HomeMy WebLinkAbout2620 LA GOLONDRINA ST; ; 83-79-146; Permit"' z 0 ;:: .. a: :l ill a
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D I hereby affirm that I am licensed under
provisions of 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 Class _
I hereby a1flrm that I am exempt from the Contrac-
Tor' s License Law for the lollow1ng reason (Sec. 7031 5
Business and Professions Code: Any city or county which re•
quires a perm,t to construct, alter, ,mprove, demolish, or repair any structure, prior to its issuance also requires the ap-
plicant for suc/7 permit to file a signed statemen1 tha1 he 1s
licensed pursuant to the pr0'/1s,ons of the Contractor's
L,cense Law {Chapter 9 commencing w,th Section 7000 of
Div1s1on 3 of the Business and Professions Code) or that is ex· empt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by an applicant 1or a permit sub·
jects the applicant to a c1v1I penalty of not more than five hun-
dred dollars ($500)
C I. as owner of the property. or my employees with wages
as their sole compensation. will do the work. and the struc-ture Is not intended or offered for sale (Sec. 7044. Business
and Professions Code· The Contractor's License Law does not apply lo an owner of properly who builds or improves
thereon and who doos such work himself or through his own
employees. provided that such improvements are not intend· ed or offered for sale. If, however, the building or ImprOV!l-
ment is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or Im·
prove for the purpose ol sale)
[J I. as owner ol the property, am exclusively contracting with licensed contractors to construct IM project (Sec. 7044,
Business and ProlessIons Code The Contractor·s License
Law does not apply to an owner of property who bu-Ids or im-proves thereon, and who contracts !or each proIects with a contractor(s) license pursuant lo the Contractor's License Law)
□ As a homeowner I am improving my home, and the follow-
ing cond1!10ns exist· 1 The work_ 1s be_ing performed prior to sale
2 I have lived In my home tor twelve monttis prior to completion of th_is work
I have not claimed this exemption during the last three years.
:::J lamexemptunderSec _______ B&PC.
for this reason
0 I hereby affirm that I haoea cert1hcate o! consen1
lo sell-insure or a ceJ11!1cate ot Workers Gompensat1on Insurance. or a cert1f1ed copy thereof
[Sec 3800 Labo, Cf"'•I '(' . /')I
,OLICY NO E'2= } <--( -L¾ ½f r't.,
COMPANY {hi ._:,,;,[ (.) (\ I VL,1., ·-
)
D Copy Is filed with !he city
0 Certol,ed copy Is hereby lum1shed
CERTIFICATE. OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE (Th,s ~tIon need no1 be completed ,t tne perm,t
,s !or one hundred dollars 1s1001 or less)
0 I ceJ11fy that rn the performance ot !he worl< 1or
wh,ch th,s perm,t ,s issued. I shall no1 employ any
person ,n any manner so as to become subIect l<.J
the Worl<ers· Compensat,on Laws o! Cal,torn,a
NOTICE TO APPLICANT 11, after mak,n~ this Cert,
t,cale ot Exemption. you should become subIect t-:, the Workers· Compensat,on prov,s,ons of the Labor
Code. you must toJ1hw1th comply w,th such pro~Is,ons or this perm,! shall be deemed revoked
0 I hereby aHirm 1hat there Is a consIruct,on
Iend1ng agency !or the periormance of the worl< for
which thiS perm,1 ,s r,l)frt~~~~C~
Lender s Name l " -J'-.,:.
