HomeMy WebLinkAbout2081 TRUESDELL LN; ; 81-520; Permit. ~
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tJ I hereby l ,I, that I am licensed under
p<o¥1alona of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and ProfHslons Code, and my license Is In
full fo«:e and effect.
Lie No ___ Class
I he<eby att,nn thol I am exempt from the Con ~:t~=~~.:.':.:~~~~ county which requires ~ pem,,t to construct
iilter, improve, demolish, or repai, any structure,
poor to its issuance also requires the applicant for such pemut to hie a signed statement that he ,s
hc:ensect pu™>ant to lhe p<OIIISIOl'IS of the Con-tractor·• uc:ense uw (Chapter 9 c:ommenc,ng wolh Sect,on 7000 of 0.vosoor, 3 of the Business Mid Pro-fessions Code) or thol ,s exempt therefrom and the basis for the alleged txemptoor, Any •-1101'1 of Sectt0n 7031 5 by an apphc:ant for a penn,1 sut>,ects
tne ~ICM'lt to a c,v,I penalty of not more than five hundnld OOIIMS ($5001
D I, as owner of the property, or my employeos ,.,th wages as thet, sole compensation, w,11 do the w011l♦-~ the structure ,snot intended or offered for sale ISec 7044, Bus,ness and Professt0ns Code The Contractor's License Law does not apply to an
owner of Pfoc>ertY who builds Of 1mp,OYeS thereon and who does such WOf1' himself or through his own
empk>yees, provtded that such ,mproveme;its are not 1ntende1 or ottered fOf saJe It, however, the
building or ,mproyement 1s sold within one yu,, of compJelt<>n. the owner-00Itder will have the burden
ol pt0¥1ng that he dKt not bu1k2 or improve fOf the purpose of :we)
□ I. as owner ot the propeny, am exclusively
contraclt"il with hcensed contractOfs to construct
~~b!'i"-~~-L~=~~ 00::".!o~.:.: to an owner of property whO bu1k1s or 1mp,oves ~=-~ ~~nc:'~:!~: ~~,:~~~.;::.: Lacense Law).
D I am exempt unde< Sec
tor lhlS ,e.uon
__ .8 &PC
□ I hereby afhrm 11'\at I haw a cert1f1ciite of consent
to self-insure, or a certificate ot Wor1ters Compensation Insurance. or a cerohed copy thereof
(Sec 3800. Labor Code!
~ D Cet11tted copy 1s hereby turmshed
CERTIFICATl OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE
(Ttus section need nol be completed ,t the perm,1 ,s tor one hundred <1011= (SIOO) or less)
D I certify tl'\at ,n the performance of the Wont tor
which th,s pemut 1s issued. I shaH not emp~ any
person 1n any manner so as to beeome sub1eet to
the Workers· Compensation Laws ot Cahtorn,a
NOTICE TO APPLICANT II. afte< ma1<1n~ 1h15 Cert,
tJQte ot Exemptton. you shOuk:S beCOmf' sut>,ect t-:>
the WOf'kers· Compensatt0n prov,s10ns ot the l..abot Code. you must tonhw1th comply w,th such
pro"1st0ns Of this permI1 Shall be oettmed reYOked
0 I hereby affirm 1na1 ttlere is a cons1ruc1ton
lending agency tOf the performance ol ttie w0f1f. fOf
wtucn th,s permit 1s 1ssueo {Sec 3097 C1v1I Code)
Lenders Name ___________ _
Lenders Address __________ _
Ullt ll"LL l'UIIII l'tll Olll T _! PRE~S HARO -... ,..;----------~-----------------------------· APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND r""""LARATIONS.
_ CARLSBAD BUILDING DEPARTMENT \.,,_ Y APPLICATION & PERMIT
1200 Elm, Carlsbad, Callfornla 92008 (714) 438-5525
j~D~i TRUe:51::iELL LI/. -43ll-11q I A~;
1
r;;~oz~~;NI 0~3:;E7~ENSE# VALUATION it~ITNUMBER
I tZ·;~/)(1 Yrl (!Ll~A I lz~':'io40 AR7/ir-~6 Auma"nA 7:i;/31~6-ZONE S:Lo
OWNER'S~=s:;,;t;;sfi~ #h!>lle cj;JjJ/Z.flZ~,hhl-~ ;:;;;H93u PLANI.O.# BLOGUSECOOE
LOT BLOCK I SUBDIVISION I ASSESSOR PARCEL NO. DESIGNER STA)i LICENSE,, STAN DARO PLAN# BUil.DiNG so. FOOTAGE
DESCRIPTION Of WORK ( , ,c "=if/?
