HomeMy WebLinkAbout2325 VIA FRANCISCA; ; 83-271-4-3; PermitIll z 0 ~ a: j
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O '1 hereby attlrm 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.
L,c No ------Class
I he1eby alfirm that I am exempt 11am the Conllac-tor's License Law lor the following 1eason (5ec 7031 ~
Business and Pfotess1ons Code A.ny city °' county whach re· qu,res a permit to construct, alter, improve. demolish, or
repair any structure, prior to its issuance also requires :heap-plicant for such perrrut to t,te a stgned statemenl that he 1s
licensed pursuanl to lhe prov1sM>ns of the Con1rac10,·s
License Law (Chapter 9 commenc111!! with 5ect,on 7000 ot 01V1s1on 3 ol the Busmess and Proless10ns Code) or thal 1s ex·
empt lheretrom and the bisrs for lhe aUegeo exemption Any vlOlauon ot Sect10n 7031 S by an applicant tor a permit sub· 1ects ltle apphcanl to a c,v,I penalty of not more than hve hun-
d1ed dollalS ($500).
□ I, as owner of lhe p1operty, or my employees with wages
as !heir sole compensation, will do the work. and lhe slfuc·
ture is not Intended or offered for saie (Sec 7044, Busmess
and Professions Code. The Contractor's License Law does nol appty to an owner ot property who bt.ulds Of improves
thereon anCI who does such work tumself or through his <Mn employees, provided lhat such improvements a,e not intend-
ed or offered tor sale. If, however. the bu1khng or improve-ment is sold wittun one ~rot completion, the owner-bui&der
win have the burden ot proving lhal he did not bu1ki or im•
prOYe for lhe purpose ot sale),
0 1, as owner of the prC>perty. am exclusively contracting wtth licensed contractors to construct lhe project (Sec. 7044, Business and Prolessk>ns Code: The Contractor's License
Law does not apply to an owne, ot p1operty who builds or im-proves thereon. and who contracts for each projecls with a contractor(s) license pursuant to the Contractor's License Law).
□ As a homeowne, I am improving my home, and the !allow· ing conditions exist:
I. The work is being pertormed prior to sale. 2. I have lived In my home tor twelYo months
prior to completion ot this work. 3. I have not claimed !his exemptton during the last three years.
l;, :h~:,-::::i unde1 Sec.------, B & P.C. ------"-----
□ I hereby .affirm that I ha.-e a cen1hcate ot consent
10 self-insure. or a cen1t1ca1e of Workers·
Compensahon lnfance, or a cen1hed copy thereof
(Sec 3800, UOO< I
POLICY N';,/0
COMP,
0 C.er11f1e<I CoPy 1s hereby furnished
CERTIFICATl OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE (Th1.s section need not be completed 1f the perm,1
,s tor one hundre<I OOllars (S 1()()) or less)
0 I certify that 1n the performance ol lhe we>OI lor
wh.Ch this permit 15 issued. I shall nol employ any
person in any manner so as to be-Come sub1ect 10
lhe WOf'kers· CompensatK>n Laws of Cahtomia
NOTICE TO APPLICANT If. after makin1 this Cert•
hcate ol E•emption. you sh0vk1 beeome subJect I? the Workers· Compensation pro..,1s1ons of the Labor
Code. you must forthwith comply w1lh such
prov1s1on5 or 1h15 perm11 Shall be deemed re\/Oiile<J
O I nereby affirm lhat there ,s a construc11on
lend,no aoency IOf the periounance or lhe wont lo,
which this permit 15 issued tSec JIJ97 C1v1I Codel
Lenc,e, s Name ___________ _
Lender's Address __________ _
USE BALL POINT PEN ONL!_!_ PRE~S HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
CARLSBAD BUILDING DEPARTMENT
1200 Elm, Carlsbad, California 92C>08-1989 (619) 438-5525 APPLICATION & PERMIT
JOB AO0RESS
2325 Viahancl~c~
AV. ST.RO. BUSINESS LICENSE •
-, SUBDIVISION
NEAREST CROSS ST.
Hosp
] ASSESSOR PARCEL NO
I DA TE OF Al"PLICA-TION-,
Q/21 /81
VALUATION
'-908.:;; ~7tl?
ZONE /
PERMIT NUMBER
-,.f,3 ;;,Jfl LOT BLOCK CONTRACTOR
_:i~~~
OWIIIE R'S NAME OWNE R"S PHONE Community Resources Corp .
Community Resources Corporation 483-6500 C0NTAACTOR"S AOOAESS
OWNER'S MAILING A0ORESS
2204 Garnet Avenue, San Diego, Ca. 92109 DESIGNER
DESCRIPTION OF WORK
DESIGNER'S ADDRESS
Building 4-3 8 Units
F/P FLR ELEV.
