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Home My WebLink About2486 UNICORNIO ST; ; 81-419; Permit8/-419 cJ.t 5 _ ;;i7D .,,O&, ,Q[) MISSING ORIGINAL PERMIT AND INSPECTIONS . - CII z 0 ~ a: ,c _, (.) 11,1 0 flC i[ 0 (.) IIC 11,1 0 _, 5 I 11,1 z ~ 0 z 0 .:: ~ z w a.. :IE O I hereby• t I am licensed under provisions of ,._ ., 9 (commencing with Section 7000) or Division 3 of the Business and Professions Code, and my license Is In lull force and effect. lie No _______ Class I hereby att1nn that I am exempt from the Con-~~cr;~~~=:: ~ ~.~r:.~~~~~,c~ county which requires a permit to construct alter. improve. demohsh. or r&paJr any structure, pnor to ,ts issuance also requires the appt,cant for such permit to fife a s.gned slatement that he 1s heensed pursl.Wlt to the provIsIons of the Coo- tractor's Ltcense Law (Chapter 9 commencing with SectlOf'l 7CXX) ol 01vrsl0fl 3 of tl'\e Business and Pro- fessfOfls Code) or that 1s &J:empl therefrom ~ the basis for lhe alleged exemptK>n Any VH>latton of SecttOO 7031 5 by an apphCM'lt for a permit subJects 1ne applicant to a c1v1I penalty ol not more than live hundred doll;ars (S500) 0 I, as owner of the pre>perty, or my employees ._,,th wages as lheu sole compensation, will do the. work. and the structure 1s not intended Of offered for saJe (Sec 7044, Business and Professions Code The Contractors License Law does not apply to an owner of property who builds °' improves thereon and who does such w()O( himself or through his own employees, provided that such ,mproveme:1ts we nol mtende1 Of ottered fOf sale If, however. the building or Imp,ovemenI ,s sold within one year of complehon. the owner-builder wI11 have the burden of proving that he did not build or improve tor the purpose of sale) □ I. as ownet of the property, am exclusively 1 contractInfi1 with licensed contractors to construct the proJect (Sec 7~. Business and Professions Cooe· The Contractor's License Law does not ~ly to an owner of property who builds or ,mpro..,es ~~~i~~ 7i~nc~~~!~~ ~~~h~,~~~;;:.: License Law>. 0 I am exempt under sec _______ 8 & PC tor this reason □ I her~y afhrm that I ha'"e a cert1t,cate of consenl to self-insure. or a cert1f1ca1e of Workers· Compensation Insurance. or a cen,hed CoPy thereof (Sec 3800. Lat,or Code) POLICYNO __ COMPANY D Copy 1s hied w11n the city □ Cer11f1ed copy ,s hereby lurn1sned O CERTIFICATl OF EXEMPTION FROM :;: WORKERS' COMPENSATION INSURANCE a: (Th,s section need not be completed ,t the permit w )& ,s for one hundred dOllars {$100) or less) :,,:: cc I cert1ty that m the performance of the work for O w h this pemut ,s issued, I shall not employ any ~ person ,n any manner so as to become subIecI to the Wo"'ers· Compensation Laws ot Cahtt>rn1a if NOTICE TO APPLICANT It. after makmJ !his Cert• hcate ot E•emption. you should become subIect t') !he Won..ers· Compensation provisions of lhe Labor Code. you musl lortl"lw1th comply with such provIs,ons Of ttus penmt shall be deemed revoked &.t:t, O I here0y alt.rm lhal !here 1s a consIructIon lend,~ agency tor !he performance ot lhe work tor which 1h15 permit 15 •SSue<l (Sec 3097. C1Y1I Code) Lenoe, s Name ___________ _ LenOer s Address __________ _ USE BALL POINT PEN ONLY & PRE~D CA 1200 f:. -----------------~ }AD BUILDING DEPARTMENT ( 1) .-rlsbad, California 92008 (71 4) 438-5525 APPLICANT TO FILL IN INFORMATION WITHIN SHADf" "REA AND DECLARATIONS. APPLICATION & PERMIT _.j ~q '7...C. JOB ADDRESS -AV. ST. DATE OF APPLICATION-BUSINE~ LICENSE Ii VALUATION PERMIT NUMBER .2¥"& I OWNE~~~ .. ""'-~ OWNER"S PHONE RO. Ld ZONE ?/-£/If? OWNER"S MAILING A.OORESS _,,f,,/ .._ '~ l/~ ~~RA~~A:;;~ ~AU-gc~;N; S2- f•~i, ' I PLAN 1.b. l), p., BLOG use coo~. LOT SUBDIVISION ASSESSOR PARCEL NO DESIGNER DESCRIPTION OF WORK F Pi ~ St= 1) T'"G"'"""""'M -F/P FLRELEV. YO NO CENSUS TRACT L LANO USE I PARKING SPACE t RES UNITS I GRAOING f'.ERMIT ISSUED YO N □ REDEVELOPMENT AREA vO NO QTY. QTY. PLUMBING PERMIT· ISSUE EACH FIXTURE TRAP EACH BUILDING SEWER EACH WATER HEATER ANO/OR VENT EACH GAS SYSTEM 1 TO 4 OUTLETS EACH GAS SYSTEM 5 OR MORE / [:;_ II QTY. 37~ ~--yv I'll • - y ~P- 'v~ MECHANICAL PERMIT· ISSUE INSTALL FURN. DUCTS UP TO 100.000 BTU OVER 100,000 BTU BOILER/COMPRESSOR UP TO 3 HP BOILER/COMPRESSOR 3-15 HP METAL FIREPLACE -----+-------+---t- EACH INSTAl . ALTER , REPAIR WATER PIPE V ENT FAN SINGLE DUCT EACH VACUUM BREAKER MECH EXHAUST -HOOD/DUCTS -------+-------+----+-- WATER SOFTNER RELOCATION OF EA FURNACE/HEATER EACH ROOF ORAIN (INSIDE) TOTAL MECHANICAL .,. TOTAL PLUMBING 5 l.,. 