HomeMy WebLinkAbout2546 LUCIERNAGA ST; ; 80-87; PermitLICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provi-
sions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Profes-
sions Code, and my license is in full force and ef-
fect.
OWNER-BUILDER DECLARATION
C'I hereby affirm that I am exempt from the Con-
tractor's License Law for the following reason
{Sec. 7031.5 Business and Professions Code), Any
city or couflty which reQuires a permit to con-
struct, alter, improve, demolish, or repair any
structure, prior to its issuance also reQuires the
applicant for such permit to me a signed state-
ment that he is licensed pursuant to the provi-
sions of the Contractor's License law (Chapter 9
commencing with Section 7000 of Division 3 of
the Business and Professions Code) or that is ex-
empt therefrom and the basis for the alleged ex-
emption. Any violation of Section 7031.5 by an ap-
plicant for a permit subjects the applicant to a
civil penalty of not more than five hundred dollars
($500).
c:1 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 of-
fered for sale (Sec. 7044, Business and Profes-
sions Code: The C~'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 such improvements are not intended or of-
fered for sale. If, however, the building or improve-
ment 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).
::::1, as owner of the p(ope_rty, am exclusively con-
tracting with licenSed ccmlra1:tors to construct
the project (Sec. 7044, Business and Professions
Code: The Contractor's License Law does not ap-
ply to an owner of property ·•ho builds or im-
proves thereon, and who contracts for such pro-
jects with a contractor(s) license Pursuant to the
contractor's License Law).
I am exempt under Sec. _____ , B. & P.C.
for this reason
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of con-
sent to self-insure, or a certificate ... of W rkers'
Compensation Insurance, copy
thereof (Sec. 3800, Labor Co
POLICY NO. __ _,""'~,.,-"-~ ___ _
COMPANY ----'>--'-+--1------
C:Copy is filed with the city.
L • Certified copy 1s hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This sectmn need not be completed ii the per-
mit i's for one'hundred dollars (S100) or less).
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 Wo~kers' Compensation Laws of California.
NOTICE TO APPLICANT: lf, after making this Cer-
tificate of Exemption, you should become subject
to the Work.1rs' Compensation provisions of the
Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
CONSTRl.'CTION LENDING AGENCY
I h<>r<>h11 ,.ffirm that there is a construction len-
CITY OF CARLSBAD-BUILDING DEPARTMENT
USE BALL POINT PEN ONLY APPLICATION & PERMIT
1200 ELM AVENUE (714) 438-5525
APPLICANT TO FILL IN INFOR -
MATION WITHIN RED LINES.
"'· I~ JOB ADDRESS
, AV.ST. !°ATE OF APPLICATION BUS, LICENSE PERMIT NUMBER
