HomeMy WebLinkAbout2653 VANCOUVER ST; ; 84-496; Permitvif
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O I hereby affirm that I am licensed under
provisions of Chapter 9 (commencing with
S.Ctlon 7000) of Division 3 of the Business
and Professions Code, and my license is In
full force and effect.
t,c No ______ Clm
I hereby affirm that I am exempl lrom lhe Conlrac♦
tof's Lteense Law lor lhe loUowing reason (Sec 7031 5 Business and Pfoless,ons Code Any city or county which re· quires a perrntl to construe!. atter improve, demohsh. or repair any structure. pnor to ,ts issuance also requires ?heap·
phcan1 fOf sut:h permit to hie a si9ned stateme:nl that he ,s licensed pursuant to lhe prov1st0ns of Ille Con1rac10( s
L1tense law (Chapter 9 commencing with Sect10n 7000 ot 0iv1s1on 3 ol the Business and Proiess10ns Code) or thal 1s ex·
empt therelrom and the basis fOf lhe a11egeo e.xemphon Any vt0ta11on ot Section 7031.5 by an apphcan1 lor a perm11 suo•
iec1s the applicant to a CIVIi penalty ol nol more than r,ve hun·
dred dollars ($500}
I, as owner of the property, or my employees w11h wages
as their sole compensation. will do !he wotk, and the slruc·
ture is not intended °' offered lor sale (Sec 7044 Business
and Prolesst0ns Code The Contractor's bcense Law does not apply to an owner of property who builds or improves
thereon and who does such work h1mseU or through his own
employees, provided lhat such Improvemen1s are no1 intend· ed or oflered for sale If, however. !he building or improve-
ment 1s sold wIlhm one year ot completion. lhe owner-builder will have the burden proving lhal he did not build or Im-
proviil the t sate) ~
fJ/ r f#operty. am exclusively contrachng ~ ns co~ra ors lo construct the pro1ec1 (Sec 7044, Busmess and Proless1ons Code· The Contrac1or·s license
Law does not apply to an owner o! property who builds or 1m• proves thereon, and who contracts for each protects with a contractOf(S) hcense pursuanl to lhe Contractor's license Law}
C1 As a homeowner I am ,mpr01Jmg my home. and the follow mg cond111ons exist
t The work is being performed prior 10 sale 2 I have lived m my home lor twelve months
prior to completion of !his work 3 I have not claimed 111,s exemp1Ion dunng the
last three years
0 I am exemp1 under Sec _____ _ for this reason B&PC
-------------
D I hereby affirm lha1 I ha"e a cer1,t1ca1e ol consent
10 self insure, or a cemt1ca1e ol Workers Compensation Insurance. or a cert1tred copy !hereof
!Sec 3800 UbOf Code}
POLICY NO
COMPANY
□ Copy IS hied With !he City
0 Cert1t1eo copy ,s heret>y turn,sl'leo
CERTIFICATl OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE
(This section need not t>e compIeIeo 11 lhe perm11
,s tor one hundred <Jollars 1s1001 Of less)
D I certify lhal ,n the performance ot !he wor'k tor
•h1Ch lhlS permit IS ,ssuea. I shall not employ dO) pe,son in any manner so as 10 become subIect 1v
!he Wor'll.ers· CompenS.Jtton Laws ot Calllorn,a
NOTICE TO APPLICANT II at1e1 makm3 lh1S Cer,1
hcate of Exemp11on. you shoolel t>eeome subJect I? lhe Workers Compens.a11on provisions of Ine Labor
Cooe you must forth-... 111, comply w1tri socn
orov1s1ons or this permit shall be deemed re ... 011.eo
O I nereby atlum that !here 1s a consirucllon
1enchng agency tor the pertorrnance ot lhe w(){); to,
which 1h15 perm1I •S ISSue<J 1Sec. 3097 C1v1J Cooe1
Lenders Name ___________ _
Lenders Address __________ _
