HomeMy WebLinkAbout2811 VIA DIEGO; ; 84-124; Permit•
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0 I hereby affirm that I am ttcensed 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.
lJc No ------Clm
I hereby affirm that I am exemp1 from lhe Contrac-
to(s L1tense law tor lhe following reason (Sec 7031.5 Busirtess and Profess100s COde Any c,ty or county whic.h re-qu,res a perm1t to construct, atter. improve. demolrsh. or repair any slructure, pnor to ,1s issuance also requires the ap·
phcant tor such permit to Ille a signed statement that he Is hcensed pursuant to the provIstons ot !he tonlractor·s
license Law (Chapter 9 commencing with Section 7000 ot O!vtStOn Jot the Business and Professions Code) or thal 1s ex·
empt therefrom and lhe basis for lhe aUegeo exemptt0n Any vIotatIon of Section 7031.5 by an apphcant tor a permi1 sub·
1ects lhe apphcan1 to a tfYI~ penalty or not more than five tnm-
dred dOllars [$500).
0 I, as owner ol lhe property. or my employees w•h wages
as their sole compensation, will do the work, and !he struc-ture Is not lnlended or otrered tor sale (Sec 70441, Business
and Pro1esst00!. Code. The Contractor·s license Law does
not appty to an owner of property who buIkSs or unproves !hereon and who does such work hrmself or through hrs own employees, provided l~t such unprovemerns are nol intend· ed or ottered lor sale, II, however. the bufldmg or improve-
ment is sold wilhin one year of cc:mp6ehon, the owner-builder
will have the burden ol provu19 that he did noc botld or im-prove tor the purpose of sale).
D I, as owner of lhe property, am exclus1vety conlfictmg
with licensed contractors to construct the pcOJect (Sec 7044. Business and Prolesst00s Code. The Contractor's license
law does not apply to an owner of property who bvilds or im-proves thereon, and who contracts for each prOJectS with a contraclor(s) license pursuanl to the Contraclor's license law).
D As a homeowner I am rmp,OYing my home, and the IOllow· mg conditions exist
1. The work ,s being pe~ormed prior to sale. 2. I have hved in my home lor twetve months
prior lo completion of thrs work.
3. I have not claimed !his exemptk>n during the last three years
D I am exempt unde, Sec. ----,--. B & P C. tar this reason
I ~ I :~~.~~~~~~m ~7a1 ~ hac":;.~~::~•ca~r o~:,ks:,~1 I
Compensation Insurance. or a cen1hed cooy thereof I
(Sec 3800, Labor Godel I
POLICY NO I
I COMPANY
□ Copy IS hied Wllh lhe city
O Cen1l1ed copy 1s hefeDy furn1she<J
CERTIFICA Tl OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE
(This section nee<i nol be completed if the perm,t
,s for one hundred dollars 1$100) or less)
0 I certify that ,n the perlorm,ince ot lhe work tor
which lh1s permit ,s ,s.s~. I shall not employ any
person in any manne1 so as lo become subJecl to lhe Workers· Compensatton Laws ot Calllorn,a
NOTICE TO APPUCANT If. after maktn1 this Cert, hcate of Exemption. you should become sub1ec1 1-:,
the WOf'kers· Compensation pro\11SIons ol lhe LabOr
Code you must lorth-.1th comply w1in suc-tt
prov,s10.ns or 1h1s permll shall be deeme<J revoked
0 I hereby attum Iha! there 1s a con~1ruct1on
1end1no agency to, lhe perlormance of lhe wo"' to,
wh1Ch 1h15 permit 1s issued (Sec 3097 C1v11 COdeJ
Lenders Name ___________ _
lende(s Address __________ _
USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO ~ILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
I CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT • 1200 Elm, Carlsbad. California 92008-1989 (619) 438-5525
JOB ADDRESS I AV ST.RO. NEAREST CROSS ST.
I
OATE Of APPLICATION,I BUSINESS LICENSE d VALUATION t/ERMIT NUMBER
;l.. 8il I V '°' 1) oc: ..,,,r':) 3 -1-'8<t ~ -
~ /e:?-Y LOT I BLOCK-.,I SUBDIVISION ASSESSOR PARCEL NO. CONTRACTOR ..::r CONTRACTORS PHONE • ZONE
OWNf R'S NAME • ~ > 1 OWNER'S PHONE sA'2-K Ai<-1rt-J I A A.J 4 3 ~-03 'f'-CONTRACToR·s ADDRESS LICENSE NO. PLAN 1.0 .-# BLOG USE COOE
OWNER'S MAILING AOORESS Ou.)lJGK
:)_8o~A"'~~~A~~":J~.t;-~~vr= DESIGNER LICENSE " STANDARD PLAN # BUILDING SO. FOOTAGE -
DESCRIPTrON OF WORI(
'\,, ~ \ oc; 'v... ..w .. "' a..o.<. f'\:QE"S. DESIGNER'S AODRESS. . OESIGNli R•s PHONE --
'J ' ' '
-------r----·-' -~------F/P FLA ELEV. NO OCC GP EDU Alt'0:1.r i 4i; .,10 STORIES I J a,
vO NO --C"Jt1 t~~fQ I ~IC W81. I ti.:~ •
CENSUS TRACT I GP LAND USE I PARKING SPACE I RES UNITS I GRADING PERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRE SPA -,, ,.,r., AREA CONST -
YO ND vO NO vO NO Not Valid Un~s ~chine CertifiM
Q TY. PLUMB IN G PERMIT· ISSUE -J~ QTY. M EC HANIC AL PERMIT. ISSUE 3--SUMMARY/ACCOUN T 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 ANO/OR VENT BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01 ·00·00·8806 ~A
EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING 01 ·00·00·8222 /1!1 v---
/ 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 BREAKER MECH EXHA USl -HOOD/DUCTS MOBILEHOME 01 ·00-00·8225
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP
EACH ROOF DRAIN (INSIDE) ,{ lJ SOLAR 01·00·00-A??~
/ ~ A ~A.A . ;,,J...,....-..., -TOT t.L MECHANICAL STRONG MOTION 80·92·33·0519 -(7 TOTAL"l>LUMBING I Jo Y-' FIRE SPRINKLERS 01 ·00·00-8227 .
