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Home My WebLink About2081 TRUESDELL LN; ; 80-880; PermitLICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provl• slons of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profes· slons Code, and my license is in full force and ef• fect. OWNER-BUILDER DECLARATION 0 1 hereby affirm that I am exempt from the Con- tractor's License Law for the following reason (Sec. 7031.5.Buslness and Professions Code), Any city or county 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 file a signed state- ment that he Is licensed pursuant to the provl· slons 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). □ 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· slons Code: The Contractor'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. 11, 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). '.JI, as owner of the property, am exclusively con- tracting with licensed contractors to construct the project (Sec. 7044, Business e.nd 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. ____ _ for this reason / J Q 1 . Date Owne WORKERS' COMPENSATION OECLAfllo\TION I hereby affirm that I have a certificate of con- sent to self-insure, or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Labor Code). POLICY NO, ___________ _ ~MPANY /f!t':°PY Is flied with the city. □Certified copy Is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed If the per· mlt Is for one hundred dollars ($100) or less). I certify that In the performance of the work for which this permit is Issued, I shall not employ any person In any manner so as to become subject to the Workers' Compensation Laws of California. NOTICE TO APPLICANT: If, after making this Cer· tlflcate of Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction len· ding agency for the performance of the work for ,. ~,_., u .. 1.., --~-1• 1-'--••--' 10--'lf'V'I~ r,: •. 11 ,.._.,...,, CITY OF CARLSBAD-BUILDING DEPARTMENT USE BALL POINT PEN ONLY APPLICATION & PERMIT 1200 ELM AVENUE (714) 438-5525 APPLICANT TO FILL IN INFOR- MATION WITHIN RED LINES. ~------I NO. JOB ADDRESS AV. ST, ~ATE OF APPLICATION BUS. LICENSE / PERMIT NUMeER Zc.HJ1/1 17iA'1 UE"i~1!')(£i l1l.1 1 L, J4, 111 J;;j RO /36'6?') \i I I I I I I I I I l I I ~-/1./-iO OWNER ~l's PHONE PRIME CONTRACTOR STATE LICENSE I" ~~~ hJ/P. A~n hUK, .lJ,c. JJ ul ~ /!,4,i?So ;t/ !f,a'f/-179/ 8/iEC/,;E~.,;,,., .r7 J,;vl,6J_ IJ/1 ~ ·-,r . - ~ NE~· MAl~l~G AlA~REss ,,,,. ~,mE"KT zt,fg STMo~· CONTRACTOR'S ADDRESS ~,A,, ,J;.ONTRACTO,vs ':J'U7 " ~ ) o ~ :;(). hi ~ C,lf/U-SB,lfb 3t>9SS7?117i sr:; ' HONE?, 2-mt l,li l[ -• ..,, \ 72. -I 0121 / i:11 • J / .. ' BLOCK !SUBDIVISION I ASSESSOR'S PARCEL NO, LOT a;;:IGNER ~ •-• ,....., c: L ICE':NSE p1/l;u,1 IHllC 1/1/b17f-il 181tJJ-1Z/ l 'IS ~I~ w...__ _ C ;!-'/Ort/ DESCRIPTION OF WORK .1:1;-,. -,.~ AC MA~U /l'r,?f,??✓Ll/ ;/bdn,.,,, £7;JJU!~ 1i};IGNER'S ADDRESS .$l DESIGNER'S PHONE :s-~ ,;, t;/i',,tMl/l> u,rc 2c o kr/'Z.Jf/i71) .le J:'7?1p ,lJ IFZ,, IVl>l-1)() Ci/' i./39-1139 CENSUS TRACT GP L ANO USE ZONING l RES. UNITS l PARKING SPACE ~ I NUMBER OF STORIES ./1,,,. /Jr, Nat V•lid Unless M•chin, IArtifild BLOG SQ. FT. BLOG USE OCC. GP I STANDARD PLAN# 116~J'J'o 7 ~ TYPE CONST I occ. LOAD I QTY. PLUMBING PERMIT AMT. QTY. MECHANICAL PERMIT AMT. \ -- EACH Ffl(JURE TRAP INSTALI\.FURN. DUCTS UP TO 100.000 BTU EACH BUIL~G SEWER \ DVE R 100.000 BTU EACH WATER H~TER AND/DR VENT BOILER/CD~RESSOR UPTO 3 HP EACH GAS SYSTE"'l TO 4 OUTLETS BOILER/COMPR~R 3-15 HP EACH GAS SYSTEM N.I!