HomeMy WebLinkAbout2824 UNICORNIO ST; ; 81-23; PermitLICENSED 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 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 lhe 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),
D I, as owner of the property, or my employees
with wages as their sole compensation, will do
the work, 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. If, however, the building or improve-
ment Is sold within one year of completion, the
owner-builder will 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-
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, _____ B. & P.C.
for this reaso .. ._ ___________ _
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of con-
sent to self-insure, o, a certificate of Workers'
Compensation Insurance, or a certified copy
thereof (Sec. 3800, Labor Code).
POLICY NO•------------COMPANY ___________ _
□Copy Is filed with the city. D 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 ($100) or less).
I certify that In the performance of the work for
which this permit Is Issued, I shall not empl~any
person In any manner so as to become subject to
the Workers' Compensation Laws of California.
NOTICE TO APPLICANT: If, after making this Cer-
tificate 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 permit Is issued (Sec. 3097, Civil Code).
APPLICATION & PERMIT
USE BALL POINT PEN ONLY 1200 ELM AVENUE (714) 438-5525
At't'LII..AN I I u r ILL IN INrUI'\'. -
MATION WITHIN RED LINES. .t:J. 3 .:l t"'J a ~-r----~·
NO. JOB AOORESS AV, ST.'.JOATE OF APPLICATION eus. LICENSE / PERM(yi'JIMj'l'JI ~ •
l!l :? 'Vi l i. " ' fi,l. I El ""' --• ~ t!! r "" "") • 1~1 '111 1t /,r,,r1/'J /I~ I I I I I I I I I I I I I I I J -'),,., --/ 0HA✓/L., ~ M -,Jf,-,,.-?:;;:-;H;;E? Pn:,7NTP;;~M> f''""n/Si;;_/~Ji;;;('"~ J'/_.tj •
OW~ER S MAILING ADDRESS ' • ~ ) CONTRACTOR'S ADDRESS 1 ;~NTRACTOR'S f /i0/81300'4 ,37e50
P .r?. /3r,v 1.x"s;;; .. ~/'1¥1 Mt""l,,,,.,c/'",-J /9 /91""") T1,,,,,--l,L '51n ... /?,.,4 'fl'ls ~·Yo ··--,_, --·
LOT j ,BLOCK 11 S~OIVIS~N _ It ,A. J _'ASSESSOR'S PARC_§,L )JO. Al. DESIGNER r{Q ' STATE LICENSE 1
C/.c,. l>-.,(/ntulA',~IJ,/,!ii--("')f;,.,/1-1rJ7--r-'-'-In I 1 .... _,,/,n r
DESCRIPTION ~WORK /' • ii. ).0 r <I r1f'ft2. 0/:;, _'!!/ V~r"') I C)
)-,n ,,., / ,,...,.,... f f I' 1 J ('" 'j-JAL__.., olslGNER'S ADDRESS • oes1GNER's PHONE
v -J ..2.. I ::J"" Li-,o/v J.//t · E) 41/ J--9} ~0
CENSUS TRACT GP LANO USE ZONING I RES. UNITS I P ARKING SPACE / NUMBER OF STORIES
Not V•lid Unless ~chin, CMtifi«J
BLOG SQ, FT. BLOG USE occ. GP I STANDARD PLAN# I PLA'fj l#-,,;;23 I TYPE CONST l occ. LOAD I ,
QTY. PLUMBING PERMIT AMT. QTY. MECHANICAL PERMIT AMT.
EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100,000 BTU
EACH BUILDING SEWER OVER 100,000 BTU
EACH WATER HEATER ANO/OR VENT -!} . l)l:, BOILER/COMPRESSOR UP TO 3 HP ,
EACH GAS SYSTEM 1 TO 4 OUTLETS 7l -~ BOILER/COMPRESSOR 3-15 HP
EACH GAS SYSTEM 5 OR MORE BOILER/COMPRESSOR 16-30 HP
EACH INSTAL., ALTER, REPAIR WATER PIPE ")_. t,/v VENT FAN Sl~!GLE DUCT ~ (\ _ _ ..--.-, •_ , / 1 /) ,dl"';;JPo-
EACH LAWN SPRINKLER sYsTEM MECH EXHAUST -Hooo,oucTs \( ~ I , tJu -
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER BUlfolNG PERMIT / I I I ~r--o
\ >-. "-, , • ~ Ar, \ "-\,, l a ~ .~ sIGN PERMIT , • , 1 1
TOTAL PLUMBING TOTAL MECHANICAL PLAN CHECK I , 1 I /I ..,._
CONTRACTOR o/ . ~ CONTRACTOR ALL INCLUSIVE PERMIT I I I
TOTAL PLUMBING I I~./) IV
QTY. ELECTRICAL PERMIT AMT. QTY. MOBILE HOME PERMIT AMT. ELECTRICAL I l 7.-rll n
NEW CONST EA AMP/SWT/BKR _.:;-. /Y) AWNING MECHANICAL I I I
1 PH .25 3 PH PORCH MOBILE HOME I I I
EXIST BLDG EA AMP/SWT/BKR SET-UP SOLAR I I I I
1 PH .25 3 PH RAMADA, CABANA ~ "1r A -• -t--A,. ._ ~'t'v,,. I , I I • er"~
REMODEL/ALTER PER CIRCUIT FENCE OVER 6' ..._) I I I . I
TEMPPOLE 200AMPS TOTALMOBILEHOME MICO·FILM I , I I I
OVER 200 AMPS I , I I ; I
TE~P OCCUPANCY (30 DAYS) I I I I
,l\.).. .. o .!l fY"' 1 .11 I
TOTAL ELECTRICAL -1 I1----+---------------+------ll TOTAL FEES PAYABLE I
CONTRACTOR /, p'l) I I , I~ 5iz>
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT, AND DO "AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER
HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I 5'-0" DEEP AND DEMOLITION OR CONSTRUCTION OF C' _ ('\ __ ~ -::,-• A ,,f
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
BF'
! ~ ~
5 j:::
~ Q. Vl ~
OF THE GRANTING OF THIS PERMIT, V)~ICANTt SIGNATURE' OWNERQ CONTRACTOR□ !APPROVED BY DATE
-,,A J_ /7_...-~;,,./,'y\ AGENC¥ BYPHONEQ ./_.~/'/L-_.-/1}-d'lct
V 7 7
b-2(
I I I
•· .... -SITE . • 8'1 ,c.f} ADDRESS: -,.. OWNER: PERMIT NO: .. •---."r. • ;:-__ !L -. FIELD INSPECTION RECORD
INSPECTION DATE INSPECTOR INSPECTOR'S NOTES
WOOD FLOOR :
FOUNDATION• FORMS• SET BACK • TOILET • -~ . ... J.'., -UNDER FLOOR PLU_MBING -t -' ' . . .. .
