HomeMy WebLinkAbout1851 VALENCIA AVE; ; 80-624-O; 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 el•
feet.
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 Ille a signed state-
ment that he Is licensed pursuant to the provi•
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-
plicant for a permit subjects the applicant to a
civil penalty of not more than five hundred dollars
(SSOO).
DI, 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•
slons Code: The Contractor's License Law does
not apply to an owner of property who bullds 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-bullder wlll have the burden of proving that
he did not build or improve for the purpose of
sale).
'.JI, as owner ol 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 bullds 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, 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·
mil Is for one hundred dollars {S100) 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
t'ti Wor~ers' Compensation Laws of California.
NOTICE TO APPLICANT: If, after making this Cer•
tificatin>f Exemption, you should become subject
to the Workers' Compensation provisions of the
L,tor COde, you must forthwith comply with such
provlslonRnr 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 Codel.
~~-i~ /\ ..:ITY OF CARLSBAD-BUILDING DEPARTMENT
USE BALL POINT PEN ONLY APPLICATION & PERMIT
1200 ELM AVENUE (714) 438-5525
I I No;; ~S("' I I 7/ a.fh .Ari ;; J?:;•I: I ~I I I I I I I tR~T-1~ zc:p~e~
OWNER
f};~T/J;.~,'?J-IIP -
OWNER'S PHONE PRIME CONTRACTOR
/,£. 7:J.C/-79// /{,am/?-12 t1Jnrr-('/') In<
o'J!?}~~NG 7/li-f',,4f<1 cz,~~n (1,.4.,
CONTRACTOR'S ADDRESS
9.:WoY /5t> J( ) L Ii Ji: f' .71-0 I .r '2 Ll/'1
LO?H'BLOCK J SUBOIIA'/lj N ASS'ESSOR'S PARCEL NO. DESIGNER
I la✓-1 'tl/EPA,/J 'i ~Ot 2 ,'-I )5 00 I Kam/J-~ (~ 11sr C7o lA .. -
~
CRIPTi?ON F P,RK n . . A 1 nc. L , ?J ,";11 L '1 , IA) ;:,LU n_c frL1 LfJ 2 /? /5. DESIGNER'S ADDRESS
!JJ/1nc. .4RJ:14-JCJ9,j L<:I'~ 1 'v1.,:1""'17 -f{_,1Z.r.t'l 1 S4/HIF
CENSUS TRACT GP LANO US!: ,
foN(NG RES. 1UNITS
N. t~rJl.wl 1') Io .. ;).o -:71
APPLICANT TO FILL IN INFOR-o,
MATION WITHIN RED LINES.
SUS. LICENSE PERMIT NUMBER
~91"8% la-6J~-o STATE LICENSE
/1,/9~ --: ~~ 7.'_'.:
CONTRACTOR'S
PHONE_9 '9', rJ 7::l .,7 /.
\ t-.. ST ATE LICENSE
... ,,r;.IJ/'>1.i' i . J-
DESIGNER'S PHONE
r Gin-,f! I P;RKING SPACE SF I NUMBER OF STORIES
Not V•lid Unwss Machin• c.rtifi.t
BLOG SO. FT. BLDG USE occ. GP l STANDARD PLAN It I PLAN ID It I TYPE CONST I occ. LOAD I .-_
QTY. PLUMBING PERMIT AMT. QTY. MECHANICAL PERMIT AMT. Fpu,,.1 '
/t? EACH FIXTURE TRAP ~--L INSTALL FURN. DUCTS UP TD 100,000 BTU U.-
/ EACH BUILDING SEWER -
?--OVER 100,000 BTU
I EACH WATER HEATER AND/OR VENT ..::i .-BOILER/COMPRESSOR UP TO 3 HP
EACH GAS SYSTEM 1 TO 4 OUTLETS -BOILER/COMPRESSOR 3-15 HP
/ EACH GAS SYSTEM 5 OR MORE ~ So BOILER/COMPRESSOR 16-30 HP
EACH INSTAL., ALTER, REPAIR WATER PIPE L VENT FAN SINGLE DUCT ....:z.-J>ftJ?t; VALUATION: -EACH LAWN SPRINKLER SYSTEM MECH EXHAUST -HOOD/DUCTS
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER BUILDING PERMIT I , ii:'( le) .J 1 -t-Issue j_. U l issue 3 .. 00 SIGN PERMIT ,nl_ I , I I I TOTAL PLUMBING J~•S-c) TOTAL MECHANICAL 9,-:-PLAN CHECKfj(,,,°;J) b I l.f-S-7) I I ls~l/q .
