HomeMy WebLinkAbout2623 GALICIA WAY; MULTI-PERMIT FILE; CB100164; Permit. -
k • City.of Carlsbad
1635 Faraday Av. Carlsbad, CA 92008
01-25-2010" •, Plumbing Permit Permit No: 0B100164
Building Inspection Request Line (760) 602-2725
S- .. - -
.... --
* ••
Job Address: 2623 GALICIA WY CBAD --• .
Permit Type: PLUM Status:- ISSUED
-Parcel No:. 2161803400 . Lot #: 0 Applied: 01/25/2010
- . Construction Type: NEW Entered By: KG
Reference #: - Plan Approved: • 01/25/2010
r., PC#: '', • -. Issued: 01/25/2010
Project Title: MERTES RES REPLACE WTR HTR Inspect Area:
Aplicant: - —Owner:------,-_.
*
AFFORDABLE WATER HEATER MERTES FAMILY TRUST 06-05-97
24707 SAN FRANANbO RD 2623 GALI CIA WAY 5.
SANTA CLARITA, CA 91321 CARLSBAD CA 92009'
661:259-7131 .2 •. -•
Plumbing Issue Fee . $20.00
Fixture or Trap / /' 0, $0.00
;Building Sewer / / 0 • ,O $0.00,
Roof Drain
. / / 0 J $o.oci
Install/Repair Water Line 0 . $0.00
Water. Heater and/or
H- 2
'Gas Piping System 0 $0.00
Other Plumbing Fees
'tMaster Drainage Fee
Sewer Fee
"'Additional Fees"'
-`~.16TA'CPEkMIf FEES WOO
\• s..., :\ \ tNC01PORATED / / •
. 'Total Fees: -.' • -$2700 Total Payments To Date: 1952 $27.00 Balaôe Due: / $0.00 \ ,—& .i— -*\\\(' /.•:
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FINAL APPROVAL • ' - '•
'H•.- •': "lnspctor: 1 17J 1i.__.. Date: ___________ Clearance:
NOTICE: PIeasetake NOTlCEat approval of your project includes the 'Imposition of fees, dedications, reservations, or other exactions hereafter collectively
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. • -
,. -.. - - • . p - .¼ .
You are hereby FURTHER NOTIFIED that your right to protest the ipecified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity •
-. changes, nor planning, zoning grading or othei similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any
'
fees/exactions of which you have previously been given a NOTICE similar to this or as to which the statute of limitations has
Plan Check No./(J(p Building Permit Application , -
1635 Faraday Ave., Carlsbad, CA 92008 Est. Value
CITY OF . 760-602-2717/2718/2719
Fax: 760-602-8558 Plan Ck. Deposit
Date
f -170 ,p CAR LSBAD -
JOB ADDRESS I I SUITE#/SPACE#/UNIT# APN I -
CT/PROJECT # LOT Ii - PHASE # # OF UNITS I B BEDROOMS it BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OC GROUP
DESCRIPTION OF WORK: Include Square Feet of Affected Area(s)
5' CvttOf\ 3atc jJ&'t€x -kAjtr
cvnt. toe-&i-;Or = Extar C loc.e4-
EXISTINGUSE EXISTI NG USE POSEDUSE GARAGE (SF) ?ATIOS(SF) DECKS(SF) IFIREPLACE IAIRCONDITIONING IFIRESPRINKLERS
T
POSED USE
YES 0 #__. NOD YES 0 NOD YES 0 NO 0
CONTACT NAME (If Different Fom Applicant) APPLICANT NAME
S.ott t-1-je..FTe(el
ADDRESS ADDRESS -.
CITY STATE ZIP CITY STATE ZIP
PHONE . - FAX PHONE FAX
EMAIL' . ,. EMAIL
Per jkS_@AtJ4A?._br'
PROPERTY OWER NAME CONTRACTOR BUS. NAME cxte.. J+€x cd-_rs nor-f-tc ADDRESS ; ADDRESS
_________________________________
CITY STATE ZIP CITY STATE ZIP
•
-
FAX
.