9) :JJ,. ELECTRICAL PERMIT· ISSUE QTY. I SOLAR -ISSUE NEW CONST EA AMP/SWT/BKR COLLECTORS 1 PH 3 PH STORAGE TANKS EXIST BLOG EA AMP/SWT /BKR ROCK STORAGE 1 PH 3 PH PUMP REMODEL/ALTER PER CIRCUIT PLAN CHECK FEE TEMP PO LE 200 AMPS OVER 200 AMPS TEMP OCCUPANCY (30 DAYS) TOTAL E LE CTR ICA L ] TOTAL SOLAR NO STORIES TYPE CONST STATE LICENSE tt ST A tt.f,A f"~ P "!'ttt I 11 ~U/L~NG so. FOOTAGE DESIGNER"S PHONE OCC GP EDU OCC LOAD FIRE SPR vO NO Nor Valid Unlt!Ss Machine urrifi«J SUMMAR~ACCOUNTNUMBER BUILDING PERMIT SIGN PERMIT PLAN CHECK TOTAL PLUMBING ELECTRICAL MECHANICAL MOBILEHOME MOBILEHOME PARK INSP SOLAR STRONG MOTION FIRE SPRINKLERS PUBLIC FACILITIES FEE BRIDGE FEE SCHOOL FEE • DISTRICT Carlsbad Encinitas San Oieguito San Marcos TOTAL FEES PAYABLE -56=-- r 56'~ I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION AND PERMIT" AND DO HEREBY CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY ANO AGREE IF A PERMIT IS ISSUED; TO COMPLY WITH ALL CITY, COUNT'( ANO STATE LAWS GOVERNING BUILDING CON• STRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS 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. Exp,rat1on E¥1try permit issued by the Building Ol11c1al under the proY1s1ons of this Code shall expire by lim1tat1on and become null and void If the budding or work authorized by such permit JS not commenced w1th1n 180 days from the date of such permit. or 1f the ~ifd1ng or work au1ho112ed by such permit 11 suspended ot abandoned 11 any time alter the work 1s commenced for a penod ol 180 davs \/ * AN 06HA PERMIT IS AE0U1AEO FOfl EXCAVATIONS OVEII S' O" DEEP ,.NO DEMOLITION 0A CONSTRUC110N Of STRUCTVMS OYEA 3 STORIES IN HEIGHT / _m ~WNER O CONTRACT~ ~ BY PHONE 0 APPROVED BY 77 ~ {o/h V 7 ~ u:: >, ;;; 0 a. E a, t-- 1 -0 0 (!J C <1l 0 0. a. <{ I -"' C a:: 0 1/) 1/) a, 1/) 1/) <{ I ~ .Q -a; >- ui 1/) a, 0 0 ct <1l <ii 0 € a, 0 C <1l C u:: C a, ~ (!J 0 u a, a. 1/) C ~ .c. s: INSPECTION TYPE DATE -INSPECTOR .... --. BUILDING FOUNDATION I ' REINFORCED STEEL . MASONRY GUNITE OR GROUT ' FLOOR & CEILING SUB FRAME SHEATHING FRAME ' EXTERIOR LATH INSULATION INTERIOR LATH & DRYWALL I PLUMBING : I SEWER AND BL/CO . PLUMBING UNDERGROUND PLUMBING TOP OUT I TUB AND ~HOWER PAN I GAS TEST I ELECTRICAL I I TEMPORARY POWER I ELECTRIC UNDERGROUND l ROUGH ELECTRIC I I ELECTRIC SERVICE I I BONDING A G. F. I. -SMOKE DETECTOR . I MECHANICAL ' I DUCT & PLEM., REF. PIPING HEAT -AIR COND. -SOLAR SYSTEMS VENTILATING SYSTEMS CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE ITEMS ABOVE HAVE BEEN APPROVED. JOB SITE FINAL -- PLUMBING I 4-27-IL ~ ELECTRICAL ' MECHANICAL I GAS I BUILDING ' SPECIAL CONDIT "'IS CERT OF occup/ ,SUED - ✓ x-1--L/tC, p ,, FIELD INSPECTION RECORD REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES INSPECTION REQ IF INSPECTOR'S DATE CHECKED APPROVAL SOILS COMPLIANCE PRIOR TO FOUNDATION INSP STRUCTURAL CONCRETE OVER 2000 PSI PRESTRESSED CONCRETE • POST TENSIONED CONCRETE FIELD WELDING HIGH STRENGTH BOLTS - SPECIAL MASONRY PILES CAISSONS , ~ ~ - -- < --• -• . -' . ... . ..., ' ~--,__~ ...... -.... . ,__ ' -I---\ ~ \ :lj I ~' Ch z 0 ~ cc C ..J u Ill 0 ·- IC I[ 0 u IC "' 0 ..J 5 ~ "' z 3 0 z 0 ~ Ch z Ill A. :I 0 u Ch ii:: "' " cc 0 3 ![ O I hereby am ;m llcensed under provisions of Ch, (commencing with Section 7000) of Dl,,.,on 3 of the Business and Professions Code, and my llcense Is In full force and effect. Lie No _______ Class _____ _ I Mreby att,rm that I am exempt from u,e Con- ~~<>;":.:!~,:'; ~w ~C:,!:~':"~~':~1~ county whteh requires a permit to construct aJter. 1mpt0Ye, demohsh, or repair any structure, p,10< to its 1sSUAOCe also requires the apphcant for such permit to hie a signed statement that he ,s licensed pursuant to lhe P,O'IOSIOOS of the Con- tractor's l.lCense Law (CIWlpter 9 commenc,ng wolh Sectoon 7000 ot Dmsoon 3 ol the Bus,neso and Pro-fessions Code) Of' that ,s exempt therefrom and the basis tor the alleged exemplion Any violahon of Sectoon 7031.5 by an applocant for• perm,t subjects 1ne applicant to a c1vtl pet11ilty ot not fflOfe than hYe hunchd dol-($500) O I, os owner ol the p,operty, or my employees .,,,lh wages as their sole compeosat,on. will do the W<>fk:. and the structure 1s not intended or offered for sale (Sec ~-Business and Professions Code The Contractor's License uw does not apply to an owner of property who bu1k1s or improves thereon and who does such work: himself or through his own empk>yees, prO¥tded that such improvements are not intende1 or offered for s,aJe It, however. the buIldmg or improvement Is sold w1Ihin one ye¥ of eomp6ehon, lhe owne, bu1lde, will have the burden of pr0¥1ng that _he dtO not build or improve lo, the purpose ol sale) □ I, as owner ot the propeny, am exclusively contracting wt1h l1Censed contractors to consIruc1 the p,Oje(:t (Sec 7044. Busmess ond Prolessoons Code· The Contractor's License Law does not apply to an owner of property who builds or improves ~':::;i~ 7.~n~~~~!