HomeMy WebLinkAbout2081 TRUESDELL LN; ; 81-378; PermitCl) z 0 ~ a: C ..,
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c ~ I hereby affirm that I am licensed under o ~lalona of Cnapter 9 (commencing with
I:> [ Section 7000) of Division 3 of the Business
c and Professions Code, and my llcenae Is In e= full force and effect. z lie No _______ Cl•ss _____ _
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I hereby attum tl\al t am e,empt lrom the Con ~:~•~~== ;!,w ~f=,~~c;2'¼C•~ county which requires a pemt1t to construe,
a,1er. 1mp,owi, demolish, o, repaer .-.y structure.
P,lOf to ,ts issuance aJso requires the applicant fOf such penn1t to hie a s,gned statem.nt that he 1s
hcenMd pursuant to the p,ov1S10ns of the Con-
tractor's License Law (Chapter 9 commencing with SectK>n 7tXXJ of 0tv1sK)l't 3 or the Business and Pro·
fess10ns Code) o, that ,s exempt lherefrom and the
basts tor the alleged exemption Any v1ola1ton of
Sechon 1031 ~ by an applicant 10< a penml sut>tec:ta
tne apphcant to a c1v1I penalty of not more than hve
hundred dollars ($500).
0 I, as owner ol the prOl)erty, 0< my employees
-•th wiges as their sofe compensat•on. will do the
WOtk, Ind the structure ,snot intended or ottered fo, sale (Sec 7044, Business and Professions Code
The Contractor's lteense Law does not appty to an
owner of p,operty who builds or improves thereon
and who does such won-. himself or 1hrough his own
employees. proYKSed 1ha1 such improvements are not intende1 or ottered for sale 11. however the
building or improvement 1s sokj within one year of comp+euon, the owner builder wilt NYe the burden of proving lhal he did not build or improve to, the
purpose, of sale)
□ I, a.s owner ot 11\e pre>peny, am exclusively cont,act109 with hcensed contractors to construct
the p,o,ect (Sec 70U, Business and ProtessJOns Code The Contractor's License Law does not apoly
to an owner of propeny wno builds or improves ~~~i~ 7'~nc:'~~!~~ ~~~h:'~\~~::.;
Ltcense Law)
D I am exempt un<Jef Sec
tor this reason
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0 I hereby alftrm that I ha.,. a cer11ticate of consent
to self,msure, Of a certlf1ca1e ot Workers· Compensation Insurance. or a cen1hed ccpy thereol
(Sec 381JO. Labor Code)
POUCYNO __
COMPANY
----------
□ Copy IS hied with the city
0 Cen1t1ed copy 1s hereby furnished
CERTIFICATl OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE
(This sectt<>n need not be completed 11 lhe permit ,s tor one hundred OOlllfS ($100) or ~SS)
~
n,ty that ,n the performance of the wOtk tor
h,s perrrut ,s ,ssued. I shall not empl0y any
,n any manner so as to beeome subject to
the Wor);ers' Compensation Laws or Cahro<n1a
NOTICE TO APPI.ICANT 11. alter mak1n1 lh1s Cer,,
ticate of hempt1on. you should beeome sub1ec1 t?