DESIGNER'S ADDRESS DESIGNER'S PHONE .,_......,"""--------r~---------------------1 f<,,_/)/1) (>JJ //~ /JI ,IL. j A /_£T 9' ,,,,~ __________ ......,.. _ _,...._...,.......,_..-!! . .'_210 I 1813126 D (
,1 ~-,tz. /V-ZT-• M",-,,,!__ -~---~ -F/P FLRELEv. No occGP Eou ri00l3728 12/0I/ I,•
,~ ,,. --~-_ STORIES --_ _ 81 IG,O
/l'l/ rT / ~ 'C TT' f +-"" vO NO
CENSUS TRACT GP LANO USE I PARKING SPACE RES UNITS I GRAOING PERMIT ISSUED I REOEVELOPMENT TYPE occ LOAO FIRE SPR ' AREA CONST
y D N O vO NO vO NO Not Valid Uniffs Machint Cl!rtififtl
QTY. PLUMBING PERMIT -ISSUE --J.$D QTY. MECHANICAL PERMIT· ISSUE SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100,000 BTU BUILDING PERMIT
EACH BUILDING SEWER OVER 100,000 BTU -,, SIG!:J,HRMIT
/ EACH WATER HEATER ANO/OR VENT ,..,.?~u BOILER/COMPRESSOR UP TO 3 HP A/. ./ f"P'LAN CHECK />
EACH GAS SYSTEM I TO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP , .~ 1'° TOTAL PLUMBING /.A::---
EACH GAS SYSTEM 5 OR MORE --1,------+---t-METAL FIREPLACE _.,., \. "I-> / ( \ ELECTRICAL
EACH INSTA~ .. ALTER, REPAIR WATER PIPE VENT FAN SING LE DUCT ( / J ' V _..,("t,.._ ) MECHANICAL _
EACH VACUUM BREAKER MECH EXHAUST -HOOD/DUCTS I'"\ "<;. / < ""'-/ / "'. MOBILEHOME
WATER SOFTNER RELOCATION OF EA FURNAWl{E~Efy"' IT MOBILEHOME PARK INSP
EACH ROOF DRAIN (INSIDE) I "_/ ~ / SOLAR
TOTI.L ME~1,£1y / i v _s_TR_o_N_G_M_o_r _1o_N ___________ +----------1
-TOTALPLUMBING ·-I //).M (!../~/ /\-FIRESPRINKLERS
• ,,£. \. I PUBLIC FACILITIES FEE QTY. ELECTRICAL PERMIT-ISSUE QTY. SOLAR /~un-\ a--BR_ID_G_E-FE_E __________ __,,__ ______ ....,.
NEW CONST EA AMP/SWT/BKR COLLECTORS ._ 1 tf SCHOOL FEE · DISTRICT
I PH 3 PH STORAGE TANKS Carlsbad -------------4---------~ EXIST BLOG EA AMP/SWT/BKR ROCK STORAGE Enc1mtas
I PH 3 PH PUMP San D1egullo
REMODEL/AL TEA PER CIRCUIT PlAN CHECK FEE San Marcos
TEMP POLE 200 AMPS
OVER 200 AMPS 1----+---
TEMP OCCUPANCY (30 DAYSI 1---+---
TO TA L ELECTRICAL -l -TOTAL SOLAR TOTAL FEES PAYABLE
1
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I HAVE CAREFULLY EXAMINED THE COMPLETED •APPlJCATION AND PERMIT .. ANO 00 HEREBY Eap,rabon E--.,,-milluuecll,¥tlleBulldongOff,e&afunclerll1eprovillOft9ofll'l•I * AN OSHA l'EMIIT IS~ FOR EJICAVATIONS 0V£A
CERTIFY UNDER PENALTY OF PER,IURY THAT AU. INFORMATION HEREON INCLUDING THE Code -I axp,re by t,m,htlion and become null and VOid If the building or wont !r o•• DEEP AND DEM0UTlON OR CONSTIIUCTION Of
DEC, •RATIONS ARE TRUE AND CORRECT AND f FURTHER CERTIFY AND AGREE IF A PERMIT IS autt,onzed by auch permit II not com.-.ced ••th'" 180 deys from Ille date ol aucl'I STFIUC'TUAES OYER 3 STORIES IN HEIGHT ~ panntl o, ,1 Ille building 0t work authorlZed by ouch permit ta ...-paneled or
ISSUED TO COMPLY WITH All CITY, COUNTY ANO STATE LAWS GOVERNING BUILDING CON· ~-~-~-~a=:t.:an::;•vt.:li::::·me~eller=:...:IN~work=~••.!:c~om~menced==t.:f~or!....!a!..J"""~l:!l'od:!.:o~f...!1~80"11111;~•L--=:-t,~~~~~--------~~~----""'1 STRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND 11ANT'S StGNAT -0 _ '1'f APPROVED BY OATE KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS. COSTS AND ~-~ OWNER CONTRACTOlj!LJ 0
EXPENSES WHICH MAY IN ANY WAY ACCRUE A6"1NST SAID CITY IN CONSEQUENCE OF THE --BY PHONE O J/ Lj I I / /~ J
GRANTING OF THIS PERMIT. ,,/, j ,._ ~ ~ ~ 'ti .fJ
--7 -, i::77 I I" I
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