~~ ~::~~,~~~;;:.: Ltc.,,se Ulw) D I am e•empt undef Sec _ tor this reason __ .B &PC 0 I hereby affirm that I ha~e a certificate ol consent to self-insure. or a cert1f1c-ate of Workers Compensation Insurance. or a cert1f1ed cooy thereof (Sec Jl!OO. Libo< Code) POLICY NO COMPANY 0 Copy IS hied with the Ctty 0 Certified copy 1s hereby furnished CERTIFICATl OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Th1JI:fc!'C:;::',,;:, ~l~p;1t~) ~l~s~rm,t t certify that in the perlOffl\ance of the work tor 'per any manne, so as to beeome subIecI to ~ h this permit 1s issued. I shall not employ any the ers· Compenwtton Laws of Galltornia NOTICE TO APPLICANT 11, alter makon1 taos een, heate of Exemption. you should beeome subject t? the Worite,s· Compensation p,ov,s10ns ot Ine LabOf Code. you must forthwith comply with such p'°f;;""/!._"flS perm,t soall oe oeemed oeVOked 0 I hereby affirm tnat there ,s a cons1ructIon lend,OQ agency tor lhe performance ot !he wOOI. tor wn1cn this permit 1s issued (Sec. Y/37 Civil Cooel Lenders Name· ___________ _ Lende(s Address __________ _ ' I USE BALL POINT PEN ONLY & PRESS HARD -----·--.. -. -------------,.... . CARI D BUILDING DEPARTMENT ( " APPLICATION & PERMIT 1200 Elm Jad, California 92008 (714) 438-5525 APPLICANT TO FILL IN INFORMATION WITHIN SHAD\'o.D ~D DECLARATIONS JOB ADDRESS ~-./ --~-A~tT•liX rh7'CATIONI ~N;i/s-1• / v ALUAIIUN"' D .,,.,, .u ... , .-::2_1/pt, . ~-:21~ ----OW~ER' ~ _ __,/I I OWNER'S PHONE ~ ECONTR:/TOR , , CONTRACTORS PHONE • ZONE , V :...v .. A } ?/-t/11/J ~~/~ ---~ ~~A --7 '(JW'(','-_~·~~ 4/M-.n,,,'/ '-... ~---~ OWNER'S I\IIAILING ADDRESS (/ CONTRACTAOR'S ADDRESS CJ /:.-~ LICENSE NO. PLAN 1.0. # BLOG USE CODE JU,/, "4 .. -'A,.,!. .J I ao, ,yl:, 7 LOT BLOCK I SUBOI VISION I ASSESSOR PARCEL NO DESIGNER 'ilTATE LICEN$'( It STANDARD PLAN# BUILDING SO. FOOTAGE DESCRIPTION OF WORK -./ ~ DESIGNER'S ADDRESS DESIGNER'S PHONE I/ It, tlli:?6~89 ~s.s /,,, .-. ~ : • O....,_ '\ ~ L _ .J ~ • I J ) 00~_1-~~e9 l/I_8182 ea.ea I. ~ ------r -, ---~ -~,._ 1:--a) --~ _, -F/P FLA ELEV. NO OCCGP EDU ,, STORIES vO NO CENSUS TRACT I GP ""'NO USE PARKING SPACE I RES UNITS I GRADING f'.ERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRESPR AREA CONST YO N 0 vO NO vO NO Not Valid Unlffs Machine Certifirtd QTY. PLUMBING PERMIT -ISSUE QTY. MECHANICAL PERMIT · ISSUE 3~ SUMMARY/ACCOUNT NUMBER EACH FIXTURE TRAP ~ INSTALL FURN. DUCTS UP TD 100,000 BTU P..r>:C. BUILDING PERMIT 01-000-4220 EACH BUILDING SEWER OVER 100,000 BTU --SIGN PERMIT 01-000-4221 - EACH WATER HEATER ANO /OR VENT BOILER/COMPRESSOR UP TD 3 HP PLAN CHECK 01-000-4806 EACH GAS SYSTEM 1 TD 4 OUTLETS BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING 01-000-4222 EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE ELECTRICAL 01-000-4223 ~ -EACH INST Al . ALTER, REPAIR WATER PIPE V VENT FAN SINGLE DUCT arr_;;.., MECHANICAL 01-000-4224 /,~ EACH VACUUM BREAKER MECH EXHAUST -HOOD/DUCTS , MOBILEHOME 01-000-4225 WATER SOFTNER RELOCATION OF EA FURNACE /HEATER MOBILEHOME PARK INSP r-r, EACH ROOF DRAIN (INSIDE) SOLAR 01-000-4226 /~-:---- TOT J;L MECHANICAL /~ STRONG MOTION 65-640-0519 TOTAL PLUMBING I FIRE SPRINKLERS 01-000-4227 3~ PUBLIC FACILITIES FEE 25-000-4933 QTY. ELECTRICAL PERMIT • ISSUE QTY. SOLAR -ISSUE BRIDGE FEE NEW CONST EA AMP/SWT/BKR I COLLECTORS _s~ SCHOOL FEE • DISTRICT 1 PH 3 PH I STORAGE TANKS ... ~ Carlsbad 65-623-0519 ~-~ EXIST BLDG EA AMP/SWT/BKR . ROCK STORAGE Encini1as 65-624-0519 1 PH 3 PH / PUMP ~ -San Oiegulto 65-625-0519 REMODEL/ALTER PER CIRCUIT PLAN CHECK FEE ~-J~ San Marcos 65-626-0519 TEMP POLE 200 AMPS OVER 200 AMPS TEMP OCCUPANCY (30 DAYSI --- TOTAL ELECTRICAL -7-TOTAL SOLAR /~ ~ TOTAL FEES PAYABLE I ~tf' gJ____.., -........... &.ype,111M--byllle8ililding0fficlalune11t ... p,o,,iaion1ofth11 I HAVE CAREFULL V EXAMINED THE COMPLETED "AM.ICATION AND PERMIT" AND DO HEREBY * AN OSHA PEJNIT IS IIEOUIAED FOR EXCAVATIONS OVER CERTIFY UNDER PENALTY OF PERJURY THAT AU. INFORMATION HEREON INCUJDING THE Code 1111111 Ujllnl by Hlllitallaft and "-'-null and void. If Ille building or work !I' O" DEEP AND DEM0UTION OR ClONSTRUCllON OF DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE 1F A PERMIT IS aulllarizledby-llpennitia--icedwitlltn ,.,day8fnlmllledateofauch STIIUClUIIES OVER 3 STORIES IN HEIGHT parnill. or if .. ~• wwt, eulllorind by auc:11 permit• ~ ,. ISSUED: TO COMPL V WITH AU CITY, COUNTY AND STAT£ LAWS GOVERNING BUILDING CON· 111a11c1o1-,a1-lilne •-"• -fora-al•.,-STRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I Al.SO AGREE TO SAVE INDEMNIFY AND "ZA"f8IGNATUAE1J /~ OWNER□ CONTR~CTO APPROVED BY /Id 14✓ KEEP HARMLESS THE CITY OF CARUl8AD AGAINST ALL UAIIIUTIES. JUDGMENTS. COSTS AND EXPeNSES WHICH MAY IN AJl'f WAY ACCAUe AGMlST SAID CITY IN CONSEQUENCE OF THE ~..... . .... ·av GRANTING OF THIS PERMIT. ---,.