FOUNDATION ONLY vO NO
CENSUS TRACT GP LANO US,ARKING SPA CE I RES UNITS I GRADING PERMIT ISSUED I REOEVELOPMENT
AREA
YO N 0 vO NO
QTY.I PLUMBING PERMIT · ISSUE 7~ QTY. MECHANICAL PERMIT · ISSUE
EACH FIXTURE TRAP . INSTALL FURN . DUCTS UP TO 100,000 BTU
EACH BUILDING SEWER OVER 100,000 BTU
EACH WATER HEATER ANO/OR VENT BOILER/COMPRESSOR UP TO 3 HP
EACH GAS SYSTEM l TO 4 OUT LETS 80 ILER /COMPRESSOR 3-15 HP
EACH GAS SYSTEM 5 OR MORE MET AL FIREPLACE
EACH INSTA~. ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT
EACH VACUUM BREAKER MECH EXHAUST -HOOD/DUCTS
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER
EACH ROOF ORAIN (INSIDE)
TOTJ;L MECHANICAL
TOT AL PLUMBING I
QTY.I ELECTRICAL PERMIT • ISSUE ::r--QTY. SOLAR • ISSUE
NEW CONST EA AMP/SWT 1BKR COLLECTORS
l PH 3 PH ' STORAGE TANKS
EXIST BLOG EA AMP/SWT /BKR ROCK STORAGE
l PH 3 PH PUMP
REMOOEL 'ALTER PER CIRCUIT PLAN CHECK FEE
TEMP POLE 200 AMPS
OVER 200 AMPS
TEMP OCCUPANCY (30 DAYSI
TOTAL ELEt:TRICAL l TOTAL SOLAR
-------;w-
STORIES
TYPE
CONST
3-
CONTRACTORS PHONE •
LICENSE NO. PLAN 1.0 . # BLDG USE COOE
LICENSE• ST ANDA RO PLAN# BUILDING SO. FOOTAGE
DESIGNER'S PHONE ~c! 1,,~ -... ~ .. 188!;51
OCC GP EDU
DCC LOAD F IRE SPR
vO NO Not Valid Unlffs Machine Certifil!d
SUMMARY/ACCOUNT NUMBER
BUILDING PERMIT 01 ·00·00·8220 ~
SIGN PERMIT OHl0-00·8221
PLAN CHECK 01 ·00·00·6606
TOTAL PLUMBING 01 ·00·00·8222
ELECTRICAL 01·00·00·8223
MECHANICAL 01 ·00·00·6224
MOBILEHOME 01 ·00·00·8225
MOBILEHOME PARK INSP
SOLAR OH!Q·00·8226
STRONG MOTION 60·92·33·0519 -su-...i._
FIRE SPRINKLERS 01·00·00·6227
PUBLIC FACILITIES FEE 32·00·00·8933 t4J5l-
BRIDGE FEE
SCHOOL FEE • DISTRICT
Carlsbad 80·92·21·0519
Encinitas 80·92-22·0519
San Dieguito 60·92· 23·0519
San Marcos 80·92· 24·0519
LICENSE TAX 01-00-00-8162
CREDIT DEPOSIT zn.3,z
TOTAL FEES PAYABLE r l9 ~351
I HAVE CAREFULLY EXAMINED THE COMPLETED "'APPLICATION AND PERMIT" AND DO HEREBY
CERTIFY UNDER PENALlY OF PERJURY THAT AU INFORMATION HEIIEON INCLUDING THE
DECLARATIONS ARE TRUE AND COftRECT ANO I FURTHER CERTIFY ""8 AGREE IF A PERMIT IS
ISSUED: TO .COMPLY WITH ALL Clt.Y. COUNTY ANO STATE LAWS GOV£RN1NG BUILDING CON-
STRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY ANO
KEEP HARIIILESS THE CITY OF CARLSBAD AGAINST AU LIABILITIES. JUDGMENTS, COSTS ANO
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE. OF THE
~NTING OF THIS PERMIT
~.e-y....---~6'lftlel--lliepr-oflllla
(:ollt--~~-----..... "°"'· lf-llullding«-'
* AN~ 'fMlfT. IIEQI-, RIii EXCAVATIONS OVER s· 0--DEEP AND DEIIIOUTION OR 00NSTffUC1'10N ~ MdllarDdllr ii ___. ..... .,., __ tfomtbedaleol-
,.,8111. DI It • • _. au111or111111 !Ir IUCh permit iS or
~x-•-•:;;---~.:--.. TOR□ ·c:,. .,.--BYPHONEO
-----······----
Sl'RUCn.e_ OVER 3 STO.S IN HEIGHT L .. ~1FL~
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TYPE I DATE INSPECTOR I
BUILDING I
--~ ,.._ ' -•
' 8~"~' 1-l.f~ ' ,,, ~ . ' • -
r · . 1 ~'1'•-"-.
FOUNDATION I
REINFORCED STEEL I
MASONRY I
l
GUNITE OR GROUT I
FIELD INSPECTION RECORD '-I. ' 1 \ .
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES , ,. l • .. . INSPECTION REO IF INSPECTORS DATE CHECKED APPROVAL -. .
FLOOR & CEILING SUB FRAME ' / I
SHEATHING □ ROOF ~HµR • !_•)> kl_ / ~
FRAME ' I
. . .
SOILS COMPLIANCE
PRIOR TO ' FOUNDATION INSP t
EXTERIOR LA TH -I
I
STRUCTURAL CONCRETE
OVER 2000 PSI
INSULATION I PRESTRESSED
INTERIOR LATH & DRYWALL I ·.,-,~[·~ , -~-~
' I
CONCRETE " 1
POST TENSIONED .
I CONCRETE
PLUMBING I FIELD WELDING
SEWER AND BL/CO □IPL/CO I . . 1 '
UNDERGROUND □ WASTE □ 'yVATER
TOP OUT □ WASTE □ WATER
HIGH STRENGTH ~ . . I I sou's ,-.,... --• f ••
I SPECIAL MASONRY . . ' ,
TUB AND SHOWER PAN I .. _..__
I
GAS TEST I
I
.