CONTRACTOR CONTRACTOR ALLINCLUSl~T I I J'
ELECTRICAL PERMIT AMT. TOTAL PLUMBING I J,<.d J..) P QTY. AMT. QTY. MOBILE HOME PERMIT ELECTRICAL J l.2 -7..f -t-
NEW CONST EA AMP/SWT/BKR JS-.-AWNING MECHANICAL I I q.,J=:.-
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 I I I I
REMODEL/ALTER PER CIRCUIT FENCE OVER 6' I I I . I
TEMP POLE 200 AMPS TOTAL MOBILE HOME MICO -f I LM l I I I
OVER 200 AMPS I . I I ; I
TEMP OCCUPANCY (30 DAYS) STRONG MOTION: I . I I <~. J1 i Issue 2.00 I I I I I
TOTAL ELECTRICAL J.. 7, t>C,
TOTAL FEES PAYABLE I I ~ J> V /-6). CONTRACTOR I --SCHOOL FEES: -
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION ANO PERMIT, ANO DO •AN OSHA PERMIT IS REQUIRED FOR E;~CAC OVE/
HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE ANO CORRECT ANO I 5'-0" DEEP ANO DEMOLITION OR CONS C N C F
FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED; TO COMPLY WITH ALL CITY, STRUCTURES OVER ~ ~ -.. r'/
COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER
SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY ANO~ HARM• ~_.~ ~ / ----4/4, LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, ~ EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONN7EQUEN ' .... ~
OF THE GRANTING OF THIS PERMIT. '
/S SIGrURE° r ---=> • ::~ER~
CONTRA~TQ~APPR..,__o.,.,.. -_,
! I-~ ~
~ ~ u w 0.. V) ~
' ~ ./\. ...
SITE ,.
ADDRESS: ,, OWNER: . ' -'PERMIT NO: S<:h-i,.., s{,,4-; . '
-. FIELD INSPECTION RECORD -
INSPECTION DATE INSPECTOR INSPECTOR'S NOTES
WOOD FLOOR H Fv--1<-Gt!nuJD o.v 4-tt-eu /Ju-· FOUNDATION • FORMS • SET BACK • TOILET l~_((,f,,Z,. C
/\:
. 7/ \
UNDER FLOOR PLUMBING ,14-,'lm. '. . _. -!J,, .. ·-f
~ . ' ~ .._ ·:_-~--
UNDER FLOOR HEATING -.. . ' OK TO INSTALL SUB FLOOR ~ ~. --
' '
,_ ,. ..
-· . ? -.
SLAB FLOOR
UNDER SLAB PLUMBING
FOOTING• FORMS• SETBACK • TOILET
OK TO POUR CONCRETE .. ~.,~ G:H-
~I
FRAME
ROUGH ELECTRICAL .
ROUGH PLUMBING ..
ROUGH HEATING/VENTILATING
FRAME OK• PLACE INSULATION
INSULATION OK• PLACE WALLBOARD r
WALLBOARD OK• PLACE T AP-E
EXTERIOR LATH OK• PLACE STUCCO .
FIREPLACE ,,;-.
DAMPER 8: STEEL 1· -
PLATE Tl Es/HEIGHT OF CHIMNEY
'
OTHER
T EMP POWER (POLE)
SEWER
GAS TEST ,.
SWIM POOL • STEEL BONDING
• PRE DECK
• FENCE PREPLASTER
SHOWN • FRAME ""\
• PAN . v, .,)
FINAL INSP BY BLDG DEPT <'A..._\~V IIJ ,I ,ftlfl ($ .
OTHER DEPT'S REQ COMPLETED \ ,, --~
ELEC METER-PERM-TEMP .. -
GAS METER-PERM-TEMP 1
. . -.. .. ---t
.. ::.,_.,-~. ·-
CERT OF OCCUPANCY ISSUED • \ . ~
-