Lender's Address __________ _
USE BALL_ POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONb
CARLSBAD BUILDING DEPARTMENT
1200 Elm, Carlsbad, California 92008-1989 (619) 438-5525
APPLICATION & PERMIT
•JOB AOORESS ' ~__: ' AV,ST. DATE OF APfl,.ICATION 8USINE$S LICENSE # ii·a"t/~ PE~MBER
I, A...,"?o A ~0Lo~t2.i A.I-At RO. LltZZ:/83 3587 • . . . ~14-'l, OWNER'S' NAM~-f OWNER'S PHONE ~· FC()!\Tf'~TOA. ~TIJACTOAS PHONE # ZONE " mn~ 1-J()mE,S =,;:.... ;,.,,l R-.:..,~ ~e. (~~~
OWNER'S MAILING ADDRESS CQN.TRACTOR'S AOORESS LICENSE NO. PLAN 1.0. # 8 DG USE CODE
Ir:: ~Y'-) S)iQ «:Jr II l-) r f'II I f'l-1 RD. S ,D.Sl.?/2~ ' It BLOCK f/~v~s~ r ASSESSOR PARCEL NO. OES,tGNEf't . LICE.NSE # STANDARD PLAN# BUILDING SO. FOOTAGE .· . -···--.. -. · r iiM~ ~ r -lift'il Be 8 ti;: / IA lt-1/~ r,. v Tl , = O., CRIPTION oF.WO~K. I . ,
. ... -OES4GN<ER'S ADDRESS F •• s-·• •• -• • DESIGNER'S PHONE ·
,p;, 01\,-\'' ';\..F--~ -~ Ar,, ,_ ... /4," ,"; '\ ~li".1<'.i.Y (:{ bJ2,l1L It< , 7 ..14 I 1s b ,~~ -~e I
Nl • I
. 'ti ,.,tJ.;, :!; F/P F LR!l:b NO or:3 '°'J j I STO,ES -'-vD NO
CENSUS TRACT GP LAND use PARKING SPACE AES UNITS GRADING PERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRE SPA I AREA vr vD ,Ii( y D ND •□ ~ Not Vil/id Unless Machine Certified
s1J .
OTY. PLUMBING PERMIT -ISSUE 7--QTY. MECHANICAL PERMIT -ISSUE 3---:-SUMMARY/ACCOUNT NUMBER
~ • 'I.. EACH FIXTURE TRAP ,-i,,J_ ~ I INSTALL FURN. DUCTS iJP TD 100,000 BTU I.I...-, ,,,.-BUILDING PERMIT 01-00-00-8220 1..1.J)LJ -
V EACH BUILDING SEWER "-~~ OVER 100,000 BTU SIGN PERMIT 01-00-00-8221 .
--t ----~. -·-,:;; EACH WATER HEATER AN□.:□R VENT _i__ '2--· BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01-00-00-8806 •l> -----',---------------------------
' EACH GAS SYSTEM 1 TO 4 OUTLETS i ...... BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING 01-00-00-8222 -:a-
EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE ELECTRICAL 01-00-00-8223 ,... --------
EACH INST A~ .. ALTER, REPAIR WATER PIPE I VENT FAN SINGLE DUCT -L.,,-,,..-MECHANICAL 01-00-00-8224 Q ----------I EACH VACUUM BREAKER MECH EXHAUST -HOOOlOUCTS MOBILEHOME 01-00-00-8225
WATER SOFTNER RELOCATION Of EA FURNACE/HEATER MOBILEHOME PARK INSP --· ------
EACH ROOF DRAIN {INSIOEi SOLAR ____ 91-00-00-8226 ------
TOTt.L MECHANICAL q STRONG MOTION 80-92-33-0519 t.. I t--I -:2,_4.? TOTAL PLUMBING FIRE SPRINKLERS 01-00-00-B227
QTY. ELECTRICAL PERMIT -ISSUE s--QTY. SOLAR· ISSUE I PUBLIC FACILITIES FEE 32-00-00-B923
BRIDGE FEE
/bh
. ~--------
NEW CONST EA AMP:'SWT:BKR COLLECTORS SCHOOL FEE • DISTRICT -. lPH 3 PH STORAGE TANKS Carlsbad 80-92-21-0519 ---
EXIST BLOG EA AMPiSWTlBKR ROCK STORAGE Encinitas 80-92-22-0519 •--••a ---·-. -lPH 3 PH PUMP San Oiegu1to 80-92-23-0519 ---------·-~. -REMOOEL.'ALTER PER CIRCUIT PLAN CHECK fEE San Marcos 80-92-24-0519 It,,~?/" ----· --------·-------------
TEMP PO LE 200 AMPS \ . --·------~ -
OVER 200 AMPS ( (7 .. -1.)~~-r--l /.J. ( ( l. ,
------··--·-----------·---· -------
TEMP OCCUPANCY 130 DAYS) ...
