HomeMy WebLinkAbout2622 LA GOLONDRINA ST; ; 83-79-145; Permit"' z 0
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0 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 ls in
full force and affect.
L,c No __ Cla,s
I hereby alfirm that I am exempt from the Contrac-
tor's License Law tor the following reason (Sec 7031.5
Business and Professions Code: Any city or county which re-qurres a perm,t to construct, alter. improve, demolish, or
repair any structure, prior to_ I1s issuance also requires the ap-
plicant for such permit to file a signed statement ttlat he 1s
licensed pursuant to the provisions ol the Contractor's
License Law (Chapter 9 commencing w,th Section 7000 ot
Div1s1on 3 of the Business and Proless1ons Code) or that Is ex-empt therelrom and the basis tor the alleged exemption Any
violation ol Section 7031_-5 by an applicant for a permit sub-
iects the applicant to a c,vII penalty of not more than live hun-
dred dollars 1$5001
.J I, as owner of the property, or my employees wrth wages
as the,r sole compensation, will do the work, and the struc-
ture ,snot intended or oflered !or sale {Sec 7044, Business
and Protessions Code: TM Contractor's License Law does
not apply lo an owner of property who builds or improves
thereon and who does such work h;mself or through his own
employees, provided that such improvements are not intend-
ed or ottered for sale. It. however, Ille bu,lding or ,mprove-
ment is sold within one year of completion. the owner-builder
will have the burden ol proving that he did not build or im-
prove !or the purpose ol sale).
[_ I. as owner of the property, am exclusively contracting
with licensed contractors to construct the project (Sec 7044,
Business and Prolessions Code: The Contractor"s License Law does not apply to an owner ol property who builds or im-
proves thereon, and wM contracts !or each projects with a
contractor(s) license pursuant to the Contractor's License Law)
□ As a homeowner I am ImprovIng my home, and tile follow-
ing conditions exist 1. The work is being periormed prior to sale
2 I have lived In my home for twelve months prior to complehon of this work
I have not claimed this exemption during the
last three years
,J lamexemptunderSec ______ ,B&P.C
for this reason
0 I hereby afhrm that I have a cen,1,ca1e of consent to self-msure, or a cer1,t,cate al Workers
Compensatmn Insurance, or a cen1f,ed copy !hereof
:,c':':o ezw: -J-13{,i; jj,J)
"'·"'" 1'" l"'~•I'' COMPANY t___J_~.J!v J _ -1 I f"-\,. • '-.
0 Copy •s hied woll'l the Ctly
0 Cen1hed copy ,s hereby furn,shed
CERTIF!CATl OF EXEMPTION FROM
WORKERS-COMPENSATION INSURANCE
(Th,s section need no1 be completed 1f the permit Is tor one hundred dollars 1S100) or less)
0 I cert,ty that In the performance of the war!< for
wh,ch 1h,s permit ,s ,ssued. I shall not employ any
person In any manner so as to become subIec1 tu the Workers· Compensat,on Laws of CaI1torn,a
NOTICE TO APPLICANT It. atte, makmJ Jrus Cer1,
lfcate of Exempt.on. you should become subIec! t'J
1he Workers' Compensation pro.os,ons ol \he Labor
Code you mus1 !or1hw,1h comply with such
provIs,ons or this permit shall be deemed re,oked
0 I he,eby affirm tha1 1here IS a conslructIon
Iend1ng agency for !he performance of the worl< 10,
which this perm,t is_ ,s~~9"i~cl;,~ c~_W,_,C~e1
Lenders Name /:CA / (_,(~ .. .;(.'t
Lenders Address __________ _
USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT
1200 Elm, Carlsbad, California 92008-1989 (619) 438-5525 a,
JOB~OORE~-i-... 12-J ~ ~ ----r--A"alT. D~r fziia30N BU~556!7E # VALo7Nto >ERMIT NUMBEIR-P -
0ron~~)_J-lom~ 9c:0BS5S ~ =AACT~ PH;,NE# ~ ~--1 q •
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OWNER'S MAILING ADDRESS CONTRACTOR'S ADDRESS
l\::CO ~~Ltlli..~ 120, s,D. 92 IZ\
BLOCK ASSESSOR PARC.EL NO, DESIGNER
,QESCR!PTION OF WO~K
CENSUS TRAC, I GP LAND use I PA(J,~ce RES UNITS
I GRADING ~ERMIT ISSUED
¥0 'I □ I
REDEVELOPMENT
AREA ,. /
y O Nl[I l~;l
•
LICENSE NO.
