HomeMy WebLinkAbout2315 VIA FRANCISCA; ; 83-271-3-5; Permit..
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o;,hereby~ thot ; am licensed under
p,ovlalona of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Proleealons Code, and my license is In
lull force and effect.
Lie No ______ Clm
I hereby affirm thal I am exempt lrom the Contrac· 1of's License Law tor the foftowmg reason (Sec 7031 5
Business and Protess10ns Code Any city or county which re-
quires a permit 10 construct. alter. improve. demotish, or repair any s1ruc1ure. prior 10 ,ts issuance also requires the ap•
pl,cant tor such permit to file a s19ned s1a1ement lhat he is
licensed pursuant to the provisions of the Conlractof s
L1Cense Law (Chapter 9 eomme:nclng wllh Sectt00 7000 ol Oiv1sK>n 3 of lhe Business and Prntesst0ns Code) oc lhat tS ell·
empt therefrom and Ille baSls for the al!egea exempt,on ~ny
lflol::tf~I Section 7031.5 by an apphcant IOI a permit sub-
:o/o1::\'s''~\o a CIVIi penany of nol more than five hun·
I. as owner of !he propeny, or my employees with wages
as their sole compensation. will do the WOfk. and the struc-
ture 1s not intended or ottered tor sale {Sec 7044, Business and Professions Code: The Contractor's License law does
not apply to an owner ol property who builds or improves
thereon and who does suth work himself or through his own employees, provided that such improvements are 001 intend-
ed or offered tor sale If, however, !he building or improve· men~I sold w1lh1n one year of complehon, the owner-builder will !he burden ot provmg lhat he did not build or im· prov lor the purpose of sale).
Wit~i::n:dn~~t~~orf'1'r~Str~~t ~1::r t~•-~cf.~~
Business and Protess10ns Code. The Contractor's Ucense u,w does not apply to an owner of property who builds or im-proves thereon. and who contracts !or each pro,ects with a
contractor(s) license pursuant to the Conrractor's License I.Jlw)
□ As a homeowner I am improving my home. and Ille lollow· Ing conditions exist: t f~a:'~i!, ~;:9 :1~= f~t0r1!.°e1:le roonlhs
prior to completJOn ot this work.
3. I have not claimed this exemption during the last three years.
□ I am exempt under Sec. ______ , 8 & P.C.
lor this reason ____________ _
□ I hereby alhrm lllat I ha.-e a cert1f1caIe of consent
to self tnsure. or a certtl1caIe of Workers
Compensa11on Insurance. or a cer11t1ed copy thereof
!Sec 3800, Labor Godel
POUCYJO
COM~NY
'Copy IS filed w,lh the cI1y
0 Cen,hed copy 1s hereby turn1she<J
CERTIFICATl OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This sectton need noI be compteled 11 the perm,1
1s !Of one nundred dollars (S HlOI or less)
D I cer11ty lhal in the per1ormance of !he wont lor ,.._h,ch 1hIs pemut Is issued. I snail 001 employ any
pe,son in any manner so as 10 t>ecome subIect to
1he Workers Compensation Laws ot California
NOTICE TO APPLICANT 11. afle, makin~ this Cer11
llcale ol Exemption. you sf'lould beC0"1e subJecl I? me Workers· Compensation p1ovIsIons ol Ihe Labor
Code you must torthWr.1th comply w11h sucn
provIs1ons or this perm,1 shall be deemed revokeo
0 I hereby athrm 1naI there ,s a conslructton
Iend1ng agency tor tne peno,mance ol the work for
wtuch lh1s permit Is issued !Sec )097 C,v,I COOel
Len<Ser s Name ___________ _
Lenders Address __________ _
USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
CARLSBAD BUILDING DEPARTMENT . APPLICATION & PERMIT
r 1200 Elm, Carlsbad. California 92008-1989 (619) 438-5525
JOB ADDRESS AV. ST.RO. NEAREST CROSS ST.
1 °i0Ti i7ffilONI BUSINESS LICENSE ,; VALUATION PERMIT NUMBER
2315 Via Francisca 32011~
LOT BLOCK I sue_1o1Iv1sI0N I ASSESSOR PARCEL NO CONTRACTOR , / CONTRACTORS PHONE • ZONE . .-,.-, 83-271 -3-5 OWNER'S NAME I OWNER"S PHONE Community Resources Corp.
Community Resources Corp. 483-6500 CONTRACTOR'S ADDRESS LICENSE NO. PLAN 1.0 . # BLOG USE CODE
OWNER'S MAILING ADDRESS .
DESIGNER LICENSE• STANDARD PLAN # BUILDING SQ. FOOTAGE
')')(\/, r...,.---~ ft •• -c, __ I"\~---,..,. 0?1(\Q ~q~L.l. OESCR•PTION OF WORK ~
A 11.0 ..,;...,c;--,.1~ DESIGNER'S ADDRESS DEStGNER"S PHONE
1n•
_ _ __Bldg._ 3!"'5 12 Units_• __ e\)_&a., GAUf.t.» 10/ t.ic/el4784 --F/P FLRELEV. NO OCC GP EDU sos r;ur ~ ~~ e,Jl),n:(~ ~~n-ST~ES R-l ' ---,J. .. l>.L.~~ . .
