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2320 VIA FRANCISCA; ; 83-271-2-5; Permit
II) z 0 ;::: C a: C ~ u Ill 0 IC IL l z 0 ;::: C II) z Ill Q. 2 0 u II) ir Ill ,0: a: 0 3 L ![ 0 I hereby affirm that I am licensed under provlo,-,,no 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. LIC No ------Class I hereby atwm lhat I am ex.empt from the Contrac-lor' s License Law tor Ille lollow1ng reascn (Soc 7031 5 Business and PJofessJOns Code Any city or county wh1c.h re-quires a perm,t 10 cons1ruc1. a11er. 1fflP{OYe demohsh, or repaM' any wucture. pnor 10 its issuance also requires !heap-phcanl _for such pennit to tile a s1qnect sta1ement that he 1s licensed pursuanl to lhe prOV1s100s of lhe ContractOf's license Law (Chapter 9 commencing with Sec110n 7000 of Divis.on 3 ot lht Bus.ness and Prnfess.ons Code) Of that ,s e11,~ empl therelrom and the baSlS lor !he altegea txemphon Any viola11on Section 7031,5 by an apphcan1 tor a perm11 sub-1ects I apphcant 10 a civil peNhy of nol more lhan hve hun-- dr ollars ($500) I. as owner of the property, or my employees with wages as lhetr sole compensatlOl"I. w,11 do the work. and the s1ruc- ture 1s not mtended or offered for sale (Sec 7044, Busmess and Profess,ons Code The ContractOf·s License Law does no1 apply 10 an owner ol property who builds or improves thereon and whO does such work himself or through his own employees. provided lhat such 1mpr0Yements are nol intend- ed or offered tor sa~. It, however. lhe building or improve- ment is SOid within one year of completion. the owner-builder w1l~hav the burden ol l)fOYU'IQ that he did not build Of im-P'"'" Ille purpose ot sale) , as owner of the proper1y. am exclus1vety contracting h licensed contractors to construct Ille project (Soc. 7044. Business and ProtesStOns Code. The Contractor's license Law does not apply to an owner ol property who buUds or im-proves thereon. and who contracts for each projects wit~ a contractor(s) lieense pursuant to the Contractor's Ltcense Law). D As a homeowner I am improving my home. and the follow· ing cond1t10ns exist: 1. The work is being pe~ormed prior to sale 2. I have lived in my home tor twelve moolhs p<kH to completion of this work. 3. I have not claHned this exempttOO during the laS1 three years. D I ,m exempt under Soc. ______ , 8& PC for this reason ------------- D 1 hereby afftrm lhal I na...e a cen111ca1e ol consent to self insure, or a cert1f,ca1e ot Workers Compensation Insurance. or a certified copy thereof (Sec 3800. l..lbo< Code> ~ ICY 0 CO ANY Co()y IS filed with the cI1y 0 Certified copy Is hereby turnishe<J CERTIFICATl OF EXEMPTION FROM WORKERS· COMPENSATION INSURANCE (Trus s.ec11on nee<J not be completeo 1t lhe permit ,s toe one hundred dollars (S 1001 or 1ess1 0 I cen,ty thal tn the pertormance ol the woo !or wtuch 1h1s permit Is issued I snail not employ any pe,son In any manner so as to become sub1ec1 to the Wot1te,s· Compensatt<>n Uilws of Calilorma NOTICE TO APPLICANT If. after mali.1n1 this Ceni ftcate ot Exemption you shOYld Deeome sub1ec1 l"l ttte wor11.ers • Compensat,on prov1s1ons ol Ille uoo, Code you must tor1hVi>1lh comply w,111 such provIsIons or this permit shall be deeme<J reVOke<J O I hereby affirm 1"411 there Is a cons1ruc1Ion Ieoo1ng agency tor the per,ormance of the "-'0rtii: tor wruch this perm,1 •S ,ssue<J 1Sec )097 c, ... II Cooel Lenoer 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 JOB ADDRESS AV ST.RO. NEAREST CROSS ST ID,~ ,tp g~ONI BUSINESS LICENSE It J):;_~N PERMIT NUMBER 2320 Via Francisca Hoso .. LOT BLOCK I suB01vrf's1 I ASSE,~01 pl~ N~ 0 V CONTRACTOR / I CONTRACTOR$ PHONE • ZON!il' -.,~, 83-271 -2-5 OWNER·s NAME ' OWNER'S PHONE Community Resources Corp. Community Resources Corp. CONTRACTOR•s ADDRESS LICENSE NO PLAN 1.0. # BLDG USE CODE OWNER'S MA•LING ADDRESS -DESIGNER LICENSE" STANDARD PLAN # BUILDING SO. FOOTAGE 2204 Garnet Ave., San Diego, Ca. 92109 I~~ 053 DESCRIPTION OF WORK DESIGNER'S ADDRESS DESIGNER'S PHONE . IUdg. 2-5 At...4;,Q s~ J~IJ___u_it n,r: ~-F/P FLA ELEV. NO OCC GP EDU t:9~ ~ w ...._Tlt' .J ~\~ vO NO s:3Es R-1 CENSUS TRACT GP LAND USE PARKING SPACE l REi~TS l GRADING PERMIT ISSUED I REDEVELOPMENT T YPE OCC LOAD FIRESPR I ~/ : i / .,: l ~ .