,.::2,s;<;,c; I,...., ,J S-1/6. I , • (Z,;. ,, I ' I I I ' ' I ',' 17'11.s-£0-87 ,.a'j/;;,~ y;' 7d,_~ l) OWNER'S PHONE PR!M:g;TRACTOR STATE LICENSE . . . ~,.)--'""' '31111t7tJ ' ·-~-
OW6R'~ /AlL\Nm;~\ J.t--L ,... -rn-_, ✓--
C~)N:A~TOR~D({: •• ~;_i CONTRACTOR'S
. ,,-r-;)...d I ,-.,.....,,_. 174 c, y'o ]~3& l'loJ
)}~ BLOCK ~I~ · I 1 ASSESSOR'S PARCEL NO. , 3,7, OESIGNER STATE L!CENSE .c · ~, I, s; ,.:l.,6 ,I! , 3Y Jl/ 7 <3 DESCRIPTION OF WOR:.-P j 1,.k1 . ..,., ~, DESIGNER'S ADDRESS DESIGNER'S PHONE -.)J/L~ / __ -_-, LN .....e..e ~ l./ ~£~(Jc/
CENSUS TRACT GP LAND usi C ZOK -)..--I RES. UNV [ ';'"'VeAC;Jl~ ·1 NUMBER OF VS
Not Va.id Unless Machine Cartifi«I
BLOG SQ, ~lf. ,-1~ B~~ R'3 I STA;;; :;/~y I PLAN ID# l"v :·;v l occ. LOAD I -
'-' . , ~ UTY. PLUMBING PERMIT AMT. QTY. MECHANICAL PERMIT AMT. (-r/_,.<.;.t ' ,
I'> C. EACH FIXTURE TRAP . l 2,-::,. INSTALL FURN. DUCTS UP TO 100,000 BTU 15 ':-' :J "1' ~ ... EACH BUILDING SEWER . A. ;.-' , n OVER 100,000 BTU 1,, .Ch;? ~ .., ~ EACH WATER HEATER AND/OR VENT ~/ l!OILEfi/COMPRESSOR UPT03 HP ~ \\ :2. EACH GAS SYSTEM 1 TO 4 OUTLETS ,, / BOILER/COMPRESSOR 3-15 HP
EACH GAS SYSTEM 5 OR MORE '/ BOILER/COMPRESSOR 16-30 HP
EACH INSTAL., ALTER. REPAIR WATER PIPE /', VENT FAN SINGLE DUCT If-cJ--O r 78,/ 3,?.),' EACH LAWN SPRINKLER SYSTEM >' -· ,.,. ' MECH EXHAUST -HOOD/DUCTS VALUATION:
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER BUILDING PERMIT I I 7'fd c> ~ (
Issue 3 .• o, Issue --:3. oc SIGN P I I • I
TOTAL PLUMBING 7..J~ TOTAL MECHANICAL 33~ ~LAN CHECK/Jr/-1/>~, )S' # / /,2 $k ,, I.Jlb3 .1',;
CONTRACTOR CONTRACTOR Af:c I I -"
ELECTRICAL PERMIT AMT. / AMT. TOTAL PLUMBING I '.).. u-
QTY. QTY. MOBILE HOME PERMIT ELECTRICAL I , .. ,.2. a-o
·1~ NEW CONST EA AMP/SWT /BKR .< a -c-AWNING / MECHANICAL I ,:;,3.......:
1PH .25 3 PH PORCH -/ MOBILE HOME I I . I
EXIST BLDG EA AMP/SWT/BKR SET-UP / SOLAR I I I . I
1 PH .25 3 PH RAMADA, CABANA / I I I . I
REMODEL/ALTER PER CIRCUIT FENCE OVER 6' / I I . I
/ TEMP POLE 200 AMPS /,, . .....-o TOTAL MOBILE H~E MICO-FILM I I I . 1
OVER 200 AMPS / r_,,. • d. F u I I Al$ f I <>,
TEMP OCCUPANCY (30 DAYS) / ,?, . , I I?~"· 2.< J,
T<0~"= 2.00 ,/ I I I . I
TOTAL ELECTRICAL 02. trO TOTAL FEES PAYABLE I .6?!;/> CONTRACTOR ..--I I
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT. AND DO "AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER
HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I 5'-0" DEEP AND DEMOLITION OR CONSTRUCTION OF SCHOOL FEES: ~ FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUE□;TO COMPLY WITH ALL CITY, STRUCTURES OVER 3 STORIES IN HEIGHT ,~? ~ COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER ~~ ~.-~~ SPECIFIED HEREIN OR NOT I.ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM ' LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS. COSTS AND
EXPENSES WHlCH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE . .
OF THE GRANTING OF THIS PERMIT. A~~•s83NA;J'E~
OWNER □ CONTRACTOR}'.) l~ED BY C. '-:· . DATE
__.,,. '"'-<-I . .• .• -AGENT 0 BY PHONE00 __b. ' ~ [,) ·'f-
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SITE
ADDRESS: OWNER: PERMIT NO:
FIELD INSPECTION RECORD
INSPECTION DATE INSPECTOR INSPECTOR'S NOTES
WOOD FLOOR
FOUNDATION• FORMS• SET BACK • TOILET
UNDER FLOOR PLUMBING
UNDER FLOOR HE-ATING
OK TO INSTALL SUB FLOOR
SLAB FLOOR
UNDER SLAB PLUMBING
' FOOTING• FORMS• SETBACK• TOILET
OK TO POUR CONCRETE
FRAME
ROUGH ELECTRICAL
ROUGH PLUMBING
ROUGH HEATING/VENTILATING
FRAME OK• PLACE INSULATION
INSULATION OK • PLACE WALLBOARD
WALLBOARD OK• PLACE TAPE
EXTERIOR LATH OK• PLACE STUCCO
FIREPLACE
DAMPER 8: STEEL
PLATE TIES/HEIGHT OF CHIMNEY
OTHER
TEMP POWER (POLE)
SEWER
GAS TEST
SWIM POOL • STEEL BONDING
• PRE DECK
• FENCE PREP LASTER
SHOWN • FRAME
• PAN
FINAL !NSP BY BLDG DEPT
OTHER DEPT'S REQ COMPLETED
ELE<..: METER-PERM-TEMP
GAS METER-PERM-TEMP
L.::_ERT OF OCCUPANCY ISSUED
REQUEST FOR INSPECTION TIME:~~--
INSPECJOn_ _________ PERMIT NO_~_tf_-_l-'-J __ DAH· ~ . --d'a·~
OWNER __ ..IC.-""'-'~u,<..e..,:==:.......,------------------------
ADDRESS_.12,;,2~5":..lf-::_,'/'--,t./4~.2_~\I_'f,!20__,;z=:::_/,;~,,::l'.'.•'.{.,.e,_ 4·~ •··,.i::~..::•j...,i-L·L.....--------
/ /I -BUILDING ELECTRICAL
0 FOUNDATION
0 REINFORCING STEEL O TEMPORARY SERVICE
0 MASONRY O ELECTRIC UNDERGROUND
0 GROUT -GUNITE O ROUGH ELECTRIC
D FLOOR AND CEILING FRAME O POOL BONDING
0 SHEATHING O ELECTRIC SERVICE
0 FRAME O CEILING HEAT
D EXTERIOR LATH \1 0 G.F.1.
0 INSULATION r'\ \: □ SMOKE DETECTOR
D INTERIOR LATH OR DRYWALL \)• 1 {~ 0 FINAL
~ FINAL \'\t' ,, L--.P.,~,--------'~~'~__..,,
PLUMBING
D UNDERGROUND PLUMBING
0 UNDERGROUND WATER
0 ROUGH PLUMBING
0 TOP OUT PLUMBING
0 SEWER AND PL/CO
D TUB OR SHOWER PAN
0 GAS TEST
D WATER HEATER
D FINAL
MISCELLANEOUS
0 PLENUM AND DUCTS
0 COMBUSTION AIR
0 PATIO
0 SIGN
0 GRADING
0 DRIVEWAY
0 CONDITIONED AIR SYSTEMS
0 REFER PIPING
D FINAL
READY FOR INSPECTION: □MONDAY ~~ESDAY ~EDNESDAY D THURSDAY D FRIDAY
OA.M. \S' _/
OP.M. //.