vO NO
CENSUS TRACT GP LANO USE
ll\t:~S~E
l RE,ilTS
GRACING PERMIT ISSUEO I REDEVELOPMENT TYPE DCC LOAD FIRE SPA
AREA ,r.:rUI. y O N 0 v□ N~ vO Nb( Nor Valid Unlns Machine Certified
QTY. PLUMBING PERMIT • ISSUE QTY. MECHANICAL PERMIT· ISSUE SUMMARY/ACCOUNT NUMBER ,'\_ ~
EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100,000 BTU BUILDING PERMIT 01 ·00·00·8220 l~-
EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT 01 ·00·00·8221
EACH WATER HEATER ANO/OR VENT BOILER/COMPRESSOR UPTO 3 HP PLAN CHECK 01·00·00·8806 ~-
EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP TOTAL PLUM BING 01 ·00·00·8222
EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE ELECTRICAL 01 ·00·00·8223
EACH INSTAl . ALTER. REPAIR 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 -M08ILEHOME PARK INSP
EACH ROOF DRAIN (INSIDE) SOLAR n1 .nn.nn.aooc
TOT J;.L MECHANICAL STRONG MOTION 80·92·33·0519 ~~ 'J.-'l'l"L
TOTAL PLUMBING r FIRE SPRINKLERS 01 •00·00·8227 -
PUBLIC FACILITIES FEE T 'TIAII -32·00·00·8933 ---.... QTY. ELECTRICAL PERMIT · ISSUE QTY SOLAR • ISSUE BRIDGE FEE
NEW CONST EA AMPISWT 'BKR COLLECTORS SCHOOL FEE • DISTRICT
I PH 3 PH STORAGE TANKS Carlsbad 80·92·21 ·0519
EXIST BLDG EA AMP/SWTIBKR ROCK STORAGE -....... Encinitas 80·92·22·0519
I PH 3 PH PUMP / Q. -./ San Dieguilo 80·92·23·0519
REMODEL AL TEA PER CIRCUIT PLAN CHECK Fil /1 ., a.,,,AY' /. San Marcos 80·92· 24·0519
TEMP POLE 200 AMPS ,,./1/?(J./-'I, 7 /
OVER 200 AMPS I (,,)'./ ./ I I .,.. / LICENSE TAX 01-00-00-8162
TEMP OCCUPANCY 130 DAYSI .'.::>/ / "-~ CREDIT DEPOSIT
TOTAL ELEC1RICAL l IUlf\L ;)ULAR TOTAL FEES PAYABLE I 8()5"1~
Exp,ratlon. E-y pe,mot ossued by the Butldtng Olfic1at under the provoStons of thta --,
I HAVE CAREFULLY EXAMINED THE COMPLETED "AP\>1..ICATION AND PERMIT" ANO 00 HEREBY * AN OSHA PERMIT IS AEQUIAEO FOR EXCAVATIONS OYER
CERTIFY UNDER PENALTY OF PERJURY THAT All INFORMATION HEREON INCLUDING THE ~:
.~,. y limolallon and become null and vo,CI II the bu11d1ng or work s· O" DEEP ANO DEMOUTION OR CONSTIIUCTION Of
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS mil oa not commenced W11lltn 180 days from the date ,>I such STflUCT'UfllS OYER 3 STORIES IN HEIGHT t oldt~or "'°"' 1uthor1Dd by such perm,t ,. suspended or ISSUED: TO COMPLY WITH All CITY. COUNlY ANO STATE LAWS GOVERNING BUILDING CON• dO al 1-■ Ille"°"' oscom-toro•r..,,ol 111it~----
STRUCTION WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND ~L~72·· TURE • OWNE"f'. CONTRACTOR 0 APP~VEOBY 1t7'/4~ KEEP HARMLESS THE CiyY OF CARlSBAD AGAINST All LIABILITIES. JUDGMENTS. COSTS AND
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE BY PHONE 0 ' -"l. GRANTING OF THIS PERMIT •,; ~ _ .,.._
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TYPE l DATE INSPECTOR
' ~ '\ ;.., -8"5 -;), 71--3 ----~
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\
BUILDING i ' ' ( ' > \ ,, ' I .. ,~ ' ' FOUNDATION ! FIELD INSPECTION RECORD ' \
REINFORCED STEEL I
MASONRY i
GUNITE OR GROUT !
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES . .l -REQ IF INSPECTORS ' . -INSPECTION CHECKED APPROVAL DATE
---FLOOR & CEILING SUB FRAME I
SHEATHING □ ROOF □ SHEAR
SOILS COMPLIANCE
PRIOR TO
FRAME I FOUNDATION INSP "
EXTERIOR LATH l STRUCTURAL CONCRETE
OVER 2000 PSI
INSULATION I •
INTERIOR LATH & DRYWALL I
PRES TRESSED
CONCRETE
POST TENSIONED
I CONCRETE
PLUMBING I
I FIELD WELDING
SEWER AND BUCO D IPUCO I
UNDERGROUND □ WASTE D WATER
HIGH STRENGTH -:•ft-ccri--BOLTS -
TOP OUT □ WASTE D WATER SPECIAL MASONRY -.,, .... . ,
TUB AND SHOWER PAN I ·-
GAS TEST I
D WATER HEATER □ SOLAR W4TER
PILES CAISSONS
I
ELECTRICAL I
□ ELECTRIC UNDERGROUND □ it)FFER
ROUGH ELECTRIC I
~-
" ·. I•
□ ELECTRIC SERVICE □ TEMPOAARY I -tf
D BONDING □ POOL I I ' I
MECHANICAL ' I
" ~ . -l ";' ~; .. } 1-t ' •• ,: .-_;_ .
D DUCT & PLEM., □ REF. PIPlljlG ......... ....iii. • ., .S°', I ,.-\ -~ ' • • a..,-J , . ~ l • -!
HEAT -AIR COND. SYSTEMS .. -'-~ I
VENTILATING SYSTEMS I .
I ' -~ • 'r' t -: .. . ,. -k ,--· " . • . .
I , ,
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CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE BEEN APPROVED .
... : ~ ...
FINAL I
I
PLUMBING I -
ELECTRICAL I
MECHANICAL i, • ... ~ -
I
GAS I ' ' . . ' -
BUILDING I . . -. .
' ' • S.EECl&L CONDITIONS I
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C -O fh«eby at!Trm that I am licensed under
provlalona of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Profeaalons Code, and my license is In
full force and effect. ![
0 0
lie No ______ Class.
