HomeMy WebLinkAbout2612 VIA BOCAS; ; 84-582-487; PermitCII z
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O I hereby alllrm that I am licensed under
provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Professions Code, and my license is in
full force and effect.
lie No ______ Ci,ss
I hereby afhrm that I am exempl from !he Contrac·
tor's License Law fOf !he fot:owmg reason (Sec 7031 5 Busmess and Professions COde Any city or county which re-Quires a permII to construct, aiter. rmorove, demohsh. 01 repair any s1ruclure pnor 10 IIs issuance also reQuires ?heap-phcan1 for such permit 10 hie a signed statement that he 1s
licensed pursuant 10 !he prov1s1ons at the contractor· s License Law (Chapter 9 commencmg with SecI1on 7000 ot Oav1s10n 3 of !he Business and Professions Cade) or that ts ex-
empt therefrom and lhe basis tor the allegeo exemption Ariy vM>lahon of Sec11on 7031.5 oy an applicant for a permit sub-
1ects the apphcan1 to a c1v11 penally of nol more than hve hun-
dred dollars 1$500)
1. as owner of lhe property or my empJoyees with wages as their sole compensallon. w1U do lhe work, anc the strut· lure Is nol mlended or offered for sale (Sec 7044. Business
and Protesst0ns Code The Contractor's license law does
not apply to an owner ot property who builds or improves
thereon and who does such work himself or through his own
employees. provided that such improvemen1s are not intend· ed or offered tor sale If, however. the bu11dmg or improve-
ment is sold within one year of completion, lhe owner-builder will have !he burden of proving that he did nol build or 1m• prove tor !he purpose o1 sale).
C I. as owner of the property, am exclusively contractmg w11h licensed conlractors 10 cons1ruc1 the proiect {Sec. 7044
Business and Protess.ons Code The Contractor's license Law does not apply to an owner of property who butlds or ,m-
proves !hereon. and who contracts lor each protects wilh a contractCN"(s) 11cense pursuant to the Conlractor's license Law)
LI As a homeowner I am ,mprovmg my home. and the lonow mg ctJndn10ns ex1sl
1 The work lS being performed prior to sale 2 I have lived rn my home for twelve months prior to complellOf'I of lh1s work 3 I have not claimed this exemphOn during lhe last three years
D I am exempt under Sec ______ . 8 & P C tor lh,s reason
D I hereby affirm 1ha1 I ha,,.e a cert1l,ca1e ol consent
10 self insure or a cemt1ca1e ot Workers Compensallon Insurance. or a cer1,f1ed copy !hereof
(Sec 3800 Labo< Godel
POLICY NO
COMPANY
□ Copy IS hied wI1h the c,ry
0 Cet11hed copy Is hereoy furnished
CERTIFICATl OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE
(This section neeo not De completea ii lhe permit
Is tor one hun<!red dOlla,s ($100) or 1ess1
0 I cen,ty thal In the perto,mance 01 the work 1or wh1cf'I 1h1s perm,1 1s ,ssued I shall no1 emptoy any