_ MORE BOILER/COMPRESSOR~ HP EACH INSTAL., ALTER, REPAIR~ PIPE VENT FAN Sl~!GLE DUCT 'I ~~~ n/'::' J _;2.;(rt)/4 • -EACH LAWN SPRINKLER SYSTEM l MECH EXHAUST -HOOD/DUtTs .. WATER SOFTNER '--RELOCATION OF EA FURNACE/HEATtK ... BUILDING PERMIT / I 11 1t'): ~ _.,., --. ;::; th ,,,,Jf .A .... ;;1 0 A'&>-o SIGN PERMIT I I I l . TOTAL PLUMBING TOTAL MECHANICAL PLAN CHECK I 1Ar1. "r CONTRACTOR CONTRACTOR ALL INCLUSIVE PERMIT ( I I ELECTRICAL PERMIT AMT. TOTAL PLUMBING I I I QTY. AMT. QTY. MOBILE HOME PERMIT ELECTRICAL IT/-~ NEW CONST EA AMP/SWT/BKR AWNING MECHANICAL I (. I 1 PH .25 3 PH PORCH MOBILE HOME I I I EXIST BLDG EA AMP/SWT/BKR SET-UP SOLAR ~' I , I I L -1 PH .25 3 PH RAMADA, CABANA _,,,,~ ----~ A/,r ~J I . I I ,.-!:JU REMODEL/ALTER PER CIRCUIT h-~ r-FENCE OVER 6' I'/ I l l J TEMP POLE 200 AMPS TOTAL MOBILE HOME M ICO -FI LM I . I I I OVER 200 AMPS l . l I J TEMP OCCUPANCY (30 DAYSI I . I I l / .,.,~, 11 .2AnJ I . I I l TOTAL ELECTRICAL 7_f!J2 TOTAL FEES PAYABLE l @ CONTRACTOR / A A . I I . 1?il_. :r:: -.,L; J~ ~ JI ././"~ .,, , Jet. , -I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION ANO PERMIT, ANO DO •AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OV HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I 5'-0" DEEP AND DEMOLITION OR CONSTRUCTION OF FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED;TO COMPLY WITH ALL CITY, STRUCTURES OVER 3 STORIES IN HEIGHT COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER ~;.,.;.,, L'3 . 13../~~~ SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM• l LESS T HE CITY OF CARLSBAD A GAINST ALL LIABILITIES, JUDGMENTS, COSTS AND >-,.../"""I EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. APPLICANT'S SIGNATURE• OWNERQ CONTRACTORJ'P8PROV. 0/-<' ~ G,£,.~ A I o/tf=-)., AGENT D -~-V BY PHONED ! ~ ~ ~ i= hl 0.. V) ~ ~t~~ ~ -......... SITE t;,o -')$ $0 ADDRESS: OWNER: PERMIT NO: FIELD INSPECTION RECORD INSPECTION DATE INSPECTOR INSPECTOR'S NOTES WOOD FLOOR . \"•' FOUNDATION • FORMS• SET BACK • TOILET UNDER FLOOR PLUMBING "\ ~ '• ' • " . l . C ~ ~ UNDER FLOOR HEATING ..: . . . 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 I ' -.----. - WALLBOARD OK • PLACE TAPE -EXTERIOR LATH OK• PLACE STUCCO ; . . FIREPLf-CE ' ' ~- DAMPER &STEEL PLATE TIES/HEIGHT OF CHIMNEY OTHER TEMP POWER (POLE) SEWER GAS TEST SWIM POOL • STEEL BONDING . • PRE DECK • FENCE PREPLASTER SHOWN • FRAME , ✓ I J • PAN /f/-w~ /A?t.-bl FINAL INSP BY BLDG DEPT I' ff / -A ' . . . . OTHER DEPT'S REQ COMPLETED {/ ELEC METE~-PERM-TEMP GAS METER-PERM-TEMP ' CERT OF OCCUPANCY ISSUED REQUEST FOR INSPECTION TIME: ______ _ INSPECTOR ____ L~7~-----.--:?~~~,r ,/-'d DATE //-/';f-,f:o owNER __________ __.c;a"""'-"-c;..:;.-:;,,,,-~....c::;_~"'--"''--'-.... ~-___._(__._7 ... ~=--?..__---'-/----"-~ ...... Y'---=-o ___ ) __ ADDRESS __ ____::~:.....;:..l,0(2:..........ILj....L/ _ _____,,,7~/-...c:.~-:::....:......-=--_...~.__,l?_~~----~~'-""""----- BUILDING □ FOUNDATION 0 REINFORCING STEEL □ MASONRY □ GROUT -GUN I TE □ FLOOR AND CEILING FRAME □ SHEATHING □ FRAME □ EXTERIOR LATH □ INSULATION INTERIOR LATH OR DRYWALL FINAL PLUMBING 0 UNDERGROUND PLUMBING □ UNDERGROUND WATER □ ROUGH PLUMBING 0 TOP OUT PLUMBING 0 SEWER AND PL/CO 0 TUB OR SHOWER PAN □ GAS TEST 0 WATER HEATER D FINAL ELECTRICAL 0 TEMPORARY SERVICE 0 ELECTRIC UNDERGROUND □ ROUGH ELECTRIC □ POOL BONDING 0 ELECTRIC SERVICE □ CEILING HEAT D G.F.1. 