I hereby affirm Iha! I am exempt from the Contrac-lor's Lanse Law tor lhe lollowmg reason (Sec. 7031.5
Business and PJofess10ns Code Arr, city Of counly which re-quires a permit to construct. aaer. improve demohsh, or
repalf any structure, prior to its issuance also requires !heap• phcant tor such perrrut 10 flle a sisined statement that he tS
IJCensed pursuant lo the provisions or lhe ConIracto(s
License Law !Chapler 9 commencin~ wIlh Seclion 7000 ol 0tv,s10n 3 of !he Busmess and Professoons Code) or Iha! Is ex·
empl lherefrom and !he baSIS for !he allegeo exempt,on Any vtOlalion of Section 7031.5 by an apphcant tor a permn sub•
ieets the apphcanI to a civil penahy of not more than five hun-
iidoflars ($500)
as owner of the property, Of my employees wrth wages
etr sole compensatJon, witt do the WOtk. anc the srruc· Is nof ,n1ended or oflerod !or sale (Se< 7044. Business
anc Professions Code. The ContractOl"'s tteense law does not apply 10 an owner of property who builds OI" improves thereon and who does such work l''llmsell or through h1s own
employees. provided lhat such improvements are not inlend-ed or otlered lor saM!. If. however. the building or improve-
ment is sold w1thIn one year ot completion, the owner-buiJder
will have !he bur<len of proving Iha! he did no! build or ,m.
iove for !he purpose of sale) .
, as owner of the proper1y, am exciusivety conlracting licensed contractors 10 construct the pro,ecl (Sec. 7044, ness and ProtessK>ns Code: The Contractor·s Ucense
does not appfy to an OWnef of property who buiJds or im-proves thereon. and who contracts tor each pro,ects with a
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cootractor(s) license: pursuant to the Contractof"s bcense Law).
D As a homeowner I am improving my home, and !he follow· Ing condttions ex,st ~: rt:r~iv'!.i be/::9 ~:.:: f~•"i.:r:1:lemonlhs
prior to completion ot this work. 3. I have nol claimed lh,s exemption during !he lasl lhree years.
D I am exempt under Sec. ______ , 8 & P.C.
!or this reason -------------
□ I hereby affirm thal I hai'e a cert1hcate ot consent
to self-insure. or a cer11f1ca1e of Workers·
Compensatt0n Insurance, or a cert1t1ed copy thereof
!Sec 3800, Labo< Cooe)
PO\.ICYNO
(. ~~PANY
~Copy IS hied with the city
□ Certthed copy 1s hereby furnished
CERTIFICATl OF EXEMPTION FROM
WORKERS" COMPENSATION INSURANCE
(This sect,on need not be completed 1t lhe permI1
Is to, one hundred dollars {$1001 Of less)
0 I cer11fy that In the perto,mance ol the work ICH
which this perm11 1s issued, I shall not employ any
perSOf' in ¥iY ma.nnet" so as to become sub1ec1 to
ltle Workers· Compensation Ulws of Callforn,a
NOTICE TO APPLICANT If. after mak1n11h1s Cert,
t,ca.te of Exemphon. you snould beeome sut>1ec1 I?
the Wor'kers· Compensation provisions of !he UbOf
Code. you must tortt1w11h comply with such
pfO'IIStOOS or this permit shall be deeme<:I revOke<J
0 I hereby afflfm ltlat there ,s a cons1rvct•on
1end10Q agency fOf the ~no,mance ot 1he wont !Of
wn,ch lh•s perm,1 1s issued tSec .3097 C,v,1 Cooe1
Lenders Name ___________ _
Lender-., Address __________ _
USE BALL POINT PEN ONLY & PRE~S HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
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, CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT
" ' 1200 Elm, Carlsbad. California 92008-1989 (619) 438-5525 J rv J J\ QCj ,,
JOB ADDRESS AV. ST.RO. NEAREST CROSS ST. • IDATE Of APPLICATION I BUSINESS LICENSE• I ""{/KL ~Tl6N/' PERMIT NUMBER f
2315 Via Francisca Hesp 9/21/83 _ ""1
~ ": -?,.
LOT BLOCK I suBDov,s,oN I ASSESSOR PARCEL NO. CONTRACTOR CONTRACTORS PHONE• ZONE t}'l y I _,
owNER's NAME f owNER'SPHONE Community Resources Corp. fJ7
CONTRACTOR'S ADDRESS LICENSE NO. PLAN 1.0. # BLOG USE CODE
:ommunitv Resources Cornorati on 483-6500
OWNER.6 MAiLiNG ADOAESS
DESIGNER LICENSE• STANOAAO PLAN# BUILDING SO. FOOTAGE
2294 Garnet Avenue. San Diep;o. Ca. 921 09 ----
DESCRIPTION Of WORK
._ _______________ ...;.. ___ ...;.... _ __, _______ .;;;.-_-ti OESIGNEA•S ADOAESS 0£SIGNER'S PHONE
R11i 1tii,.,,. 3 -f:i 12 llnit_ci •. ..,_ ____________ ...., _____ ""'!' 'J2f/,effl5Qp$ 2_8 l;f.□j