person In any manner so as to become sutnec1 10
!he Workers· Compensa11on Laws of Cahlorn1a
NOTICE TO APPLICANT It after mak1n1 this Cert,
t1cate ot Exemp11on you shoul<J become subIect l'J the Wonters Compensatton provisions of lhe LabOr
Code you mus! tonn .... 1lh comply w11h such
provIsIons or !his permit shall be oeemeo ,e,,,011eo
0 1 hereby alhrm thal there Is a construc11on rending agency 10, the performance ot !he w0f1,. to,
wh1Ch lh•S perm,! tS issued ISeC )(Y37 C1\11I COOe
Lenaer s Name ___________ _
Lenders Aoo,ess __________ _
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USE BALL POINT PEN ONLY & PRESS HARO APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT
1200 Elm, Carlsbad, California 92008-1989 (619) 438-5525
JOB ADDRESS
V;a.,..J3oCA-S
AV ST RO. NEAREST CROSS ST I j:E; :ppg ~ONI
BUSINESS LICENSE d VALUATION PERMIT NUMBER
/)..&,/~ •r 7904c3 fj(f-.56::J-
zJ~I BLOCK I suBDrq1s10N I ASSESSOR PA4EL NO .., o u CONTRACTOR CONTRACTORS PHONE• ZONE 487 7 -d-5 / 187 I :l I
OWNER'S NAME I OWNER'S PHONE f
-rh e )-f, 4/.i !OA1cJ. L€) CONTRACTOR"S ADORESS LICENSE NO PLAN I.D. 41 BLDG USE CODE
I '. ' OWNERS MAIL NG ADURESS ' r
... DESIGNER ~ LICENSE a STANDARD PLAN d BUILDING SO. FOOTAGE .... ,,-., •' ' -r . ~I._) /7bCJ DESCRIPTJON OF WORK J' • -.... ..._ : ,c-, ~ ( r ,.,, DESIG-NER'S ADDRESS DESIGNER'S PHONE L !.i ... lL ......... ,
I ,J 1 -. '--~-;
,-. F1P FLRELEV. NO OCC GP EDU
STORIES
vO NO ---
CENSUS TRACT I GP L AND USE 1 P41;p;CE RES UNITS J GRADING PERMIT rSSUED
t
·REDE,VEi-OPMENT TYPE OCC LOAD Fl RE SPR 'AREA CONST
YO N D YO ... o vO NO Not Valid Unless Machine Certrhed
QTY. PLUMBING PERMIT· ISSUE ·-QTY. MECMANICAL PERMIT· ISSUE SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP .iJ INSTALL FURN DUCTS iJP tQ.J:iiqllll0 BTU .4--BUILDING PERMIT . 01·00·00-8220 --'"I" 7--! -EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT 01 ·00·00·8221
EACH WATER HEATER ANO OR VENT ~ .. tn B0ILER/COMP.RESS0R UP T(l 3 HP PLAN CHECK 4 ,r -01-00·00·8806 --'4...J. ._..;
EACH GAS SYSTEM l fO 4 OUTLETS I . :_ SC BOILER/COMPRESSOR 3 15 HP ... TOTAL PLUMBING 01 ·00·00·8222 ..::,.;.'., «::-",-. ... ~
EACH GAS SYSTEM 5 OR MORE j METAL FIREPLACE
.. .. -ELECTRICAL 01 ·00·00·8223 ~ __,,# ..
EACH INSTA~. ALTER. REPAIR WATER PIPE -VENT FAN SINGL__§ 0,UCT , .. /'_ ·-::.~ MECHANICAL 01·00·00·8224 ,, ' _.) ··•
EACH VACUUM BREAKER I MECH EXHAUST H0'.00:0iJCTS, MOBILEH0ME 01 ·00-00-8225
WATER S0FTNER RELOCATIQ~(Of fA ~4f\N.~~EIHEATER MOBILEH0ME PARK INSP
EACH ROOF DRAIN I ,NSI0EJ ~ • ~ t·'. #
SOLAR 01 ·00·00·.B126...
TOTJ;l MECHANICAL . , ;.i • STRONG MOTION 80·92·33-0519 ~ ..:.~ -' ( .. ,-....
+(,, .~") -'\1 .• . ~---, _ _._ ~ ~
TOTAL PLUMBING I ••' ,.. ... ~ --FIRE SPRINi<LERS 01 ·00·00·8227 ,--
p"• . r~ .; ·-.. PUBLIC FACILITIES FEE 32·00·00-89ll ,-.