~ 7 ~~ rt~ AREA N'b( nr-T, k vO N~ YO ND vO N ~ . Nor V;,/id Un~s Ahchine Certified - QTY. PLUMBING PERMIT -ISSUE QT Y. MECHANICAL PERMIT -ISSUE SUMMARY/ACCOUNT NUMBER ~- EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TD 100,000 BTU BUILDING PERMIT 01-00-00·8220 ~.6D- EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT 01-00-00-8221 ~ -- EACH WATER HEATER AND/OR VENT BOILE R/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 EACH GAS SYSTEM ~ 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 BREAKE R MECH EXHAUSl -HOOD/DUCTS M0BILEH0ME 01-00-00·8225 WATER SOFTNER RELOCATION OF EA FURNACE/HEATER M0BILEH0ME PARK INSP EACH ROOF DRAIN !INSIDE) SOLAR n,.nn.nn.•oo• -~-~ TOH,L MECHANICAL STRONG MOTION 80·92·33·0519 I /~.: -TOT AL PLUMBING I FIRE SPRINKLERS 01 ·00·00·8227 .I PUBLIC FACILITIES FEE 32·00·00·8933 /-~~~- Q T Y. E LECTRICAL PERMIT • ISSUE QTY. SOLAR • ISSUE J BRIDGE FEE NEW CONST EA AMP'SWT BKR COLLECTORS ...._____ SCHOOL FEE -DISTRICT I PH 3 PH STORAGE TANKS ,,,,,.,.. .. ' '\ Carlsbad 80·92·21-0519 EXIST BLOG EA AMP/SWT 'BKR ROCK STORAGE / / I I Encinitas 80·92· 22-0519 l PH 3 PH PUMP / r ' ~, I San Dieguito 80·92· 23·0519 REMODEL ALltR PEA CIRCUIT PLAN CHECK FEE/ ~ . I I San Marcos 80·92-24-0519 TEMP POLE 700 AMPS / {\A!}' ,_o / ? OVER 700 AMPS I _\Jr/ ,, LICENSE TAX 01-00-00-8162 ./ TEMP OCCUPANCY (30 DAYS) I I I .. , / \./ / CREDIT DEPOSIT TOTAL ELECTRICAL . I \___ TOTAL SOLA TOTAL FEES PAYABLE I 1.{i/1~ I HAVE CAREFULLY EXAMINED THE COMPLETED 11.PPLICATION II.NO PERMIT ANO 00 HEREBY E •porahon E--,~p,,rm1t 1ssue<1 by the Buotdtng Otf,coal under the p. rov,s,ons of tl'l1s * AN OSHA Pf.RMfT tS AEOUIRE0 fOfl EXCAVATIONS OVER CERTIFY UIII0ER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code~:pue m1tat1on and become null and VOtd If the building o, work 5· 0" DEEP 4flO DEMOl.fTION 0A CONSTRUCTION OF DECLARATIONS ARE TRUE II.ND CORRECT AND I FURTHER CERTIFY ANO AGREE IF A PERMIT 15 author b sue 111,1 not commenced wrttun t 80 days from the date i>f such STRUCTI.IAES OVER 3 STORIES IN HEIGHT perm, o, the ~~. Of wo,k authonzed by 1uch oe,m11 1s suspended or A ISSUED TO COMPLY WITH ALL CITY. COUNlY ANO STATE LAWS GOVERNING BUILDING CON• t a • er Ille wof'l 11 commenced tor a oenod of 180 A •••• STRUCTION. WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND A ICtyrzs:r;;::URE _. OWNE~ CONTRACTOR 0 APPROVI ) BY ,. "1:-t'· Ii-lo'J''/8? KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS. COSTS AND EXPENSES W)-HCH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE I I GRANTING OF THIS PERMIT & AM-BY PHONE 0 ~-'CL>t ~ a .. • -7 I -, ~ u:: >, ro 0 Q E Q) t- i -0 0 c., C co -~ 0. a. <{ I f4;: ii 0 "' "' Q) "' "' <{ I ~ .2 <P ~ "' "' Q) () 0 a: co co 0 ~ a, () C co C u:: C a, Q) 0 0 0 Q) a. rJ> C ~ E 3: TYPE I DATE INSPECTOR \~, ,_ \_ . ... ,-"{~ . ~ -..,-... --._\ I> \ '- BUILDING I I ' . ' ' ' ' _,.: •i <;~ ,;)-7 /-z.,~ \ ,· \ ,·, \ • t \ . FOUNDATION I FIELD INSPECTION RECORD ' REINFORCED STEEL I MASONRY I -I GUNITE OR GROUT ! REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES . INSPECTORS ,. ' REQ IF . INSPECTION CHECKED APPROVAL DATE FLOOR & CEILING SUB FRAME I SHEATHING D ROOF D SH~R FRAME I / EXTERIOR LATH I '.71 ~ ~ SOILS COMPLIANCE PRIOR TO FOUNDATION INSP STRUCTURAL CONCRETE OVER 2000 PSI INSULATION ! . - I INTERIOR LATH & DRYWALL I PRESTRESSED CONCRETE POST TENSIONED I CONCRETE . PLUMBING I / l FIELD WELDING SEWER AND BUCO DIPUCO I ID?J,·~ ~ UNDERGROUND D WASTE D WATER HIGH STRENGTH ,· ,..,.. ' ~----BOLTS TOP OUT D WASTE O W,ATER SPECIAL MASONRY "' TUB AND SHOWER PAN I GAS TEST I □·WATER HEATER D SOLAR WATER PILES CAISSONS I ELECTRICAL I D ELECTRIC UNDERGROUND D \JFFER ROUGH ELECTRIC I I ot.!'-~ '(. ..... ~- D ELECTRIC SERVICE D TEMPORARY ~-J.,.. ... ~~~' .. I ,, - D BONDING D POOL I I . ... I MECHANICAL I I D DUCT & PLEM., D REF. PIPING -;--\ .. : ; ~( V . - HEAT -AIR COND. SYSTEMS -. I .