HomeMy WebLinkAbout2610 UNICORNIO ST; ; 80-190; 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
0 1 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 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 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).
~
s owner of the property, or my employees
wages as their sole compensation, will do
ork, and the structure Is not Intended or of-
fered for sale (Sec. 7044, Business and Profes-
sions 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. II, however, the building or improve-
ment Is sold within one year of completion, the
owner-builder will have the burden of~rovin
he did not build or improve for the p
sale).
'.JI, as owner ol the property, am exclusively con-
tracting with licensed contractors to construct
the project (Sec. 7044, Business and Professions
Code: The Contractor's License Law does not ap-
ply to an owner of property 1•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 _____ 8. & P.C.
for this reaso .. ~------------
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of con-
sent to sell-insure, or a certificate of Workers'
Compensation Insurance, or a certified copy
thereof (Sec. 3800, Labor Code).
POLICY NO. ___________ _ COMPANY ___________ _
□Copy is filed with the city. □Certified copy Is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed If the per-
mit is for one hundred dollars ($1<l0) or less).
I cel ify that In the performance of the work for
-whlch,~ls permit is Issued, I shall not employ any
person n any manner so as to become subject to
the \'Ojijers' Compensation Laws of California.
NOTICe;,I O APPLICANT: 11, after making this Cer•
tlficate of Exemption, you should become subject
Jo 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
which this permit Is Issued (Sec. 3097, Civil Code).
CITY OF CARLSBAD-BUILDING DEPARTMENT
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525
APPLICATION & PER~ .,_
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APPLICANT TO F ILL IN INFOR
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OWNGene /? L?~umAA/ OWNER'SPHONE PRIMSC;;JCTOR ofg • ST#;ANSE '-/ ;'!J ',
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, BLOCK IL';~:11~:;,,,J.1,.,.,r~, l1,A?1Ez;;t'~.2:£.o ;· _1l1lJ J DESIGNER A/ //If STA:: ~x:;_sE 12/ ,Nt.i :-;~7 I ' '
oEscRIPJ;,IPNJiF woRK f 1 /"' I) /V·; rr
.::>o A,,,,. lfo ul.>,-f l'J-" s y' r;,.ir!__;,-, ,l}t// t'd DESIGNER'S ADDRESS OESIGNER'S PHONE
-fo e><1sl-lh< 1-lu f hJ.,,_l-~r S'y.Jf t'11-. #/ 11 A/ I/)
CENSUS TRACT lfp LAND USE ZONING I RES, UNITS I PARKING SPACE sf I NUMBER Of STORIES
# Nor Valid Unless Machin• (Mrifi,d
BLDG so. FT. BLOG USE occ. GP I STANDARD PLAN It I PLAN I D It I TYPE CONST I occ. LOAD I
QTY. PLUMBING PERMIT AMT. QTY. ME~NICAL PERMIT AMT.
EACH FIXTURE TRAP C"t:l~CT/JC-S S .{fV INSTALL FURN. ObCTS UP TO 100,000 BTU
EACH BUILDING SEWER "\.,OVER 100,000 BTU
EACH WATER HEATER ANO/OR VENT ,.;z... . "'° BOILER/COMPRESSOR Uf"'\.0 3 HP
EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3-15 H1'_
EACH GAS SYSTEM 5 OR MORE BOILER/COMPRESSOR 16-30 HP'\,,
EACHINSTAL..ALTER.REPAIRWATERPIPE VENTFANSINGLEOUCT " vALuArioN· :zr ~
EACH LAWN SPRINKLER SYSTEM MECH EXHAUST -HOOD/DUCTS "\._ •
WATER-69FlNER ~ )J,1/V ;J-. VV RELOCATION OF EA FURNACE/HEATER "\., BUILDING PERMIT I , I I I
Tc::; c::; UP. 3 . O O .I.s_s_ue 3 •. 0 0 SIGN PERMIT 1 • 1 I 1
TOTAL PLUMBING TOTAL MECHANICAL PLAN CHECK I , I j ~ $16
CONTRACTOR ..._ /l) , (JC> CONTRACTOR ALL INCLUSIVE PERMIT I I I
A~... • TOTAL PLUMBING 1 / 1/J · II O QTY. ELECTRICAL ~AMIT AMT. QTY. MOBILE HOME PERMIT AMT. ELECTRICAL f I . I
NEW CONST EA AMP/SWT/BKR"\ AWNING '\,, MECHANICAL I I I
1 PH .25 ~PH PORCH "\. MOBILE HOME I I j
EXIST BLDG EA AMP/SWT/BK R " SET-UP '\.. SOLAR I I I j
1 PH .25 3 PH "\ RAMADA, CABANA "\. I I I . I
REMODEL/ALTER PER CIRCUIT "\ FENCE OVER 6' '\._ I , I I . I
TEMPPOLE 200AMPS ' TOTALMOBILEHOME "\ MICO-FILM ! J I j
OVER 200 AMPS '\_ '\. I , I I ; I
TEMP OCCUPANCY (30 DAYSI '\_ " -STRONG MOT I ON: I I I I
Issue '2 .. 00 \ I I I I
TOTAL ELECTRICAL '\. TOTAL FEES PAYABLE I
CONTRACTOR • I 1 . i/ .ll_ . ..>IO
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT, AND DO ·AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER SCHOOL FEES: /P A·(lo
HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I 5'-0" DEEP AND DEMOLITION OR CONSTRUCTION OF ( rf
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
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 WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE
~ OF THE GRANTING OF THIS PERMIT. APPLl~NATURE_P' ./2 OWNER~ CONTRACTOR□ lA:-?~ -./21 ~ DATE ~
'/J,;?z;/ /4l// .. A1.A AGENT □ BYPHONEQ _ J~~~~1LZ•P~,
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SITE
ADDRESS: OWNER: PERMIT NO: <i?n--1 CfD
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FIELD INSPECTION RECORD
INSPECTION DATE INSPECTOR INSPECTOR'S NOTES
WOOD FLOOR
FOUNDATION• FORMS• SET BACK• TOILET
UNDER FLOOR PLUMBING -~ '-
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
WALLBOARD OK• PLACE TAPE
EXTERIOR LATH OK• PLACE STUCCO
FIREPLACE ,_ ,
DAMPER &STEEL
PLATE Tl Es/HEIGHT OF CH IMNEY
I al•
~ .
I
OTHER
TEMP POWER (POLE) ..
SEWER
GAS TEST
SWIM POOL • STEEL BONDING
• PRE DECK ,1. , .
• FENCE PREPLASTER ~
SHOWN • FRAME '-:-_:-.... ~
...._____ ~ ,----' • PAN
FINAL INSP BY BLDG DEPT C'C"s. .......__ ~ -
OTHER DEPT'S REQ COMPLETED -~ .,
ELEC METER-PERM-TEMP
GAS METER-PERM-TEMP
,
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CERT OF OCCUPANCY ISSUED