PILES CAISSONS
□ WATER HEATER □ SOLAR WATER i---:-! rs ..
1' ' I
ELECTRICAL ' I
Ii
□ ELECTRIC UNDERGROUND □ UFFER
ROUGH ELECTRIC I
l! b ... ,,., ~ .
II '..,, \ .
I
□ ELECTRIC SERVICE □ TEMPO~ARY ~
,.., ..
-"\i,.-1
□ BONDING □ POOL I ~ . ~----~ ~ I
I t:
,. -I ..
MECHANICAL I
I
-~ . ,. r
□ DUCT & PLEM., □ REF. PIPING -
HEAT -AIR COND. SYSTEMS I
VENTILATING SYSTEMS I
I
I .. ..,..-.-_. --•
CALL FOR FINAL INSPECTlbN WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE BEEN APPROVED.
~~ "\.-•-. .
FINAL I
PLUMBING I
'-1,' ' \. . .,. .,. .,. l
't-~\. \ ... '\\ -")
-. -\ . . .
ELECTRICAL ' I
MECHANICAL I
I
GAS I
' \." BUILDING ' I .
SPECIAL CONDITIONS I I -
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It;) : hereby efllrm lhat 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 ______ Class
I hereby alfirm !hat I am exempl from the Con1rac-1of' s license Law for the rollowtng reason (Sec 7031.5
Business and Professions COde Any city or county whd1 re-quires a permit lo construct. alter. improve. demohsh. Of
repa,r any struclure. prlOt' 10 its issuance also requires the ap-
pkcant tor such perm,1 to flle a s10ned statement th.al he ,s
licensed pursuant 10 the prov1s10ns ol the coniracto( s License Law {Chapter 9 commencing with SectlOfl 7000 ol
Ow1s1on 3 oJ the Busmess and Professions Code) or that 1s ex-empt lherelrom and the ttasis tor lhe aUegea exemption Any
v!Olation o SeclJOn 7031.5 by an applicant tor a permu sub-jects th pphcant to a c1V1I penalty of not more than live hun-dred lars (S500)
I. as owner 01 lhe property, or my employees with wages
~ their sole compensahon, will do !he work. and lhe slruc·
ture 1s not ,nlended Of ottered I« sale (Sec 7044, Business
and Professions COde The Contractor's Ucense Law does
001 apply to an owner of property who builds or Improves
thereon and who does such work himself or 1hrough his own emptoyees, provided that such improvements are not intend-
ed or otter for sale. If, however. the bu11dtng or improve-ment Is d wrthin one year of complehon, !he owner-builder
will h the burden Of provmg tha1 he did not bu1k:1 or im-+ prov or the purpose ol sale)
I, as owner of the property, am exctustvely con1ract1ng w11h licensed tor1lrac1ors 10 conslruct lhe project (set 7044. Business and Protess10ns Code: The Contractor's License
Law does oot apply 10 an owner ot property who buHds or im• proves thereon. and whO contracts for each pro,ects with a contractor(s} license pursuant to the Contractor's Ucense Law)
D As a homeowner I am omprovmg my home. and lhe lollow·
ing conditions exls1:
1. The -k is being performed prior 10 sale. 2. I have tived in my home for twelve months prior 10 completion of lhis work. 3. I have not claimed this exemption during the lasl three years.
D I am exempt under Set.------· B & PC. for this reason
□ I hereby athrm th.at I ha.,e a cen11+ca1e of consen1
to self-insure, or a cen,hca1e of Wor~ers Com~_!'l~lton Insurance. Of a cer1tf1ed copy thereof
tSec :iep,. Lal)Or Cooe)
□ Cert,tied copy 1s hereby tum1shed
CERTIFICA Tl OF EXEMPTION FROM WORKERS· COMPENSATION INSURANCE (This seclton need not be compleled ,I the perm,!
1s tor one hundred dollars (S HX}) or tess)
0 I certify that 1n the per1ormance ot the wo,11 tor
•tuch lh1s permit 1s ,ssued I shall not employ any
person m ;Jny manner so as lo beeome sub1ect to
the Worli!.ers· Compensahon La*s ot Calllorn1a
NOTICE TO APPLICANT II. afler makin~ this Ce,i1
hcate of Exemption. you should beeome sub1ect t">
tl'le Wof'k.ers· Compensation prov,s1ons of ll'le Labor
Code, you must lorth-.1lh comply with such
prov1s1ons or this permit shall oe deemed ,e..,Okeo
O I hereby affirm thal lhere ,s a construc11on
1end1no agency '°' lt'le periOl'mance ot lhe •o"'-tor
wruch th,s pe,rm,t 1s ,ssued (Sec YIJ97 c,-..,1 C~1
Lenoer s Name ___________ _
Lenders AOdress __________ _
USE BALL POIN! P~ 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) 438-5525
JOB ADDRESS AV. ST.RD. NEAREST CROSS ST. I iDti ;7~~IONI
BUSINESS LICENSE • VALUATION PERMIT NUMBER
?,?c; Vi ;:i Fr;:inr-i !':C:a Hoso ~~/.~'}~
LOT BLOCK I SUBDIVISION I ASSESSOR PARCEL NO CONTRACTOR f ,I, CONTRACTORS PHONE• ZONE ,
83-271 -4-3 OWNER'S NAME I OWNER'S PHONE Community Resources Corp.