I • f/P FLA ELEV. NO OCC GP EDU
. ' , STORIES
I -r II ·--iilf nut·~-·. -':--· ·--:. -vO NO
CENSUS TRACT I GP LAND USE PAAKiNG SPACE RES UNiTS I GRADING PERMIT ISSUED I REDEVELOPMENT TYPE occ LOAO FIRE SPA AREA CONST
y D N O v O NO v□ NO Nor Valid Unless Machine Cerrifi«J
QTY. PLUMBING PERMIT -ISSUE 7?-QTY. MECHANICAL PERMIT. ISSUE -~-SUMMARY/ACCOUNT NUMBER 1 ✓ _
EACH FIXTURE TRAP • INSTALL FURN. DUCTS UP TO 100.000 BTU BUILDING PERMIT 01·00·00·8220 ~11 J,r:
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 0HXJ-00·8806 .L. "D..., f..d. ~
EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3·15 HP TOTAL PLUMBING 01·00·00·8222
EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE ELECTRICAL 01·00·00·8223 1
EACH INSTA~ .. ALTER. REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01·00·00·8224
EACH VACUUM BREAKER MECH EXHAUST -HOOO/OUCTS MOBILEHOME 0HJO·0Q·8225
WATER SOFTNER REL OCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP
EACH ROOF DRAIN (INSIOE) SOLAR 0HJO-nn.Ant=:
TOT f;L ME CHAN ICA L STRONG MOTION 80·92·33·0519 -/. 7,,,,1/
TOTAL PLUMBING I FIRE SPRINKLERS 01·00·00·8227 , _ 1
s= PUBLIC FACILITIES FEE 32·00·00·8933 ~ 1---
QTY. ELECTRICAL PERMIT· ISSUE -QTY. SOLAR · ISSUE BRIDGE FEE
NEW CONST EA AMP/SWT 1BK R COLLECTORS SCHOOL FEE · DISTRICT
1 PH 3 PH STORAGE TANKS Carlsbad 80-92·21·0519
EXIST BLDG EA AMPJSWT /BKR ROCK STORAGE Encinilas 80·92·22·0519
1 PH 3 PH PUMP San Dieguito 80·92·23·0519
REMODEL'ALTtR PER CIRCUIT PLAN CHECK FEE San Marcos 80·92·24·0519
TE MP PO LE 200 AMPS
OVER 200 AMPS LICENSE TAX 01-00-00-8162
TEMP OCCUPANCY 130 DAYS) / ,
CREDIT DEPOSIT '/ / • ~ t
TO TA L ELE!:TRICAL I TOTAL SOLAR TOTAL FEEs PAYABLE I v8' 1~ .o ~ _
IHAV£CAREFULLYEXAMIN£. DTHECOMPL!TEO.· :la.·~~~.·.· • ~: .. ~ •. -.~. ~ .·• .c!,:=. ·-~::-~--~~=~~=~~ •• * ... ,.,.ISl'llQli-,pqllExc:AVA110NI.~ CERTIFY UNDER PENAL'tY'OF PERJURY TNAT AU-' ' ioit~ ~= ... ,..==·THETHE . .. . ~-....,. ' ·-_, s·rDIS'ANDOlllil0UnONOACONSTRUCllONO,
OECLARATIONSARETRUEANDCOflRECT ANl>I • ~e::::11J'A~IS .. IIIGllllidllt,_. ■not • tlO .. fromtlle ofaucll SfflUC1\NSOV8USTOIIES .. MIIGHT
ISSUED, TOCOMPLY~ALLCITY.COUNTVANO.sTA~......,_ •• ,"""'.•~~...:.=_ ~•i!_.. Gr.lJlllll-:--011,-"."""11 ~..,-or
STRUCTION.WHETHEA!IPECIFtEOHEREINOfll'j()T ••. IAUIO. · .••.• E = . "!C ANO AM. ,..Lf~J._ -□ CONTAACTOA□ APPRO OBY • -D ~ KEEPHAAMLESSTM£crrt-OFCARU18AO~lliS1'""'1:-JJ~ --~ooetlANO ·""fl'!ll"7""7' ..,..._, ' / EXPENSES WHICH MAY IN AtfY WAT·ACCRUE ~--Ctn'~ ElfJUIINCEOl"TI'II! --~ • -• BY PHONE □ -,,., ~ ~ L l
' ~TIHG OF THIS PEAli1IIJ-• . • ~--.· . . • #t.... --• ... I
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TYPE I DATE INSPECTOR -~,, .... \'r: :~ ,~ .. ----
BUILDING ' I
' -' ~b•-:},7) ... ,~~ . .
FOUNDATION I FIELD INSPECTION RECORD ..,,_.,)
REINFORCED STEEL I
MASONRY ' I
GUNITE OR GROUT I
_I
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTION REQ IF IN SPECTORS DATE CHECKED APPROVAL ---' FLOOR & CEILING SUB FRAME I /
SHEATHING D ROOF O{SH~AR ?-:-"'1.A ,, -:-£,,)~I
FRAME I , I '? • ~-<;.'1_,, ~ ~..,,,,......,'V""
EXTERIOR LATH I !~,q .~ i-,--~
-' SOILS COMPLIANCE
PRIOR TO . --FOUNDATION INSP 1 . .
STRUCTURAL CONCRETE
~ OVER 2000 PSI
INSULATION I /
INTERIOR LATH & DRYWALL I ~ :2.2..·~ II .LU'
PRES TRESSED
11 CONCRETE . -POST TENSIONED r -I CONCRETE
PLUMBING I • ·-I FIELD WELDING :
SEWER AND BUCO D IPUCO I
UNDERGROUND D WASTE D WATER
HIGH STRENGTH '·
~\ ~-:_ .:.-... BOLTS ;.._., . .,. .
TOP OUT D WASTE □WiATER , •ZJit',-~ r~~ I SPECIAL MASONRY \' • .... _.:,
TUB AND SHOWER PAN I -ij ~-. -.
GAS TEST I
D WATER HEATER D SOLAR W4TER
I
PILES CAISSONS ,'
' I' " "
Ir .. ,
I ,,
ELECTRICAL I I 1
D ELECTRIC UNDERGROUND D _!.J_FFER /
ROUGH ELECTRIC I • ?--7...«--~ ~
D ELECTRIC SERVICE D TEMPORARY -
, • ,_s~ ~ ' --i.;
" . -.
D BONDING D POOL I
I ....._',-I ' ; -..
I -
MECHANICAL I
• '
D DUCT & PLEM., D REF. PIPll'J'IG -
HEAT -AIR COND. SYSTEMS I
VENTILATING SYSTEMS I -I I ,:; .. ,.._--: _,
J
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE BEEN APPROVED.
FINAL I
PLUMBING I
I
ELECTRICAL I
MECHANICAL I
GAS I
I
~ I ·-,.
