HomeMy WebLinkAbout1858 TULE CT; ; 83-234; Permitl
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O I lleteby affirm that I am licensed under
provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Professions Code, and my license Is In
lull fon:e and effect.
Lie No _______ Class
I he<eby aft,rm that I om exempt lrom tho Contrx-
tor' s LiceMe Law tor the lot!owlng ruson (Sec. 7031.5 Business and Professions Code Any c,ty 0< county which re-quires a perm,1 to construct, alter. improve demotish, a, repa.-any structure. pnor to its Issuance also requtres the ap-
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Llceose Law (Chapter 9 commencing with Section 7000 of OMslon 3 of the Business and Protess,ons Code) o, that Is ex-
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jects the applicant to a c,v, penalty of not more lhan live hun-dred dollars ($500)
□ I, as owner ol the properly, or "Pf employees with wages
as their sole compensation. will do lhe work. and the struc~ lure Is not intended °' ollered fo, sale (Sec 7044, BuSlness and Prolessl011s Code The Controcto,'s LJCense Law does
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employees, provided that such wnproYemonts are not Intend· ed 0< offered tor sale If. '-ever, the bullchng or lmpro,e-
ment is sold within one year of completion, tho owner-builder will have the burden of proving that he did not build 0< Im-prove for tho purpose of sale).
□ I, as owner of the properly, om exclusively contracting with licensed contractors to construct the prOject (Sec. 7044, Business and Professions Code· The Cont'1Ct«' s License Law does not lf)ply to an owner of property who builds or m-prove< thereon, and who contracts tor each projects with a
E.~rctor(s) license pursuant to the Conlract0<'s License
□ As a -nor I om Improving "Pf home, and the lollow· Ing conditions exist: 1· rt~°'~1-!!l"l::9 .:~= r.,"" ~·months
3. r':.'." ~ol l~I~ =ption during the last lhree years.
0 lamexemptunderSec. ______ , B&P.C.
for this ruson ____________ _
D I hereby affirm that I haote a cen1ficate of consent 10 self-insure. or a cer11t1ca1e of WOtke,s·
Compensation Insurance. cw a cen1hed eooy thereof
(Sec 3800. La~~·'· '<j/<I
POLICY NO ..(..!-I • -~-/'J ,-HJ
COMPANY _. ~,/J .J.I
~ IS Med with '"lhe City
0 Cer11t1ed copy 1s hereby furnished ~
CERTIFICATl OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE
(This section need not be completed 1I the perm,t
1s fOJ one hundred dollars (S 100) or less)
0 I cen1ty that ,n lhe performance ol the work to,
,;which this permit is ,ssued, I Shall not employ any person ,n any ~nner so as to become sub1ect to
the Wor'kers· Compensatt00 Uws of Cahtom1,
NOTICE TO APPLICANT II. after makin1 ttus Cert1
hcate of E•empt1on. you shoukl become sub1ect t? the Wof'kefS' Compensauon p,ov1s1ons of lhe ~ Cooe you must forthwith comply with such
prov,s,ons Of ttus permll shall be deeme<J revoked
0 1 hereby aftum that !here ,s a cons1ruc1H>n
1e""1no agency !Of tne ~o,~nce ol the w<>"' t0t
wruch lh1s perm,1 ,s ,ssued 1Sec 3097 C1v,1 Cooe)
Lenoer s Namt ___________ _
lenders Actoress __________ _
USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT 1200 Elm, Carlsbad, California 92008-1989 (619) 438-5525
JOB ADDRESS ~ (l_oue.1-AV, ST. ,DATE OF "'""LICATIONII BUSINESS LICENSE # VALUATION 6?;;-:;-·· J g !->" <3 J {Al E AD, 3~ 1U-4Jrvit'
ffle~N;_ME P,'G el¼-++ lt1a-i~i:~ Sc;;;"';~~ Pttt!atA CONTRACTORS PHONE • ZONE
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OWNER'S MAILING ADDRESS &3/f/ot/."'!Z~~ 9, SSENO PLAN l.O. # BLOG USE COOE
S/Jnu..., ?602~
LOT I BLOCI( I SUBOIVISION j ASSESSOR PARCEL NO DESIGNER . LICENSE• STANDARO PLAN# BUILDlNG SQ. FOOTAGE
~I_I __ II~~ :7, IJe~I DESCRIPTION OF WOAY,1 Jr77P~. fvL1.·n.1 . () J·» .Md . 1
__ . J na DESIGNER'S ADDRESS DESIGNER'S PHONE
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CENSUS TRACT I GP LAND USE I PARl(ING SPACE I RES UNITS I GRADING ~ERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAO FIRE SPA AREA CONST