~FAXPHONE PHONE
-
151 01131 1- 45' 5Si
EMAIL EMAIL
ARCH/DESIGNER NAME & ADDRESS STATE UC. B STATE UC.# I CLASS
k9'
I CITY BUS. UC.#
(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 tile a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law jChapter 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 70315 by any applicant for a permit subjects the applicant to a
civil penalty of not more than five hundred dollars ($500)).
Workers' Compensation Declaration: thereby affirm under penalty of perjury one of the following declarations:
- 0 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 [he work for which this permit is issued.
W'7have and will maintain workers' compegsatiqjl, as required by Section 3700 of [he Labor Code, for the performance of the r this permit is issued. My workers' compensation insurance carrier and policy
number are: Insurance Co. 1.e.h •j• b• Policy No._1 0 Expiration Date
This section need not be completed if the permit is for one hundred dollars ($100) or less.
0 Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shalt not employ any person 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, dama es as provided for in Section 3706 of the Labor code, interest and attorney's fees. --
le CONTRACTOR SIGNATURE dAGENT DATE f - 0 - I 0
thereby affirm that lam exempt from Contractor's License Law for the following reason:
0 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 Cede: The Contractor's
License Law does not apply loan 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).
0 I, as owner of the properly, 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).
O I am exempt under Section Business and Professions Code for this reason:
I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 Yes 0 No
I (have I 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 (indude name address! phone! contractors' license number):
I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name I address! phone! nlractors' license number):
-
' 5. I will provide some of the work, ball have contracted (hired) the following persons to provide the work indicated (include name! address I phone! type of work):
,.PR0PERTY OWNER SIGNATURE Em I(AGENT DATE I '- cs'- 0 ' 1 0
City of Carlsbad Bldg Inspection Request
For: 02/19/2010
Permit# CB100164 Inspector Assignment: PY
Title: MERTES RES REPLACE WTR HTR
Description:
Type: PLUM Sub Type:
Phone: 7607530997
Job Address: 2623 GALICIA WY
Suite: Lot: 0
Location: Inspector:
OWNER MERTES FAMILY TRUST 06-05-97 -
Owner: MERTES FAMILY TRUST 06-05-97
S
Total Time: Requested By: NA
EnteredBy: JANEAN
CD Description Act Comments
25 Water Heater/Vents
29 Final Plumbing
Comments/Notices/Holds
Associated PCRs/CVs Original PC#
Inspection History
Date Description Act Insp comments
02/17/2010 25 Water 1-leaterNents NR PY NO ONE HOME 1:42PM
City of Carlsbad
1635 araday Av Carlsbad, CA ,92008
08-13-2008 1 Mechanical Permit Permit No CB081559
Building Inspection Request Line (760) 602-2725
Job Address: 2623 GALICIA WY CBAD
Permit Type: MECH . Status: ISSUED
Parcel No: 2161803400 Lot #: 0 Applied: 08/13/2008
Valuation: $0.00 Entered By: RMA
Reference #: - Plan Approved: 08/13/2008
PC #: . Issued: 08/13/2008
Project Title:' - MERTES RES-REPLACE FAU & ADD Inspect Area:
P : NEW A/C UNIT W/ ELECTRIC
Applicant: . .,.. Owner: .. .
MAJOR LEAGUE HEATING & AIR CONDlTIONlNG.— MERTES.FAMILY TRUST 06:0597
1356 BOBOLINK DRIVE '' 2623 GALICIA WAY..
VISTA 92083 •. CARLSBAD CA 92009
- .