BUILDING I
SPECIAL CONDITIONS I
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• O 41 hereby '7itirm that I am licensed under
provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Profeaalons Code, and my license is In
full force and effect.
lie No ____ _ Cla~s
I hereby afltrm !hat I am exempt lrom lhe ConIrae· tor's License Law lor tho lollowlng roason (Soc 7031 S
Busmess and Profess,ons Code Any city or county wh.c.h re-quires a permit to construct. alter tmprove. demohsh. Of repair any structure, prior 10 its issuance also requires !heap-plicant for such perm,t 10 hie a s,~nect sIaIement lhat he Is
r1eensed pursuanl to the provisions 01 the conuacI0( s L1<ense Law (Chapter 9 commenc,ng with Soc110n 7000 ol
OM~ 3 of lhe Busmess and Protessaons CoOe) or lhal 1s ex· empt lherefrom and !he basis ror the allegeo exemp1ton Arr(
vIolal.,n 01 Sec1100 7031.5 by an appl1eanI lor a perm,1 sub· iects lho appl1eanI10 a civil penany 01 not more than live hun•
dred dollars ($500)
D I. as owner of the property. or my employees w11h wages
as 11'1e1r ~e compensat10n, will Clo the work. and the slruc-lure 1s not mt ended or offered tor sale {Sec 7044. Business
and Prolessions Code The Conlracl0J's Ltcense law does
:r:t!n~
0 :;o =:rs~:tl~t ~'j~~~~~;~~
employees.. prMded lhat such improvements are not intend• ed or oflered for safe. H, however. the building or improve-
ment is sold wilhm one year of cornplellon, lhe owner-builder will have the burden of provmg that he did not 001ld or im-
prove tor lhe purpose of sale)
D I. as owner of lhe property, am excluswe1y contracting wIlh lttensed coniractors to construct !he pro,ecl (Sec 7CM4.
Business and Professions Code The Conlractor's license
Law does 001 appty to an owner o1 property who builds or im• proves thereon. and who c;ontracls IOJ each projects wtlh a conlractOf{SJ license pursuant to the Contractor's license Law)
D As a homeowner I am improving my home, and lhe follow· ing condItIons exist:
1. The wor1< is being performed piior 10 sale 2. I have lived in my home lor twelve monlhs
3. r':v'e° ~C:P~:::: 1'~1~ :'!p1t0n during !he las1 three years
g :h~: ,':,,;':' under Sec. ______ . B & pc -------------
D I hereby afhrm lhal I ha.-e a. cet11l1cate ol consenl
10 sell-insure. o, a cer11f1cate of Workers
Compensation Insurance. or a cer11t1ed copy lt\ereot
(Sec JBOO Labor Code!
POLICY NO
COMPANY
□ Copy IS hied with the city
D Cen1hed copy 1s hereDy tu,n,shed
CERTrFICATl OF EX~MPTI0N FROM WORKERS COMPENSATION INSURANCE
(This section neeo not be compleled 11 lhe perm,1
,s for one hundred dollars (S 1()()) Of tess)
O I cer11ty thal in lhe pe,rtormance of lhe won,, ro,
•h1cri this pemut ,s issued. I shall nol employ any person m any manner so as to become suD1ecr 10
lhe Workers· Compensation Laws ol Cahlorn,a
NOTICE TO APPLICANT It. alter mak.mJ lh1S Cer1•
hcate ol Exemption. you sl'lOuld t>ecome suD1ect f')
the Workers Compensahon prov,s,ons ol lhe LabOf
Code )'OU musl fOt'lh .. ,lh comply Wllh such
prov1s1ons o, this oerm1t shall be deemed revokeo
0 1 heret>y athrm lhal 1here 1s a. con!1tuc11on
lend.no aoency tor the per1o,ma.nce ot the ..... o"' to,
\Nruch th•s perm,1 1s ,ssued lSec 3097 c,..,,1 COde1
Lenders Name ___________ _
Lenders AOdress __________ _
USE BALL POINT PEN ONLY & PRE~S HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT
I 1200 Elm. Carlsbad, California 92008-1989 (619) 438-5525
JOB ADDRESS AV ST. RD NEAREST Z/4 ~ l°A;~;;~TIONI
BUSINESS LICENSE # VALUATION PERMIT NUMBER
~.:E'/S-CC:iu~~
83-~7;_ n LOT BLOCK -, SU801VISIQN I ASSESSOR PARCEL NO. CONTRACTOR CONTRACTORS PHONE • ZONE
y/~1.a'. 1/0/2 J --~ ./ ·_L_ ?/~/41"1' -i/f'f?/ QWNE R'S NAME ~4P I~~;;,;;~;;~ ~
/I_ • .A-CONTRACTOIC« ADORESS tl'alr LICENSE NO PLAN 1.0 . # BLOG USE C0OE 1 -. --77 ,:;,«s-s,1,-1-.iZ~~ OWNER'S MA LING AOdl(EsS -
~~d~ ~ ~-"'-·' DESIGNER V LICENSE # STANDARD PLAN# BUIL0ING SO. FOOTAGE
71
DESCRIPT,QN OF WOR,c; '7 ~.4 .• ~~✓-:. .... -
DESIGNER'S ADDRESS DESIGNER'S PHONE ----IC:'~~ -<; .,j,.r'
t..A_/1 -#-/.7 /oi< ~ -----F/P FLR ELEV. NO a ce GP EDU -
STORIES
vO NO ---
CENSUS TRACT I GP LANO USE I PARKING SPACE I RE S UNITS I GRADING PERMIT rSSUE0 I REDEVELOPMENT TYPE OCC LOAD FIRE SPR
AREA CONST