lhe Wof1c;ers· Compenwt,on PfO'IIStOnS ol lhe: latK)f
Code you must forthwith comply with such
~~•e•~1/
l O I hereby affirm that 1nere ,s a cons1ruc11on ffi 1end1nQ agency t()+' !he pe,rlormance ot !he wot11. lor
0 • which itus permn ,s issued tSec 3097 C1v11 Co<Je)
z "' Lenders Name ___________ _ ..,
Lenoer s Address __________ _
USE BALL POINT PEN Olllf • r11t~~ """u CARLSBA....l'BUILDING DEPARTMENT AFPLICA I IUN Cll rcnm,, 1200 Elm, Carlsbad, California 92008 (71'4) "38-5525
JOB ADDRESS
A~i.T I Def: :r;LtATIONI
BUSINESS LICENSE # VALUATION PERMIT NUMBER
".oer i"'f<V~OF::1 l · LN , !2..11 f I' ltf1o €,l,':;18
.;_;;~~;:~. P lGHAA.D r~r?,~ .. , I OWNER'S PHONE PRIME CONTRACTOR CONTRACTORS PHONE• ZONE
~'-'Ei..,..'-1 ~~l'.l~O 17..:.29-J <"~9
OWNER'S MAIL•NG ADDRESS CONTRACTOR'S ADDRESS .. LICENSE NO PLAN I.D. # BLDG use CODE
,&AV\~ I "'°n I/Al enc,~ flk_JEL 3;?.S~.39 ~ C\I~
LOT I BLOCK I SUBOIVISION I \~~~f'fl)')-'U DESIGNER STATE LICENSE • STANDARD PLAN# BUILDING SO. FOOT AGE
DESCRIPTION OF WORK . -9/ I 1 /81 q ~ ...
DESIGNER'S AOORESS DESIGNER'S PHONE ou□.l~B 19 fl/f =-.
2-l7*
I BI' • -7.,, a. Philo CcN02S-1@ --F/P FLRELEV. NO OCCGP EDU
WooD @ IEti/1 STORIES 12..-3' vO NO -
CENSUS TRACT I GP LANO USE I PARKING SPACE RES UNITS I GRADING f'.ERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAO FIRE SPA
AREA cv::tJ -" io v□ Nrl TO N 0 vO NO Nor Valid UnltM M.chine <Artifi«J
QTY. PLUMBING PERMIT • ISSUE 7.50 QTY. MECHANICAL PERMIT· ISSUE 3.00 SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP INSTALL.JUAN DUCTS UP TO 100,000 BTU BUILDING PERMIT 'h'L-1~CJ
EACH BUILDING SEWER / OVER 100.000 BTU SIGN PERMIT 7 --
~LEA/COMPRESSOR UP TO 3 HP 'I.LI~ EACH WATER HEATER ANO/OR VENT PLAN CHECK
EACH GAS SYSTEM 1 TO 4 OUTLETS / BOILER/COMPRESSOR 3 15 HP TOTAL PLUMBING
EACH GAS SYSTEM 5 OR MORE V METAL FIREPLACE ELECTRICAL -----
EACH INSTA~ .. ALTER. REPAIR WATER PIPE ./ VENT fAN SINGLE DUCT MECHANICAL
EACH VACUUM BREAKER 7. MECH EXHAUST HOOD/DUCTS MOBILEHOME
--7 WATER SOFTNER RELOCATION Of EA FURNACE/HEATER MOBILEHOME PARK INSP -
EACH ROOF DRAIN (INSIDE) ~I/ SOLAR
-~--
TOT/.L MECHANICAL STRONG MOTION ~ t=;r, ---
TOTAL PLUMBIN FIRE SPRINKLERS
QTY. ELECTRICAL F =RM~UE { / 2. 00
PUBLIC FACILITIES FEE
QTY. SOLAR • ISSUE BRIDGE FEE
NEwcq NST EA AMP.J3N ~R I 1 !7 COLLECTORS SCHOOL FEE • DISTRICT -
1 PH/ l I/ 3 PH "'<,. ./ STORAGE TAN KS Carlsbad
EXID-'B .()15/EA jtf{PISWT l!t'<fV\. V / ROCK STORAGE Encinitas
1 PH ' '/ \ 3'1'H Ii •. PUMP San 01egu1to
REM~E rl"ALTER PER Clt\l:UIT I I\ \ r, r . PLAN CHECK FEE San Marcos --/ . \
TEMM°O E 200 AMPS I \ 1 'I' Pf Pl/l.ll\tC, Vf AN r:MEfJ:.. (11ii.7°?\
,¢ER~ AMPS I I or\. ~.....llf..-...at ' .J
/ ~ TEMP OCCUPANCY (30 DAYSI {/ \ ' r -
