::~ •, ,, ' . . ' ' ' .. ,-·----.. -_:': f.etJ~E -. . .. . . ~ . . . . . .. ....... , . ~