YO N 0 vO NO vO NO Not Valid Unless Machine Certdied
QTY. PLUMBING PERMIT • ISSUE 7,So QTY. MECHANICAL PERMIT· ISSUE 3,oa SUMMARY/ACCOUNT NUMBER
r;~ EACH FIXTURE TRAP /t:Y'J .-INSTALL FURN DUCTS UP TD 100.000 BTU BUILDING PERMIT 01 ·00·00·8220
, / EACH BUILDING SEWER ~ -SO OVER 100.000 BTU -SIGN PERMIT 01·00·00·8221
/., EACH WATER HEATE R ANO/OR VENT ~() .-BOILER /COMPRESSOR UP TO 3 HP PLAN CHECK 01·00·00-8806 ,
EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3 15 HP TOTAL PLUMBING 01 ·00-00·8222 d-311. ---
EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE ELECTRICAL 01·00·00·8223
EACH INSTA~. ALTER. REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01 ·00·00·8224
..J EACH VACUUM BREAKER ..!:,-. -MECH EXHAUST H000I0UCTS M0BILEH0ME 01 ·00·00-8225 -WATE R S0FTNE R RELOCATION OF EA FURNACE/HEATER MOBILEH0ME PARK INSP
EACH ROOF 0RAIN ( INSIDE) SOLAR 01.nn.nn-R??n
TOT M MECHANICAL STRONG MOTION 80·92·33·0519 --
TOT AL PLUMBING I -"~Q . -FIRE SPRINKLERS 01 ·00·00·8227
QTY. ELECTRICAL PERMIT · ISSU E <..1vi QTY. SOLAR • ISSUE
PUBLIC FACILITIES FEE 32-00·00·8933
BRIDGE FEE
NEW CONST EA AMP SWT BKR COLLECTORS SCHOOL FEE • DISTRICT
1 PH 3 PH STORAGE TANKS Carlsbad 80·92·21·0519
EXIST BLDG EA AMP/SWT BKR ROCK STD RAGE Encirnlas 80·92·22·0519
I PH 3 PH PUMP San Dieguito 80·92· 23·0519
REMODEL ALTt:R PER CIRCUIT PLAN CHECK FEE San Marcos 80·92· 24·0519
TEMP POLE 200 AMPS
DVE R 200 AMPS LICENSE TAX 01·00-00-8162
TEMP OCCUPANCY (30 DAYS)
CREDIT DEPOSIT
TOTAL ELECTRICAL
I
TOTAL SOLAR TOTAL FEES PAYABLE
I ~37-----
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION ANO PERMIT" AND DO HEREBY E•p1tehon. Every permit ,ssuecl by lt\e Bu,tdtng Off1c,aI under the prov1sI0t'IS of tr.is * AN OSHA PEFMIT IS REOUIAEO FOR EXCAVATIONS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall exptre by. hm,tetton and bec~me n and void If the bu,ld,ng or work 5' o-DEEP 1'NO DEMOLITION OR CONSTRUCTION OF
DECLARATIONS ARE TRUE ANO CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS avthort:~ed by rmIt 1s not commence t,,n 180 days from the date l)f such STRUCTUAfS OVER 3 STORIES IN HEIGHT
ISSUED TO COMPLY WITH ALL CITY. COUNlY AND STATE LAWS GOVERNING BUILDING CON· ::::O Of 'at •~ t,~':ff.~~0w~r:~•h ~f~~ ::;.';!~•~fs~~~~~ or
STRUCTION, WHETHER SPECIFIED HEREiN OR NOT f ALSO AGREE TO SAVE INDEMNIFY ANO 7T7aJ/ ow CONTRACTOR 0 APPROVED BY DATE KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL UABtUTIES. JUDGMENTS. COSTS AND -u_ EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST S1'1D CITY IN CONSEQUENCE OF THE BY PHONE 0 1//-2..-'/ GRANTING OF THIS PERMIT ,,
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TYPE I DATE INSPECTOR
BUILDING I l
FOUNDATION I
REINFORCED STEEL !
I
MASONRY I
I
GUNITE OR GROUT I
FLOOR & CEILING SUB FRAME ' I
SHEATHING D ROOF D SH~AR
FRAME I
EXTERIOR LATH I
INSULATION I
I
INTERIOR LATH & DRYWALL ! :
PLUMBING I
SEWER AND BUCO D IPUCO !
UNDERGROUND D WASTE D WJATER
TOP OUT D WASTE D Wl-\TER
TUB AND SHOWER PAN I
GAS TEST I
D WATER HEATER D SOLAR WAtrER
I
ELECTRICAL I
I
D ELECTRIC UNDERGROUND DUFFER
ROUGH ELECTRIC I
D ELECTRIC SERVICE D TEMPO~ARY
D BONDING D POOL I
I
MECHANICAL l
D DUCT & PLEM., D REF. PIPING
HEAT -AIR COND. SYSTEMS I .
VENTILATING SYSTEMS I
I \._'
I
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
--·· ITEMS Al3Q_VE HA Vf BEEN APPROVED
FINAL
PLUMBING
ELECTRICAL
MECHANICAL
GAS
BUILDING
SPECIAL CONDITIONS
-'~ •
I
I
!
l
I
I
I
I
I
I
7
I
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--' ~· -~' -
·,
~
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTION REQ IF INSPECTORS DATE CHECKED APPROVAL -
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRESTRESSED
CONCRETE ' POST TENSIONED
CONCRETE
FIELD WELDING
HIGH STRENGTH
BOLTS
SPECIAL MASONRY
PILES CAISSONS -.
--
' C
-
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....
'
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t,~.1-?: r~: -
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,.. .... ~ " ·' , . ' " ~-. . --. \
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O"i hereby)ftlrm that I am llcensed onder
provlelone of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Profeaelons Code, and my llcense Is In
full force and effect.
