HomeMy WebLinkAbout2610 VIA BOCAS; ; 84-582-490; PermitUI z 0 ~ Ir "' _,
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D I hereby affirm that I am licensed under
provlatona ol Chapter 9 (commencing with
Section 7000) ol Division 3 of the Business
and Professions Code, and my license Is in
full force and effect.
Lie No _____ _ Clm
I hereby afhrm that I am exempl from the Contrac•
!or's License Law ror !he lollcrNmg reason (Set 7031.5 Business and Pro1essions Code A.riy cJfy o, c:oumv wrucn re-
Qurres a permit 10 constrnct, alter, improve. demolish. or repair any siructure prior 10 1ts,ssuance a1so requires ?heap~
pIIcar11 tot such vermIt to file a 's1Qned .sIatemen1 rhal he ls hcensed pursuant lo the provisions of too CQnuac-1o<"s
License Law (Chapler 9 commencing w11h Secrron 7000 of
Divtsian J °' the Busfness and-Professions Code} or 1t1at1s ex· ernpl therefrom and the basis ro, the allegeo exemption An'/
v1oJa1"n o1 Sect,on 7031 .5 by ao apphcanl !or a perm, sub· Jects lhe applicant to a civir penalty of not more than h\/e hun-d1ed dollars 1$500\.
ri '· as owner ol lhe property, or my employees with wagts as ttle1t sole compensaliQn. w,n do the work. a11d the siruc· lure 1s n0I 1ntendet:1 or O1tered for sale (Sec, 7044. Busmess
and Prolessions Code The Contrac101· s License Law does
nor apply 10 an owner ol p1openy wtto butlds or improves Jhoreon and who does such work himself or lhrOUjjh his own
employees, provided lhat sucn 1mprovemen1s are not intend-ed or olfered lor"Sle. II, however, 1he buIkhng or Improve---
menl is sold within one year ot eompletion. lhe owner-builder will have lhe burden of proving thal he did not build or im-
prove lor !he purpose or saleJ.
J I, as owner o1 the property, am ex1tlus1Vely contracllng
with ticensed contrac.1ars 10 construct The proIecI (Sec 7044 Business and Ptofessions Code· The Contractor·s Ucense Law does nor apply to an owner ol properly who bull(!s o, im-prove!! !hereon, and who contracts far each projects with a.
~~)~r.tor(s) license pursuant to lh.e Contractor's Lttense
D As a homeowner I am 1mprovlng my home. and the follow
1119 cond1t1ons ex1s1: The work 1s being performed pnor lo sare
I t\ave hved m my home lor lwelve mooths pr10r fo complelion al fhtS work. 3. I h.,ave not claJmed lh1s exemptmn dunng the last three years
D I hereby artirm tha1 I tta·11e a cemhcale al conseni
to seH insure, or a cer11tica1e 01 Workers
Compensahon lf'\surance. or a cer1,t1ed copy tJ'lereot
!Sec 3800 L.aoo, Cooe1
POLICY NO
COMPANY
□ Copy' IS filed wrth lhe Clt'v
D Ce'11he(] copy ,s hereby rurmshed
CERHFICATL OF EXEMPTlON FROM
WORKERS' COMPENSA HON INSURANCE
(This section need not be compleled if me permtl
t5 !or one hunc:!red dollars ($100) or iess)
D I cert,ty 1ha1 1n the pertormance ot 1he woo,; tor
which 1h15 perm11 ,s ,ssued I s!)a:11 r,01 efTlploy an~
person 1n any rnanne, so as to become sut>iecl 10
lhe Wori(ers Compens.,11ron Laws of Cal1torn1a
NOTICE TO APPLICANT It afler rnakinJ lh1s Cenr
t,cate ot Exemplion yCKJ .should t>eeome sut11e:c1 t'l
the Workers Compensal1on provisions of ine Labor
Cooe you mus1 ror1n-...,1h comply wllh s1..1ch prov,s1ons or Uus perm11 shall be deemed ,e-.okeO
0 I ttereb',' aftmn Iha! there ,s a con.slruc11on
iend,rtQ agency lot me pertounance ol ine ~Ork tor
which lh1:S pe1m1t 1s issued lSet 109'7 c,..,,I Code)
Lende1 s Na-nie ___________ _
I USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
' CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT . 1200 Elm, Carlsbad, California 92008-1989 (619) 4.38-5525 • JOB ADDRESS AV ST.RO. NEAREST CROSS ST. I OAT£ OF APPLICATION' BUSINESS LICENSE # PERMIT NUMBER Vt a.,,, tsoe__p,, s
VALUATION ; d.~10 64-52);2-j mol BLOCK 1s~l/~1~S I ASSESSOR PARCEL NO.I._/-(} CONTRACTOA CONTRACTORS PHONE • ZONE I ~ 74 I ;i Jo-oc Ljq D I 0111/NER'S NAME I OWNER'S PHONE / t J 71ie l-l14A !a.A-lei Ca CONTRACTOR"S ADDRESS LICENSE NO. PLAN 1.0. # BLDG USE CODE
I , .