SPECIAL INSTRUCTIONS _ _,./Z,~-~~-~---'~J., -lf~c--~ ... j{)~·--------------
/v_ Li! -PHONE NO . .I/.J{-6,Yi?/
PERSON TAKING REPORT ~ 7
TIME·-_____ _ REQUEST TION
1NS,PECTOR-----~-l"-"c....=;._...,__ PERMIT NO. fo-S Z <-~; DATE:~,_)~--~--
BUILDING
0 FOUNDATION
0 REINFORCING STEEL
0 MASONRY
0 GROUT -GUNITE
0 FLOOR AND CEILING FRAME
0 SHEATHING
0 FRAME
0 EXTERIOR LATH
0 INSULATION
0 INTERIOR LATH OR
D FINAL
PLUMBING
0 UNDERGROUND PLUMBING
0 UNDERGROUND WATER
0 ROUGH PLUMBING
0 TOP OUT PLUMBING
0 SEWER AND PL/CO
D TUB OR SHOWER PAN
0 GAS TEST
0 WATER HEATER
D FINAL
ELECTRICAL
D TEMPORARY SERVICE
0 ELECTRIC UNDERGROUND
0 ROUGH ELECTRIC
0 POOL BONDING
0 ELECTRIC SERVICE
0 CEILING HEAT
0 G.F.1.
0 SMOKE DETECTOR
D FINAL
MISCELLANEOUS
0 PLENUM AND DUCTS
0 COMBUSTION AIR
0 PATIO
D SIGN
0 GRADING
0 DRIVEWAY
0 CONDITIONED AIR SYSTEMS
0 REFER PIPING
D FINAL
' READY FOR INSPECTION: □MONDAY □TUESDAY □WEDNESDAY □THURSDAY □FRIDAY
DA.M. __/,,_,,,6__,.L ~
D p .M. ~ -/
sPEclAL 1NsTRucT10111~ ... _-......,,C"""'a..,,£....,.p ____________________ _
~-~ ./
REQUESTED BY :;$,;~ PHONE NO. u?& 1
PERSON TAKING REPORT _______ _
,.,,, 1' j6..,/9d/ r . INTERDEPARTMENTAL INFORMATION SHEET RECEIVED
G 'DEPARTMENT
NG ADDRESS:
'/4 DATE, NOV 13 1979
2S-'fi/l ~S-f/ ~TY OF CARLSBAD
~ /21" ~ £? ~-P--f Building Department
\
J PLANNhl_,G DEP A~ENT
.,, \ n V ZONE W...I LOT SIZE LOT WIDTH.1 ' -/ ---_,-----
UNITS ALLOWED _____ '~V _____ UNITS PROVIDED ___ -_, ________ _
PARKING SPACES REQUIRED PROVIDED /
%•COVERAGE ALLOWED PROVIDED ____ \_/__,~-----
---------------➔g~------
BUILDING HEIGHT ALLOWED PROVIDED ----------.. FRONT SETBACK: SIDE SETBACK: REAR SETBACK:
ALLOWED ______ _
PROVLDED ___ ~~#-,/ __ _ ,I V
INTRUSIONS -----
\NDSCAPE & IRRIGATION PLAN COMMENTS: _}K ______________ _
ENVIRONMENTAL PROTECTION REQ:
_f>/-'--•-=-f~ ___ DATE 50-;/~
ENGINEERING DEPARTMENT ///; 3j)i-y~ (-<j-W• 1;;~,-."11
L WASTE j I A IMPROVEMENTS ~X/_ ... ------R.O.W. -----
SEWER CONNECTION --,------'<---P,~'/("'--_DRIVEWAY LOCATIONS_..;_;'----------,-..,......
GRADING PERMIT _ __,_t1 __ ____; __ EAS,EMENTS_::...:....:.=-::=-:....:::.:...-----DRAINAGE "'.,.itfu.l fuor-t
LEGAL DESCRIPTION ___ L __________ ?-'-/_r_~_,_"1_~---------
S' Ll~Y lt/4E W StTE /'.J-. d/1/ IACI nt: /lf/C':,!;>
FIRE DEPARTMENT
SPRI~KLING SYSTEM . ___________ FIRE PROTECTION EQUIP . ______ _
FfRE ALARMS EXITS
FIRE HYDRANTS FIRE RETARDAN>t ROO~F-8£-QU-IR-ED ___ _
ADDITIONAL COMMENTS . ~ ) u.o,e,
,.