Community Resources Corp. 483-6500 CONTRACTOR'S ADDRESS LICENSE NO. PLAN 1.0. # BLDG USE CODE
OWNER'~ MAILING ADDRESS
DESIGNER LICENSE• STANDARD PLAN#
BUILDZ.i 9BGE ??n4 n~,..n~t Ave .. San DieQ:O . Ca . 92109
DESCRIPT•ON OF WORo; .... ..._ -~ DESIGNER'S ADDRESS DESIGNER'S PHONE _l,0/ ~/~::~,--. ,
Bldg. 4-3 8 rUriits 4DVIA, ~~I! e = I .L.,
-~ NO EDU
A£.~~-~~ -.?~••A~~n~J -JkANJ;. F/P FLA ELEV. RC GP
vO NO
s13Es -/
CENSUS TRACT I GP LAND USE
PJ~;;;;CE REBNITS I GRADING PERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FtRESPR
AREA ,bl CONST
vO ND v□ N rt1'-1~. vO NO Not Valid Unkss Machine CertifiM
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 -,.,,ro-
EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT 01·00·00·8221 I
EACH WATER HEATER ANO/OR VENT BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01 ·00·00·8806 lf.P.LJ--EACH GAS SYSTEM I 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
EACH INSTA~ .. ALTER, REPAIR WATER PIPE VEN T 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 DRAIN (INSIDE) SOLAR n1-nn-nn.on~ -·'·. TOTI.L MECHANICAL STRONG MOTION 80·92-33·0519 ,:,~ ..
TOTAL PLUMBING I FIRE SPRINKLERS 01 ·00·00-8227 ., . , .
QTY. ELECTRICAL PERMIT • ISSUE QTY. SOLAR • ISSUE
PUBLIC FACILITIES FEE 32·00·00·8933 ,#f 'T':t-"·-
BRIDGE FEE
NEW CONST EA AMP'SWT BKR COLLECTORS SCHOOL FEE • DISTRICT
I PH 3 PH STORAGE TANKS ----r---.. Carlsbad 80·92·21·0519
EXIST BLOG EA AMP/SWTIBKA ROCK STORAGE / II "' Encinitas 80·92· 22·0519
I PH 3 PH PUMP / ll ' • San Dieguito 80·92·23·0519
REMODEL ALTER PEA CIRCUIT PLAN CHECK FEV n/!7 -San Marcos ' 80·92-24·0519
TEMP POLE 200 AMPS I rL, !(}/,.,, ')( \ 1 /
OVER 200 AMPS A ( lL..,~ I I ,.... -..k1tENSE TAX 01-00-00-8162
TEMP OCCUPANCY 130 DAYSI lF L /{I ./.,,
I J ./ CREDIT DEPOSIT
TOTAL ELECTRICAL I \. TOTAL SOLAR v----TOTAL FEES PAYABLE I 5:~"1 ---I HAVE CAREFULLY EXAMINED THE COMPLETED ••APf>LICATION AND PERMIT" AND DO HEREBY E~p,r ~-•· ~ ...... t-bylheBulldingOlf,c,elunderlheprov,s,onsofthts * AN OSHA PEMIIT IS AEOUlfl£O FOIi EXCAVATIONS OYER CERTIFY UNDER PENALTY OF PERJURY THAT All INFORMATION HEREON INCLUDING THE Code I llmt!atlOn and become null and vord II Iha building or work 5' O" Df£P Ma> DfMOUTlON OR CONSTAUCTION OF eut ed b permit IS not commenced wlltlm 180 days from Iha dale of such STRUCl'\IA!S OYER 3 STOAtfS IN HEIGHT DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS per . or ,tdr~o, work euthonzed t,y euch permit ,s suspended or
ISSUED TO COMPLY WITH ALL CITY COUNlY AND STATE LAWS GOVERNING BUILDING CON-bme r the wort, IS commanced to, a nenO<I of 180 ,._.
STRUCTION. WHETHER SPECIFIED HEREIN OR NOT I A.LSO AGREE TO SAVE INDEMNIFY ANO rtC -ATURE •
OWN~ CONTRACTOR 0 AJVEO BY -;J •~ -· i'a;l,, Ii~ KEEP HARMLESS THE CITY OF .CARLSBAD AGAINST ALL LIABILITIES. JUDGMEJIITS. COSTS AND I/, ~-
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE ~ BY PHONE 0 GRANTING OF THIS PERMIT. • _,. ,,,L..,,,/!. A.,A....• ~-A-A
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O I hereby affirm that I am llcensed under
provlalooa of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Professions Code, and my ttcense is In
full force and effect.