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QTY. PLUMBING PERMIT · ISSUE °hl5?J QTY. MECHANICAL PERMIT· ISSUE '"~t,o SUMMARY/AC~MBER
EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100,000 BTU BUILDING PERMIT _/ 01·00·00·8220
EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT ./ 01·00·00·8221
I EACH WATER HEATER ANO/OR VENT ,,.;2 .5t BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK_/ OHXl-00·8806
EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP TOTAL~BING 01·00-00-8222 10-
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EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE fiECTRICAL 01 ·00·00-8223
EACH INSTAl , ALTER. REPAIR WATER PIPE VENT FAN SINGLE DUCT / MECHANICAL 01 ·00-00-8224
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EACH VACUUM BREAKER MECH EXHAUST -HOOD/DUCTS .._ A I ) / MOBILEHOME 01 ·00-00-8225 -II r/. WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP ,,; "' EACH ROOF DRAIN (INSIDE) _,)./ / SOLAR 01 -lllJ-00-A??~
TOTJ;L MECHANICAL -1.~ /cf} STRONG MOTION 80-92-33·0519 -------I JC TOTAL PLUMBING -FIRE SPRINKLERS 01 ·00·00·8227
Joo QTY. SOLAR -ISSU~ / 1\ "J PUBLIC FACILITIES FEE 32·00-00-8923 QTY. ELECTRICAL PERMIT -ISSUE BRIDGE FEE
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NEW CONST EA AMP/SWT BKR COLLECTORS / ./ SCHOOL FEE • DISTRICT
1 PH 3 PH STORAGE TANKS / Carlsbad 80·92·21·0519
EXIST BLOG EA AMP/SWT/BKR ROCK STORAGE / Encinitas 80-92·22·0519
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1 PH 3 PH PUMP / San Dieguito 80·92·23-0519
REMODEL 'ALTER PER CIRCUIT PLAN¢CKtEE San Marcos 80·92·24·0519
TEMP POLE 200 AMPS / -
OVER 200 AMPS /
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TEMP OCCUPANCY (30 DAYS) V --------./ --
TOTAL ELECTRICAL --l TOTAL SOLAR TOTAL FEES PAYABLE I /[, -
I HAVE CAREFULLY EXAMINED THE COMPLETED ''APPLICATION AND PERMIT"' AND DO HEREBY Exptrahon Every perm,t 1-by the Bu~dtr,g 0111c1at under the prov11,on1 of th11 * All OSHA P£AMIT IS IIEQU9IED FOR EXCAVATIONS 0YEfl CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code 1hall ••ptre by hm1tat1on end baeome null end vo;d It the bu,ld1ng or wor~ 5· o· DEEP ANO OEM0UTION Ofl CONSTAUCTION Of: DECLARATIONS ARE TRUE ANO CORRECT AND I FURTHER CERTIFY ANO AGREE IF A PERMIT IS auttior1zed by such permit ,1 not commenced w1thIn Uk) daya from the date of such STAUC'I\JAES OYER 3 5J~S 1H HEIGHT ISSUED" TO COMPLY WITH ALL CITY. COUNTY ANO STATE LAWS GOVERNING BUILDING CON :;'::C,!.i 1~t •:~v ~,:1J,:';i,.WO,.~'t!"~~~~~ ~i;:;:,i'~r•=.~ or
STRUCTION, WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND . ~ OWNER □ CONTRACT~ APPROVED BY # IDA~//;3 ·
l<EEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO APPLICAZT s G/NATU.RE •
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE • / ,,. BY PHONE 0 GRANTING OF THIS PERMIT ~ ,:i· •' ~ -
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INSPECTION TYPE DATE INSPECTOR ···-· --• -·. ---~-
BUILDING
FOUNDATION
REINFORCED STEEL ·'
MASONRY
GUNITE OR GROUT
FLOOR & CEILING SUB FRAME
SHEATHING "
FRAME
EXTERIOR LATH lNSULATION •
INTERIOR LATH & DRYWALL
PLUMBING l
--
SEWER AND Bl/CO
PLUMBING UNDERGROUND '
PLUMBING TOP OUT --TUB AND !:;HOWER PAN
GAS TEST
ELECTRICAL ' f
I
TEMPORARY POWER
ELECTRIC UNDERGROUND
ROUGH ELECTRIC '
ELECTRIC SERVICE
BONDING J
G. F. I. -SMOKE DETECTOR
MECHANICAL
DUCT & PLEM., REF. PIPING
HEAT -AIR COND. -SOLAR SYSTEMS
VENTILATING SYSTEMS
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE BEEN APPROVED.
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JOB SITE FINAL ,,. r
PLUMBING le:'" Ii-Ji 'ls; ~,
ELECTRICAL /' I
MECHANICAL
GAS
BUILDING
SPECIAL CONDITIONS -
CERT OF OCCUPANCY ISSUED
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS
INSPECTION REO IF INSPECTORS
CHECKED APPROVAL
SOIL$ COMPLiANCE
PRIOR TO
FOUNDATIQ", INSP . STRUCTURAL CONCRETE
OVEP 2000 PSI
I PRESTRESSED
CONCRETE
POST TENSIONED ' CONCRETE
FIELD WELDING ""°'-.ro '. .. HIGH STRENGTH \,-BOLTS
t,
SPECIAL MASONRY
.
PILES CAISSONS
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INSPECTOR'S NOTES -.. . -
DATE
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