-\ -~ 'U 7 ~ u:: ~ C1I 0 a. E ~ I 'O 0 (!) ~~ ~I a. a. < I .:,c C: ii: 0 "' "' Q) "' "' < I := .Q Qi >- cii "' Q) 0 0 a: C1I «i 0 §: Q) 0 C: C1I C: u:: C: Q) Q) c5 0 0 Q) a. "' C: 2! :c :!: INSPECTION TYPE BUILDING FOUNDATION I I : DATE -v-:-~ INSPECTOR I-·v FIELD INSPECTION RECORD REQUIRED SPECIA L INSPECTIONS REINFORCED STEEL I • I MASONRY ·--' I I REO IF I INSPECTOR'S I I CHECKED APPROVAL INSPECTION DATE GUNITE OR GROUT • SOILS COMP IANCE FLOOR & CEILING SUB FRAME j ~~i :D:~ION INSP ,, SHEATHING I STRUCTURAL CONCRETE \ ' ~ ,. .... INSPECTOR'S NOTES ~ - l ~ f -4 I '1 -11\ " , --~- . - FRAME ! OVER 2000 PSI PRESTRESSED EXTERIOR LATH lNSULATION I CONCRETE C ------~. ..... =1 I POST TENSIONED INTERIOR LATH & DRYWALL I CONCRETE \ 1-------s;'-"-' -=--""--------------------·- PLUMBING ! •IE'l [) WELDING \ ------.. l SEWER AND BL/CO , -.... STRENG TH ---------1 • BOL TS ' ______________________ _ PLUMBING UNDERGROUND I """ ----I I SPECIAL MASONRY e , ' , PLUMBING TOP OUT , , 's: -- -TUB AND SHOWER PAN I . • I ---- GAS TEST ! I --------------------------------.. ELECTRICAL I I ~ ~---...... _ -'~--~.:.~ PILES CAISSONS TEMPORARY POWER ! I --1----------------------·~ ELECTRIC UNDERGROUND j I ________ _ ROUGH ELECTRIC I I 1------------------------------1 ELECTRIC SERVICE ' ! I I BONDING 'I I -- G. F. I. -SMOKE DETECTOR MECHANICAL I I I I DUCT & PLEM., REF. PIPING ;,i,. , .... 1 • ..,_ ' r;---T-"" HEAT -AIR COND. -SOLAR SYSTEMS --.-, VENTILATING SYSTEMS I : ·~-I ~~·.,-.., ,~,.1..4 ~~~~ CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE ITEMS ABOVE HAVE BEEN APPROVED. . -.. -' ----·--------- l------------------------------------------------ 1--------------------------------------------- , ... ---l JOB SITE FINAL , , ~,-_· ...... -""\ ,-, 'J ,-. 7· ~ --·----,, PLUMBING I r-. '~'.l. ____ _ ELECTRICAL : ,, -__ r,:;.-c> .. ~\ \' ;, °t ~,. ,,\--_ ~ t• ,.-'~--,, . \ \ . ~ECHANICAL 1 4--:J7·8L 'f ~ ~ ~ ------+---t------':----lf--------1 i -,,.. __ ~ .~ --U-· '\.' ~ GAS I 1 ~ _ _ ~ .h _ • , ~ ~ , , ~ • r -. ~-· ___ _ BUILDING ! , '-"~· ,-:: -~--,\ t\t·\ ~,"-." '~"'\ '-' ~~\.\---.J -.. ./ SPECIAL CONDITIONS 1 --•• -....... -+------If-------! ----·------------------ CERT OF OCCUPAI 5UED I I L_ . -~ .,. .. ..,. .,, z 0 ~ C a: C .., u Ill 0 ... C I[ 0 u a: Ill 0 .., 3 ~ Ill z ~ z 0 ~ ~ z w ... :I 0 u .,, ~ w "' a: 0 3 ( 'riJ I hen., that I am licensed under ~lslons ~ter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is In full force and effect. Lit No _______ Class I r,e,et,y athrm ttlalt I am exempt lrom lhe Con-~~o;·~~:~:: ~ ~t!::'~c2'~,~ county whteh requires a perm11 to construc1 aJter. improve. demot,sn. or repair any structure pnor to its issuance 1Jso requires lhe appheant tor such pemut to hie a s.gned s11tement that he 11 ltCenMd pursuant 10 the p<OYIStOf'IS of the Con tractor's License Uw (Chapter 9 commencmg with SectlOf'I 70JO of Otv1s1on 3 or the Business and Pro fess.ons Code) or that ,s exempt therefrom And the basis for the alleged exemphon Any vK>tatlOn of Secllon 7031 S by an appi.,.,,t to, a perm,1 subjects tne apphcant to I c1v,I penalty of not ffl()(e than hve hundrod doll= (S500l 0 I, as owner ol the property. o, my employees .. 11h wages as their X>le compensat•on. will do the WOik. and the structure 1s not intenOed or offered '°' sale (Sec 7044. Business and Protess1ot"ls Code The Conlractor's License Law dOes not apply to an owner of property who builds or improves thereon and who does such W0n( himself or througt-his own employMs. prov,ded lhat such 1mproveme:-1ts are not 1ntende1 o, ottered for sale If. however the bu1kj1ng or ,mptOYement ,s sotd within one year of complehon. the owner-builder w,11 have the buroen o1 proving that he dtd not bU1ld Of improve tor the purpose ol sale) C I, as owne, of the property. am exclusively contract!~ with lteensed contractors to construe• the pro,ect (Sec 7044 Business and Professions Code The Contractor's L,cense Law does not apply to an owner of property who builds or improves ~':t~i~~ ~~nc:'~~~: ::~,!r~~~~::.: Ltcense Law) 0 I am exempt under Sec fOf ltus reason ___ ,B &PC □ I hereby afhrm that I t\a\18 a een,t,ea1e ot consent to self insure, or a cert,t,cate of Workers' Compensat,on Insurance. or a cen1hed copy thereot (Set 3800. ubO< eooe, POLICY NO __ COMPANY __ "$,.Cooy ,s hied w,1n the c,ty /'~ ti~ 6 Cert,hed CoPy ,s hereby turnis~ \~--- CERTIFICATl OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed ,t the permit Is fOt one hundred OOllars (StOO) or less~ O I cen1ty that ,n lhe performance of the won,. to, which this permit ,s issued. I shall not employ any person ,n any manner so as to become subJect to the wonc.ers· Compens.tt0n Uws ot Cahfornia NOTICE TO APPLICANT II. alter ~k•n~ ,n,s een, hate ot E•empuon yOY should beeome sut>,ect 1-, the W0f11.ers· Compensation prov1s10ns ot ll'le Labor Code. you must fortt1w1th comply with such prO\l'ISIOOS or 1h15 permit Sha.JI be deemed revOked D I hereby aflum lhat !here •s a cons1ruc1,on 1eoo,ng agency tor 1~ perlOfmance of lhe wof'1il IOf wh,cl'l ttus oerm11 is issued tSec 3097 C1v,1 Cooel lenders Name ___________ _ Lenders Address __________ _ USE BALL POINT PEN ONLY & PRE~S HARP-,-APPLICANT TO FILL IN INFORMATION WITHIN SHAO~D_AREA AND DECLARATIONS. -- Cl' BAD BUILDING DEPARTMENT ( ' ) APPLICATION & PERMIT 1200 Jarlsbad, California 92008 (71-4) -438-5525 JOB ADDRESS A~·i .T· i ,r~; :erTIONI B~,i~o VALUATION PERMIT NUMBER ~4-q~ {0\I\A11:Y'V\.