lie No ______ Clas,
I hereby affirm that I am exempt lrom the Contrac· IOf's license Law lor the tonowmg reason (Sec 7031.S
BuS1ness and ProlesS.00s Code Any c,ty °' county which re-quires a permit 10 construct. alter. ,mprove. demolish. °'
repair any s1rucIure. prt0r to ifs issuance also requires !heap· plteanl for such perm,t lo fife a s1pned statemenl that her~
hcenseo pursuanl 10 lhe prov1SJOns of the conuac1« s Ltcense Law (Chaoter 9 commencing with Sechon 7000 ol
Oov1sion 3 ot the Business and ProfesSIOns Code) or 1t1at ,sex-empt therefrom and lhe bas.s tor ttte allegeo exemplton Any
v1olatt0n cl Seelion 7031.5 by an apphcanl tor a permit sub· Iec1s the apphcanl to a cIv1I penalty of not more than five hun-dred dollars ($500)
0 I, as owner of the property. or my employees with wages as their sole compensatt00, wiR do the work. and lhe strut·
lure Is no1 ,niended Of offered lor sale (Sec 7044, Business
and Protess,on~ Code The Contrac1of's license law does not apply 10 an owner ot pcoper1y who builds or improves
!hereon and who does such work h1msell Of lhrough his own
employees, provided that such Improvements are nol 1nlend· ed or ottered for sale. If, however, !he buIldmg or Improve-menI ,s sold wtthin one year of complehon, lhe owner-builder
will have the burden of provmg tnat he did 001 build or im-
prove '"' the purpose of sale)
D 1, as owner of lhe pcopeny, am e.xclusiVely conlracting w1lh licensed contractors 10 construct the prC)Je<t (Sec 7044. Busmess and Protess10ns Code The Contractor's Lk:ense
Law does not apply to an owner or property who builds or im+ proves thereon, and who contracts for each pro,eets with a contractor(s) ncense pursuant 10 the Contract01's lecense law).
0 As a homeowner I am ,mprOV\ng my home. and the follow-
ing conditaons exist: ~-lt:~i!i ~~ ~rt= f~M>f t!0~1e months
priof to complet,or, ol tlus work. 3. I have not claimed this exemption during the last lhree years.
g /h~:r:.~t under Sec. ______ • B & PC -------------
□ I hereby athrm that I ha11e a cert1hcate or consent
to self-insure, Of a cen1f,caIe of Workers
Compe-ns.ahon Insurance. or a cert,f1ed copy thereof
(Sec 3800. Law eoo~,
POLICY NO
COMPANY
0 Co()y 1s hied wttl"I the city
□ Cen•hed copy ,s hereDy furnished
CERTIFtCATl OF EXEMPTION FROM
WORIIERS' COMPENSATION INSURANCE (This section nee<J not be compleled 11 lt\e perm,1
,s !Of one hundred OOlla.rs tS H)O) or less)
0 I certify that ,n lhe per10<m.ance ot lhe woni. to,
which 1hIs permit 1s issued. I shall not employ any
person In any manner so as to become subIecI 10
the Wor1(ers Compensation Laws ot California
NOTICE TO APPLICANT II. arter makm1 this Cen,
f1cate ot E,:emp11on. you should become sub1ect t')
the Worke1s· Compensatton prov,s10ns ol the Labor
Code. you must f0flh.....,·1th comply w1ll'l such
prov,s,ons or ltus permit shall be deemed revoMeo
0 I hereby at11rm lhal !here 15 a cons1ruct1on
1end•oO agency tor the periOfmance ol lf'le 1Nor1it to,
wt11ch 1h15 permI1 ,s issued 1Sec. 3097 C1v1I COdel
Lenders Name ___________ _
Lenoe,·s Address __________ _
USE BALL POINT PEN ONLY & PRE~S HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
. CARLSBAD BUILDING DEPARTMENT
1200 Elm. Carlsbad, California 92008-1989 (619) 438-5525
APPLICATION & PERMIT
JOB ADDRESS
LJ;1,. .r,..~Jl~l!i~;:_:_· NEAREST CROSS ST.
17b?~ONI
BUSINESS LICENSE ,t VALUATION PERMIT NUMBE~
2.12r; ~3771/ ~-1'1 l" LOT I BLOCK I SUBOIV1$1QN I ASSESSOR PARCEL NO CONTRACTOR ~ I , i~ CONTRACTORS'6iONE• ZONE . -
c'fle~,J, /!~'J:;,'---'j. ~. 1-17 7:J.L /6/0 OWNER'S NAME
f~,.h' N'"A .,., I J./4,;1.~f,i/ C"' fl1 m. o-D l T11 Y.i;ci:~;:✓-/~I) ~)~p
LICENSE NO PLAN 1.0 . # BLOG USE COOE
3~i~2.~ OWNE R·S MA1 L1NG ADDRESS/ ~ -~ ~{), A, . ., OESIGNER r ---LICENSE II STANDARD PLAN# BUILDING SO. FOOTAGE 2?.~t-/ I" A/"~, ell f f
oeScR1PT I<JN oF """"ft .
DESIGNER'S AODRESS • DESIGNER'S PHONE -
IS!~i.c/P--L I.Pi/~)~ ~/1,;6/l . ~~-, .., ' -.