-\ f ~-,, ~ .. ~ , ,_,i -... . "' l ; 1' ' I •. • . I • . , VENTILATING SYSTEMS ' i • I ... ---' ---.... I . CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE ITEMS ABOVE HAVE_B~EN APPROVED. ,. FINAL : PLUMBING I ELECTRICAL I J' •• -. ' • .I ... I '.c.· ' . ..:\ .... ~ 1 ,t • •. ""') I . -. ' ..... MECHANICAL : ' j GAS I BUILDING I . ' .. .. , .. . ' SPECIAL -CONDITIONS I I I -- tll z 0 ~ IC C ... 0 "' 0 ~[ ~ C ... z 0 0 0 I hereby affirm that I am licensed under pro,talona of Chapter 9 (commencing with Section 7000> ot Dl•lslon 3 ot Iha Business and Profeaalons Code, and my license Is In lull force and effect. lie No ______ Clm # 0 ... 5 ~ "' z 3t 0 r z 0 ~ ~ z "' IL 2 0 0 tll ir: "' "' IC 0 3t I hereby att,rm 1nat I am exempt lrom the Contrac-ror-s License Law !or the following reason {Sec 7031 . 5 Business and Pro1ess,ons Code Any cily oc coun1y which re-quires a permit to conslruct. alter. improve, dernohsh, °' repair any slruclUre, pnor 1011s issuance also requ,res !heap- phc.an1 lor such penrnt to tile a s19ned statement thal he ,s hcensed pursuant to lhe prtMSions ol the Comractor s l1tense Law (Chapler 9 commencing w1lh Sec110n 7000 ol 0,v,s10n 3 ol lhe Business and Proless10ns Code) or Iha! rs ex• em.pl therefrom and Ille: bas-s roe lh! allegeo exemption Any vlOlat,on Of Sec!lon 7031.5 by an apphcant !or a permit sub· 1ec1s the app1tcan1 to a civ,I penalty of not more than trve hun· dred dollars ($500) ~ I.as owner of 1he properly. or my employees with wages I lhe1r sole compensation. w1U do the WOt'k. and lhe siruc-1 ture ,snot intended or ottered for sale (Sec. 7044. Business and ProtesstOnS COde. The Contractor·s ucense Law does not apply to an owner of property who budds or improves thereon and who does such work btmselt or th.rough his own employees. provlded lhal such improvements are not mlend- ed or ottered 101' sale II, however. lhe bu1khng 01' improve-ment ,s sofd wtth1n one year ot comp~hOn, the owner-buikjer w,11 have lhe burden ot prov,ng Iha! he did nol build or ,m- i • lor !he purpose ol sale). I, as owner ot lhe property. am exclusively contracting licensed contractors to conslrucl the projecl (Sec. 7044, Business and Professk>ns Code: The Contractor· s License Law does not apply 10 an owner of property who bu1kls or im-proves thereon, and who contracts foe each projects with a contractor(s) license pursuant to the Contractor's LJcense Law). □ As a homeowner I am improving my home, •nd lhe lollow-ing conditions exist 1. The work Is being performed prior 10 sale 2. I have lived ,n my home lor IWelYe monlhs priof lo comP'etion of this work. 3. I have not claimed th,s exempt,on during the Ias1 three years. g 11h~: ,:::'_ u_ndef __ Sec_. ===========-, 8 & P.C. 0 I nereby affirm lhat f ha-,e a cen11tca1e of consent 10 sell-insure, or a cer1'11ca1e of Workers· Compensatt0n Insurance. o, a cen,hed copy thereof !Sec 3800. Lal><>< Code) POLICY NO COMPANY Y C-Or,y ,s Mee:, ••th the city □ Certified c0py ,s hereby fum1shed CERTIFICATl OF EXEMPTION FROM WORKERS· COMPENSATION INSURANCE (This section need noI be completed •f lhe permit ,s for one hundred dollars (S 100) o, less, 0 I cen1fy that ,n the ~r1ormance of the WOOl to, which this penmt ,s issued. I shall not employ any person m any manner so a.s 10 become sub1ec1 h> the Workers· Compensation U ws ot California NOTICE TO APPLICANT If. after ma•un1 tt11s Cert, hcate of Exemption, you shOuld t>ecome sub1ect t? lhe W~ers· Compen~t,oo pr°"ISt00S of the Labot cooe. you must tor1h'A-1lh comply w11h such prov1sIons or this permit shall be deemed ,e,..Okeo i[ 0 I hereby attum lt\at mere Is a cons1ruc11on 1endmg aigency IOf lhe periQfmance ot !he ""'OOt fo, which this permit ,s issued (Sec J097 c, ... II Code) Lenoet s Name ___________ _ Lenders Address __________ _ USE BALL POINT PEN ONLY & PRESS HARD ·-APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. CARLSBAD BUILDING DEPARTMENT C APPLICATION & PERMIT 1200 Elm, Carlsbad, California 92008-1989 (619) 438-5525 JOBAOORESS AV ST.RO NEARESTCAOSSST. IDATEOFAPPL!CATIONI BUSINESS LICENSE Ii Lo~~·n,o PERMIT NUMBER~ 2320 Via Francisca Hosp 9/21/83 I 'ry J •~r ✓-V LOT BLOCK I sueo1v,s10N I ASSESSOR PARCEL NO. CONTRACTOR CONTRACTORS PHONE• ZONE t1 i\ :)A' v~ ii >, ~ 0 owNe R·s NAME I owNER's PHONE ..... c_o_mm __ u_n_i_t_y __ R_e_s_o_u_r_c_e_s __ c_o_r_p_. ___ +----=-=""'=-.,.,,..