Mechanical Issue Fee / '- -, C - 'J.\ _$15.00
lnstall/Furn/Ducts/Heat Pumps Fee / '2i, . $18.00
Fireplace Installation Fee .. 0 - , , $0 00
Exhaust Fan Fee• / ,' 7 0 / ,i J',' - \ \, so.00'
Installation/Relocation Vent Fee 0 - $0.00
Hood Fee ) 0.. ! t'$000
Boiler/Compressor td15HP Fee / "' - '' \ , '$000
Other - /7 $20 00
Additional Fees r
- $000
TOTAL PERMIT FEES $53.00
iI \ ;;
- /
.. TotalFees: $53.00 Total Payments To Date:" • $53.00 -Baiane Due: $0.00
.:
/
'Inspector: .
.
FINALR
Clearance:
NOTICE: Please take NOTICE that approval of your project includes the 'Imposition" of fees, dedications, reservations, or other exactions hereafter collectively
- 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. - •
4 - -.
- You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY t&water- and sewer connection fees and capacity
changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this proj9ct. NOR DOES IT APPLY to any
•.-'. fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitatiornriras previously otherwise expired.
J
Ci4póf Carlsbad
1635 Faraday Ave., Carlsbad, CA'92008
70-602-2717 / 2718/ 2719
Fax: 760-602-8558
Building Permit Application
n Check No. (
--f
Est. Value
lan Ck. Deposit
Pate 1/,
P
JOB SUITE#/SPACE#/UNIT# •
C BATHROOMS I
I APN
- - - CT/PROJECT C LOT# 1.
PHASE# #OFUNITS _*_BEDROOMS
.
I TENANT BUSINESS NAME I TYPE OF CONST.
-I
.
I 0CC. GROUP
DESCRIPTION OF WORK: (Please d,crlbe present use and proposed u e)
)-cU
BUILDING AREA (SF) ADDITION AREA (SF) GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE
YES 0 #_ NO 0
I AIR CONDITIONING
YES 0 NO 0
-
FIRE SPRINKLERS
YES 0 NO 0
CONTACT NAME (If Different Fom Applicant) APPLICANT NAME
ADDRESS AD
DRESS
i,,
J c /!5 16
CITY , STATE ZIP . CIT
,
) -. ST ZIP
PHONE FAX -- PHONE I FAX -.
EMAIL EMAIL -
OWNER '3 ry) . CONTRACT R BUS. NAME—
ADDRESS . - ADDRESS
STATE
FA
CITY STATE ZIP
_______________________ P7
,()
çQ7fFAX PHONE - FAX
EMAIL - . . EMAIL
ARCH/DESIGNER NAME & ADDRESS STATE LIC. # STATE yC.# CITY BUS. LIC.#
(sec. 1031.5 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 is licensed pursuant to the pmvisions of the Contractor's License Law (Chapter 9, commending with Section 1000 of Division 3 of the Business and Professions Code) or that he it exempt therefrom, and the bait for the alleged exemption. Any violation of Section 10313 by any auolicant for a oermit subieces the aoolzcant to a civil oenaltv of not more than five hundred dollars 1flfl001l
F
__ .4:.:'--" . • '.' H
Workers' Compensation Declaration: I hereby affirm under penally of perjury one of the following declarations:
tJ 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.
I have and will ma in workers' mpens lion, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My 'irs' compensation insurance carrier and policy
number are:
Insurance Co. 4J2'15 (?)Policy No. ion Date-
-This section need not be completeff if the permit is for A hundred dollars ($100) or less.
0 Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of
California. WARNING: Failure to secure workemc pensatlon coverage I unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), in
addition to of the Labor Interest and attorney's tees.
DATE -.
I hereby affirm that lam exempt from Contractor's License Law for the following reason: . . .
O I, as owner of the properly or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sate (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 subh 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).
0 I, as owner of the properly, 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).
0 I am exempt under Section - Business and Professions Code for this reason:
1. I personally plan to prSvide the major labor and materials for construction of the proposed property improvement 0 Yes - 0 No
2.1 (have I have not) signed an application for a building permit for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed construction (include name 6ddress / phone! contractors' license number):
- 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and rovide the major work (include name! address phone contractors' license number):
5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name address phone type of work):
'PROPERTY OWNER SIGNATURE . - - -'DATE -
øOOoOU Qo
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? 0 Yes 0 No - -
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 Yes - 0 No • • • -
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 Yes 0 No 1 -
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. -
-
I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Ciil Code).