/ -------t I -
TOTAL ELECTRICAL TOTAL SOLAR TOTAL FEES PAYABLE I ??,,qo
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT AND DO HEREBY Exl)lr■lton Every perm,1 ,uued by the But1d1ng Olflc,11 under the prov,a,ons olth,s * AN OSHA PEN,IIT IS AEOUlflEO FOA EXCAVATIONS OVEII
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shaJI exptre by lrm,tahon and become null and vo,d If the building or work S O" DEEP ANO OEMOllTION Ofl CONSTAUCTION Of'
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS authorized by such perm,t 11 not commenced within 180 days from the date of such STRUCTURES OVEII J STORIES IN HEIGHT permit. or 1f the build•~ or work 1utho11zed by auch permit ,1 1u1pended or ISSUED TO COMPLY WITH ALL CITY, COUNT':'. ANO STATE LAWS GOVERNING BUILDING CON• abandoned at any t,me I er tt,e work 1s commenced for a """Cid of 180 "•u• STRUCTION. WHETHER SPECIFIED HEREIN OR NOT, I ALSO AGREE TO SAVE INDEMNIFY ANO . CONTRACTOR 0 ~~ CATE KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS, COSTS AND APPLICANTS SIGNATU;7✓E • -~ OWNER~
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF "Hl~ ~ -/;~• BY PHONE 0 I 't--to -St GRANTING OF THIS PERMIT :::" 7J-,,S,Z..,,,-
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f INTERDEPARTMENTAL INFORMATION SHEET
B iILDING DEPARTMENT rO ~ ~ DAT..J •
BUILDING ADDRESS: _d=---_O_tJ~/-~/.IU,-<M~-~---h, ____ , _, _L_E_C_E_I_V_E_D_
SEP 04 1981
PLANNING DEPARTMENT
CITY OF CARLSBAD Bulldlng Department
ZONE ___ R~,---'-----LOT SIZE _________ LOT WIDTH ________ _
UNITS ALLOWED UNITS PROVIDED ------------------------
PARKING SPACES REQUIRED __________ PROVIDED __________ _
PROVIDED -------------% COVERAGE ALLOWED
BUILDING HEIGHT ALLOWED
FRONT SETBACK: @
ALLOWED 1--0 ,-J...
PROVIDED ___ ,_,'------
INTRUSIONS
PROVIDED ----------
SIDE SETBACK:
LANDSCAPE & IRRIGATION PLAN COMMENTS:
REAR SETBACK:
ofL
NVIRONMENTAL PROTECTION REQ: _lf_~ ___ f_1 __ ~-------------6
ADDITIONAL COMMENTS: M:OC~~-/~~ S~,-11\
OK TO ISSUE
ENGINEERING DEPARTMENT Jsvi::1 -
R.O.W. ______ INDUSTRIAL WASTE IMPROVEMENTS ---------------
SEWER CONNECTION DRIVEWAY LOCATIONS ---------------------
GRADING PERMIT _______ EASEMENTS __ _,_, ______ DRAINAGE ____ _
LEGAL DE s CR Ip TIO N _ ___,,,,.....l_{'--+-7_-_l~P_tJ~---d-_ _,/-------------
AD DI TI ON AL COMMENTS ----------------------
OK TO ISSU¾,m= DATE C\ ~ ~, -8 ( PWI ____ OK TO FINAL ____ DATE ___ _
FIRE DEPARTMENT
SPFI~KLING SYSTEM FIRE PROTECTION EQUIP. -------------------
FIRE ALARMS EXITS ----------------
FIRE HYDRANTS LOCATION ----------------------,
ADDITIONAL COMMENTS
OK TO ISSUE: DATE OK TO FINAL DATE ---------------------
WATER DEPARTMENT
RE9UIREMENTS OF APPROPRIATE DISTRICTS MET ________ DATE _______ _
81-378