-----tf---------+-tS-v.....,.. >) ______ --1 Communi ty Resources Corporation 483_6500 coNTRAcToR·s AooRess ucENSE No. PLAN 1.0 . # ei.DG usE c o oE OWNER"S MAILING ADDRESS 2204 Garnet Avenues, San Diego, ca. 92109 0Es1GNER ucENsE• sTANDAROPLAN# eu1Lo1NGso.FooTAGE DESCRIPTION OF WORK 9~ J /fi~f ~, ......... ,. DESIGNER'S ADDRESS DESIGNER'S PHONE -.. ----• --' ' --------------------------------- ____ B_u_i_l~d :i.1'!8__ 2 _ -2 . _ _ _ . 15 _Uni ts ---• ~ FIP FLR ELEV. No occ GP Eou FOUNDATION ONLY STORIES -< -vO NO -- CENSUS TRACT I GP LANO USE I PARKING SPACE I RES UNITS I GRADING PERMIT ISSUED I REOEVELOPMENT TYPE occ LOAD FIRE SPA AREA CONST y □ N □ vO NO v O NO Not Valid Un~r Machine Certified QTY. PLUMBING PERMIT -ISSUE -7~ QTY. MECHANICAL PERMIT· ISSUE °3'-SUMMARY/ACCOUNT NUMBER /' I ---_.,.. EACH FIXTURE TRAP ' INSTALL FURN. OUCTS UP TO 100,000 BTU BUILDING PERMIT 01-00-00-8220 ~._.\, .J.t".'.> EACH BUILDING SEWER OVER 100.000 BTU SIGN PERMIT 01·00·00-8221 ~ - EACH WATER HEATER ANO/O R VENT BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01-00-00-8806 '""L.7J ~ , /~ EACH GAS SYSTEM l TO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING 01·00-00-8222 EACH GAS SYSTEM~ 0 R MORE METAL FIREPLACE ELECTRICAL 01-00-00-8223 - EACH lNSTAl .. ALTER. REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01-00-00·8224 EACH VACUUM BREAKER MECH EXHAUST -HOOOIOUCTS M081LEHOME 01-00·0Q-8225 WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP EACH ROOF DRAIN ()NSIDE> I SOLAR n1.no-nn.o??~ TOT I.L MECHANICAL STRONG MOTION 80-92-33-0519 / I 0-:J TOl AL PLUMBING I FIRE SPRINi<LERS 01-00-00·8227 QTY. ELECTRICAL PERMIT -ISSUE C QTY. SOLAR -ISSUE PUBLIC FACILITIES FEE 32·00·00·8933 "2-c> // - .,/ -BRlDGE FEE NEW CONST EA AMP/SWT1BKR COLLECTORS SCHOOL FEE . DISTRICT 1 PH 3 PH STORAGE TANKS Carlsbad 80-92-21-0519 EXIST SLOG EA AMP/SWT'BKR ROCK STORAGE Encinitas 80·92-22-0519 1 PH 3 PH PUMP San Dieguito 80·92·23·0519 REMOOEL'AL TEA PER CIRCUIT PLAN CHECK FEE San Marcos 80·92·24-0519 TEMPPOLE 200AMPS OVER 200 AMPS , LICENSE TAX 01-00-00-8162 TEMP OCCUPANCY 130 DAYS) ._ CREDIT DEPOSIT .(_ / /, ~) TOTAL ELEClRICAL I .. TOTALSDLAR TOTAL FEES PAYABLE I '?.-7-:W,-1-1 ·1 HAVE CAREFULLY EXAMINED THE COMPLETED .. APPLICATION AND PERMIT"' AND DO HEREBY ~-fll!lrYpermt~byfllellulldingOffic:relundertlleproviSKJnaof1t1,a * AN 08HA 1'£MffT IS~ FOR EXCAVATIONS OVEfl CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE h ..... ,~t,yffm andlleeoffltlnult-•Old N!llebutldlngorwortr !l'O"DEEPANOOEMOlJTIONCIRCONSTIIUCTIONOF DECLARATIONS IIIRE TRUE AND CORRECT ANO I FURTHER CERTIFY ANO AGREE IF A PERMIT IS aut °'.'z' 7,' 8',"'':,~ not ---180 Claya lrom Ille dafeol such STRUCTUAIES OYER 3 STOAIES IN HEIGHT ISSUED. TO COMPLY WITH ALL CITY. COUNl.Y AND STATE LAWS GOVERNING BUILDING CON-PWffllt 1!.&m,-::::.,; .,:,:,:~co:.~ ~ :::::!,i'~ ~ ot • STRUCTl()N, WHETHER SP-ECIFIED HEREIN OR NOT t ALSO AGREE TO SAVE INDEMNIFY AND Al~C~J'S SI ~ 0 0 AP:!)ED BY ' 0~¾0 KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS, COSTS AND V OWNER CONTRACTOR EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE .f. BY PHONE □ /. ~ 1J • ,., 1 "<l'::z.. GRANTING OF THIS PERMIT. • / /V~., _,., -.. I / ''"" 7 7 7 a. E Ql I- I -0 0 0 ...,cs C as .!:? ci a. <( I .x: C a: 0 "' "' Ql "' "' <( I ~ .Q ai >- en "' Ql (.) 0 a: as ca 0 ~ Ql (.) C as C ii C Ql ~ (.!) § (.) Ql a. "' C ~ .c. ~ .l. TYPE I DATE INSPECTOR BUILDING I -FOUNDATION I (J-,\. ~·,i; ,., I ......... xu, REINFORCED STEEL I ,r 1·~-,___., ' MASONRY r GUNITE OR GROUT I 1 FLOOR & CEILING SUB FRAME I SHEATHING D ROOF D SHEAR FRAME I EXTERIOR LATH I INSULATION I INTERIOR LATH & DRYWALL I J I l -PLUMBING I SEWER AND BUCO DIPUCO I .,,..