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Home My WebLink About2704 LA GOLONDRINA ST; ; CB980721; PermitB U I L D I N G 03/09/98 17:04 Page 1 of 1 Job Address: 2704 LA GOLONDRINA ST Permit Type : PLUMBING Parcel No: 215-541-02-00 Valuation: 0 P E R M :;: T Suite: Lot#: Permit No: CB980721 ProJect No: A9800948 Development No: 4810 03/09/98 0001 01 02 . C-PRMT Construction Type : NEW 27-00 Occupancy Group: Reference#: Status: ISSUED 03/09/98 03/09/98 RMA Description: REPAIR GAS LINE Appl/Ownr : NATIONAL LEAK DETECTION 6853 CARNATION DR CARLSBAD CA 92009 **I< Fees Required Fees: Adjustments: Total Fees: Fee description Enter "Y" for Pl Gas Piping System *** 760 Applied: Apr/Issue: Entered By : 931-8108 .00 ,00 27.00 *** Ext fee Data 20.00 Y 7.00 PPPOVAL [ • I i. 2· t1 I INSr ~~-- CLEARANCE--::..-::.-:..-:...-_-_-_- CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK No.9'f07). / CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 EST. VAL. _________ _ Plan Ck. Deposit -7re-:------- 1, PRojECT INF0RMATI0~ ,;t-7 OL/ 1 /A Address Unclude Bldg/Suite I) Business Name tat this adck..,I Legal Description Lot No. Subdivision Name/Number Unit No. Phan No. Total # of units Existtng UH Proposed UH SQ. FT. #of Stories I of Bedrooms # of Bathrooms 2. ·coNTACT PiRSDN (If dlff ..... floin .;,,,ilanil N■m■ ,3. APPLICANT ~Contractor Address D Agent tor toninicior Name Address 4. ~RTY OWNJUI /.J ,'\ -1-{,J(\ r. t2 0 '.!::, r..J (2 {) Name AddrHS &. CONTRACTOR ~ COMPANY NAME City D Owner·-D Agom iodlwnor City Chy State/Zip Stlte/Zip State/Zip Telephone# Fu# Telephone# Telephone I (Sec. 7031.5 Business end Profn1ion1 Code: Any City or County which reQl,riru • permit to construct, alter, Improve, demolish or repair ■nv 1tructure. prior to Its issuance, also requires the applicant for such permit to file • signed statement thlt he is licensed pursuant to th■ provisions of the Contractor', License Law !Chapter 9, commending with Section 7000 of Division 3 of the Business and ProfHSiona Codt) or that he ii exempt therefrom, and the basis for the alleged exemption. Anv viol at' n of Section 7031 .5 bV ,1nv applicant for • per. it subJ,cta thl J~ic to a ctvil tty of not more than flv undred doHa,,-..J 9500 . 1. ~ f -, /''-tr w d °!Joi 74'u 731 Name State License I _(I.-. :..15....1-.L):Q-"'-).L-..:c):__ Addreu City State/Zip Telephone I Licenn Cillu (5", '$ L ) l( Ctty a .. -. u..,.. I [ I q ? €(1-f C Designer Name Address Ctty State/Zip State License I _________ _ 8. WORKERS' COMPENSATION .... ·-· .-· ·;--r~•,. .. ~•· --·--~··· Workers' Compensation Declaration: I hetabv affirm under penalty of perjury one of the toHowing declarations: D I have and will maintain a certificate of consent to 1elf.ln1ure for worken' compensation ■1 prcnrided by Sectkln 3700 of the Labor Code, tor the performance of the work for which this permit is iHued. ~ I have and will maintain workers' compenution, IS required by Section 3700 of the Labor Coct., for the performance of the work tor which this permit is issued. My worker', compensation tnlwance carrier end policv number are: f -r;.; l7 / / ~, /-7,0, lnsuranca Compony G.€,1 0 l :tzlf) \, Vs Cc/W\P Policy No. u, I 70 !!... .J Expirotlon Doto,_].,_-....:.._...,a:.,__ !THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS IUOOI OR LESS) 0 CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for wNch this permit ii i■1ued, I shell not emplov eny person In any me,.,.., 10 •• to become subject to the Workers' Compensation Lew, of California. WARNING: FaUure to ncure w:ft' compenutlon coverage la unlawful, and .... aullject an employer to crlmlnal penaldaa and chrll fine• up to one hundred thOUHnd dollars l$i1 .ooo,. In ~ the cost of compenutlon. dllmagu • prowled for In Secdon 3708 of the Llibof code, lntll'Nt~ attomay'e ..... SIGNATURE ~ _,I p,____&i A 4 0 DATE 3--S: ~'7' (J__ 7. OWNER·BUIL EA DECLARATION ·-. . ·~: -·~. '' ~ r:-,,:;,....i.1r• .... · •• '?fj'f: ,-• I hereby affirm that I am exempt from the Contractor'• License Law tor the following renon: D I, H owner of the property or my employeu with wages ■1 their sole COfl'IP(tnlatktn, wNI do the work and the struct1n hi not mtended or offered for Hie (Sec. 7044, 8uain8P and Profusions Code: The Contractor•• Ucense Law dON not apply to an owner of property who buHda or lmprowa thereon, and who does 1uch work himHlf or through Iv• own employen, provided that such lmprovementa ■re not Intended or offlfed for ..... tf, however, the building or Improvement Is sold within one year of completion, the owner-builder wHI have the but'den of prcnring that he did not build or tmprow for the purpDN of .... ,. D I, as owner of the property, am exclusively contracting with licensed comr■ctOfl to construct 1h11 protect fS.C:. 