--F/P F LR ELEV. NO OCCGP EDU
STORIES
vO NO --
CENSUS TRACT I GP LANO use I PARKING SPACE I RES UNITS I GRADING PERMIT ISSUED I REOE VE LOPMENT TYPE OCC LOAO FIRESPR
AREA CONST
YO N 0 vO NO vO NO Not Valid Unlr<s ~chine CtrtdiM
QTY. PLUMBING PERMIT -ISSUE -,~ QTY. MECHANICAL PERMIT -ISSUE ,.3--SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP / INSTALL FURN. OUCTS 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 WA TEA 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 PLUMBING 01-00-00-8222
EACH GAS SYSTEM 5 0 R MORE METAL FIREPLACE ELECTRICAL 01-00-00·8223 ?...ac -
EACH INSTAl .. ALTER, REPAIR WATER PIPE VENT FAN SINGLE OUCT MECHANICAL 01-00-00·8224
EACH VACUUM BREAKER MECH EXHAUST HOOD/DUCTS MOBILEHOME 01-00·0Q-8225
WA TEA SOFTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP
EACH ROOF DRAIN (INSIDE! SOLAR n1-no-nn.ooo~
TOTAL MECHANICAL STRONG MOTION 80-92-33-0519
TOTAL PLUMBING I .. FIRE SPRINKLERS 01-00-00·8227
s--QTY. SOLAR -ISSUE PUBLIC FACILITIES FEE 32-00-00-8933 QTY. ELECTRICAL PERMIT -ISSUE -BRIDGE FEE
NEW CONST EA AMPISWT 1BK R COLLECTORS SCHOOL FEE • DISTRICT
I 1 PH 3 PH /1-.,,,,a 7,,,0f).-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 Oieguito 80-92-23-0519
REMOOEl'ALTER 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 (30 DAYS)
CREDIT DEPOSIT
TOTAL ELEURICAL I ~-TOTAL SOLAR TOTAL FEES PAYABLE k £.-4>~---
I HAVE CAREFULL y EXAMINED THE COMPLETED "APPLICATION ANO PERMIT' ANO DO HEREBY E,pirahOn Every permit -bytlle8ulidtng Olf1c1at undef the prov,,.ons ofth,s * ANO&HA .... IT / FOfl EXCAVATIONS OYER CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall e,p,re by hm,tation and become null and void II lhe t>voldmg or work 5· o--DEEP AND MOUTION OR CONSTRUCTION Of . authoozed by such permit 11 not commenced w•th1n 180 days from the date ot such _.,)TRUC-""7".ER 3 STORIES IN HEIGHT DECLARATIONS ARE TRUE ANO CORRECT ANO I FURTHER CERTIFY ANO AGREE IF A PERMIT IS permit. or if the buoldo~ or work authorized by such permol 15 suspended or
I ISSUED TO COMPLY WITH ALL CITY. COUNTY ANO STATE LAWS GOVERNING BUILDING CON ebllndoMod at a"u ·-er the wort II commenced tor a oenOd o! 1IIO ,tau• •
STRUCTION .. WHETHER SPECIFIED HEREIN OR NOT I A.LSO AGREE TO SAVE INDEMNIFY AN~O A ,c~rrSIGNATu,t,• OWNER □ CONTRACTOR r:J"" APPROVED BY~· ~
1"'3/1, /!tj KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS, COSTS ANO
EXPENSES WHICH MAY IN ANY'WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OFT C. 1 --___ / BY PHONE 0 GRANTING OF THIS PERMIT· ~ V --~ -
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TYPE I DATE INSPECTOR -. ~-,,-\ ,~ ,:v,,..,, id'-<-, ' .......
BUILDING I I '-f~ I -'\ ,._
TYPE DATE INSPECTOR 7 r -· ~-_1_..., .--s'<•;:i,.:_ ; .......
FOUNDATION I FIELD INSPECTION RECORD
REIN FORCED STEEL I REQUIRED SPECIAL INSPECTIONS ' INSPECTOR'S NOTES MASONRY I REQ IF INSPECTORS ' GUNITE OR GROUT I INSPECTION CHECKED APPROVAL DATE
FLOOR & CEILING SUB FRAME I SOILS COMPLIANCE SHEATHING D ROOF D SHJAR PRIOR TO
FRAME I FOUNDATION INSP
EXTERIOR LATH STRUCTURAL CONCRETE
I OVER 2000 PSI
INSULATION . PRES TRESSED I CONCRETE INTERIOR LATH & DRYWALL I
-f.-~ST TENSIONED
I \ • ONCRETE
PLUMBING I FIELD WELDING
SEWER AND BUCO DIPUCO I HIGH STRENGTH
UNDERGROUND D WASTE D WATER BOLTS
TOP OUT D WASTE D WfTER SPECIAL MASONRY
I
TUB AND SHOWER PAN I
GAS TEST I PILES CAISSONS
D WATER HEATER D SOLAR W4TER -
I -
ELECTRICAL I
D ELECTRIC UNDERGROUND DUFFER .
ROUGH ELECTRIC I ,
D ELECTRIC SERVICE D TEMPORARY ' -r ,
D BONDING D POOL I --~i_?-~ -;--_L
!
MECHANICAL I
D DUCT & PLEM., D REF. PIPltlJG
HEAT -AIR COND. SYSTEMS I
' --· ' . ' -· -VENTILATING SYSTEMS •,
I -• I
CALL FOR FINAL INSPECTION JNMEN ALL APRfi'OPRIATE~/.7).· / . -ITEMS ABOVE HAVE BEEN APPROVED. '· ' ~ . .... : . FINAL I ~,~ . ' -' ' ,. . ' .. \'"""-....'-._"" . '· --" • I ,· ... -··,-:':; ' . \ ' \. -..
PLUMBING I -. _,·,,.:~ r)~~ .. ' ,r . ' ' --'-.... .