-_J UNDERGROUND D WASTE D WATER 0 -7Xh:: ~1\ TOP OUT D WASTE D WATER . - 'TUB AND SHOWER PAN I - GAS TEST I C!J WATER HEATER D SOLAR WATER ' I ELECTRICAL I D ELECTRIC UNDERGROUND D µFFER . ROUGH ELECTRIC I ~ D ELECTRIC SERVICE D TEMPOOARY G BONDING D POOL I .. ~' I MECHANICAL I D DUCT & PLEM., D REF. PIPl"JIG HEAT -AIR COND. SYSTEMS I VENTILATING SYSTEMS I •• ' : CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE ___ ITEMS ABOVE HAVf BEEN AP.PROVED. FINAL PLUMBING ELECTRICAL MECHANICAL GAS BUILDING SPECIAL CONDITIONS ~' "': ~ ... --.... -. ' '-., •. " I )'~· J.,7 /· t£ /,,&.wd-' ' ' " , . . " i. -FIELD INSPECTION RECORD \ REQUIRED SPECIAL INSPECTIONS ' INSPECTOR'S NOTES INSPECTION REO IF INSPECTOR'S DATE CHECKED APPROVAL ... SOILS COMPLIANCE PRIOR TO FOUNDATION INSP I STRUCTURAL CONCRETE OVER 2000 PSI PRESTRESSED I CONCRETE POST TENSIONED CONCRETE FIELD WELDING HIGH STRENGTH ' , . ' BOLTS ~ SPECIAL MASONRY ~ . -'· ._ ~;' . PILES CAISSONS ' ,, . I ' ' ' ' . . ' ..... ' f .. j .. .•. - ,. ~' . . -:; ~;' ..... " ,..1~· ' • ' . ---I =-... ~ ' -. =--~. . ' ' i-;"(--· ',. ~, .:~ ~--t! 1 ' ' . ..:., "' ! -, . .. , ~= ·, ... ~ ( Ill z 0 ~ < a:: < _, 0 Ill 0 C I[ 81 1' CIC Ill a _, 5 !!! CIC Ill z ~ z 0 ~ < Ill z Ill CL :IE 0 0 Ill cc Ill ..: a:: 0 ~ il O I IHlreby affirm that I am licensed under prOYlalona 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. L,c No ______ Class I hereby affirm that I am exempt from the Contrac· !or's License Law lor !he lollow,119 reason (Sec 7031 5 Business and Professions Code Any city or county whicn re-quires a perm,t lo construct aller improve, demoflsh or repair a"y struclure, prior 10 ,ts issuance atso requires !heap--phcanl for such permit to file a s1Qned s1a1ement !hat he ,s hcensed pursuant to the prov1st0ns ol the Contracto(s License Law !Chapter 9 coovnencmg with Secllon 7000 of DIVISIOR 3 or tne Bu~ness and ProfeSSIORS Cooe) (){ that IS ex· empt therefrom and lhe basis lot the alleged exemplt00 Any ;~1~i~ :~~!:11t~3c\Ji :~71:,~~: ~~= ~~~: dreo dollars ($500) I. as owner ol the property. or my employees wll.h wages as their sole compensa1ion. will do the work. and !he struc· lure 1s not intended « ottered lor sale (Sec 7044 Business and Proless,on!, COde The Conlractor's l1Cense law does 001 apply to an owner of ptoperty who bu11ds or lfflproves thereon and who dOes such work h1msell or lhrough his own employees, prov,deo lhat such ,mpn:wements are not intend· ed or ollered tor sale. II, however, lhe bu11d1ng or Improve- menI Is said within one year of completion. the DW"8f·bu1lder will have the burden ol prOVing that he did not build Of 1m- P'""• lo, lhe purpose ol sale) D I, as owner of lhe property. am e,:ctusrvely contracttng w11h ltCensed contracrors to construe! the prOJeCI (Sec. 7044, Business and Proless10ns Code· The Contractor's license law does not appty to an owner ot property who builds or im-proves thereon. and who contracts tor each protects with a con1ractor(s) l1tense pursuant to the Contractor's License Law) D As a homeowner I am Impr01Jmg my home and the follow• ing conditions exist· 1. The WOfk is being performed prior to sale 2. I have lived in my home tor twelve months prior to compIBtton ol this WO(k. 3. 1 have not ci.atmed this exempll()fl dunng the last three years 0 I am exempl under Sec. ______ . B & P C tor this reason ------------- D I rie,eby affirm that I hao1e a certificate ot consen1 10 selt insure, or a cen,t1ca1e of Workers Compensation Insurance Of a cert1f1ed copy thereof (Sec 3800 L.atx>< Code) POLICY NO COMP"NY □ Coc>y IS hied Wllh the Ctl)' 0 Cer111ted copy •s tiereb-, turn,shed CERTIFICMl OF EXEMPTION FROM WORKERS" COMPENS"TION INSURANCE (This section need not be completed 11 lhe permit 1s IOt one hundred dollars ($100) o, less) D I cer11ty that 1n the performance ol the work tor 'llll'hlCh this permit IS issued, I Shall nol emplO'f any person ,n any manner so as lo become subJetl 10 lhe Wor11.ers· Compensa11on Laws ol Cal1forn1a NOTICE TO APPLICANT If. after makm:J !his Ce,i, ltcate of Exemption. you should t>eeome sub1ec1 I? the Wor11.ers· Compensation pro..,,s,ons ol the Lat>or Code, you must forth""' 1th comply w,tn such pro..,1s,ons or 1h,s permit shall be deemed re"o"eo 0 I hereby aftum that !here ,s a con~truc11on 1endmg aoency tor !he performance ot 1he wonl tor which th•s perm,1 1s 1ssuec1 1Sec JIY31 C,v11 Cooe1 Lenders Name ___________ _ Lender's Address __________ _ USE BALL POINT PEN ON_LY & 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 ~~~VST.RO NEARESTC~/& ~ I 0ATE OF APPLICATIONII BUSINESS LICENSE ,. VALUATION PERMIT NUMBER --23.:lO ,,v~/.P..3 93->...7/-'/£ LOT I BLOCK I suao, v•S•ON I ASSESSOR PARCEL NO CONTRACTOR CONTR"CTORS PHONE • ZONE ~~µ AL .,1_ I I/ p~/4?1'-Y.??