7044, Bu■inn• and Profeuiona Code: The Contractor·, Licen11e Law dou not apply to an owner of property who builds or improves thereon, end contrac:ta for IUCh p,o;.cts wfth conuactorl■I llcenaed purauant to the Contractor'• Ucenn Law). D I am exempt under Section ______ B~neu end Profeujons Code tor this ru,on: 1 . I personally plan to provide the major labor and material, for construction of the proposed property Improvement. 0 YES ONO 2. I (have/ have not) signed an application for a building ~h for the propo,ed work. 3. I have contracted with the foHowlng person ffirml to provide the propoud construction llndudl name/ eddrea I phone number/ contractors licenn numbarl: 4. I plan to provide portions of the work, but I have hired the following person to coordmate, 1up■MH and provide the major work Ondude name/ addreu I phona number I contractors licen11e number):. ____________________________________________ _ 6. I will provide aome of the wo,k, but I have contracted Chiredl the following pe,eons to provide the work lndiceted !Include name/ ■ddrea / phone number I type of work):. _______________________________________________________ _ PROPERTY OWNER SIGNATURE ______________ ===-------= DATE ________ _ :coMPLETETHIS •.ecTl,oN FOR~ iul.DINCi PDMiTI ONi.V,'.7~~-·:-..._..,,,,, .. ,..,.,..~~~~~~·~:.y.;,·,···· -·-~ -•-•~·--·~······· ........ ~ Is the applicant or future bulleting occupant required to submit • businna plan, acutely hewdous m■tariele 1eghlbalic.N1 farm or rflik mwgemem end preyemton program under Sections 25505, 25533 or 25534 of the Pr■-y. Tanner Hazardous Subtt■nce Account Act? □ YES □ NO Is the applicant or future building occupant required to obtain• permit from the ■tr poftutkH'I control~ or air quaNty m1n1g■ment dlstrict1 0 YES O NO Is the facility to be constructed within 1,000 fnt of the outer boundary of a school alte1 D YES O NO IF ANV OF THE.ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT IE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES ANO THE AIR POLlUTION CONTROL DISTRICT. ia, -CONSTRUCTION LENDING AGENCY ,_ ..... , ...••. ,..,..,, ., •. ,,.. •... ,, ~-•·· ..... -:-·~;:,-.,..,,.......~,.-,. .. ,,._., ,_ ... ~ ,.., """'--·'"7".-··:• '.""""' .... , ... , ... -~ -·,·~ I hereby affirm that there is a construction lending agency tor the performance of the work for wNch this permit le luued !Sac. 3097(0 Civil Code). LENDER'S NAME _____________ _ ,9, APPi.iC.ANT CERTIFICATION LENOER'SADOAESS, ____________ _:_ __________ _ ' ... --.... ,,,.,.. .. :,-, ..... 1"'"" I certify that I have read the application and state thlt the above information ii correct end thlt the Information on the plans le ■CCUl'■te. I •are, to comply with 11\ City ordinances and State laws ,.1,ting to building construction. I hereby authorizt reprnentativn of the Cltt of Cerflbad to enter upon the above mentioned property for inspection purposu. I ALSO AGREE TO SAVE. INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST AU LIABILITIES. JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY _, CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit la required for excavations over 5'0"' dnp and demoHtion or construction of structures over 3 1toriu in height. EXPIRATION: Every permit issued by the Building Official under the provisions of this Code ahall e,cpire by limitation and become null and void if the building or work authorized by such permit i, not commenced within 366 days from the date of such permit or If the building or work authorized by such permit is suspended or abandoned It anv time after work is commen d or erlod of 180 days CSection 106.4.4 Uniform Building Code). ?_Zz' o. f-' APPLICANT'S SIGNATURE -/~-it-.=...L.lC...~--\,-,,,L/,L-f,.:b,<\,,,<._____________ DATE .::.> _ .--/ J--v WHITE: File YELLOW: Applicant PINK: Finance PERMIT# CB980721 DESCRIPTION: REPAIR GAS LINE TYPE: PLUM CITY OF CARLSBAD INSPECTION REQUEST FOR 04/01/98 INSPECTOR AREA PD PLANCK# CB980721 OCC GRP CONSTR. TYPE NEW JOB ADDRESS: 2704 APPLICANT: NATIONAL CONTRACTOR: LA GOLONDRINA ST LEAK DETECTION STE: LOT: OWNER: REMARKS: C/931-8108 SPECIAL INSTRUCT: TOTAL TIME: CD LVL DESCRIPTION AM PLEASE PHONE, 760 ,,,-s,os '2if__ PHONE, ~ PHONE: INSPECTO 1J2.. ACT COMMENTS ,,-- _2_3 __ P_L _G_a_s_f_T_e_s_t_f_R_e_p_a_i_r_s _______ ~ _Ln---'-t'--t/---'fh._.c.......::__ _________ _ -------------------- ***** INSPECTION HISTORY ***** DATE DESCRIPTION ACT INSP COMMENTS 032798 Gas/Test/Repairs co PD 032598 Underground/Under Floor CA PS 032598 Gas/Test/Repairs CA PS