PUBLIC FACILITIES FEE 32·00·00·8933 QTY. ELECTRICAL PER MIT · ISSUE s-Q T Y. SOLAR • ISSUE
.:/ : BRIDGE FEE
NEW CONST EA AMP/SWT BK R COLLECTORS SCHOOL FEE • DISTRICT
1 PH 3 PH STORAGE TANKS Carlsbad 80·92·21·0519
EXIST BLOG EA AMP/SWT 'BKR ROCK STORAGE ' Encin11as 80·92· 22·0519
1 PH 3 PH PUMP San Dieguilo 80·92· 23-0519
R EMOOE L 'ALTER PER CIRCUIT PLAN CHECK FEE San Marcos 80·92· 24-0519
TEMP POLE 200 AMPS l
OVER 200 AMPS LICENSE TAX 01-00-00-8162
TEMP OCCUPANCY 130 DAYSI /)?~
CRfolT DEPOSIT
TOTAL ELEClRICAL I TOTAL SOLAR TOTAL FEES PAYABLE l /P~
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT' AND DO HEREBY ~-Ewry permil-b\tllleBuildlng Oflrc••I uncle< the p,o.,srons of this * AN OSHA PERMIT 1$ RE0UIAEO FOR EXCAVATIONS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code 11\111 •p1re b\t llllllllilllln and bac:ome null and vo,d If lhe building or wor~ s· O" OEEP AND DEMOLITION OR CONSTRUCTION OF
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS aulhonnd bit IUCII pennit ill IIOI commeo..-1 wrthtn 180 days from the date of sue h STIIUCT\IR£$ OVER 3 $TORI£$ tN HEIGHT permtl. ot if ltle ~Ot ...ti autllOtiZed by such permit •• suspended or ISSUED· TO COMPLY WITH ALL CITY COUNTY AND STATE LAWS GOVERNING BUILDING CON-lbendOllad Ill -11111e .. WOfll la commenced for a oenod of 1110 d•v• STRUCTION. WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND APPLICANT'S SIGNATURE IJ OWNER c:?"' CONTRACTOR 0 APPROVED BY
131/11 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 Jj--GRANTING OF THIS PERMIT ,
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TYPE I DATE INSPECTOR
BUILDING I
I
FOUNDATION I
REINFORCED STEEL I
MASONRY I
I
GUNITE OR GROUT I
FLOOR & CEILING SUB FRAME I
SHEATHING D ROOF D SH~R
FRAME I
EXTERIOR LA TH .
I
' INSULATION :
INTERIOR LATH & DRYWALL I
I I
PLUMBING I
SEWER AND BUCO D\PUCO I
UNDERGROUND D WASTE D WATER
TOP OUT D WASTE D WATER
TUB AND SHOWER PAN I
GAS TEST I
I
D WATER HEATER. D SOLAR WATER -
I
ELECTRICAL ;
D ELECTRIC UNDERGROUND □1 UFFER
ROUGH ELECTRIC • I
D ELECTRIC SERVICE D TEMPORARY .
D BONDING D POOL I
I
MECHANICAL I
I
D DUCT & PLEM., D REF. PIPING .
HEAT -AIR COND. SYSTEMS I
VENTILATING SYSTEMS l
J
I
CALL FOR FINAL INSPECTiON WHEN ALL APPROPRIATE
ITEMS ABOVE HA 'AE BEEN APPROVED .
FINAL I
PLUMBING I I
ELECTRICAL I </-Ck\ I
MECHANICAL I ,,/ r •
1
GAS I ?'
BUILDING I
SPECIAL CONDITIONS I
I
I
~4~1~
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTION REO IF INSPECTOR S DATE CHECKED APPROVAL . SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRESTRESSED
CONCRETE
POST TENSIONED
CONCRETE 'I
FIELD WELDING
HIGH STRENGTH
BOLTS . -·
SPECIAL MASONRY
-
PILES CAISSONS
-
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