UNDER FLOOR HEATING . -.-. . -~ OK TO INSTALL SUB FLOOR C . ..
' 'I-' . .. '
SLAB FLOOR I
UNDER SLAB PLUMBING
FOOTING• FORMS • SETBACK • TOILET 1
OK TO POUR CONCRETE ,,
FRAME
ROUGH ELECTRICAL
ROUGH PLUMBING
ROUGH HEATING/VENTILATING '.
FRAME OK• PLACE INSULATION ·,
INSUL ATION OK • PLACE WALLBOARD
WALLBOARD OK• PLACE TAPE -
EXTERIOR LATH OK• PLACE STUCCO ' , -
' ,. .,, -· i ·~· ~ '-.. . ' ~ FIREPLACE ,_ ' ~ ,;.. :
DAMPER &STEEL
PLATE Tl Es/HEIGHT OF CHIMNEY
OTHER
TEMP POWER (POL E) .
SEWER
GAS TEST
SWIM POOL • STEEL BONDING , . ..,· j
• PRE DECK
• FENCE PREPLASTER
SHOWN • FRAME
• PAN ' I ~ .
' FINAL INSP BY BLDG DEPT In I I /.
OTHER DEPT'S REQ COMPLETED '/1 ln /ki.,./
ELEC METER-PERM-TEMP / f Vf I
GAS METER-PERM-TEMP --......
\. ' .
CERT OF OCCUPANCY ISSUED I
...
DEL PflDIIE PDDLS
12120 INDUSTRY ROAD, LAKESIDE. CALIF. 92040
Phone: 443-9440 1/29/81
City of Carlsbad
1200 Elm Ave.
Carlsbad, Ca. 92008
Att: Tim Phillips
Mr. Phillips:
This is the certification sticker taken mirectly from a rolP of
PVC flexable pipe. This pipe was used on the spa at 2824
Unicornio St. We hope this meets with your approval. If not
please contact me at 443-9440.
Thank You, J .
~~
Denise Jermyn, Del Padre Pools
2 1°31
r;yy _OF CARLSBAD ~~ ~ C:nlding Department ~-~~
~~
INTERDEPARTMENTAL INFORMATION SHEET
' BUILDING DEPARTMENT ◄
dBJ:J UAJ,c/ruuAY DATE: RECEIVED
BUILDING ADDRESS:
JAN 20 1981
PLANNING DEPARTMENT
ZONE LOT SIZE LOT WIDTH ----------------------------
UNITS ALLOWED ___________ UNITS PROVIDED ____________ _
PARKING SPACES REQUIRED
% COVERAGE ALLOWED ----------==--~---
BU IL DING HEIGHT ALLOWED--,..-:::::...-------
FRONT SETBACK: SIDE SETBACK:
ALLOWED
PROVIDED -------f
pPfai)_
7
INTRUSIONS
LANDSCAPE & IRRIGATIO COMMENT
ENVIRONMENTAL PROTECTION REQ:
(OK TO ISSUE:
ENGINEERING DEPARTMENT Sf/3{?--_ u~ : 7f d'-tJ''
R.o.w. ______ INDUSTRIAL WASTE _______ IMPROVEMENTS _______ _
I
SEWER CONNECTION J=f)o s DRIVEWAY LOTN~
GRADING PERMIT _______ EASEMENTS~~ D~}!AGE __ ,.,__ __ _
LEGAL DESCRIPTION ~ .5/({ d.../.~-.,..._ fl'/-0 7 (ZL(;~i:f:.-U
f j
FIRE DEPARTMENT
SPRINKLING SYSTEM ___________ FIRE PROTECTION EQUIP. ______ ~
FIRE ALARJl!S EXITS ------------------' FIRE HYDRANTS LOCATION ________________ ----'
ADDITIONAL COMMENTS
;;:;\O ISSUE: DATE OK TO FINAL DATE ----------------------.,
WATER DEPARTMENT
REQUIREMENTS OF APPROPRIATE DISTRICTS MET ________ DATE ______ ___,