QTY. ELECTRICAL PERMIT -ISSUE I -QTY. SOU~R -ISSUE ·.·,'-. ' ... ,._ BRIDGE FEE
NEW CONST EA AMP SWT BKR 15 -COLLECTORS ., '. SCHOOL FEE • DISTRICT , fr
I PH 3 PH STORAGE TANKS Carlsbad 80·92·21-0519
EXIST BLOG EA AMP SWT BKR ROCK STORAGE Encinitas 80·92· 22·0519
I PH 3 PH PUMP San 0iegu1to 80·92·23-0519
REMODE L AL HR PER CIRCUIT PLAN CHECK FEE San Marcos 80·92· 24-0519
TEMP POLE 700 AMPS -OVER 200 AMPS LICENSE TAX 01-00-00-8162 ~ -{ ~ ~
TEMP OCCUPANCY 130 DAYSI MFF 80-92-57-0519 1--,,., ; ( --·
CREDIT DEPOSIT
TOTAL ELELTRICAL I ' TOTAL SOLAR T OTAL F EES PAYABL E I ., ...'.-~ r , -
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION ANO PERMIT · AND DO HEREBY Exp,ration Every permit issued by the 8u1ldtng OU1c1al under lhe prov1st0ns of this * AN OSHA PEAM:T IS REQUIRED FOR EXCAVATIONS OVER CERTIFY UNDER PENALTY OF PERJURY T>iAT ALL INFORMATION HEREON INCLUDING THE Code shall e,cp,re by llmttat1on and become null and void If the bu,ld,ng or work 5· 0. DEEP AND 0£MOLITION OR CONSTRUCTION Of
DECLARATIONS ARE TRUE ANO CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT 1$ authonzed by such permit ,snot commenced w,th,n 180 days from the date of such STRUCTURtS OVER 3 STORIES IN HEIGHT perm11. or ,t the bu1ldm~ or work authonzed by such perm,1 Is suspended or ISSUED TO COMPLY WITH ALL CITY. COUNTY AND STATE LAWS GOVERNING BUILDING CON abandoned at anv ttme a er the work ,s commenced tor a oeriod of 180 davs STRUCTION WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY ANO APPLICANT"$ SIGNATURE .. OWNER □ CONTRACTOR □ APPROVED BY DATE -KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS COSTS AND
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE ./ ,
GRANTING OF THIS PERMIT ~--BY PHONE 0 I
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TYPE I DATE INSPECTOR
BUILDING
FOUNDATION .
REINFORCED STEEL I
MASONRY I
GUNITE OR GROUT '
FLOOR & CEILING SUB FRAME
SHEATHING D ROOF D SH~AR
FRAME I
EXTERIOR LATH ' 1
INSULATION I ' INTERIOR LATH & DRYWALL (,
f
PLUMBING l
SEWER AND BUCO DIPUCO I
UNDERGROUND D WASTE □ V~ATER
TOP OUT □ WASTE D WATER
TUB AND SHOWER PAN '
GAS TEST '
D WATER HEATER D SOLAR WAIJ"ER
I
ELECTRICAL
D ELECTRIC UNDERGROUND □ WFFER
ROUGH ELECTRIC ' l
□ ELECTRIC SERVICE D TEMPO~ARY
D BONDING □ POOL ' .
I
MECHANICAL f .
□ DUCT & PLEM ., □ REF. PIPINiG
HEAT -AIR COND. SYSTEMS I
_1
VENTILATING SYSTEMS I
.
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HA V6 BEEN APPROVED.
FINAL I
PLUMBING i -ELECTRICAL f ~ .
MECHANICAL l -\ '-I'-'
GAS ! ....__~ \ -
BUILDING '\. . c-----....'-l
SPECIAL CONDITIONS . ~ -
'
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTION REQ IF INSPECTORS DATE CHECKED APPROVAL
SOILS COMPLIANCE
PRIOR TO
~OUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRESTRESSED
CONCRETE
POST TENSIONED
CONCRETE
FIELD WELDING
HIGH STRENGTH
BOLTS
SPECIAL MASONRY
PILES CAISSONS
CITY OF CARLSBAD LOT # :5(c?,z
INSPECTION RECORD
BUILDING
FOUNDATION I · 1 lg· 8 ,-
REINFORCED STEEL
MASONRY
GUNITE OR GROUT
SUB FRAME () FLOOR ( ) CEILING
SHEATHING ( /) ROOF ( v11zi;;tJJt PG'f'r<'.-
FRAME
EXTERIOR LA'm $·U t~
INTERIOR LATH & DRYWALL ? -~~
FINAL ------------
PLUMBING
( ) SEWER & BL/~O ( ),.... PL/CO
UNDERGROUND (\:d' wm ( ) WATER
TUB & SHOWER PAN
GAS TEST
( ) WATER HEATER ( ) SOLAR WATER
FINAL ------------
ELECTRICAL
ELECTRIC UNDERGROUND ( ) UFFER
BONDING ( ) POOL
FINAL ------------
MECHANICAL
() DUCT & PLEM., ( )REF. PIPING
HEAT -AIR COND. SYSTEMS
VENTILATING SYSTEMS
FINAL ___________ _
COMPLETE BUILDING FINAL ~
DATE: 7-25--8>""'
CLEARED WITH GAS AND ELECTRIC
DATE: _______ _
NOTES ON REVERSE SIDE ..... .