ELECTRICAL u1.I~ ... ~/,(~ 't) \,.,. \i . ' ' ' '-• ·v ---' ... "\ ...._' \ -; ~
' -' I ' ..J. . ' \ .. .. \. .. . ·. '· MECHANICAL ' L rJ-y C, '°<' l \ ; ·, • .,
GAS I ~ -• ~ -\ \0 . ....-·. \ .. "' ... I • \ .,.. •,":°: ·--•• ~ ' .,.,. ,, . -~ ' . . ·, . ' 1 ~ ·-• .. -' \ " . . r• BUILDING "'J' ' . I • ~
SPECIAL CONDITIONS ' I ., ' I .. -
.,,
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-.[] I hereby attlrm that I am llcensed under
provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Professions Code. and my llcense is In
lull force and effect.
lie No ______ Clm
I Mreby atlirm lhal I am exempt lrom the Contrac·
lo<'s License law tor !he tonowmg reason (Sec 7031 5 Business and Profess10ns Code Any c,ty Of counly whttli re· quires a perm,t to construct. alter. improve. demolish. or repair any s1ruc1ure, poor to 11s issuance also requires !heap,-
phcanl for such permn to hie a signed statemenl that he ,s licensed pursuant to the prov1s1ons of the con1racto( s
l.Jcense Law (Chapter 9 commencing w1lh Seel~ 7000 ol Div~ 3 of !he Business ano Professions Code I cw thal 1s o-· empt therefrom and the basis lor lhe allegeo e:.:emplt00 Any vt0ral10n ol Secuon 7031 . 5 by an appltcanl for a perffllt sub-
iects the applu:ant to a civfl penally or not more than hve nun-dre<l dollars ($500)
0 I. as owner ol lhe prOl)Orty. or my employees w,th wages
as lhetr sole compensation. will do the work. and the struc-ture is noi 1n1ended or offered lor sale (Sec 70•4 Business and Pro1ess1on!a Code. The Contraclor's L,cense Law does
not apply to an owner ot property Who bullds or improves thefeon and who ooes such work hunself Of lhroogh h,s own employees. provided lhat such amprovements are not mlend•
ed or ottered lo< sale 11, however. the buddmg or improve-ment 1s SOid within one year of completion, the owner·butlde,
w,11 have the burden ot provlfl9 !hat he (lid not build or nn-Pf"'• 10< lhe purpose ot sale).
0 I. as owner ot the property, am excluswely contracting with licensed contractors 10 construcl the P'O!etl {Sec. 704◄, Business and Professions Code· The Contractor's Lteense
Law does not apply to an owner ol praperty who butlds Ot' im-proves thereon, and who contracts for each proiects wilh a contractor(s) lteense pursuant to the Con1rac1or·s Lanse Law)
O As a homeowner I am 1mpr<Mng my home, ·and !he lotlow·
ing cond1t1ons eJ1.:tst· 1 The work is being pe~ormed prKlf to sale
2. I have hved III my home for twefve months prior to completion of 1h1s work.
3. f have not clamled this exemption during the last three years.
0 lamexemplundosSec ----.,,..-.B&PC tor this reason • \
□ I hereby affirm that I na.,e a cer11t1cate ol consent
to self-insure. or a cer11t1ca1e of Workers
Compensation Insurance. or a cert1l1ed copy lhereol
iSec 3800. Labor Code)
POLICY NO
COMPANY
□ Copy IS hied with the Clly
0 Cer111•ed ce>py 1s hereby furnished
CERTIFICATl Of EXEMPTION FROM
WORKERS" COMPENSATION INSURANCE
(This section need not be compleled 11 lhe perm11
1s IOt one hundred dollars (S 1001 or less)
0 t cen1ty thal ,n the pertormance ol !he woni. to,
which th,s perm,t 1s ,ss~. I shall nol employ any
persoo in any manner so as 10 become suo1ect to
the WC>Olers Compensallon Laws ot Gallforn1a
NOTICE TO APPLICANT If. atler makin1 ttus Ceni flcate ol E•emphon. you should t>ecome suo,ecI I?