lie No ______ Class
I hereby al~rm 1na1 I am exempt !ram !he Contrac-1or"s License Law fo, lhe 1ollow,ng reason {Sec 7031 5 Bus.ness and Prolesstons Code Any city or county wh1cri re·
quires a permn to construct. alter. 1mpro-ni. demahsh. DI' repalr any strueture, pnor 1011s issuance also requires the ap·
pricant tor such pefm11 to hie a s19ned statement lhat he 1s licensed pursuant to the prov1s1ons of lhe Contractor s
License Law (Chapler 9 -menong w11h Sect1011 7000 01 OMsoon 3 o11he Business and ProtesSIOll> Cooe) o, lhal rs ex·
empl therefrom and lhe basis for lhe allegeo exemploon Any viOlaHon of Sec11on 7031.5 by an apphcant tor a perm11 sub·
1ects the applicant lo a c1Vtl penany ot nol mofe than hve hun-
dred dollars (S500)
O 1, as owner of lhe prO!)elty. or my emplOyees w1lh wages
as ltleir sole compensat,on, wiU do the work, and the struc-ture is nol intended or offered !or sale {Sec 7044, Business
and PJOfess1on!, Code The Conlraclor's License Law does
not apply lo an owner of property who builds or ,mproves thereon and who does such work himself or through his own
employees, provided that such imprOYements are not intend· ed or offered tor sale. If, however, the building or improve· ment 1s sotd within one year of compJetlOf'I, the owner-builder
will have the burden of proving that he did nol bulld Of im-prove for !he purpose o1 sate)
□ I. as owner of lhe property, am e:cclusrffiy conlractmg w1lh licensed contractors 10 construe! lhe prOjOCt {Sec 7Q.44, Business and Professt0ns Code: The Con1ractor's license
Law does nol apply to an owner of properly who builds or im-proves thereon. and who contracls tor each pro;et:ts with a
contractor(s) license pursuant lo the Contractor's License Law).
0 As a homeowner I am unproving my home, and lhe !allow ing conditions exist:
I. The work is befng pertonned prior lo sar..
2. I have lived in my home fo, twelve months prior to completion o1 th,s work. 3. I have no! claimed !his exemption during !he lasl three years.
0 I am exempt under Sec. ______ . 8 & P C.
for this reason ____________ _
□ I hereby affirm lhal I na.-e a cer11t1ea1e of con.sent
10 self,msure. or a cert1hca1e of Workers
Compensation Insurance. Of a cen1lled copy lhereot
{Sec 3800. Labo< Codef
POLICY NO
COMPANY
0 Copy IS hied with the Ctly
0 Cen11ted CoPy ,s he,eby furnished
CERTIFICATl OF EXEMPTION FROM
WORKERS" COMPENSATION INSURANCE
(This section need no1 be completed 11 the perm,1
Is tOf one hundrea dOIIMs {S 1()0) or less)
0 I certify that in the per1ormance ot the work lor
which this perm,t 1s issued. I shall nol employ any
person In ¥1Y manner so as 10 beeome sub1ec1 to lhe W~ers· CompensalK)n Laws ol Calitorn,a
NOTICE TO APPLICANT If. after makin"J ltus Cert•
hcate ot Exemption. you should beeome sut>,ec1 I?
the Wor11:ers • Compensait1on prov1sIons of !he UbOf
Cooe you must forthwith comply wtlh such
prov1s,ons or this perm,1 shall be deemed ,e"oke<J
0 I hereby athrm thal there ,s a cons1ruct1on
tend1nQ agency t()f the periormance ol 1he work tor
which lh•s permit 1s ,ssue<J (Sec J097 c,vll Cooe1
Lendef s 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
J~~;fiij;-1 )~,4 ~ ;11 6~1'_ ,~;v c; NEAREST CROSS ST 17;41i;TrQNI BUSINESS LICENSE # VALUATION PERMIT NUM8E(6_.
~3? 7tJ, f/1:11,, ~ LOT BL{>C K I SU801VISIQN. I ASSESSOR PARCEL NO. .l?.,~:Z?/-r;;~ ~ 1 __ !r-J,t CONTRACTORS PHO'/E • ZONE --
OWNER'S NAME I I. I 1n~;;;;; r-?~l ... /6/l>
r'.r ...... ,, I, 1 7 LI r/1!. Jt.-, ""' Cl' . .:; ;;:;;,T07J::::_ d f)c.,~ UCl:NSE NO PLAN 1.0. # BLOG USE COOE
3#.? 2 ::i. (,,,, OWNER"S MAILING AOOR,SS r
'l.1~J...I /!, • 11/U t_T ~ • ., .... <.Q DESIGNER -LICENSE• STANDARD PLAN # BUILDING SO. FOOTAGE
OESCR,PTIQN OF WORK ✓
OESrGNER"S ADDRESS DESIGNER'S PHONE
~ I~~; c,·A-, u..J / /)L)~ ~---F/P FLRELEV. NO OCCGP EDU 1./LG/t.i..,;.;;i.., I STORIES . -. .