~/t -8f-+~9e. r , OWNER'S NAME l4~2 ffffE ~ CONTRAC;OR ~Lw_,, CONTRACTORS PHONE• ZONE &1.rL~ ~di\J)N\A--71(,LL/~t. /"l'-vv..L"> OWNER'S MAILING ADDRESS V CONTRACTOR'S AODRESS ib,z-LICENSE NO. PLAN 1.0. # BLDG use CODE L..~ 7~' ~~t-1 11.>-l\..10 ~ nrr:.. ~nf:. [)_Q · (6;rr 17 6S b3ll:4-n axer. LOT I BLOCK I SUBDIVISION I ASSE~SOR PARCEL NO DESIGNER ¥ STATE LICENSE # STANDARD PLAN # BUILDING SO. FOOTAGE DESCRIPTION OF WORK DESIGNER'S ADDRESS DESIGNER'S PHONE _EW:,-r~ ON\,,,Y fo~ S .F. p. --F/P FLA ELEV. NO OCC GP EDU I 1/30/813639 02,~1-STORIES 000_13639 11/30/ 81 vO "-0 --t t2,tE! CENSUS TRACT I GP LANO USE I PARKING SPACE I RES UNITS I GRADING f'.ERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRE SPR AREA CONST YO ND vO NO vO NO Nor Valid Unlffs Machine Certifitd \ QTY. PLUMBING PERMIT -ISSUE 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 SIGN PERMIT ------- EACH WATER HEATER ANO/OR VENT BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE ELECTRICAL t::://_, 0 0 --EACH INSTAl-, ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL EACH VACUUM BREAKER MECH EXHAUST -HOOD/DUCTS MOBILEHOME WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP EACH ROOF DRAIN (INSIDE) SOLAR TOTI.L MECHANICAL STRONG MOTION ---I . -__ . ___ TOTAL PLUMBING FIRE SPRINKLERS ,Z.oo PUBLIC FACILITIES FEE QTY. ELECTRICAL PERMIT -ISSUE QTY. SOLAR -ISSUE BRIDGE FEE NEW CONST EA AMPISWT BKR ,, D/'1 A c;v,00_ COLLECTORS SCHOOL FEE -DISTRICT I PH 3 PH STORAGE TANKS Carlsbad EXIST BLOG EA AMP/SWT/BKR ROCK STORAGE Encinilas 1 PH 3 PH PUMP San Dtegu110 REMODEL/AL TEA PER CIRCUIT PLAN CHECK FEE San Marcos TEMP POLE 200 AMPS OVER 200 AMPS - TEMP OCCUPANCY 130 DAYSI ----- -T - TOTAL ELECTRICAL Gt/JO TOTAL SOLAR TOTAL FEES PAYABLE I 5Z,oo I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT ANO DO HEREBY Expiration. Every permit issued by the Bu,ld,ng 011,c,11 under tne provts,ons o( this 1r AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall expire by llm1t1t1on and become null and void If the bu1ld1ng or work ~-O" DEEP -'ND OEMOl.lTION OR COHSIBUCTION OF DECLARATIONS ARE TRUE ANO CORRECT AND I FURTHER CERTIFY ANO AGREE IF A PERMIT IS authonzed by such permit 1s nol commenced w1th1n 180 days from the date ot such STRUCl\JR£S OVER 3 STORIES IN HEIGHT ISSUED: TO COMPLY WITH ALL CITY, COUNl'!' ANO STATE LAWS GOVERNING BUILDING CON-~:::On':ci '!, ':~y t;:'~!1~.~~~~~.:::t:O~~..:'l~~~~ r~r;::~.i~f•~:r.r-~ 0 ' STRUCTION. WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY ANO ~S;ATU7/ ~ OWNER□ CONTRACTO~ AP~Jr DATE KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS. COSTS ANO EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE I J\~~BI GRANTING OF THIS PERMIT-BY PHONE 0 ~ ~ u:: >, ~ 0 0. E Q) I- I 'O 0 (.'.) C as -~ 0. -0. <( I :,:: C a: 0 U) U) Q) U) U) <( I 3: .2 .; >- en U) Q) 0 0 a: as <ii 0 ~ Q) 0 C as C u:: C Q) ~ (.'.) 0 0 Q) a U) C ~ ~ 3: INSPECTION TYPE DATE INSPECTOR BUILDING FOUNDATION REINFORCED STEEL MASONRY GUNITE OR GROUT FLOOR & CEILING SUB FRAME SHEATHING FRAME EXTERIOR LATH lNSULATION I INTERIOR LATH & DRYWALL PLUMBING ,' I -- SEWER AND BL/CO I PLUMBING UNDERGROUND PLUMBING TOP OUT TUB AND $HOWER PAN GAS TEST ELECTRICAL TEMPORARY POWER I ELECTRIC UNDERGROUND I ROUGH ELECTRIC I ELECTRIC SERVICE BONDING A I G. F. I. -SMOKE DETECTOR. I MECHANICAL DUCT & PLEM., REF. PIPING HEAT -AIR COND. -SOLAR SYSTEMS VENTILATING SYSTEMS .. • u CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE ITEMS ABOVE HAVE BEEN APPROVED. JOB SITE FINAL PLUMBING ELECTRICAL 14'--:J?-BZ .. IA.f MECHANICAL ' GAS BUILDING SPECIAL CONr·~10NS CERT OF ace~ YISSUED .. -~ ~ i I 3'/-L/1C, G FIELD INSPECTION RECORD REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES INSPECTION REQ IF INSPECTOR'S DATE -CHECKED APPROVAL SOILS COMPLIANCE PRIOR TO FOUNDATION INSP STRUCTURAL CONCRETE . OVER 2000 PSI . PRES TRESSED CONCRETE POST TENSIONED CONCRETE FIELD WELDING -- HIGH STRENGTH . BOLTS SPECIAL MASONRY PILES CAISSONS ~--,_..__ ' . . r .. l ~ ,- ' .• .,.... . .,_ , -. ',_. - c-l-.. -' • I -H 'I. ~. I -~ . . ~ . ~ tr· . \ ...... ,-' ' \ -,f-'~ ~ - ( \ ' '\ ) -I .J ' _,/ , I ):( ~~AA.MM~AA,t)J;JAAA/i~ .. 1~JAIAl~"~JN.AJMAAA~)( ~ • ~ ~ Qlrrttfira t r nf ®rrupattry ·!,) l ~ ~ j CITY OF CARLSBAD ~ ~ This Certificate issued pursuant to the requirements of Section 306 -=---~ j of the Uniform Building Code certifies that at the time of issuance ~ ~ this structure complies with applicable ordinances of the City ~ 3 regulating b~ilding c_onstruct.ion use. ______ ~ j Use Classification Single Family Dwelling Bldg. PermitNa.81-419 ~ Group _____ Type Construction _____ Fire Zone _____ Use Zone______ ~ Occupant Load_____________________________ ~ ~ Owner ofBuildinv~j ~bard An~hony '• ••. . 