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1 USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
~ hereby affirm that I am licensed under
1
-CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT
1200 Elm, Carlsbad, California 92008-1989 (619) 438-5525 provtatona of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Profeeslona Code, and my license is In
full force ~qd e9ec~ n ~ lie No 4 1 Class ~
I hereby attirm that I am exempt trom the Contrac-tor's License Law tor the tottow1ng reason (Sec 7031 5
Busine-ss and Professoos Code Any city Of county which re-quires a permit to construct. aller, improve. demolish, 01 repair any structure, pnor to its issuance also requires !heap-
plicant lor such oerm1t to ti~ a signed statement lhat he is hcensed pursuant lo the p<CMSJOOS of the Contractor" s License Law (Chapter 9 commencing with Sect1011 7000 of
Dlvis,on 3 o1 the Business and PrOfessJOns COde) °' !hat 1s ex· empt therefrom and the basis tor the allegeo exemphon Any
vlOlation ot Section 7031.5 by an applicant tor a permI1 sub· 1ects lhe applicanl to a civil penalty ot not more than hve hun-dre<l dollars ($500).
0 I, as owner of the property, or my employees with wages as lheIr sate compensa110n. will do the w01k. and the struc-
ture is not intended or o11ered lor sale (Sec. 7044, Bus,ness
and Profess10ns Codt The Con1ractor's Ucense law does not apply 10 an owner DI p,openy who bu1kls or 1rnp,oves
thereon and who does such work rumseff °' through his own
employees. provided that such 1mpr0Yeff'lents are not intend· ed or ottered tor sale. II, however. lhe bu1k1ing or imp,ove-ment is sold within one year of completion, the owner-builder WIii have the burden of prOYlng lhal he did not build 0( im-
prove tor lhe pur-of sale).
D I, as owner of lhe p,operly, am exctustVOly contracting
wllh Hcensed con1rac10<s 10 cons1rucl the p<IJIOCl (Sec. 7044, Bustness and PfofesslOOs Code. The ContractOJ's License Law doeS not apply to an owner of p,operly who bu1kls or Im·
proves thereon. and who contracts for each projects wilh a contractor(s} license pursuant to the Con1rac1or·s Lteense Law).
D As a '1omeowner I am imp,oving my home, and the lollow· Ing conditions exist
1. The work is being perlormed pr,or 10 sale. 2. I have lived in my home l0< twelve monlhs
prior to cornplet,on of lhis work. 3. I have not claimed this exemption during the last three years.
D lamexernptunderSec. ______ , B&P.C. for lhis reason
L,et,y affirm lhal I na;,e • cert1hcate ol consent
to self-insure, or a cer11t1cale of Workers
Compensatl()n Insurance, or a cert,t1ed copy thereol
(Sec 3800. Lal)()< Code)
POLICY NO WP 233-02-48
coy(>ANY Fireman's Fund ~ Copy 1$ filed Wllh the C11'y
0 Cert1hed copy ,s hereby furnished
CERTIFICATl OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE
(This ~chon need not be compleled 11 the perm,1
1.s to, one hundred Oollars (S 100) o, ~ss)
I cert1ty lhat 1n the performance of the w~ lor
Which this permit ,s issued. I shall not employ any
person 1n any manner so as to beeome sub1ec1 to
tne Wor1'.ers· Compensatt0n Laws of Cahtom1a
NOTICE TO APPLICANT It. at1e1 mak1n~ this Cef11
hcate ol Exempll()fl you should t>ec:ome sub1ec1 I?
the wonc:ers' Compensahon prov,s,ons of 1ne ut>or Code. you must f0f"lh1111,1th comply w11n such
prov1s1ons or 1h15 pecmll sMII be oeemed revoked
I hereby afl11m 1na1 !here 1s a construction
1enchng aoency tor the perlo,mance ot 1he woni:. 10,
which ttus permit ,s issued ISec 3097 C1v1I Cooel
Len<le, s Nam.Crocker Bank
Lender s Address
JOB ADORESS AV ST. RO. NEAREST CROSS ST.