0 SMOKE DETECTOR D FINAL MISCELLANEOUS 0 PLENUM AND DUCTS 0 COMBUSTION AIR D PATIO 0 SIGN D GRADING 0 DRIVEWAY D CONDITIONED AIR SYSTEMS D REFER PIPING D FINAL READY FOR INSPECTION, ~:~NDAV D TU~S~A/ bt□';;!!_~HURSDAV O P.M. /J 'F- D FRIDAY SPECIAL INSTRUCTIONS_-t6c"r-r7r-------~----/Um.~~~~~ ........... ~~c..-..------ ~ff REQUESTED BY __ ,:__ _______________ PHONE NO. ___ ,...,?_,---,,7?".A"'7"'---- PERSON TAKING REPORT _ ___,,_;Q__,,1...., 1,,#''-_9,;,,-'-_= __ _ fL,(,)_ df,<_/'tr 7/~ ~ -/~ (J_)w7 -) - A . .-:--.-;t;;J ,+ ~ REQUEST BUILDING 0 FOUNDATION 0 REINFORCING STEEL 0 MASONRY 0 GROUT -GUN I TE 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 0 TUB OR SHOWER PAN 0 GAS TEST 0 WATER HEATER D FINAL READY FOR INSPECTION: D MONDAY D TUESDAY D A.M. TIME:_'f--'----'-/ /_D___,.'--_ DATE: __,/_tJ_-;)_>-=ic_o_ ELECTRICAL 0 TEMPORARY SERVICE 0 ELECTRIC UNDERGROUND 0 ROUGH ELECTRIC 0 POOL BONDING 0 ELECTRIC SERVICE 0 CEILING HEAT D 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 □WEDNESDAY □THURSDAY ~ <~.M. ~ INSTRUCTIONsL ........ -----______ -__ \ _________________ _ SPECIAL REQUESTED BY __ ---'~=------'"---.......,._ _________ PHONE N0.1 J q -? _s-_;-4 PERSON TAKING REPORT __ 'f""'O ____ _ pt(_ o ~ a.A--at;_wdL ~ g-/)~, p>~ / TIME: ______ _ REQUEST F9-f!, INSPECTION INSPECTOR ;2'6~ PERMIT NO. fo -c/'/{) /~~ DATE: -~~--"Z.!._ ___ _ OWNER ADDREss ~o tf'I ~ ~ 0 REINFORCING STEEL 0 MASONRY 0 GROUT · GUNITE 0 FLOOR AND CEILING FRAME 0 SHEATHING ftFRAME 0 EXTERIOR LATH 0 INSULATION 0 INTERIOR LATH OR DRYWALL 0 FINAL PLUMBING 0 UNDERGROUND PLUMBING 0 UNDERGROUND WATER 0 ROUGH PLUMBING 0 TOP OUT PLUMBING 0 SEWER AND PL/CO 0 TUB OR SHOWER PAN 0 GAS TEST 0 WATER HEATER D FINAL READY FOR INSPECTION: D MONDAY D A.M. 0 P.M. (LECTRIC -) 0 TEMPORARY SERVICE 0 ELECTRIC UNDERGROUND [J;J,'ROUGH ELECTRIC / [J POOL BONDING 0 ELECTRIC SERVICE 0 CEILING HEAT D G.F.1. 0 SMOKE DETECTOR 0 FINAL MISCELLANEOUS 0 PLENUM AND DUCTS 0 COMBUSTION AIR 0 PATIO 0 SIGN 0 GRADING 0 DRIVEWAY 0 CONDITIONED AIR SYSTEMS □ REFER PIPING D FINAL □TUESDAY □WEDNESDAY ~□FRIDAY SPECIAL INSTRUCTIONS_...;...~ _ _____;;;..__'-_· tt"-'_~_~ ___ /2_~------------- REQUESTED BY ____ a __ -_z=i_l'.'.:_~ ___________ PH0NE NO. /,,2._7'-,2. '>r)/ ~// PERSON TAKING REP0RT-7 ~-=--'--I..1:¥--____ _ c:::,__------------ < -g k--uo ~ I t1-2 z_. h REQUEST FOR INSPECTION TIME: ______ _ INSPECTOR ___________ PERMIT NO. _______ DATE: l}-7-A OWNER----------------.......... -~-------------- ADDRESS __ f:_(!)_tf, ___ 7:--'~'-------,----------- 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 DRYWALL D FINAL PLUMBING 0 UNDERGROUND PLUMBING 0 UNDERGROUND WATER D ROUGH PLUMBING D TOP OUT PLUMBING 0 SEW AND PL/CO D 1: 0 WATER HEATER D FINAL READY FOR INSPECTION: ~AV O P.M. □TUESDAY ELECTRICAL 0 TEMPORARY SERVICE 0 ELECTRIC UNDERGROUND 0 ROUGH ELECTRIC 0 POOL BONDING 0 ELECTRIC SERVICE 0 CEILING HEAT D G.F.1. □ SMOKE DETECTOR D FINAL MISCELLANEOUS 0 PLENUM AND DUCTS D COMBUSTION AIR 0 PATIO D SIGN 0 GRADING D DRIVEWAY □ CONDITIONED AIR SYSTEMS D REFER PIPING D FINAL □WEDNESDAY □THURSDAY ~AV SPECIAL INSTRUCTIONS __________________________ _ REQUESTED BY ~-Ru..-C-e.( PHONE NO. ~ / PERSON TAKING REPORT / I t-7-I•