'Mdress 4473 Kittiwake Way, Oceanside, Ca. ~ ~ Building Address -~~~',Un'tC'9rnV> Str,~et_, ~ Locality Carlsbad, California ·•' 92008) I ~ • i • .e . -,"A •• ·t -J l .. • • t ..,...--+-,,---~ ~ -----------------P---+-~=-1--=--J..L-..µt~II:::----~ ~ ----------------__ __,_,..,..._~ ....... ..._~,,,_,______ ~ ~ NOTE: Alt•rations, changu, aclclitions or c occ:upan ; ~ (Past in conspicuous ploce) ~ ~ffWWMMMMMMMMMMMM MM MM"""W~~W\Y/WWWWX -'--... ---•• :..> ..... ,.-:J..; ,·.,,... ---... • ,.J....~~.,..~----... ,~--~-~·· ~--~ ~:: -:-_;~-:.;;~ .. _.;-, -,~ ............ ~ . . ;:~-r...:--~ ~~ :.-:· . .., ,~ .... :~,:~ ... --, . ..,._ L . f I ! , , ·, I j, • I •• • :.: .! I ,,,,, ;:" . //'j1 • I 11 .: I I I --.. INTERDEPARTMENTAL INFORMATION SHEET BUILDING DEPARTMENT BUILDING ADDRESS: PLANNING DEPARTMENT DATE: ""EC EIVED OCT o 5 1981 r ZONE lL.--\ LOT SIZE LOT WIDTH -~~~ ... 1,------------------------- UNITS ALLOWED ___________ UNITS PROVIDED ____________ _ PARKING SPACES REQUIRED ~r0-: PROVIDED ___ ~A~,~,_ _____ _ % covERAGE ALLOWED lLL PROVIDED u~ BUILDING HEIGHT ALLOWED PROVIDED FRONT SETBACK: ALLOWED PROVIDED __ ~O~l~2-=--- INTRUSIONS ---------- SIDE SETBACK: O[C LANDSCAPE & IRRIGATION PLAN COMMENTS: ENVIRONMENTAL PROTECTION REQ: ADDITIONAL COMMENTS: OK TO ISSUE: ENGINEERING DEPARTMENT R.O.W. INDUS TRIAL WASTE REAR SETBACK: IMPROVEMENTS --------------------- SEWER CONNECTION ________ DRIVEWAY LOCATIONS ___________ _ GRADING PERMIT ~ EASEMENTS _________ DRAINAGE ____ _ LEGAL DESCRIPTIONd°'~-59 ~ '#-/ ADDITIONAL COMMENTS ---------------------- 0 K TO ISSUE: ~ATEiv , 13,✓fl{ PWI ____ OK TO ) FINAL Ju,t.g; DATff-2.iBZ 'FIRE DEPARTMENT SPRI~KLING SYSTEM FIRE PROTECTION EQUIP. ------------------- °FIRE ALARMS EXITS ----------------• FIRE HYDRANTS __________ LOCATION _________________ _ ADDITIONAL COMMENTS OK TO ISSUE: DATE OK TO FINAL DATE ---------------------- WATER DEPARTMENT REQUIREMENTS OF APPROPRIATE DISTRICTS MET ________ DATE ________ _ ALPHA LABORATORIES, INC. SOIL & FOUNDATION ENGINEERING Richard Anthony 4473 Kittiwake Oceanside, California 92056 PROJECT NO. 3290 October 7, 1981 SUBJECT: Lot 39, La Costa Meadows, Unit No. l, Grulla and Unicornio Carlsbad, Cal ifornia Gent l emen: This is to report the res ults of observations and suil samples performed on October 6, 1981 at Lot 39, La Costa Meadows, for the purpose of determining the moisture content in the expans ive soils included on the subject site. Field explorations were made to retrieve so il sampl·es in the center of the building pad. Test pits were dug to a depth of at least 2 feet bel ow finish grade and moisture samp l es were obtained at intermediate levels. We found the fi e ld moi sture to be 20.5 percent. A maximum dry density determination was performed in accordance with ASTM D1557 to ascertain optimum mo i sture content of the subject soil. The maximum density was found to be 116 .0 pcf at 14 .7 percent moisture. In conclusion, we find the fi e ld mo i sture exceeds the optimum by at leas t 3 percent which meets the minimum requirements. If you have any questions, please contact this office. Thi s opportunity to be of service is sincerel y appreciated. Respectfully s ubmitted, ALPHA LABORATOR IES, IN C. !'lllJ~ C.H. Wood, RCE 10778 AS:b i cc: (3) Subm itted 7895 Convoy Court -San Diego -California 92111 -714 / 292-0660 ALPHA LABORATORIES, INC. SOIL & FOUNDATION ENGINEERING TO _____ R_i~c_ha~r .... d~A_n~th_o~n~y ________ _ ADDA ESS ___ 4.:..4'""'7""'3.....:.:.K'-'i t_t:..:.i.;..;.w""'ak"""e:;.__ _______ _ Oceanside, California 92056 RE: Fl ELD Lot 39, La Costa Meadows, Unit No . 1, Gru lla and Unicorn io, Carl sbad, CA Field Technician 10-6-81 2 .0 Hrs. LABORATORY TESTING Optimum Mo i sture, Maximum Density (Ch. Pt.) 1 MILEAGE 54 Miles TOTAL -THIS INVO ICE THANK YOU NET DUE AT TIME OF INVOICING. INTEREST AT 1 ½ % PER MONTH CHARGED ON PAST DUE AC- COUNTS. FURTHER WORK ON PAST DUE ACCOUNTS WILL BE C.0.0. INVOICE NO. 04415 DATE October 7, 1981 P. 0 . NO. ________ _ JOB NO. _____ 3 __ 29 ___ 0 ____ _ $31 .00 $62.00 40.00 .35 18 .90 $120.90 7895 Convoy Court • San Diego -California 92111 -714 / 292-0660 I l i '-. , , ... _ ........... • ~ cR,vj_ JI=-YI-~11 \ LEUCADIA COUNTY WATER DISTRICT POST Ol'P'IC£ UOX 2397 • LEUCADIA, CALIF"ORNIA 92024 • 7113-011111 •. February 28, 1980 Dear Property Owner: On August 19, 1979, the Board of Directors of Leucadia County Hater District approved the allocation of 3,150 sewer permits to applicants to the District's Allocation List. Our records indicate you are the owner of ;;. p;~opcrty which wa:; a11o-.::a-::~d c.nc of these permits. The allocated permits have been subject to the r.ules and regulations as outlined in Ordinance No. 19, a copy of which was supplied when you were notified of the availability of sewer permits. Under Ordinance No. 19, those properties which were part of a final subdivision map or final parcel map were required