USE BALL POINT PEN ONLY & PRE~S HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT 1200 Elm, Carlsbad. California 92008·1989 (619) 438-5525
,oa AODRESS AV. ST. RO. NEAREST CROSS ST. l01~?ll1
~
BUSINESS LICENSE d VALUATION PERMIT NUMBER
~GS3 VftlVC.OU VER sr, CONCOR() V oOO gv-~rt LOT I BLOCK I SU801 VISION I ASSESro.; .l?f'Ei~ ~ 0 ~ 0 u CONTRACTOR CONTRACTORS PHONE • ZONE
('J.8 OWNER'S NAME l . OWNER'S PHONE
fl#Tf/0/J y T, SVR~ Y CONTRACTOR'S ADORESS LICENSE NO. PLAN 1.0. # BLDG use CODE
OWNER'S MAILINGAOORESS
S!tME AS 4801/F: OESIGNER LICENSE :r STANOAAO PLAN# BUILDING SO. FOOTAGE
OESCR ,PT10N OF WORK R I]/ I () P1+ 1lt2 LQ/LFP OESIGNER'S ADDRESS DESIGNER'S PHONE --1
,____ F, p FLR ELEV. NO OCC GP EDU 9/Eo/bl.,:H:jpU g4.J5 STORIES
vO NO --IWDt3B6ll. !.:i/cb/ Ali ~Li • ')f
CENSUS TRACT I GP LANO USE l PARKING SPACE I RES UN ITS l GRADING PERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAO FIRESPR AREA CONST
YO ND vO "'□ vO NO Not Valid Unless Machine Certified
QTY. PLUMBING PERMIT -ISSUE ?,Sa QTY. MECHANICAL PERMIT -ISSUE tf,IN SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP INSTALL FURN DUCTS UP TO 100.000 BTU BUILDING PERMIT 01 ·00-00-8220 -...,~,.,.17:JrJ
-EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT 01 ·00-00-8221
EACH WATER HEATER AND,OR VENT BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01 ·00·00-8806 'J.C... n C:::.~
-
EACH GAS SYSTEM 1 TO 4 OUTLETS l 80 I LE R /COMPRESSOR 3 15 HP TOTAL PLUMBING 01 ·00-00-8222
EACH GAS SYSTE M 5 OR MORE METAL FIREPLACE ELECTRICAL 01 ·00·00·8223
EACH INSTAl . ALTER. REPA IR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01·00·00·8224 ---EACH VACUUM BREAKER MECH EXHAUST HOOD DUCTS MOBILEHOME 01 ·00·00·8225
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP
EACH ROOF CRAIN (INSIDE> SOLAR 01-00-00-A??~
TOT t;L MECHANICAL STRONG MOTION 80·92-33-0519 r:::..n ~ -
TO [ AL Pl UMBING I FIRE SPRINKLERS 01 ·00-00-8227 -SOLAR • ISSUE PUBLIC FACILITIES FEE 32·00·00·89lJ QTY. ELECTRICAL PERMIT· ISSUE .j,dd QTY.
BRIDGE FEE
NEW CONST EA AMP SWT BKR COLLECTOR5 SCHOOL FEE • DISTRICT
1 PH 3 PH STORAGE TANKS Carlsbad 80·92·21·0519
EXIST BLOG EA AMP SWT BKR ' ROCK STORAGE Encinitas 80·92-22-0519
1 PH 3 PH PUMP San D1eguilo 80·92-23-0519
RE MOOE L AL Tt R PER CIRCUIT PLAN CHECK FEE San Marcos 80·92-24-0519
TEMP POLE 200 AMPS
OVER 200 AMPS LICENSE TAX 01-00-00-8162
TEMP OCCUPANCY 130 DAYS) MFF 80-92-57-0519
CREDIT DEPOSIT
TOTAL ELELTRICAL I TOTAL SOLAR TOTAL FEES PAYABLE I L,4 ~.I
Expiratton £very permtl issued by the Bu,ldmg Ofhc1eI under the prov,s,ons ot tn,s
.
I HAVE CAREFULLY EXAMINED THE COMPLETED 'APPLICATION ANO PERMIT' ANO DO HEREBY * AN OSHA PEAM:T IS REQUIRED FOR EXCAVATIONS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall expire by hm1tahon and become ntJII and void If the bu,Id1ng or work 5' o· DEEP ANO DEMOLITION OR CONSTRUCTION OF
DECLARATIONS ARE TRUE ANO CORRECT AND, FURTHER CERTIFY AND AGREE IF A PERMIT IS authorized by such permit ,snot commenced w1th1n 180 days from the da1eof such STRUCT\JRES OVER 3 STORIES IN HEIGHT
ISSUED TO COMPLY WITH ALL CITY COUNl Y ANO STATE LAWS GOVERNING BUILDING CON ~~~::On~ 1
~t t~~v ~~~1:Pt.i~h=~,:~~h~~~~eil~~~~ r~~~'~,s~:r:.~~ or
STRUCTION WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND ~~ u CONTRACTOR 0 APPROVED BY DATE KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS. COSTS AND A PLI rl ~RE f OWNER~
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE • /, ~ BY PHONE 0 CT.c..e-/ I _g_ -~~--.. <zif GRANTING OF THIS PERMIT. ,-r __.