OK TO ISSUE:\...,{&j~&:::,d~~DATE DEC. 10 1970 OK TO FINAL ______ DATE ____ _
WATER DEPARTMENT
REQUIREMENTS OF APPROPRIATE DISTRICTS MET ________ DATE _______ _
b-<;;1-q~ lf_b
I L~---~
PHILIP HIENKING BENTON
P11t~a10&NT • CIVIL &NGINSSlllt
The Gregor Company
229 North El Camino Real
Encinitas, California 92024
BENTON ENGINEERING. INC.
APPLIED ao1L MECHANIC. -l"OUNOATIONa
111140 RUr-l"IN ROAD
SAN DIEGO, CALll"ORNIA 921 Zll
January 7, 1980
Subject: Project No. 79-12-13M
Gentlemen:
Moisture Contents in Subgrade Soils
Lot 178 of La Costa Meadows Unit No.
Carlsbad, California
T•L•P,HON• ( 714) 111111. utee
This is to report the results of tests to determine the mo ·sture contents of the soil s in the upper
three feet below finished grade in the proposed building area at the subject site in Carlsbad,
California.
The soil samples were obtained on December 28, 1979 and the results of the moisture
determinations are presented as follows:
Approximate
Location of Samples
Northwesterly portion of proposed building area
Southeasterly portion of proposed building area
Depth Below
Existing Grade
(In Feet)
1. 0
2.0
3.0
1. 0
2.0
Moisture Content
(% dry wt)
17. 1
21. 0
21. 5
20. 1
20. 1
Too rocky to sample at 3. 0 feet
It is conduded fran the field observations of the various soil types and the final results of the
moisture determinations that the soils in the upper two to three feet below finished grade at the
loc.ations sampled have been sufficiently moistened to minimize the potential expansion of the
soils, as recommended in our report under Project No. 70-10-280 1 dated October 12, 1971.
Respectful I y submitted ,
BENTON ENGINEERING, INC.
Distribution: (3) Addressee
RCR/PHB/c
"HILIP HENKING BENTON
P'IIC:81D.NT · CIVIL SNOINSCR ,,
The Gregor Company
229 North El Camino Real
Encinitas, California 92024
BENTON ENGINEERI NG. INC.
A""LIED SOIL MECHANICS -P'OUNDATION8
1111•0 RUP'f"IN R OAD
SAN DIEGO, CALlf"ORNIA 92123
January 29, 1980
Subject: Project No. 79-12-13M
lnspecti on of Lot 178
Gentlemen:
La Costa Meadows Unit No. 1
Carlsbad , California
T l:LU'HONI: (71<l) 8118,198 8
In accordance wi'th the request of the Building Inspection Department of the City of Carls~d,
we have made an inspection of the soil conditions existing on the subject lot. ·
An inspection was made by a representative of our organization on January 29, 1980 and
it is concluded that the soil conditions are essentially the same as presented In our report
on the grading of th is subdivision dated October 12, 1971. The soils in the upper three
feet below fi n ished grade were classified as Type 8 {.Marg inolly expansive) and therefore
the recommendations for special design and precautions presented in the above dated report
should be incorporated In the plans and specifications for any proposed construction
on this lot.
If there are any further questions concerning the soil conditions on this lot, please contact us.
Respectfully subm itted,
BENTON ENGINEERING, INC.
By --d? ~ ~-e:!-n:
R. C. Remer
Reviewed by~ w~
Ph(,p H.r( on, Civil E~ineer
RCE No. 10332
Distribution: (3) Addressee
RCR/PHB/c
1200 F LM A VENUE
CARL.SSM), CALI FORNIA 92008
February 14, 1980
Attention: Mr. Jerry Sorint
San Diego Gas & Electric Company
P.O. Box 1831
San Diego, California 92120
Attention: Subdivision Coordinator
Gentlemen:
TELEPHONE:
(714) 729-1181
In accordance with Sections 301, 505 and (1301
or 1401) of the uniform Building Code, this age ncy has,
· determined that t h Gre are buildings in subject
proj~ct and wil l issue sep_arate buil ding permit s to cover
these group _R~_3 __ _ (Rl or R3)occupancies.