to make application for a building permit within 12 months of notjf- ication and to obtain the building permit 60 days later. Those properties which~had a tentative approved map had 15 months in which to make application for building permit and to obtain the building permit 60 days later. Those properties which had a sewer availability letter had 18 months in which to make application for a building permit and to obtain the building permit 60 days later. ' On February 26, 1980, the Board of Directors adopted Ordinance No. 24 (copy enclosed) which has changed these restrictions: LOTS OR PARCELS SHOWN ON FINAL SUBDIVISION MAPS OR FINAL PARCEL MAPS NOW HAVE 48 MONTHS IN WHICH TO OBTAIN A BUILDING PERMIT , OTHER LAND WHICH HAS A TENTATIVE APPROVED MAP OR A SEWER AVAIL- ABILITY LETTER NOW HAVE 48 MONTHS IN WHICH TO RECORD A FINAL MAP AND 48 ·MONTHS FROM RECORDATION IN WHICH TO OBTAIN A BUILDJNGjERMIT clH 0 q, tlla ~ The following change appli~s to your particular property: ,~t~ o · A final map must be recorded by _____ _ M Building permit(s) must be obtained by _J_J -;;i. -f?.3 Please read the enclosed ordinance carefully for additional changes to Ordinance No . 19. If you have any questions please contact this office and a me1nber of our office staff will be happy to help you. Yours very truly, LEUCADIA COUNTY WATER DISTRICT ~~~ Richard E. Hanson Secretary-Manager DISTRICT OP'P'ICI!, 1080 LA COSTA AVl!NUll • CARLSBAD. CALll'ORNIA ::•· ,,' •'v ,.·, .,,··: ··,.• ·,· ..... ;,•tft'P'.,·1. ;.· ·, .•• -~--t·:.~ ,,.,,,v ,;. •• ,.,, , .... ,~-11 ,~~-:•,,!. ".·,i .r,,, ... --.'.J -~ , •. \ 7-24-79 LEUCADIA COUNTY WATER DISTRICT APPLICATION FOR SEWER SERVICE Owner I s Narr.e Mr. Leon Schwartz Phone No. ."753"..-:s-oso_ Mailing Address +.&.--B-ox 991--t~O Gs...i1£_~a\. '""Ho2.. . Carl sbftd, Ca H f 9289& SEWER l'ERMIT ISSUED UPON C,.\"'.Ll'CW~. Service Address: __________ __........,..-"""" ~~\S RECEIPT OF BUILDINO PERMIT. _____ ___;, __________ _ Tract Description: lot 39 La Costa...Me.ad.o,~,l,aJ1s._ _____ _ Assessor's Parcel No. BUILDl~~G PERMIT MUST l?E APPLl~u FOR BY }Q-Q,.-~.._ Type of Building s.f. No. Units 1 Connection Fee$ 600.00 ,f (2()1'1\~"f lateral Size: 4" 6" 8 II Saddle Easement Connection pre-p_ •• " • ..., ·Extra Footage: __ @ $_. __ _ Extra Depth: __ @ $ __ ":iCQ._(X;> Amount Rec'd $'-IOQ.co1 Lateral Fee Ck. No/Cash ~.:09.Q . . Prorat~d Sewer Date l\ ~ Service Fee ~ Rec'd By~ . Total . $D=/ The application must be•signed by the owner (or his authorized representative) of the property to be served. The total charges must be paid to the District at the time the applicatio~ is submitted. If a service lateral is required, it will be installed by the Leucadia County Water Dic;trict! The service lateral is that part of the sewer system that extends from the main collection line in the street (or easement) to the point in the street {at or near the applicant's property line} where the service lateral is connected to the applicant's building sewer. The applicant is responsible for the construction, at the applicant's expense, of the sewer pipeline (building sewer) from the appli -• c.:'nt's plumbing to the point in the street (or eas~ent) where a connection is made ~o the service lateral.{ • The connection of the applicant's building sewer to the !.ervice lateral shall he ffia:!~ b~· th2 app1icant at his ~}tpense. Tho c~;;r.ecticn mu:;t be rn~de in co:1for4n~~ty with the District's specifications, rules and regulations; and IT MUST 8£ INSPECTED AND 'APPRO'/ED BY THE DISTRICT BEFORE THE SEHER SYSTEM MAY BE USED BY THE APPLICANT. THE APPLICANT, OR HIS AUTHORIZED REPRESENTATIVE, MUST NOTIFY THE DISTRICT AT THE TIME INSPECTION IS DESIRED .. ANY CONNECTION MADE TO THE SERVICE1 LATERAL OR COLL£C-. TION L!NE WITHOUT PRIOR APPROVAL AND INSPECTION BY THE DISTRICT 'WILL BE CONSIOERf~' lN'JALID AND WILL MOT BE ACKNOWLEDGED. :, The prorated sewer se;vice fee is. based upon the date the Oistri~t estimates that service will begin and covers the balance of the fiscal year. There will be no adtiit:ional fee or refurid if service actually comnences on a different date. For- succeeding fiscal years, the sewer service fee will be collected on the tax roll in the same manner as property taxes. The undersigned hereby agrees that the above information given is correct and agrees to the conditions as stated. U1 1~ I ~~ Owners s1,mature .., . t t _. lbf Xhq ~ \ \ ~ Account No. .. .I (1;t;: ~IF! l?M . COMPLETE IN OUPLICATE ANO POST WITH THE INSPECTION RECORD CARD ~ ~. THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH THE ~;ri~ CURRENT ENERGY REGULATIONS, CALIFORNIA ADMINISTRATIVE CODE, TITLE 25, STATE .2.IJ/18"2_ OF CALIFORNIA, IN HE-8.t.JILDIHG LOCATED AT : ~ (/211,co~ •• , l,, ~ SITE ADORE Number EXTERIOR WALLS Manufacturer __ O~W_E_N_S_CO_RN_I_N_G __ Thickness/Type ___ 3½_2'_'_ R Va I ue 11 CEILINGS Batts: Manufacturer __ ow_EN_s_c_o_R_N_IN_G __ Thickness/Type ltD'' ..5IO :I!