LICENSE#
OCC LOAD
I
FIRE SPA
YON~
'
PLAN I.D. # BLOG use CODE
STAN DA ~IL;"~~ r "~ Q ~
~,f\<r
Not Valid Unless Machine Certified
QTY. PLUMBING PERMIT -ISSUE /~ QTY.
""T
MECHANICAL PERMIT· ISSUE 3--;--SUMMARY/ACCOUNT NUMBER lf-0-f;; I /~!EACH FIXTURE TRAP
EACH BUILDING SEWER } "V~ .f
EACH WATER HEATER AND/OR VENT_ . --f--i .. ID,_IA--
EACH GAS SYSTEM 1 TO 4 OUTLETS ___ f _ j~
I INSTALL FURN DUCTS i.JP TO 100.000 BTU
OVER 100.000 BTU
BOILER/COMPRESSOR UP TO 3 HP
BOILER/COMPRESSOR 3-15 HP
METAL FIREPLACE EACH GAS SYSTEM 5 OR MO RE <--+--EACH INSTAI,,. ALTER, REPAIR WATER PIPE ~VENT FAN SINGLE ouCT--
--u.-. ,-BUILDING PERMIT
SIGN PERMIT
PLAN CHECK
TOTAL PLUMBING
ELECTRICAL
lJ;.: ,,.,.-MECHANICAL
EACH VACUUM BREAKER Uf\RII J:HQME MECH EXHAUST -HOQQ.'QLJCTS mvv, ....
01-00-00-8220 -01-00-00-8221
.., J,,, "";._ 3.12
I.LU--
01-00-00-8806
01-00-00-8222
01-00·00-8223 ...,_Fl -01-00-00-8224 /1 -01-00-00-8225
WATER SOFTNER ----------+----'----I-uno11 cunuc:: PARK INSP RELOCATION OF EA FURNACE/HEATER I ~VUILUIVIYI
~ I _EACH ROOF DRAIN (INSIDE) __ _ _! __ ---
TOTAL PLUMBING C
II I TQT/'.il MECHANICAL I I I VULrn
<:rn ,.,1:1 01-00-00·8226 I l.~ -----
~STRONG MOTION 80-92-33-0519 I II CIR£ SPRINKLERS 01-00-00-8227 ' #?1 '
5--:. PUBLIC FACILITIES FEE 32-00-00-8923
QTY. ELECTRICAL PERMIT· ISSUE QTY. SOLAR · ISSUE BRIDGE FEE
NEW CONSTEA AMP SWT BKR (()() I -,....,.s ,,,... COLLECTORS SCHOOL FEE -DISTRICT
1 PH 3 PH ·-ti-.. STORAGE TANKS
-----------------~-Carlsbad 80-92-21-0519
EXIST BLOG EA AMP1SWT.'BKR ROCK STORAGE Encinitas 80-92-22-0519 j ----·--
1 PH J PH PUMP 80-92-23-0519
REMOOEL'ALTER PER CIRCUIT
>----TEMP POLE 200 AMPS
OVER 20(] AMPS C---+--
I---~ E~O CC UPAN CY {30 DAYS)
--
--+------__,.