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4 1200 ELM AVENUE TELcPHONE:
CARLSBAD, CJ\LIFORNIA 92008 (714) 729-1181
t.
Bu·ilding Department
<ltitp of <!nrlsuaa
JfSIDENTll~LCNEEGlJl(S.lG..~CERTIFICATIOM
.-· Perm·it No. ------
Issue Date: August 29 , 1979
.. CfRTIFIC~TE .OF.. .ca,1eLI NJCE t1!ITrt []ERG'{ COtJSERV8IION DESIGH HEQUI PJ-J~fNTS
COi\ffAINED IN P,RTICLE L PAfff 6, Tiill 24 .. Cft.LIFOffiJI A AU't CODE
I · . , Greg He_c_k_;.__ ___ . j, hereby c ertify that I am fami "li ar
with the state energy·co n~ervati on stand ard~ mandated in
. . . CAC Titl e 24 , Section T20-1401 through T20-l406, and that the
pl ans a nd other documc:1ts submitted in support o f the appli cati on -
for a buildi ng pe rmit a t 2544-46 Luciernaga Street, Carl sbad, Ca. 92008
..
·215 ... 260-3.7
Ass essor 1 s Parcel No . t
Address
..
February 4, 1980 ---Dated
c~mp~y wit~
1
1 . m:quireme nts of these regul ations ~
.S1gna,.ure ~~ _ _ _ ______________ .•
Titl e General Contractor, THE GREGOR COMPANY ( Archi tect, tng i ne er , Cc-n-tr_a_c_t_o r-,--,,-0--t h_e_r_ .... ). ~-------
State license or Certificate No. #347470 • ---------------
Date February 4, 1980 . ---
Su bmit to the Oui ldi:19 Department with permit app~i cation.
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CITY OF CARLSBAD
1200 ELM AVENUE • CARLSBAD, CALIFORNIA 92008
729-1181
('-/.·I C'7
RECEIVEO FROM ·'-/-.// /,·j • :7. 1 ' l_ , . (~ --'? ('
OATE_,_...r __ ~_.,_·-_,.J~·~·c):::_ __ _
AOORESS
A l e. NO. D ESCRIPTION AMOUHT
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CITY OF CARLSBAD
1200 EL M AVENUE • CARLSBAD, CALIFORNI A 92008
729-1181
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RECEIVED FRDi.k · /-· l.1 Id · ·, ~ • f.' () c~ -"7 <'.-DATE _.._/1 __ -_..,_· -_.~J_. _'"CJ ___ _
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,,: "-t_; ~-.,-1 .~"' ~ 1 This Certificate issued pursuant to the requirements of Section 306 ~
j of the Uniform Building Code certifies that at the time of •issuance ~
~ this structure complies with applicable ordinances of the City ~ '.i regulating building construction use. e
.-::g i ...
..-,: u c 1~-. Duplex Bid P "N 80-87 ~ ,'< se as ,cation__________________ g. erm1t o.________ r ~ Group J Type Construction VN Fire Zone_~ ____ Use Zone______ ~ ~ ~ ~ Occupant Load ··· .•; ·:· ~
~ OwnerofBuildin~--AJ\dT.ea S.-Wh_lt,e.-,, •. 'Mdress341 Broa<;l St.·, Manchester, Con!i',
q; .. i· s... s ·4·4·1·2 s· 4 i:. · r. · ··· · P--<~ Bu ilding Address ·,_ "'A ~-~ y;-1c.~e;nagao~ality ,..,..'""::::::~.....,......._.~~.,y....-'-'~~ ........ ----~ « . i . ~ _..., , ... ~ .. • . ,. . ' s---~ . "" ..... r ~ ~~~-\ ~ -<~ __________________ By--"".-;......r:;_.;:;_~,..,._"""-_.... ________ =_ r
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