HomeMy WebLinkAbout2500 LA GOLONDRINA ST; ; CB130329; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Plumbing/Mechanical/Electrical (PME) Permit
02-06-2013 Permit No: CB130329
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
2500 LA GOLONDRINA ST CBAD
PME Status:
Parcel No: 2155612700 Lot#: 0 Applied:
Reference#:
PC#:
Project Title:
Applicant:
GALLEISKY RES= REPLACE FAU
AND DUCTS
BARBARA GALLEISKY
2500 LA GOLONDRINA ST
CARLSBAD CA 92009
760-929-81 06
Plumbing Fees
Electrical Fees
Mechanical Fees
Other PME Fees
TOTAL PERMIT FEES
Entered By:
Plan Approved:
Issued:
Inspect Area:
Owner:
GALLEISKY B&G TRUST 06-20-04
2500 LA GOLONDRINA ST
CARLSBAD CA 92009
ISSUED
02/06/2013
LSM
02/06/2013
02/06/2013
$0.00
$0.00
$154.00
$0.00
$154.00
Total Fees: $154.00 Total Payments To Date: $154.00 Balance Due:
Inspector:
FINALAPPR
Date: o1-Z-Clearance:
$0.00
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.
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
f . n f i h v Tl ii r hi . h h f imi . n h
THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: 0 PLANNING 0 ENGINEERING □BUILDING □ARE □HEALTH OHAZMAT/APCD •
~ <.._({#'j) Building Permit Application Plan Check No. C-f> I "30 ~~
~ CITY Of
CARLSBAD
1635 Faraday Ave .• Garlsbad, CA 92008
Ph: 760-602-2719 Fax: 760-602-8558
email: buldllng@carlsbadca.gov
www.carlsbadca.gov
Est. Value
Plan Ck. Deposit
Date a,._/ Co .:3
SUITE#/SPACE#/UNIT # APN
CT TENANT BUSINESS NAME
DESCRIPTION OF WORK: Include Square Feet of Al'l'ected Area(s)
$WPP
CONSTR. TYPE CCC. GROUP
EXISTING USE PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS
YES □#_ NO □ YES □ NOD YES □ NOD
APPLICANT NAME (Primary Contact) APPLICANT NAME (Secondary Contact)
ADDRESS ADDRESS
CITY STATE ZIP CITY STATE ZIP
PHONE FAX PHONE FAX
MAIL
CONTRACTOR BUS. NAME
ADDRESS
CITY STATE ZIP
PHONE FAX
EMAIL
STATE LIC.# CLASS CITY BUS. UC.#
(Sec, 7031.5 Business and P_rofessions Code: Any City or Coun_ty 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 provisions of the Contractor'.s License Law /Chapter 9, commending with Section 7000 of Division 3 of the B_usmess and Professions Code} or that he Is exempt therefrom, and the basis for the alleged exemption. Any vI0IatIon of Section 1031.5 by any appl1canffor a permit subjects the applicant to a cIvII penalty of not more than five hundred dollars [$500)).
Workers' Compensation Declaration: / heret,; affirm under penalty of pe,jury one of the following declarations:
□ 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 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 can1er and policy
number are: Insurance Co. ______________________ Policy No, ______________ Expiration Date _________ _
This section need not tJe completed Jf the permit is for one hundred dollars ($100) or less.
□ 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 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, damages as provided for In Section 3706 of the Labor code, Interest and attorney's fees.
,I!, CONTRACTOR SIGNATURE
I hereby affirm that I am exempt from Contractor's Ucense Law for the following reason:
□ I, as owner of the property or my employees with wages as their sole compensation, will do the won<. 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 himselt" or through his own employees, provided that such improvements are not intended or offered for
_.;ale. If. however, ttie 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),
ty"" l, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Cootractor's li:ense Law does not ~ply 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).
□ I am exempt under Section _Business and Professions Code for this reason:
1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. □ Yes □ No
2. I (have/ have not) signed an application for a building perm ti for the proposed work
3. I have contracted with the following person {firm) to provide the proposed construction (include name address I phone I contractors· license number):
4. 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 I phone I contractors' license number):
5. I will provide some of the work, but I hav racted (hired) the following persons o provide the rl<. indicated (include name/ address I phone/ type of work):
□AGENT
COMPLETE THIS SECTION F_OR NON•REstl:>ENTIAI.--BUII..Dl;,rG PERMITS ONLY -
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•T anner 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 AN&WERS 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 ANO THE AIR POLLUTION CONTROL DISTRICT.
I hereby affirm that there 1s a construction lendmg agency for the performance of the work this permit 1s issued (Sec 3097 (1) Civil Code)
Lenders Name Lenders Address
1 certify that I have read the application and state that the above information Is oonect and that the infonnation on the plans Is accurate. I agree to complyYnth all City ordinances and State laws relating to building oonstruction.
I hereby authorize representative of the City of Car1sbocl to enter up::m the atove menboned property br lnsp;ldion pufJX,lses. 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 CCT>JSEOUENCE OF THE GRANTING OF THIS PERMIT.
OSHA: An OSHA perm~ is required for excavations over 5'0' deep and demolition or construction of structures over 3 stories in height.
EXPIRATION: Every permit issued by the Buik:lin · I under the provisK:lns of this Code shall expire by um· and berome null and void W the building or 'M'.lO( authorized by sudl permit is not mmmenced ~thin
180 days from the date of such · ildi rk auth · su tt ls s or a,t,;,96,,g,,lji,,fllrme aft e V;Ork ls commenced for a i;ertod of 180days (Secfun 100.4.4 Uniform Building Oxle)
,/6 APPLICANT'S Sl DATE
I
• 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 www.buildinq@carlsbadca.gov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008.
CO#: (Office Use Only)
CONTACT NAME OCCUPANT NAME
ADDRESS BUILDING ADDRESS
CITY STA.TE ZIP CITY STATE
Carlsbad CA
PHONE FAX
EMAIL OCCUPANT·s BUS. LIC. No.
DELIVERY OPTIONS
□ PICK UP: o CONTACT (Listed above) c OCCUPANT (Listed above)
r1 CONTRACTOR (On Pg. 1)
□ MAIL TO: □ CONTACT (Listed above) n OCCUPANT (Listed above)
o CONTRACTOR (On Pg. 1)
D MAIL/ FAX TO OTHER:
,..S APPLICANT'S SIGNATURE
o ASSOCIATEDCB#•-------------
0 NO CHANGE IN USE/ NO CONSTRUCTION
o CHANGE OF USE/ NO CONSTRUCTION
DATE
ZIP
Inspection List
Permit#: CB130329 Type: PME
Date lnspe_<:tio11__1!em -··----
07/25/2013 43 AirCond/Furnace Set
07/25/2013 43 AirCond/Furnace Set
07/25/2013 49 Final Mechanical
07/25/2013 49 Final Mechanical
03/04/2013 43 AirCond/Furnace Set
Friday, July 26, 2013
Inspector Act
RI
MC AP
RI
MC AP
MC co
GALLEISKY RES= REPLACE FAU
AND DUCTS
Comments
9-11 NOT IN ATTIC
NO ACCESS
Page 1 of 1