the Wo~e,s· Compensation prov1s1oos ot !he LabOr
Code you must fo,thv.11h comply w1tn svch
prov1s1ons or 1h15 permit shall be oeemed revoked
0 I hereby atl,rm 1na1 there ,s a con!1tuc11on
lending agency tor me performance ol the won,. tor wn,ch this perm,, ,s •ssuea (Sec J097 C,v,1 COCleJ
lender s Name ___________ _
Lenoer s AOdress __________ _
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~As;.s-(/4;,.,, <::.7~ST RO. NEARE&~ ~/-<4 'I° l°A;~~;~ONI BUSINESS LICENSE" VALUATION PERMIT NUMBER
LOT I BLOCK I SUBDIVISION I ASSESSOR PARCEL NO CONTRACTOR CONTRACTORS PHONE. ZONE -~3 -:,_ 7 t -I 6:
OWNER"S NAME _ ~ I OWNER"S PHONE )"/,_iA. .I ,P ~ LJ, L -LY l'#/ff,-1'~ I I! ~-~ / -_/dG_,_ ,.__ CONTRACTOA"SIGORESS tJT_A/ LICENSENO PLANI.D.# BLOGUSECODE -,. ,_ "'""P ~/9/~1;;, t,1-..'-" ,,,_ ,~~ -~ l'Y'~
OWNEA"S MAI UNG A'O"!ESS a..:o2~1)"1,o>~~ :¢:::._~/11~2_/Z,~~-1.il'/4~~-~,C~~~~~~::'.~:.........::::~=~+--------+---------i---------_..j .:i.:i" ~ ~ r L _ .A _ _:_ ~ DESIGNER _ V LICENSE# STAN DARO PLAN# BUILDING SQ, FOOTAGE
OESCAIPTION OF WORK ...-._ _______________________________ _ DESIGNER"S ADDRESS DESIGNER"$ PHONE
-_/5:lj &3IL #-/r O ~ ·-F/P FL A ELEV. NO OCCGP EDU I-1~e,.1 c~Gf6, 164;1JJ • ----;::,-STORIES "" 'f;. -•----
vO NO --~ •
CENSUS TRACT I GP LAND use I PARKING SPACE I RES UNITS I GRADING PERMIT IssuED I REDEVELOPMENT TYPE occ LOAO FIRE SPR AREA CONST -
y D N D v□ NO vO NO Nor Vil/id Unlt!<s lhchine Certified
QTY. PLUMBING PERMIT -ISSUE 7, So QTY. MECHANICAL PERMIT -ISSUE ,1,oo SUMMARY/ACCOUNT NUMBER
l..,,s.;f~ EACH FIXTURE TRAP /4/.\'"": -INSTALL FURN. DUCTS iJP TO 100.000 BTU BUILOlNG PERMIT 01·00·00-8220
/ (ACH BUILDING SEWER ,t!. . .::,-, OVER 100,000 BTU SIGN PERMIT 01·00-00-8221
J? EACH WATER HEATER ANO/OR VENT .:::)rJ . -BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01·00-00-8806
EACH GAS SYSTEM l TO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING 01·00-00-8222 /cf'Y, -
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 M0BILEH0ME 01-00·00·8225
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER M0BILEH0ME PARK INSP
EACH ROOF DRAW (INSIDE( SOLAR n1.nn-nn.ooo~
TOTJ.L MECHANICAL STRONG MOTION 80-92-33-0519
TOTAL PLUMBING I /Jf'hf . -FIRE SPRINKLERS 01-00-00--82_2_7--+--------
QTY. ELECTRICAL PERMIT -ISSUE .r"_,..,, QTY. SOLAR -ISSUE PUBLIC FACILITIES FEE 32·00-00·8933
') ,&v 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 AMP1SWT 'BKR ROCK STORAGE Encinitas 80·92·22·0519
I PH 3 PH PUMP I San Oieguilo 80·92-23-0519
REMO0ELALTtR PER CIRCUIT PLANCHECKFEE I SanMarcos 80·92-24-0519 -
TE MP POLE 200 AMPS
OVER 200 AMPS LICENSE TAX 01-00-00-8162
TEMP OCCUPANCY 130 0AYSI
CREDIT DEPOSIT
TOTAL ELECTRICAL I TOTAL SOLAR TOTAL FEES PAYABLE I /j}'(, -
I HAIIE CAREFULLY EXAMINED THE COMPLETED ·APPLICATION ANO PERMIT"' ANO DO HEREBY Exp,ralion. Ewry -11UuedbytheBuildtngOt11c11I under the prov,s,onsoltnis * AN OSHA PERMIT IS REOUIAED FOR EXCAVATIONS OVER
CERT,FY UNDER PENAL TY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code -1 exp,re by lttntlabon and tlecome null •nd VOid II th" building or wort, s· o·· DEEP ANO DEMOLITION ()fl CONSTRUCTION OF
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY ANO AGREE IF A PERMIT IS aulhor,z~ such -mil 15 not commenced •1th'" lBOdays lrom lhe date of such STRUCT\IRES OVER 3 STOAIES IN HEIGHT penny. if. the bu~dtng or W<>jlt 1u1hor1zed by such permit Is suspended or
ISSUED TO COMPLY WITH ALL CITY COUNlY ANO STATE LAWS GOVERNING BUILDING CON L~~~'!/-LJen!!!'.'!1..!!Vl1!!!me!!._.!1~fler,l!J~~~:!1om~men!!!J!C~ed!!!.J:fo~r:..!•!..J""~"2!odtoQ!l~t!!!BO~da!)""~-~~~~~~----------------~
STRUCTION WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AN:v:[ ~½'P ~C APPRO ED B KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES JUDGMENTS, COSTS ANO /4CA S SIG TU OWNER CONTRACTOR O II y DATE
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE .... ------.... ~~--0 .t.?I II \ q GRANTING OF THIS PERMIT •1 r BY PHONE -U , I -~ /
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City of Carlsbad
APPLICATION FOR CERTIFICATE OF OCCUPANCY
BUILDING DEPARTMENT
1200 ELM 438-5525
Address where Business will be conducted
Name of Occupant la,10« s
Address of Home Office of
Occupant if different from above
Owner of Buildin
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
AJT...5
Address
VALIDATION
Building Permit No.
Home Office
Phone
Phone
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
Date
Date
, 19 In the City of Carlsbad, State of Californi
Signature of
Building Official
FOR DEPARTMENTAL USE ONLY
Occupancy Group Type of Construction
Disapproved By
Disapproved By
Disapproved By
By
By
White -Building Dept. Yellow -Applicant Pink -Finance Gold -Fire Dept.