HomeMy WebLinkAbout2438 UNICORNIO ST; ; 79-5194; Permit_,_ .....
LICENSED 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 Proles•
slons Code, and my license Is In lull force and ef•
feet.
OWNER-BUILDER DECLARATION
0 1 hereby affirm that I am exempt from the Coo·
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 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•
pllcant for a permit subjects the applicant to a
civil penally of not more than live hundred dollars
($500).
,-,./1, as owner of the property, or my employees
'7th wages as their sole compensation, will do
the work, and the structure Is not Intended or of•
lered 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•
lered for sale. II. however, the building or improve-
ment Is sold within one year of completion, the
owner-builder WIii 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·
tractlng 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 ••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. _____ B. & P.C.
for this reason ____________ _
Date d-12-n Owner>)Z~
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of con•
sent to sell-Insure. o, a certificate of Workers'
Compensation Insurance, or a certified copy
thereof (Sec. 3800, Labor Code). ~~~~:Yo. ___________ _
□Copy Is filed with the city.
0 Certified copy Is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed II the per•
mil Is for one hundred dollars ($100) or less).
I certify that In the performance of the work for
which this permit Is Issued, I shall not employ any
person In any manner so as to become subject to
the Workers' Compensation Laws of Calllomla.
NOTICE TO APPLICANT: 11, alter making this Cer•
tlllcate of Exemption, you should become subject
to the Workers' Compensation provisions of the
Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there Is a construction len•
ding agency for the performance of the work for
which this penmlt Is Issued (Sec. 3097, Clvll Code).
CITY OF C ARLSBAD-BUILDING DEPARTMENT
USE BALL POINT PEN ONLY APPLICATION & PERMIT
1200 ELM AVENUE ~ 729-1181
HO. J08 ADDRESS AV. ST.
W-1 ½-Ji8 I I 1l/('N'1 / 1C.1 d>Jll.1N'1 I I 0 1 I I I I I I I I I I I I I I
RO
OWNER ,A £cl ,4-i/c-+,L OWNER'S PHONE
_ 1/3 <o .-,)_ s 7 .2
PRIME CONTRACTOR
~
OWNER0'S MAILING ADDRESS
,27 b b {r4/..,.'c;/I WAI/ /....4 Cv.J'f~
CONTRACTOR'S~,
LOT BLOCK IUBOIYISION+ DESIGNER s·I Cu.r 4 '
-DESCRIPTION Of WORK Ii J_4,,t_J 1£ 6-/N-/u..J
-~ DESIGNER'S ADDRESS
APPLICANT TO FILL IN INFOR-
MATION WITHIN RED LINES.
eus. LICENSE
STATE LICENSE
CONTRACTOR'S
PHONE
ST ATE LICENSE
DESIGNER'S PHONE
PERMIT NUM8ER
? /-S-/ ,,
0~
t-
h,>11179 t8
5 ,.,,.1$,WAO, -S-/ S-S. (.,.;(.4..J4dC$ ,4,t/.(_ 11/&>l-i/6 S-or~ ; 17:3 12717 •
CENSUS T CT GP LANO USE I z G
SLOG SO. FT. 1~:E-w..LL I occ. GP
0
QTY. PLUMBING PERMIT ./ AMT.
EACH FIXTURE TRAP L
EACH WATER HEATER ANiijpi?"VENT
EACH BUILDING SEWER /
EACH GAS SYSTEM 1 ~OUTLETS
EACH GAS SYST~OR MORE
EACH INST~LTER, REPAIR WATER PIPE
EACH.Jd(WN SPRINKLER SYSTEM
j/l'l('TER SOFTNER
~
TOTAL PLUMBING
CONTRACTOR
QTY.I ELECTRICAL PERMIT /
NEW CONST EA AMP/SWT/BKR /
AMT.