#' R Value 15- 8-lehA: Manufacturer _________ Thickness/Type ____ No, Bags Wt./Bag ________ Sq. Ft. Covered ______ R Value __ _ FLOORS Manufacturer __________ Thickness/Type ___ _ R Value ---- 5.LA 13 g Pl G kA Db Manufacturer __________ Thickness/Type _____ R Value ___ _ Width of Insulation Inches ---- FOOUBAT 16 If hit LLS, ~~~~=J~~~~----~-LICENSE NUMBER..----- TITLE ~-~ DATE tfl-i3jr,-_ --------------LICENSE NUMBER 306493 BY k£..J...t:,.(~;,__:~~..as~~.z;..,,--TITLE Authorized Representative DATE c»-c) -~ d- Bl Form #121 22175 ATI'ENrION POOPEir.['Y OWNER: An "ow{1~-builder" building permit has been applied for in your nart'e and bearing your signature. Please canplete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building pennit. No building permit will be issued until this verification is received. 1. 2. 3. 4. 5. I personally plan to p,:ovide the major lator ard~ials for consttuction of the proposed property inprovement (yes or no} _...,.... ________ : I (have/have not} ____ signed the application for a building pennit. I have contracted with the following person (finn} to provide the proposed construction .. Name Phone ------------------------- Address Contractors License :Ne:>. ----- City ------------- I plan to provide portions of the \oX:>rk, but I have hired the following person to =J:!:iJ::se r JJ:ide the major =rk. ~~ Phone Address t/'ft.3 /Jf Contr-ac_to_r_s_Li __ c-ens--e-:Nc:>-.----- City~ &... t:'/UJ,t'h I I will provide some of the \oX:>rk but I have contracted (hired} the following persons to provide the work indicated: Name Address Phone Type of Work Signed: Pr=cy ~ rndjf; · Social Security Number 3 7F-0-r -"!'-/3 r Date: 10 / ..r /8"1 --"-----,7---7---~-------- 1200 ELM AVENUE CARLSBAD, CALIFORNIA 92008 rear Property Owner: Citp of Qtarlsbab d:f(f!Jz . "&)if(pC> ~. TELEPHONE: 714-438-5525 An application for a building 1--ennit has been sul:mitted in your name listing yourself as the builder of the propert:'.f improvements specified. }'or your protection you should be aware that as "owner-builde:c" you are the responsible party of record on such a permit. Building pennits are not required· to be signed by the property .owners unless they are personally perfonning their own ~rk. If your ~rk is being performed by sareone other than yourself, you may protect yourself fran possible liability if that person applies for the proper pennit in his or her name. Contractors are required by law to be licensed and rorrled by the State of california and to have a business liqense fran the City of Carlsbad. They are also required by law to put their license number on all pennits for which they apply. If you plan to do your own ~rk, with the exception of various trades that you plan to subcontract, you should be aware of the following information for your benefit and pro- tection. If you employ or otherwise engage any persons other than your imrediate family, and the ~rk (including material and other costs) is $200 or more for the entire project, and such persons are not licensed as oontractors or subcontractors, then you may be an em- ployer. If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal inccme withholding, federal social security taxes, ~rkers' compensation insurance, dis- ability i nsurance costs, and unemplo:yment contributions. There may be financial risks for you if you do not carry out these obligations , and these risks are especially serious with respect to ~rkers' compensation insurance. For specific information arout your obligations urrler federal law, contact the Internal Revenue Service (and, if you wish, the U. S. Snall Business .Administration). For 1rore specific information arout your obligations under state law, contact the Department of Benefit Payroonts and the Division of Industrial Accidents. If the structure is interrled for sale, property owners who are not licensed contractors are allowed to perform their work personally or through fheir own employees, without a licensed contractor or subcontractor, only urrler limited conditions . A f requent practice of unlicensed persons professing to be contractors is to secure an "owner-builder" building pennit, erroneously implying that the property owner is providing his or her own laror and material personally. Building pennits are not required to be signed by property owners unless they are performing their own ~rk personally. Informa- tion arout licensed contractors may be obtained by contacting the Contractors State License Board in your corrmunity or at 1020 N Street, Sacramento, CA. 95814. PLEASE COMPLETE AND REI'URN THE ENCLOSED OWNER-BUILDER VERIFICATION FORM SO THAT WE CAN C'ONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUIIDING PERMIT WILL Nor BE ISSUED UNTIL THE VERIFICATION IS RETURNED. Very truly yours, Building Departrrent City 0£ Carlsbad US( IAll POIIT ,t;,