I OW"ER'S MAtLIN6"AODRESS , •. .I ' : DESIGNER LICENSE # STANDARD PLAN# BUILDING SO FOOT.AGE
~ /49b I DESCR!PTI.QN OF WORK 11' -I , -" , • l ) j O!cSIGNER'S "-DDAES5 DESIGNER'S PHONE
I ' ) • ( ' I ,__ F1P f:. LR ELEVC~ NO OCC GP EDU
C I STO[IIES ,o NO ---. • CENSUS TRACT I -GP LAND USE I •A# s;ce I RES UNITS
I
GRADING PERMIT ISSUEO I REDE IIELOPMENT TYPE OCC LOAD FrRESPP. I AREA CONST : . r □ N D v0 NO v□ N~...,_ Not Valtd Un/t!fs Machine Certdied
" I
I QTY. PLUMBING PERMIT · ISSUE QTY. MEC HANICAL PERMIT· ISSUE ,, SUMMARY/ACCOUNT NUMBER
f ,
I EACH FIXTURE TRAP .7 ~ INSTALL FU RN. DUCTS UP TO 100.000 BTU ~ -BUI LDING PERMIT 01 ·00-00·8220 r-J ' EACH BUILDING SEWER r OVER 100,000 BTU SIGN PERMIT 01-00-00-8221
1 .. ..., -
EACH WATER HEATER AND .OR VENT BOILER/COMPRESSOR UPTO 3 HP PLAN CHECK 01-00·00·8806 I -·-1
• EACH GAS SYSTEM 1 TO 4 OUTLETS ' .< BOILER/COMPRESSORJ,15 HP TOTAL PLUMBING 01-00-00·8222 ~· .
I EACH GAS SYSTEM 5 OR MORE I METAL FIREPLACE ELECTRICAL 01·00-00-8223 ... -
I -------EACH INSTA~. ALTER. REPAIR WATER PIPE VENT FAN SINGLE DUCT ·c MECHANICAL 01 ·00-00-8224 ' -I ·--
I EACH VACUUM BREAKER MECH EXHAUST -HDOD1DUCTS MOBILEHOME 01-00-00-8225
I WATER SOFTNER RELOCATION OF EA FURNACE1HEATER MOBILEHOME PARK INSP
I EACH ROOF ORA.IN r INS10Ei SOLAR n, .nn-nn-R?% I TDH,L ME CHANICAL STRONG MOTION 80-92·33·0519 I
I , ,;l. . -.;--.
I TOTAL PLUMBING I FIRE SPRINKLERS 01 -00-00·8227
C PUBLIC FACILITIES FEE 32-00-00-89ll I QTY. ELECTRICAL PERMIT -ISSUE QTY. SOLAR • ISSUE
t ... BRIDGE FEE
~ -COLLECTOR$ I NEW CONST EA AMP SW! HKR . SCHOOL FEE • DISTRICT
I 1 PH 3 PH STORAGE TANKS Carlsbad / 80-92-21-0519 ! EXIST BLOG EA AMP'SWT BKR ' ROCK STORAGE. Enc,nrtas 80·92-22-0519 : 1 PH 3 PH PUMP San Dreguito 80·92·23-0519
i REMODEL AL HR PEA CIRCUIT PLAN CHECK FEE San Marcos 80-92-24-0519
} TEMP POLE 200 AMPS
I OVER 200 AMPS LICENSE TAX 01-00--00-8162 J I I ' • TEMP OCCUPAN CY 130 DAYS! MFF 80-92-57-0519 L ("l ' F
I CREDIT DEPOSIT
I TOTAL ELECTRICAL I TOTAL SOLAR I I TOTAL FEES PAYABLE
I I
C I HAVE CAREFUilY EXAMINED THE COMPLETED .. APPLICATION AND PERMIT' AND DO HEREBY C~p,rat,on E1,1ery permit tssued by u,e Butldtng Qff1c1a1 under Lhe provrs1on5 at this * AN OSHA PERM:T IS REOUIAEO FOR EXC.AVATIONS OYER ~ CERTiFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING TliE Code shall expire by ltm1t1rtfoo and become null .and vo,d It the budding or work 5· o--DEEP AND OEMOLITION OR COHSTflUCTION OF