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TYPE ' I DATE INSPECTOR
BUILDING I fi..tM...-I 8'Y-4C,Je, .
FOUNDATION ' .
l FIELD INSPECTION RECORD
REINFORCED STEEL I
MASONRY '
I
GUNITE OR GROUT I
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTION REQ IF INSPECTORS DATE CHECKED APPROVAL
FLOOR & CEILING SUB FRAME I SOILS COMPLIANCE SHEATHING □ ROOF □ SHE!AR PRIOR TO
FRAME .
I
EXTERIOR LATH I
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
INSULATION I
INTERIOR LATH & DRYWALL l
PRESTRESSED
CONCRETE
POST TENSIONED
I CONCRETE
PLUMBING 1 FIELD WELDING
SEWER AND BUCO □IPUCO I
UNDERGROUND □ WASTE □ WATER
HIGH STRENGTH
BOLTS
TOP OUT □ WASTE □ W~TER SPECIAL MASONRY
TUB AND SHOWER PAN I
GAS TEST I PILES C.AISSONS
□ WATER HEATER □ SOLAR WAlfER
1
ELECTRICAL I
□ ELECTRIC UNDERGROUND □ liJFFER ~· .
ROUGH ELECTRIC I
□ ELECTRIC SERVICE □ TEMPOFJ!ARY . --□ BONDING □ POOL I ., ' .
I
MECHANICAL I
□ DUCT & PLEM., □ REF. PIPINp
HEAT -AIR COND. SYSTEMS I
VENTILATING SYSTEMS I
I
CALL FOR FINAL INSPECT~N WHEN ALL APPROPRIATE
ITEMS ABOVE HAV BEEN APPROVED.
~ -
FINAL I ,
PLUMBING I
I
ELECTRICAL I --
MECHANICAL I
GAS I .
BUILDING ' 10-(114 ~ I
. '•
SPECIAL CONDITIONS 1
' 1
. ' t .. ,
PLANNING: TYPE OF STRUCTURE. _____________ _ ZONE :
SCHOOL FEES: SAN DIEGUITO -----+-----
CARLSBAD ----~-+--
% COVERAGE ---------+-~--+---+--
BU IL DING HEIGHT -----tt--t---+--~----
FENCES/WALLS -----~-1-----
------
ENCINITAS ------,---
SAN MARCOS
----t--~---
R E QUIRED
FRONT -""t"t-H"""'==:::::=--....____
SIDE
--~"7--1-------
-TWO CAR GARAGE REAR 0:::
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---------------------
;: ~ COMMENTS : ____________________________ _
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REDEVELOP~1ENT APPROVAL REQUIRED: __ ----=-----___________ _
LANDSCAPE PLAN COMMENTS:
ENVIRONMENTAL REQUI REQ.;;...: -----+-=---+--------------
OK TO FINAL: DATE: -~------------
* * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * *
ENGINEERING LEGAL DESCRIPTION VERIFIED? ____ A.P .N. CHECKED? __
P.F.F. PARK IN LIEU --------------------------
R.O.W: IMPROVEMENTS:
________________ E.D.U: _____________ _
SE~IER:
LATERAL: DRIVEWAY:
GRADING PERMIT:
DRAINAGE:
EASEMENTS : ADDITIONAL COMMENTS :
OK TO ISSUE : DATE:
* ENGINEERING INSPECTION REQUIRED: __________________ _
PUBLIC ~IQRKS INSPECTOR: _____________________ _
FINAL OK : -------------DATE : ---------------
* IF THI S ITEM rs NOT CHECKED , BUILDING DEPARTMENT WILL MAKE ALL INSPECTIONS
(DRIVEWAYS, CURB CUT, DRAINAGE, ETC.)
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