PLAN CHECK r"EE -+-----
---+-
---+---
San Die_Ruito
..... ~·· I lc;;:~F;;""f ;J.~
----
I
TOTAL ELECTRICAl l
I ~-------+------------
TOTAL SOLAR I I
1
"2---/ b 8'. 0 t,Lj TOTAL FEES PAYABLE
I HAVE CAREFULLY~EXAMfNED THE COMPLETED "APPLICATION ANO PERMIT'" AND 00 HEREBY
CERTIFY UNDER PENALTY OF PERJURY THAT All INFORMATION HEREON INCLUDING THE
DECLARATIONS ARE TRUE ANO CORRECT AND I FURTHER CERTIFY AND AGREE fF A PERMIT IS
E11.piration. Every permit issued by the SuildinQ Offieial under the provisions_O(~ Code shall e,c:pire by fimitation and become null and void. ffffie butlding or work authorized by such permit 1s not CO;l"Tlmenced within 180 days from the date of suctt permit, or if the 1>Uildtng or work authorized by fUCh permit ia suspended Of ISSUED: TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVEftNING BUILDtNG CON· I abandoned at any time after the work Is commenced tot a period of 18Q dfYlt
STRUCTIQN. WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND APPLICANT'S SIGNATURE lf-OWNER□ CONTRACTOR0
KEEP HARMLESS THE CITY OF CARLSBAD AGAINST All UABILIT!ES, JUDGMENTS, COSTS AND ,
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE,. f\ 11 . .,r11) • rr,' M)r::y/,, /Y1 L'.\ ..If ,I) BY PHONE 0
GRANTtNGOFTHISPEAM!T. \.L_Vf..JJ&///J ;f_, 1/JI.A''J'V J
I * Mi OSHA PEFIMfT IS REQUIRED FOR EXCAVATIOtlS ~ -5' O" DEEP MO 0£MOLJTION 0A CONSTRUCTION OF
STRl.JCTUfl£S OVER 3 STOFIIES IN HEtGHT
APPR~1°o/11 It?.
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INSPECTION TYPE DATE INSPECTOR
BUILDING .
FOUNDATION "'-,,
REINFORCED STEEL ' 1-ry~-n 17'
MASONRY
GUNITE OR GROUT
FLOOR & CEILING SUB FRAME .
SHEATHING S-??.IA
,,,
'•
FRAME . l~-/1-"" ~•
EXTERIOR LATH lNSULATION.r•u•HT ,.,_;..,n 'rf
INTERIOR LATH & DRYWALL
PLUMBING ,.
SEWER AND BL/CO --. -. s .,., .
PLUMBING UNDERGROUND l<:J!•ll ',.,,
PLUMBING TOP OUT ~-17-1':J .,
TUB AND $HOWER PAN
GAS TEST l~-17-l,] 1-f
ELECTRICAL
TEMPORARY POWER
ELECTRIC UNDERGROUND .
ROUGH ELECTRIC . L'..n.J.t 11'
ELECTRIC SERVICE
BONDING
G. F. I. -SMOKE DETECTOR
MECHANICAL .
DUCT & PLEM., REF. PIPING ~-1?-tS 11' -·,,
HEAT -AIR COND. -SOLAR SYSTEMS .. ,
\
VENTILATING SYSTEMS :
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE BffN APPROVED . .
JOB SITE FINAL
PLUMBING 11
ELECTRICAL '-, I~
MECHANICAL '·· "' I
GAS . -11r, " BUILDING ' I
SPECIAL CONDITIONS
CERT OF OCCUPANCY ISSUED
'2S'3-7q,..,,l{-~
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR·s NOTES
' REQ IF INSPECTOR'S INSPECTION CHECKED APPROVAL DATE
SOILS COMPLIANCE
PRIOR TO . • . FOUNDATION INSP
STRUCTURAL CONCRETE .
OVER 2000 PSI .
PRESTRESSED
CONCRETE
POST TENSIONED
CONCRETE
FIELD WELDING
HIGH STRENGTH
BOLTS
: SPECIAL MASONRY
PILES CAISSONS
.
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