/ r OWNER'S NAME ~&-l61i ;;:~;;a "I - I?. -----a_ :;;;;;;~R~ , ~1 LICENSE NO PLAN 1.0. # BLOG USE CODE -~ 0;::z~;; • IN7:::UZ-V ~AJ~.-. DESIGNER V LICENSE # STANDARD PLAN # BUILDING SO. FOOTAGE OESCRIPT•ON OF WORK V DESIGNER'S ADDRESS DESIGNER"S PHONE .A/~ #-/6 /S~. .....----F/P FLR ELEV . NO EDU -OCC GP STORIES l lf.!~,,~~~6C ·en.oc vD NO -- CENSUS TRACT I GP LANO USE I PARKING SPACE I RES UNITS I GR"DING PERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRE SPR AREA CONST YD ND vO NO vO NO Nor Valid Unltss Machine Curdi«t QTY. PLUMBING PERMIT· ISSUE 7,fo QTY. MECHANICAL PERMIT · ISSUE ~cJ() SUMMARY/ACCOUNT NUMBER ~ EACH FIXTURE TRAP "')//'J. -INSTALL FURN. DUCTS UP TO 100,000 BTU BUILDING PERMIT 01 ·00·00·8220 I EACH BUILDING SEWER 6-s-~ OVER 100,000 BTU SIGN PERMIT 01 ·00·00·8221 - l~ -EACH WATER HEATER AN010R VENT ~?-..s? 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 ~ 7V, - 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 s EACH VACUUM BREAKER /_:]. St. MECH EXHAUST HOOD/DUCTS -M0BILEH0ME OHJ0·00·8225 WATER S0FTNER RELOCATION OF EA FURNACE/HEATER MOBILEH0ME PARK INSP EACH ROOF DRAIN (INSIDE) SOLAR n1-nn-nn.o?oo TOTt.L MECHANICAL STRONG MOTION 80·92·33·0519 -- TO r Al PLUMBING I ..::1'/L/-FIRE SPRINKLERS 01 ·00·00-8227 <;(}(J 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 1 PH 3 PH STORAGE TANKS Carlsbad 80·92·21·0519 EXIST BLOG EA AMP/SWT BKR ROCK STORAGE Encml!as 80·92·22·0519 1 PH 3 PH PUMP San 01egu1to 80·92· 23·0519 REM00EL'ALTER PER CIRCUIT PLAN CHECK FEE San Marcos 80·92· 24·0519 TEMP POLE 200 AMPS I· 0 VER 200 AMPS LICENSE TAX 01-00-00-8162 TEMP OCCUPANCY 130 DAYS) CREDIT DEPOSIT TOTAL ELELTRICAL I TOTAL SOLAR TOTAL FEES PAYABLE I ,..L?Y, - I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION ANO PERMIT" AND DO HEREBY E•p1rat10n Every penn,t rssued by'"• Bu1ld1ng OH1c1e1 under the prov,s1ons of this * AN OSHA PERo.1IT IS REQUIAEO FOR EXCAVATIONS OVEII CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall e•ptre by hm,tahon and become null and void It the bu1td,ng or work 5· O" DEEP AND DEMOLITION OIi CONSTIIUCTION OF DEC LARA TiONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS authonzed ~Y. m,t 11 not commenced w1th1n 180 days from tne date of such STRUC1\JR£S OVEII 3 STOIIIES IN HEIGHT permit. Of , lld•~r;,2 ~~r1zeC1 by sucihl, perm11 1s suspended or ISSUED TO COMPLY WITH ALL CITY. COUNlY AND STATE LAWS GOVERNING BUILDING CON I an me a t ork commenced to a oenod ol 180 oa-- STRUCTION WHETHER SPECIFIED HERE.IN OR NOT I ALSO AGREE TO SAVE INDEMNIFY ANO AP717:;;r ft ow~□ NTRACTOR D. APPROVED B~ 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 BY PHONE 0 I //-l-'/ GRANTING OF THIS PERMIT / ' 7 ~ u:: >-.;; 0 a. E; ~ C "' u a. a. <t I .:,,: C a: 0 Cf) Cf) (1) Cf) Cf) <t I ;;:: 0 aj >- Cf) Cf) (1) u 0 a: "' co D ~ (1) u C "' C u:: :=. C (1) ~ C, 0 0 (1) a. Cf) C ~ .c ~ .. ~ -----...l. --------------TYPE I DATE INSPECTOR BUILDING I FOUNDATION I I REINFORCED STEEL I MASONRY I GUNITE OR GROUT I I FLOOR & CEILING SUB FRAME I SHEATHING D ROOF D SHEAR _.,,, FRAME I II . !O•f'i11 ~ I EXTERIOR LATH . I INSULATION I INTERIOR LATH & DRYWALL I I I PLUMBING I SEWER AND BUCO DIPUCO I UNDERGROUND D WASTE D WATER / TOP OUT D WASTE D W~TER '7~• 1!4-~ ~ TtJB AND SHOWER PAN I l·ID•~ IA'17JJ GAS TEST I □\WATER HEATER D SOLAR WATER I ELECTRICAL I D ELECTRIC UNDERGROUND D ljJFFER ROUGH ELECTRIC I I · I IJ ·-F'1!. I.Ac-- D ELECTRIC SERVICE D TEMPOIIIARY D BONDING D POOL ' I I MECHANICAL I D DUCT & PLEM., D REF. PIPl~G ~ ,.., HEAT -AIR COND. SYSTEMS I --VENTILATING SYSTEMS I --. . .. - I I CALL FOR FINAL INSPECTl©N WHEN ALL APPROPRIATE ITEMS ABOVE HA V! BEEN APPROVED. FINAL I I PLlJMBING I ., l ELECTRICAL I MECHANICAL ' I GAS I ~ ~ I . BUILDING I .. SPECIAL CONDITIONS I I ' j?,.., ,-, , I-ZS f /t)r,,. 