I
OATE OF APPLICATION'! BUSINESS LICENSE # VALUATION PERMIT NUMBER
2679 Vancouver Street 11-7-83 3681 80716
LOT BLOC~)iSUB01v,s10N J ASSESSOR PARCEL NO. CONTRACTOR CONTRACTORS PHO"IE • ZONE
15 C> Soinnaker Pt. I ,., 7 4--\-, 2> 4'00 Standard Pacific of San Diego 279-2042 83-83-15
OW"IER'S NAME I OWNER'S PHONE
Standard Pacific of San Diego 279-2042 CONTRACTOR'S ADDRESS LICENSE NO PLAN 1.0. # BLOG use CODE
(same) 294215 OWNER'S MA•L,NG AOD,.ESS
7290 Clairemont Mesa Blvd., San Diego, CA 92111 OEStGNER LICENSE • STAN DARO PLAN# BUILDING SO. FOOTAGE
Buzard-Henning & Associates NR
DESCRIPTION OF WORK 1583
DESIGNE,..S ADDRESS DESIGNER'S PHONE
Single-family dwelling-attached garage 4883 Ronson Ct., San Diego 921 11 278-6855
--~---4 ----. ----F/P F LR ELEV. NO OCCGP EDU
Plan 330 vO NO --
STOflES R-3 1 _1,.11 .1~/~~~~ . Ll(;l3~uE
CENSUS TRACT I GP LANO USE I PARKl~~:ACE RES ~NITS I GRADING PERMIT ISSUED I REOEVELOPMENT TYPE OCC LOAO FIRESPR
AREA CONSVN
vO Nd v □ ND vO Ne Not Valid Unlt!rs Machine Cerrdi~
QTY. PLUMBING PERMIT· ISSUE ~~ QTY. MECHANICAL PERMIT · ISSUE 3-SUMMARY/ACCOUNT NUMBER
10 EACH FIXTURE TRAP 7 -25,00 1 INSTALL FURN. DUCTS UP TO 100.000 BTU 4. u_u BUILDING PERMIT 01·00·00·8220 17F..M
1 EACH BUILDING SEWER 6.50 OVER 100,000 BTU SIGN PERMIT 01·00-00-8221
1 EACH WATER HEATER ANO/OR VENT 2.50 BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01 ·00-00-8806 ?l,t:. ~c;
1 EACH GAS SYSTEM I TO 4 OUTLETS 2.50 BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING 01 ·00·00-8222 I. I. r,r,
EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE .. ELECTRICAL 01·00-00-8223 30.00
EACH INSTAl . ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01 ·00·00· 8224 7. 00
EACH VACUUM BREAKER MECHE XHAUST -HOOD/DUCTS M0BILEH0ME 01 ·00·0Q·8225
WATER S0FTNER RELOCATION OF EA FURNACE/HEATER M0BILEH0ME PARK INSP
EACH ROOF DRAIN (INSIDE) SOLAR n1 .nn.nn.oooc
TOTJ;L MECHANICAL STRONG MOTION 80·92-33-0519 5.65
TOTAL PLUMBING I 44~UU 7.00 FIRE SPRINKLERS 01 ·00-00-8227
QTY. ELECTRICAL PERMIT· ISSUE s-QTY. SOLAR • ISSUE
PUBLIC FACILITIES FEE 32·00·00-8933
BRIDGE FEE
NEW CONST EA AMP/SWT BK R 100 Z.':>.00 COLLECTORS -------..._, ~ SCHOOL FEE • DISTRICT
I PH 3 PH STORAGE TANKS ~ \ .\ Carlsbad 80·92-21-0519
EXIST BLOG EA AMP/SWT rBKR ROCK STORAGE / r , ./ Encinitas 80·92-22-0519
l PH 3 PH PUMP / of J San Dieguito 80-92-23·0519
REM00EL'ALTER PER CIRCUIT PLAN CHECK FEE I t\ vv K ' /. San Marcos 80·92-24-0519
TEMP POLE 200 AMPS I \../ l"j-/
OVER 200 AMPS u ✓ I / LICENSE TAX 01-00-00-8162
TEMP OCCUPANCY 130 DAYS) . ./ i " "-_..,,...-CREDIT DEPOSIT ,zz.3.55/
TOTAL ELECTRICAL l 30.00 TOTAL SOLAR TOTAL FEES PAYABLE I 465.45 .