Lenders Name . . Lenders Address
I
• t
1 .
I certify that I 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 Stale laws relating to building
construction, •• .
I hereby authorize representative of the City of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND 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 PERMIT.
0511k An OSHA permit is required for excavatiogovr 50' deep and demolition or construction of structures over 3 stories in height
EXPIRATION: Every permit issued by the Building Ojficial 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
180 days from the date of such permit or-if the ba'ldng or work authorized by s h permit is suspended or abandoned at any time after the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building
APPLICANT'S SIGNATURE_/
. - DATE
City of Carlsbad Bldg Inspection Request
For: 08/22/2008
Permit# CB081559 Inspector Assignment:
Title: MERTES RES-REPLACE FAU & ADD
Description: NEW A/C UNIT W/ ELECTRIC
Type:MECH Sub Type:
Phone: 7607530997
Job Address: 2623 GALICIA WY
Suite: Lot: 0
Location: Inspector:
APPLICANT MAJOR LEAGUE HEATING & AIR CONDITIONING
Owner: MERTES FAMILY. TRUST 06-05-97
Remarks: p rn please
Total Time: Requested By: BRIAN MERTES
Entered By: CHRISTINE
CD Description Act Comments
43 AirCondlFurnace Set
Comments/Notices/Holds
Associated PCRs/CVs Original PC#
Inspection History
Date Description Act Insp comments
4-
q6-12-2006
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Plumbing Permit Permit No: CB061690
: Building Inspection Request Line (760) 602-2725
Job Address: 2623 GALICIA WY CBAD
Permit Type: PLUM
Parcel No: 2161803400 Lot #: 0
Construction Type: NEW
Reference #:
Project Title: MERTES RES REPLACE H20 HEATER
Status: ISSUED
Applied: 06/12/2006
Entered By: KG
Plan Approved: 06/12/2006
Issued:, 06/12/2006
Inspect Area:
Applicant: V V Owner:
AFFORDABLE WATER HEATER MERTES FAMILY TRUST 06-05-97 -
24707 SAN FRANANDO RD V - 2623 GALICIA WAY -
SANTA CLARITA, CA 91321 7 CARLSBAD CA 92009' ,. '• V
661 259-7131 'V.. -
V -\
V
- V I ' •; V V 'V V
Plumbing Issue Fee / - V V c' $2000
Fixture or Trap / -0
V V
V \ $0.00
V Building Sewer / V V '\ -s ; $0.00 - V
Roof Drain / ,, 7 0 $0.0&,
Install/Repair Water Line V V 0 .--. $0.00 . .
Water Heater and/or Vent '. V V 1 'V - P V " V i $7.00
Gai Piping System ,-$0 00
Vacuum Breaker 0 V '-"V $0.00
Other Plumbing Fees [ ' V.. . ''f) _._so.00 V
Master Drainage Fee _/
,.
V. c . " $000
Sewer Fee • / _\'
$0.00
'Additional Fees i $0.00
TOTAL PERMIT FEES, $27.00j V V
V V ' VV i:.v • -- / V V
Total Fees • -- $27:00 Total Payments To Date:-- $27.00 Balance Due: / ' $0.00 V
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FINAL APPROVAL -
inspector: -L_ tkJ4i7 Date: 7 Clearance: V
NOTICE: Please take NOTICE that approval of your project includes the 'Imposition" of fees, dedications, reservations, or other exactions hereafter collectively
V referred to as 'tees/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 a'ccordande with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subseqient legal action to attack,
review, set aside, void, or annul their imposition. - • V • - .' - V
V •p V - V
• 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
Vchanges, nor planning, zoning, grading or other similar application processing or service tees -in connection with this project. NOR DOES IT APPLY to any - V
tees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired.