l PH .25 ~PH
EXIST BLDG EA AMP/SWT/_
1 PH .25 3 PH
REMOOEL/ALTo/PER CIRCUIT
TEMPPOLEAQO AMPS
OVER ~AMPS
T9H'"OCCUPANCY (30 DAYS)
~
RES. UNITS PARKING SPACE
0 0
ST ANO ARO PLAN II PLAN ID II TYPE CONST
QTY. MECHANICAL PERMIT/
INSTALL FU RN. DUCTS UP TD~OO BTU
_¢ 100,000 BTU
BDILER/COMPRES~UP TO 3 HP
BOILER/COM~SSOR 3-15 HP
BOILE¢MPRESSOR 16-30 HP
FAN SINGLE DUCT
H EXHAUST -HODD/DUCTS _, RELOCATION OF EA FURNACE/HEATER
TOTAL MECHANICAL
CONTRACTOR
QTY.I MOBILE HOME PER~
AWNING _/
PORCH /
SET-UP
RAMADA, C
FENC~ER6'
!,l)<AL MOBILE HOME w ,
l NUMBER O~TORIES
Not V•lid Unlm MachiM c.rtifi«J
AMT.
AMT.
locc.J/o
----J
~
~~
BUILDING PERMIT
SIGN PERMIT
PLAN CHECK
ALL INCLUSIVE PERMIT
TOTAL PLUMBING
ELECTRICAL
MECHANICAL
MOBILE HOME
SOLAR
MICO -FILM
~7S-f>~
~A-,\
I 17'Ll'1-=--
_l__,_ I I . I
l__. 1&~
I fl. I
l I • I
1 I • I
I I · __l
I I • I
I I I • l
I I I . I
' I I • I
l____. _L_l . I
I , I I I
I , I I • I ' . I I . I --
! < 0 ~
~ .:= ~ 0. V')
~
TOTAL ELECTRICAL
CONTRACTOR
TOTAL FEES PAYAB LE I ~ I I ,.er:iI ~
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION ANO PERMIT, ANO DO
HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT ANO I
FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED; TO COMPLY WITH ALL CITY,
COUNTY ANO STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER
SPECIFIED HEREIN OR NOT. tALSO AGREE TO SAVE INDEMNIFY ANO KEEP HARM·
LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE
O F THE GRANTING OF THIS PERMIT.
•AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER
5'-0" DEEP AND DEMOLITION OR CONSTRUCTION OF
STRUCTUR OVER 3 STORIES IN HEIGHT
APPLICA1'iJT'S SIGNATURE• ~ OWNER)i'J"
AGENT D
...,7v </ ;LCV
//./
CONTRACTORQ 1 APPROVED ~
BYPHONEQ ~ ...... /) ~~r
SITE
PERMIT NO: 7q --s I 't LJ ADDRESS: OWNER:
~-
~ FIELD INSPECTION RECORD
INSPECTION DATE INSPECTOR INSPECTOR'S NOTES
WOOD FLOOR
FOUNDATION• FORMS • SET BACK • TOILET
UNDER FLOOR PLUMBING -. .
UNDER FLOOR HEATING I
OK TO INSTALL SUB FLOOR .
-'' ~:=-_, ..• :~ ,. .;\\ _ ... ,,
. : , ,\ " ·' .
SLAB FLOOR ¥ .
UNDER SLAB PLUMBING -:, "'
FOOTING • FORMS • SETBACK • TOILET l . --OK TO POUR CONCRETE ,,. ~ ,,._ ..
FRAME -... , ..
ROUGH ELECTRIC AL '·
ROUGH PLUMBING ',
ROUGH HEATING/VENTILATING '·.
FRAME OK• PLACE INSULATION ' ·,..___ ..
INSULATION 0~: a. P_LACE WALLBOARD ~
WALLBOARD OK • PLACE TAPE_ "· ~ ' . f· . ~-
EXTERI.OR LATH OK• PLACE STUCCO -~, . ~, ., .....
FIREPLACE '
DAMPEFr°(','STEEL
PLATE TIES/HEIGHT OF CHIMNEY
~ .
OTHER .
TEMP POWER (POLE) ' ' SEWER -. •.
GAS T EST ' ,
SWIM POOL • STEEL BONDING I
~ ~. . ' • PRE DECK '--• FENCE PREPLASTER c.
SHOWN • FRAME ~ ~
• PAN I, I -I '
FINAL INSP BY BLDG DEPT ]ff I ,rlln,j r, 11 ~ .
OTHER DEPT'S REQ COMPLETED ~flu/0' -v
ELEC METER-PERM-TEMP I
GAS METER-PERM-TEMP
CERT OF OCCUPANCY ISSUED -.... --··-"'