--~--------------
' -· -------f----------~
TOTAL ELECTRICAL -T ~ ---TOTAL SOLAR TOTAL FEES PAYABLE I '2-/..ij -I
1 H"4VE CAREFULLY E~INED THE COMPLETED "APPLICATION-AND PERMiT:· AND oo.ttfflEBy ,, '~: &,t~pe~il~ed~the~}•Q1ng~iundertt1eprovlSi?fisoft~ * AN OSHA PERMfT IS ftEQIJIREO FOR EXCAVATIONS OVER CERTtFY ·UN.DER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE ~,up,re by hm~ion become ffl!i(and void. Jf the building or work ·5' er DEEP ANO OBIOUTI0N OR CONSTRUCTIQN Of" DECLARATIONS A'RE TRUE AND CORRECT AND I FURTHER CERnFY ANO AGREE (F A PERMIT IS . ~ $UCh ~It IS not commence_d -·~ 'HIP days tr'?~ the date of such SlRUClURES OVER 3 STORIES tH HEIGHT ~ or ,f the buifdm~ wol'II. authorized by AUC-h permit 1s suspended or ISSUED: TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING BUILDtNG CON• ~at env time a the WOfk is comm.ft;::.;. for a oeriod of 180 .
STAUCTION, WHETHER SPECJFlED HEREIN OR NOT. I ALSO AGREE TO SAV,E INDEMN!FY AND , APPR~ VEO BY
ii111/0 KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL UABILITIES, JUDGMENTS, COSTS ANO.~ S SfGNA.TURE .If-, ?~ERO CONTRACTOR 0
EXPENSES WHICH MAY IN ANYWAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE ,j7IJ/jJ'!f rY ~~"" □ \ -. GRANTING OF THIS PERMIT. 1 t. .. ..I BY PHONE • '
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INSPECTION TYPE DATE INSPECTOR
BUILDING
FOUNDATION "' -
REINFORCED STEEL ' s-~-n ,,,,
MASONRY
GUNITE OR GROUT
FLOOR & CEILING SUB FRAME -
SHEATHING -i, .
FRAME r,, -
EXTERIOR LATH lNSULATION "•z.i.-ff j 17-,..,~ ,,
INTERIOR LATH & DRYWALL
PLUMBING •
SEWER AND BL/CO 7-yJ--IJ 1'.
PLUMBING UNDERGROUND ~4-Yf II V -
PLUMBING TOP OUT LJ,.~ I'
TUB AND SHOWER PAN
GAS TEST • ·-J,J ..,,,,,-1'
ELECTRICAL
TEMPORARY POWER
ELECTRIC UNDERGROUND -
ROUGH ELECTRIC . ~-/1-rJ ,,.,
' ELECTRIC SERVICE
BONDING
G. F. I. -SMOKE DETECTOR
MECHANICAL -
DUCT & PLEM., REF. PIPING ~-.'?-1'1 1
HEAT -AIR COND. -SOLAR SYSTEMS . I
'
VENTILATING SYSTEMS
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABO VE HA VE BEEN APPROVED.,
JOB SITE FINAL
PLUMBING '\. -ELECTRICAL '\. u
MECHANICAL '\. I l,I I
GAS '\. ·,r,:;, 1 l
BUILDING '\.. V'
SPECIAL CONDITIONS
CERT OF OCCUPANCY ISSUED
.
.
"?!. 1 --,-.,
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR·s NOTES
INSPECTION REQ IF INSPECTORS DATE . CHECKED APPROVAL -
SOILS COMPLIANCE
PRIOR TO ._ . .
F-OUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI .
PRESTRESSED
CONCRETE
POST TENSIONED
CONCRETE
FJELD WELDING
HIGH STRENGTH
BOLTS
SPECIAL MASONRY-" -.
i PILES CAISSONS
-
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