HomeMy WebLinkAbout2713 La Golondrina St; ; CBR2017-0612; PermitPrint Date: 04/10/2017
Job Address:
Permit Type:
Parcel No:
Valuation:
Occupancy Group:
# Dwelling Units:
Bedrooms:
Project Title:
Description:
2713 La Golondrina St
BLDG-Residential
2155420200
$0.00
SWEATT£: INSTALL AC UNIT
PLUMBING, ELECTRICAL, AND MECHANICAL PERMIT
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Residential Permit
www.carlsbadca.gov
Work Class: P/M/E
Lot#:
Reference#:
Construction Type:
Bathrooms:
Orig. Plan Check#:
Plan Check#:
Owner:
COOWNER SWEATT£ HOWARD AND
PATRICIA M
Total Fees: $166.00 Total Payments To Date: $166.00
Status;
Applied:
Issued:
Finaled:
Inspector:
Contractor:
KEVIN MYERS
619-446-9139
Balance Due:
Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter
collectively referred to as "fees/exaction." 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 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 limitation has previously otherwise expired.
Permit No: CBR2017-0612
Closed -Finaled
03/28/2017
03/28/2017
$166.00
$0.00
Hf ,'oLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: 0 PLANNING D ENGINEERING
. •fl"'
· (_ City of
Carlsbad
JOB ADDRESS
Building Permit Application
1635 Faraday Ave., Carlsbad, CA 92008
Ph: 760-602-2719 Fax: 760-602-8558
email: building@carlsbadca.gov
www.carlsbadca.gov
SUITE#/SPACE#/UNIT#
□BUILDING □FIRE □HEALTH D HAZMAT/APCD
Plan Check No
Est. Value
Plan Ck. Deposit
Date 0
APN
CT/PROJECT# PHASE# #8ATHROOMS TENANT BUSINESS NAME CONSTR. TYPE acc. GROUP
DESCRIPTION OF WORK: Include Square Feet of Affected Area(s)
EXISTING USE
APPLICANT NAME
Primary Contact
ADDRESS ~
EMAIL
DESIGN PROFESSIONAL
ADDRESS
CITY
PHONE
EMAIL
PROPOSED USE
STATE ( A:
FAX
STATE
FAX
GARAGE (SF)
ZIP
STATE UC.#
PATIOS (SF) DECKS (SF) AIR CONDITIONING
YES □No□
PROPERTY OWNER
CITY STATE (-A ZIP
PHONE FAX
EMAIL
CONTRACTOR BUS. NAME
ADDRESS
CITY b,
PHONE
EMAIL
STATE LIC.# CLASS \1-<Lo
FIRE SPRINKLERS
YES □No□
(Sec_. 7031.5 Business and P_rofessions Code: Any City or County which requires a permit to construct. alter, improve, demolish or repair any structure, prior to its issuance, I requires e applicant for such per_m1t to file a signed statement that he is licensed pursu~nt to the provisions of the Contractor's License Law [Chapter 9, comme_ndingw1th Section 7000 of Division 3 of the Business and Professions Code} or (hat he 1s 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 {$500)).
WORKERS' COMPENSATION
Workers' Compensation Declaratlon: I hereby affinn 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. 0 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 workers' compensation insurance carrier and policy
number are: Insurance Co________________________ Policy No _______________ 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 hich 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 workers' compensation covera e Is un all 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 Sectlo 37 of the Labor code, interest and attorney's fees.
NS CONTRACTOR SIGNATURE
I hereby affirm that I am exempt from Contractor's License Law for the following reason:
□
□
□
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 himse~ 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}.
I, as owner of the property, am exclusively contracting with licensed contractors lo construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply lo an owner of
property who buikls or improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License law).
I am exempt under Section _____ 8,usiness and Professions Code for this reason:
1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0Yes Oo
2. I (have I have not) signed an application for a building permit for the proposed work
3. I have contracted with the following person {firm) lo provide the proposed constr ction (include name address I phone/ contractors' license number)
4. I plan to provide portions of the work, but I have hired the following person to c rdinate, supervise and pro · major work (include name I address I phone I contractors' license number):
5. I will provide some of the work, but I have contracted (hired) the following perso to v1 indicated (include name/ address/ phone/ type of work)
NS PROPERTY OWNER SIGNATURE QAGENT DATE
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? □ Yes □ No
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? □ Yes □ No
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ Yes □ 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
EME.RGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
I certify that I have read the application and state that the above infonnation is correct and that the infonnation on the plans is accurate. I agree to comply with all City ordinances and State 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 ANO 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 construction of structures over 3 stories in height.
EXPIRATION: Eveiy pennit issued by the Building Official under the · ions 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 rrom the date of such permit or if the building or work a · ed by such pennit is suspended or abandoned at anytime after the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code).
AS APPLICANT'S SIGNATURE DATE
STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE.
Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection.
Fax (760) 602-8560, Email building@carlsbadca.gov or Mail the completed form to City of Cansbad, Building Division 1635 Faraday Avenue, Cansbad, California 92008.
CO#: (Office Use Only)
CONTACT NAME OCCUPANT NAME
ADDRESS BUILDING ADDRESS
CITY STATE ZIP CITY
Carlsbad
STATE
CA
PHONE FAX
EMAIL OCCUPANT'S BUS. UC. No.
DELIVERY OPTIONS
□ PICK UP: o CONTACT (Listed above) o OCCUPANT (listed above)
o CONTRACTOR {On Pg. 1)
□ MAIL TO: o CONTACT (Listed above) u OCCUPANT (Listed above)
□ CONTRACTOR (On Pg. 1)
D MAIL/ FAX TO OTHER: ________________ _
A$ APPLICANT'S SIGNATURE
o ASSOCIATED CB#'------------
□ NO CHANGE IN USE/ NO CONSTRUCTION
o CHANGE OF USE/ NO CONSTRUCTION
DATE
ZIP
PERMIT INSPECTION HISTORY REPORT (CBR2017•0612)
Permit Type:
Work Class:
Status:
Scheduled
Date
BLOG-Residential
P/M/E
Closed -Fina led
Actual
Start Date Inspection Type
Application Date: 03/28/2017 Owner:
Issue Date: 03/28/2017 Subdivision:
Expiration Date: 10/10/2017 Address:
IVR Number: 2779
Inspection No. Inspection Status Primary Inspector
04/10/2017 04/10/2017 BLDG-43 Air
Cond./Furnace Set
019429-2017 Passed Jonathan West
April 10, 2017
BLDG-Final
Inspection
Checklist Item
BLDG-Building Deficiency
019430-2017
Checklist Item
BLDG-Mechanical Final
BLDG-Electrical Final
COMMENTS
Passed Jonathan West
COMMENTS
COOWNER SWEATTE HOWARD
AND PATRICIA M
CARLSBAD TCT#73-29
2713 La Golondrina St
Cansbad, CA 92009-4326
Relnspectlon
Passed
Yes
Passed
Yes
Yes
Complete
Complete
Complete
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