I HAVE CAREFULLY EXAMINED THE COMPLETED '·APPLICATION ANO PERMIT. ANO DO HEREBY ExporallOn. Every permtl -by "'88uildlng0tfictal under Ille P,OVISlonl oflllts * AN~ PEMIIT IS flEQUIIIED FOR EXCAVATIONS OVER
CERTIFY UNDER PENALTY OF PER,JURY THAT ALL INFORMATION HEREON INCLUDING THE Code -I expire by limt1a1lon and become ntJII -VOid II the building ot wOf1t S' 0" DEEP AND DEM0UT10N Ofl CONSTIIUCTION Of'
DECLARATIONS ARE TRUE ANO CORRECT ANO I FURTHER CERTIFY ANO AGREE IF A PERMIT 1$ aulhor,zad by such permit ,a not commenced within IBO days kom tl>e date ol sucl'l STIIUCT\IAES OVER 3 STORIES IN HEIGHT permit. or ,f the 1>u1I01~or work authonncl by such permit ·••~• ded or ISSUED. TO COMPlY WfTH ALL CITY; COUNl'I' ANO STATE LAWS GOVERNING BUILDING CON· abanclOned al anv h...._ Ille worll 19 COflllll9IICed for a ....,.,.. ~-·
STRUCTION. WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND
APPl.lCANAN7£'S SI I~-OWNERB"' CONTRACTOR 0 APPROVED BY It-OA~/J,b KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS. COSTS AND
EXPEl'ISES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY lN CONSEQUENCE OF THE
A ~...._""" BY PHONE 0
I //4 GRANTING OF THIS PERMIT -> , .,,.. . ,_. ..-T . . LJ "T
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TYPE I
BUILDING I
OUNDATION ' I ...
EINFORCED STEEL ! /
IASONfiY !
iUNITE OR GROUT !
I
LOOR & CEILING SUB FRAME I
.
F
R
M
G
F
s
F
HEATHING D ROOF D SHF.AR
' RAME I
EXTERIOR LATH ' ' INSULATION I' \
INTERIOR LATH & DRYWALL ; L
I
PLUMBING I
SEWER AND BUCO DIPUCO I
_I
UNDERGROUND D WASTE D WATER
TOP OUT D WASTE D WATER
TUB AND SHOWER PAN I
I
GAS TEST I
D WATER HEATER D SOLAR W~TER :
ELECTRICAL I
D ELECTRIC UNDERGROUND □iUFFER
ROUGH ELECTRIC I
j
D ELECTRIC SERVICE D TEMPORARY
D BONDING D POOL I
I
MECHANICAL I
D DUCT & PLEM., D REF. PIPlt,JG
HEAT -AIR COND. SYSTEMS I
VENTILATING SYSTEMS \
' I
DATE INSPECTOR
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I~ ,5-~ Y~)
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2 -~-~ ~J
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t? 1 \.£:: .~ ~
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE BEEN APPROVED.
FINAL I
PLUMBING !
_I
ELECTRICAL I IML.t---
MECHANICAL I ...-:1'1c-.,.,_ 11~-/ ~~
GAS I & 1/~I'/ r\ A <..K Y I
BUILDING I ·z ,. ~-\ \ .-
SPECIAL CONDITIONS ' I
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·. ; . .
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES . --.
REQ IF INSPECTORS INSPECTION CHECKED APPROVAL DATE
SOILS COMPLIANCE <..
PRIOR TO
rOUNDATION INSP
STRUCl URAL CONCRETE
OVER 2000 PSI
PRES TRESSED
CONCRETE
POST TENSIONED
CONCRETE
FIELD WELDING
HIGH STRENGTH
BOLTS
C SPECIAL MASONRY I .
PILES CAISSONS
.
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