DE.CLARATIONS ARE TRUE ANO CORRECT AND I FURTHER CERTIFY ANO AGREE IF A PERMIT IS autnor1zed by such perm11 1s not commenced wnh,n t80 days from 1he date of such STRI.ICl\JRES OVER 3 STORIES IN HEKiHT
I ISSUED TO COMPLY WITH A.LL CITY COUN1Y ANO STATE LAWS GOVERNING BUILDING CON-:~~~n°:ci 1~1 ·~~y ~~:1:~.~~h:~6r:~~~~~~e:le~~~~ r~~~d1~,sr:g~na~!d or
STRUCTION WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND APPLICANTS SIGNATURE If, OWNER□ CONTRACTOR [J APPROVED BY DATE I KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LiABILITIES JUDGMENTS. COSTS AND
u EXPENSES WHICH MAY IN A.NY WAY ACCRUE AGAINST SAID CITY I CONSEQUENCE OF THE BY PHONE 0 I GRANTING OF THIS PERMIT .. I
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TYPE DATE INSPECTOR -
BUILDING
FOUNDATION FIELD INSPECTION RECORD
REIN FORCED STEEL ,,
'
MASONRY ,
GUNITE OR GROUT
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTION REO IF INSPECTORS DATE CHECKED APPROVAL
FLOOR & CEILING SUB FRAME \ SOILS COMPLIANCE
SHEATHING D ROOF D SHEl\R PRIOR TO
FRAME I
FOUNDATIO I SP
EXTERIOR LATH ' ;
STRUCTURAL CONCRETE
OVER 2000 PSI
INSULATION ; PRESTRESSED
INTERIOR LATH & DRYWALL i
I
CONCRETE
POST TENSIONED
I CONCRETE
PLUMBING I FIELD WELDING
SEWER AND BUCO DlPUCO !
UNDERGROUND D WASTE D WATER
HIGH STRENGTH
BOLTS
TOP OUT D WASTE D WATER SPECIAL MASONRY
TUB AND SHOWER PAN r
GAS TEST ~ PILES CAISSONS
D WATER HEATER D SOLAR WAt ER
I
ELECTRICAL •
D ELECTRIC UNDERGROUND D UFFER
' ROUGH ELECTRIC l
D ELECTRIC SERVICE D TEMPO~ARY
D BONDING D POOL ' I
MECHANICAL I
D DUCT & PLEM ., D REF. PIPING
HEAT -AIR COND. SYSTEMS r
VENTILATING SYSTEMS !
I
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVB BEEN APPROVED.
FINAL ;
' PLUMBING l \ '
ELECTRICAL ; ~ ...... ~
MECHANICAL '· --....;> • -' GAS I ~ \.:::-
BUILDING . _,
SPECIAL CONDITIONS ~ '-1.J
;
... ,/ ,/
CL!ff J J· J LAJ J (N
'Jnjs is 10 ·e;rUfy tli,Jt in suJ ,1U on has l>L:cn jns1;:i 1J ·d j n ·on fornrnicc wit h the
urr ·nt c11<.:rgy r r,u JaUon , CnJjfOlnfa /'vlrninj _ tratjvc Cotlc , TitJc 25 , State of
C;:,i]jf(J]nja , jn the buihljng J ocat d at :
---... ,:;::;-~
,/
LOT # &"9?> CITY OF CARLSBAD
INSPECTION RECORD
BUILDING
FOUNDATION 1• I 1,z ·fB, t-
REINFORCEO STEEL
MASONRY
GUNITE OR GROUT
SUB FRAME ( ) FLOOR ( ) CEILING
€HEA™!ID1 )/ F R7to¥F ?i!f'f lJtf a.lAfV'
FRAME
INSULATION .5 •2'2~f'S1?h,--
EXTERIOR LATH • .., '8 'i;;& 513-
INTERIOR LATH , DRYWALL 3·Z 7-gs-~
FINAL ------------
PLUMBING
( ) SEWER & BL/CO ( ) ~L/CO
UNDERGROUND ('\A" ~, ( ) 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:7-7_5•~~
CLEARED WITH GAS ANO ELECTRIC
DATE: _______ _
NOTES ON REVERSE SIDE ..... .