-. VV•, V -V -. - , tV' • V V V
I
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
FOR OFFICE USE ONLY
PLAN CHECK NOCSd(/ °
EST. VAL.
Plan Ck. Deposit
Validated By
Date ',i /-?'40
JV
Address (Include Bldg/Suite S) - - . Buslns Name (at this address)
Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total S of units
Parcel Use
Description of Work - SQ. FT. Sot Stories S of Bedrooms
Name Address City State/Zip - Telephone S Fax S t /APRLICANT . I?! nntrthtort I oentf'orJontrator tiIFOrr3LAaont fo,OwnerY
Name Address City State/Zip Telephone S
(OLi' '1 - 7i1 'rz.w 7O3-t Name Address City State/Zip Telephone S
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to
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Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following de
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Insurance Company . 2 .t (I i-T'I\ Policy No......Z..P b 7 I ' 701 Expiration Date I/bl I (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOU.ARS 1$ 1001 OR LESS) .0 CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit
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to become subject to the Workers' Compensation Laws of California.
WARNING: Failure to secure workerf' compensation covrage Is unlawful, and shall subject an employer to crImInal penalties and civil fines up to one hundred thousand dollars ($100,000), In addljon to e cost of compensation, damages as provided for In Section 3706 of the c011..,Ints,sst and attorney's fees. SIGNATURE_________________________________________________
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I heieby affirm that I am exempt from the Contractor's License Law for the following reason;
0 I, as owner of the property or my employees with wages as their sole compensation, will do t
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(Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an ow
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such work himself or through his own employees, provided that such Improvements are not Int
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sold within one year of completion, the owner-builder will have the burden of proving that
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pursuant to the Contractor's License Law).
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I personally plan to provide the major labor and materials for construction of the proposed propert
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0 YES ONO I (have / 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 (
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I address / phonO number I contractors license number):
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number / contractors license number):
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PROPERTY OWNER SIGNATURE
DATE
Is the applicant or future building occupant required to submit a business plan, acutely ha
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program under Sections 25605, 25633 or 25534 of the Presley-Tanner Hazardous Substance
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0 YES 0 NO Is the applicant or future building occupant required to obtain a permit from the air pollution co
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0 YES 0 NO Is the facility to be constructed within 1.000 feet of the outer boundary of a school site
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0 YES 0 NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NO
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REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL
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I hereby affirm that there is a construction lending agency for the performance of the work for which
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LENDER'S NAME
LENDER'S ADDRESS_______________________________________________________
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I certify that I have read the application and state that the above information Is correct and that t
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City ordinances and State laws relating to building construction. I hereby authorize r
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property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HAR
M
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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 PERMIT. OSHA: An OSHA permit is required for excavations over 5'0 deep and demolition or constructi
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EXPIRATION: Every permit issued by the building Official under the provisions of this Code
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authorized by such permit is not commenced withlp 180 days from the date of such permit or
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at any time after the work Is commenced for a ptod oA80 days (Section 108.4.4 Uniform Buildi
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.
APPLICANT'S SIGNATURE Anl,j L
. nATF
WHITE: File YELLOW: Applicant PINK: Finance
City of Carlsbad Bldg Inspection Request
For: 06/27/2006
Permit# CB061690 Inspector Assignment:
Title: MERTES RES REPLACE H20 HEATER
Description: S
Type: PLUM Sub Type:
S . Phone: 7607530997
Job Address: 2623 GALICIA WY ,/I4 7 1
Suite: Lot 0
Location: ' .
Inspector:
OWNER MERTES FAMILY TRUST 06-05-97 .
Owner: MERTES FAMILY TRUST 06-05-97
Remarks:
Total Time: Requested By: DIANE
Entered By: CHRISTINE
CD Description Act Comment
25 Water' eaterNents 0
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••
.5 . .5
.
.. .••
Comments/Notices/Hold
. Associated PCRs/CVs Original PC# . S
Inspection History •
.
Date Description Act Insp Comments