vO NO --
CENSUS TRACT I GP LANO USE I PARKING SPACE RES UNITS I GRADING PERMIT ISSUED I REDEVELOPMENT TYPE CCC LOAD FIRE SPR
AREA CONST
YO N □ vO NO vO NO Not Valid Unkss ~chine Certifil!d
QTY. PLUMBING PERMIT· ISSUE -?~ QTY. MECHANICAL PERMIT· ISSUE 3-SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP 7 INSTALL FURN. DUCTS UP TO 100.000 BTU BUILDING PERMIT 01 ·00·00-8220
EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT 01·00·00·8221
EACH WATER HEATER ANO/OR VE NT BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01 ·00·00·8806
EACH GAS SYSTEM I TO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING 01 ·00·00·8222
ELECTRICAL -z . .o~ --EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE 01·00·00·8223
EACH INSTAl . ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01·00-00-8224
EACH VACUUM BREAKER .. MECH EXHAUST -HOOOIOUCTS MOBILEHOME 01 ·00·0Q·8225
WA TEA SOFTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP
EACH ROOF DRAIN (INSIDE) SOLAR 01.on.nn.000~
TOTf;L MECHANICAL STRONG MOTION 80·92·33-0519
TOTAL PLUMBING l FIRE SPRINKLERS 01·00·00·8227
?-QTY. SOLAR· ISSUE PUBLIC FACILITIES FEE 32·00·00·8933
QTY. ELECTRICAL PERMIT· ISSUE BRIDGE FEE
NEW CONST EA AMP'SWT BKR COLLECTORS SCHOOL FEE • DISTRICT
I 1 PH 3 PH I -.,,,. .-~--STORAGE TANKS Carlsbad 80·92·21-0519
EXIST BLOG EA AMP/SWT 'BKR ROCK STORAGE Encinilas 80·92· 22·0519
I PH 3 PH PUMP San Dieguito 80·92· 23·0519
REMDDEL 'ALHR 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 DAYSI
CREDIT DEPOSIT
TOTAL ELECTRICAL l -z,;,r-;-... TOTAL SOLAR TOTAL FEES PAYABLE I :2, O&pa--
Expirat,on E-y permit -by Ille Bull dong 0111c1al un-the provos1ons of this -I HAVE CAREFULLY EXAMINED THE COMPLETED •·APPLICATION AND PERMIT-AND DO HEREBY * AN~ ···-o FOR EXCAVATIONS OYEA
' CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall exp,re by llmrtet,on and become null and vo10 If the bu1ld1ng or worl< s· o· . -~MOt.lTIOH OR CONSTRUCTION M authorWld by ouch permit 1a not commenced wotllln 1110 <lays from the data of such DECLARATIONS ARE TRUE ANO CORRECT AND I FURTHER CERTIFY ANO AGRE£ If A PERMIT IS permit. or 1f the bu~<l1~or work autllorWld by such permit 1s suspended or ___,sTAUC -r•ER 3 STORIES IN HEIGHT
• ISSUED TO COMPLY WITH·ALl CITY. COUNlY AND STATE LAWS GOVERNING BUILDING CON• -.OOned at 1nv lime a the work ,s COfllfflllllC8( lor a oenod of 180 "•u•
STRUCTION. WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY ANO
APPLICANT·S~IGO OWN~□ CO..,TRACTO~ APPROVED 8 V lo//li/g-lf KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS, COSTS AND _E.. ~--EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE BY PHONE 0 GRANTING OF THIS PE'™IT ------~~ . 7
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TYPE I DATE INSPECTOR . I
BUILDING I
...
-,, ,-i., "'">ti ., 6 ' ~ •-. \-... --
-t~~... ,,...-"\~ -
.,. ... ,. ' -\
FOUNDATION I FIELD INSPECTION RECORD
REINFORCED STEEL I
I
MASONRY I -REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
GUNITE OR GROUT I INSPECTION REQ IF INSPECTOR'S DATE CHECKED APPROVAL
FLOOR & CEILING SUB FRAME I
I
SHEATHING D ROOF D SHEAR
SOILS COMPLIANCE
PRIOR TO
FRAME I ' FOUNDATION INSP
EXTERIOR LATH : STRUCTURAL CONCRETE
I OVER 2000 PSI
INSULATION I
INTERIOR LATH & DRYWALL I
I '
I
. PRESTRESSED ' CONCRETE '
\ POST TENSIONED C'ONCRETE .,.
PLUMBING I ' FIELD WELDING ' SEWER AND BUCO DIPUCO I
UNDERGROUND D WASTE D VVATER
TOP OUT D WASTE D WATER
HIGH STRENGTH
BOLTS
SPECIAL MASONRY I
TUB AND SHOWER PAN ' I
GAS TEST I "
PILES CAISSONS
D WATER HEATER D SOLAR WATER
I
ELECTRICAL I --
D ELECTRIC UNDERGROUND DUFFER
ROUGH ELECTRIC I
I
D ELECTRIC SERVICE D TEMPO~ARY '--
D BONDING D POOL I --,:_,. ---..J (-... ,
I -
MECHANICAL I \'
D DUCT & PLEM., D REF. PIPING
HEAT -AIR COND. SYSTEMS ' I
VENTILATING SYSTEMS I ' • .. ---\,, \ .,. • : 1 I
' ' \'. •. \f"' ! ' • • I . .,
I
CALL FOR FINAL INSPECT~~N Y{HEN1ALL0AP.~~OPR/A TE ITEMS ABOVE HAV BEEN·APPR VE . ,, ,; , • 1·• --~. \ ,-' ' FINAL I \ ., -,,
PLUMBING ·1 , \ -., \. ' • . r,'.·~; . .J'
~. ,._ \ ~ ... ,, .\ -:,,.--• ~· • ' \ .... -""I .. ,.(~ \ \ .
\, ·.; re -~ ' , ....... ·~ -, .. -♦ -
\ ~ :,\ • ... ·"'~
ELECTRICAL I Ai:>t "~1})
MECHANICAL I ,~~ •\J '
GAS I \7 {. ~ f"'\ ( ~ '• I l .1 ~ -
BUILDING I • ./ ~•\V ' I
. -,~t-\\ 1 ~-,\., ·,> ,, .. , \ . "~"' ·-~ ¥~ ·-' "\ ' -' •.' ' ' .... '-~ -.J,, ·-' ~ .
' \ -! . ,1 . -' .;. '~~.:· _, ' _, .... \.-\ .. . ' --' SPECIAL CONDITIONS I -.. .J
I
. . ' '
City of Carlsbad
APPLICATION FOR CERTIFICATE OF OCCUPANCY
BUILDING DEPARTMENT
1200 ELM 438-5525
Address where Business
will be conducted
Name of Occupant
Owner of Building
Type of Business
Describe exact use of all portions of each building and lot
Previous use of Building
Type of flammable or explosive liquids to be used, if any
Address
luo
VALIDATION
Building
Permit No.
Business
Phone
Home Office
Phone
Phone (/.;5--65C>O
I certify that I have read the statements contained in this application: that they are true and correct, and that I make this statement under penalty of perjury.
Dated this
Signature of
Applicant
Use Zone ?-C:::..
Planning ~ 117 Departmenlt::,.N"--'
Englneerln(V"\
Departmen\.,I
Fire
Prevention
Health Department
Building
Department
, 19
White -Building Dept.
In the City of Carlsbad, State of California
Signature of
Building Official
FOR DEPARTMENTAL USE ONLY
Disapproved
Disapproved
Disapproved
Yellow -Applicant Pink -Finance
By
By
By
By
By
Gold -Fire Dept.