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 I CONCRETE POST TENSIONED CONCRETE FIELD WELDING HIGH STRENGTH BOLTS SPECIAL MASONRY PILES CAISSONS l --· . ,. ; -:...C:'""· -"' ' f ,.. ,._ " -.... . '~~ 1..J,_ .... -. ~ . ~ -· -' ,-~ -" < I ~ " -..''·'· ~ ... ~ ""\:--;.,. ,:;.. ' . --,_ '· , ... ~ ~- ~ ,_ Cl) z 0 i= C a: ~ () "' 0 C · I[ 0 0 a: "' Q .., 5 ~ "' z ~ z 0 i= C Cl) z "' ... :I 0 0 Cl) ~ "' "' a: 0 3 il O I hereby affirm 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 ______ Class I hereby alhrm lhat I am !J(empl lrom Ille Contrac· 10<'5 License Law for lhe following ,eason (Sec 703! 5 Business and Proles$lonS Gode Any aty Of coun1y wh,cli re- quires a permI1 to construe!, aI1er. ,mprow, demohsh. or repa,r any struclure. pnor to its issuance also requires !he ap- phcant for such permit to tile a signed statement Iha! he 1s licensed pursuant to lhe proviSJOns of lhe Contractors Ltcense Law {Chapter 9 commeocing with Section 7000 of O,v,sion 3 of 111• Business and Professions Corle) or lhal is••· empl 11\erefrom an<l 1he basis 10< Ille anegoo exemp110n ~ny VIOlahon ol SecllOn 7031 .5 by an appl114n1 tor a permI1 sub-1ects the applicant to a civil penally ot not mofe Utan lr,e hun-dted dollats ($500) O I, as owne, of lhe ptopetty or my emplDytes with wages as their sole compensation, w1N do the work, and the struc-ture ,s nol Inlended or oflered IOJ sale (Sec 7044, Business and Prolessions COde lhe Conlractor's Ucense Law does not apply to an owner ol property who bonds or improves thereon and who does such w«k h1mselt Of lhroogh his own employees, provided thal such Imprcwements are not inlend• eel Of oflerec for sale U. however, the building or improve-ment is sofd within one year of complehon, the owner-builder will have lhe burden of proving that he chd not butld or im-prove for Ille purpose ol safe) 0 I. as owner ol lhe property. am exclusiVety contracting with licensed conlractOfs lo construct lhe project (Sec 7044, Business and Proless10ns Code: lhe Conlractor·s Ltcense Law does no1 apply 10 an owne, ol ptope~y who builds 0< im-proves thereon. and who contracts tor each projects with a contractor(s) license pursuant 10 the ContractOf's License Law). o As a homeowner I am 1mprov1ng rrrr home, and Ille follow· ing conditions exist 1 . lhe work is being pertOfmed pnor to sale 2. I have lived in my home for lwelve months prior 10 completion of this work. 3. I have nm claimed this exemption during lhe last three years. □ I am exempl un<let Sec. ______ . 8 & P.C. for this reason ------------- □ I hereby alftrm thal I ha~ a certificate ol consent to self.insure. or a cert1hcate of Work.ers Compensation Insurance. or a cen,fted copy lhereol :I::~ ubot Code) ¥ COMPANY 0 Copy IS hled Wtlh the city 0 Cen1fled copy Is hereby furnished CERTIFICATl OF EXEMPTION FROM WORKERS· COMPENSATION INSURANCE (This seetton need oat be completed ,f lhe perm,, ,s fOf one hundred OOllars (S 1001 or less) 0 I cert,ly lhal ,n the P@rfo«nance ot Ille wort,, lor which U'Hs permit ,s ,ssued. I shall no1 employ any person 1n any manner so as 10 t>ecome sub1ect to the Workers· Compens.a.hon Laws or Calllorn1a NOTlCE TO APPLICANT ti, aher maktnJ ltus Gen, hcate ot E•emp11on. you should t>ecome sub1ect I'> 1he Wor1c.ers· Compens.a.tton prov1s1ons ol the uoo, Code. you must tonh-.,lh comply w1lh sucn p,ov1s,ons or this perrrul ShaJI be deemed re.,iokea D I hereby atti,m that tnere ,s a cons1ructIon Iend1ng agency tor the periormance of lhe .... on-. !or which 1n1s perm,1 ,s issued (Sec .)()97 C11ol COOet Lenders Name ___________ _ Lenders A<>Oress __________ _ USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. CARLSBAD BUILDING DEPARTMENT 1200 Elm. Carlsbad. California 92008-1989 (619) 438-5525 APPLICATION & PER'T DATE. OF APPLICATION BUSINESS LICENSE "f VALUATION f'""""o,o,wos~ -➔ ---f"~•;~•:~:~~,m GRADING PERMIT ISSUED --,;jo STORIES ~ ~3?,;2e, LICENSE• DESIGNER"S PHONE OCC GP EDU OCC LOAD FIRE SPR ZONE PLAN 1.0. # STANDARD PLAN # PERMIT NUMBER yy;.,71~ BLOG use CODE BUILDING SO. FOOTAGE - CENSUS TRACT I GP L ANO use I PARK1NG SPACE I RES uN1TS I YO N □ l REDEVELOPMENT AREA vO NO TYPE CONST vO NO / T . Not Valid Un!ffslhch'me Certified --- QTY.I PLUMBING PERMIT -ISSUE -;~ QTY. MECHANICAL PERMIT· ISSUE 3-SUMMARY/ACCOUNT NUMBER EACH FIXTURE TRAP / 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 AND/OR VENT BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01 ·00·00·8806 EACH GAS SYSTEM I TO 4 0 UTLETS BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING 01 ·00·00·8222 EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE ELECTRICAL 01-00-00-8223 I 7<~-- EACH INSTAl . ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01 ·00·00·8224 EACH VACUUM BREAKER MECH EXHAUST -HOOD/DUCTS MOBILEHOME 01 ·00·0Q·8225 WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MDBILEHOME PARK INSP EACH ROOF DRAIN (INSIDE) SOLAR n1.m.nn.oooc TOThL MECHANICAL I STRONG MOTION 80·92·33-0519 TOTAL PLUMBING I FIRE SPRINKLERS 01·00·00·8227 QTY.I ELECTRICAL PERMIT · ISSUE ~-QTY. SOLAR • ISSUE PUBLIC FACILITIES FEE 32·00·00·8933 \ BRIDGE FEE NEW CONST EA AMP 'SWT 1BK R ~l"Y>A /~P-COLLECTORS \ SCHOOL FEE • DISTRICT I PH 3 PH STORAGE TANKS ~ I Carlsbad 80·92·21·0519 EXIST BLDG EA AMP/SWT,'BKR ROCK STORAGE A "' ~ Encinitas 80·92· 22·0519 1 PH 3 PH PUMP /V--,Tl I San Dieguito 80-92·23-0519 REMODEL 'ALHR PER CIRCUIT PLAN CHECK FEE /,, Y ,tr /1) ✓ San Marcos 80·92· 24·0519 TEMP POLE 100 AMPS I I 11.J ~ 'b / OVER 100 AMPS r,✓_ / V ./ I II LICENSE TAX 01-00-00-8162 TEMP OCCUPANCY (30 OAYSI \ V PJ / \ / CREDIT DEPOSIT TOTAL ELECTRICAL l /~~/1 l TOTAL~AR TOTAL FEES PAYABLE I /Sf'-- 1 HAVE CAREFULLY EXAMINED THE COMPLETED• APPLICATION AND PERMIT ' AND DO HEREBY Exp,rabon Every perrntt ouued bythe8u1ldtng Ofl1c1al un-the prov,s,ons ofth1s CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall expire by hmitat,on and become null and void If the building or wort< * AN OSHA PERMIT IS FIECIUIA£O FOR EXCAVATIONS OYER DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY ANO AGREE IF A PERMIT 1$ aulhonzed by such permit ,snot commenced w,th,n 180 days from the date o>f such ISSUED~ TO COMPLY WIJH ALL CITY COUNlY AND STATE LAWS GOVERNING BUILDING CON .,.,m,t. °' ,f the build,l or worlt aulhor,zed by such pe,m,t •• s ded or STRUCTION WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND -doned at an hma • ., the work 11 commenced for• od KEEP HARMLESS THE CITY OF CA. RLSBAD AGAINST ALL LIABILITIES. JUDGMENTS. COSTS ANO APPlQT°gE If. OWNE NTRACTO'°' EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE"'-. ~ ' GRANTING OF THIS PERMIT • ~---· -~---~ BY PHONE 0 -vv / s· o· DEEP AND DEMOLITION OR CONSTAUCTIOH OJ STRUCTUAtS OYER 3 STORIES IH HEIGHT 'APPROVED BY I? 1rl11/ 7 "T .!' u::: >-.; 0 a. E Q) I-- I " 0 Cl C co () a. a. <( I ~ C a: 0 "' "' Q) "' "' <( I ;: .2 ai >- Cl) "' Q) () 0 ct co iii 0 ~ Q) () C co C u::: C Q) Q) c'.; 0 0 Q) a. "' C ~ .c ~ City of Carlsbad APPLICATION FOR CERTIFICATE OF OCCUPANCY BUILDING DEPARTMENT 1200 ELM 438-5525 Address where Business will be conducted Name of Occupant Address of Home Office of Occupant if different from above R...AOC...I Owner of Building of) /.I /111 Al IT t. S o I(_ re. E ..s Type of Business Describe exact use of all portions of each building and lot Previous use of Building t,J Type of flammable or explosive liquids to be used, If any {}A)E A Address VALIDATION Buildini Permit o. --t> ~~~i;:ss #-,3 ,P--b / O / Home Office Phone Phone './:1'-bSOO 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 Planning Department Engineering Department Fire Prevention Health Department Building Department , 19 Signature of Building Official FOR DEPARTMENTAL USE ONLY Occupancy Group (2;-Type of Construction Disapproved By Disapproved By Disapproved By By By White -Bulldlng Dept. Yellow -Applicant Pink -Finance Gold -Fire Dept.