HomeMy WebLinkAbout2807 VIA DIEGO; ; 81-452; PermitIJ) z 0 ~ cc j
fil 0
C
I[
8
cc "' 0 ... 5 I "' z ~
z 0 ;::
C IJ) z w 0.. :I
0 0
IJ)
ic "' "" cc 0 3
il
0 I hereby a ,l'that 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 __ __ Clm _____ _
I hereby athrm that I am exempt from the C.00· ~~o{~;~,::: ~ ~f~~'~l~~r~,(~
county which requires a pemut to construc1
aller, 1mp,o~. demohsh, or rep.au any structure, pnOf to ,ts issuance also requires the appheant tor
such pem·111 to hfe a signed statement that he 1s hcenSed pursU¥tt to the provIsIons ol the Con-
tractor's Ucense Law (Chapter 9 commencmo with
Section 7000 ot 01v1s,oo 3 of the Business and Pro-
tesslOl"ls Code) or that ,s exempt therefrom and the
basis for the alleged exemptton Any vK>lattOn of Section 7031 5 by an appllcan1 for a perm,t subjects
tne ~ticant to a c1v1I penalty of not more than hYe hundred dollars ($500)
□ I, .as owner ot the p,operty, o, my employees ,.,th wages as lheu sole compensat,on. w,11 do lhe
w~. and the structure ,s not 1nt&nded °' ottered for
sale (Sec_ 7044, Bustness and Professtans Code The COntractor·s license Law does not apply to an
owner of p,operty whO builds or improves thereon
and who does such WM himself o, through his own
employees. provided thal such ,mproveme:its are
not 1ntende1 Of ottered f0t saJe If, however, the bu1td1ng Of ,mpro...ement Is so•d within one year of
complelton, the owner-builder will have the burden of proving that he did not build 0t improve tor the
purpose ot sale).
□ I, as owner of the propeny, am 8J11Clus1vely
contracting with hcense<l contractors to construct the proiect (Sec 7()44, Business and Professions Code The Contractor's l icense law does not apply to an owner of property who builds o, improves
~:~i~~ ~~~nc~;~!~~~ ~~~h~r~i~~:~~-!
License Law).
0 I am exempt under Se<: ___ ,B &PC
tor this reason ___________ _
0 I hereby affirm tr\at I have a cert1f1ca1e of consent
to self-insure, or a cert1f1ca1e ol Workers·
Compensation Insurance. or a certified copy thereof
(Se<:~.~~,!/:.. 2/'n.fiif
POLICY NO ~(.LI~,..,_
COMPANYt2il/O e/J.5(.)lll,7
~Y 1s filed with the c,ty
□ Cert,t,ed CoPy ,s hereby fu,n,shed
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE (This section need not be completed 1I the perm,1 ,s tor one hundre<i dollars (S 100) or less)
0 t certify that ,n the pertorm.1nce ol the work '°'
which this pemi,t ,s issued. I shall not employ any
person in any manner so a.s to become subIec1 10
the Workers· Compens.a1ton Laws of CaMom,a
NOTICE TO APPLICANT If. after makmJ this Cer1t
hcate of Exemption, you shoufd become subJect I".>
the WMers· Compensation provIst0ns of the Labor
Code. you must tortnw,th comply with such
pr0\1IsIons 0t lhts permit shall be oeemed revoked
0 I hereby athrm tnat there •s a construct,on
lending agency tor the pt"f"tormance of !he work. tor which lh,s permit IS issued (Sec 3097 Civil Codel
Lenders Name ___________ _
Lenders Address __________ _
USE BALL POINT PEN Ol!Jl & PRE~S HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA A 1ECLARATIONS
' CARLSBAD BUILDING DEPARTMENT
1200 Elm, Carlsbad, California 92008 (7~4)_438~•55_2_5 ~~-
( APPLICATION & PERMIT
JOB ADORESS
~.Ji_07 V "tt 1) /1:60 A~-i.T-lio: ;;i~~7NI BUSINESS LICENSE #
;J_~17.S-
VALUATION
ER'S NAME t!""
OWN ,.:::)() e.. (i1 V('"('i__ ]7z9::;;;~~ PS;~TAs;;, ~ frr.du_Lic, CONTRACTORS PHONE fl
~ f~--..] :,::::.,J
ZONE
~lAMIT NUMBER
7');)..
OWNE R"S MAILING AODRESS
,.Sf},ne_
LOT 1 BLOCK
~3~oR·sx,:;;~k s, i:>, LICENSE NO.
3c;(p~z.3
PLAN 1.0 . # BLOG USE CO0E
I SUBOIVISION
1 ASSEss,u~~l'!)O ~ oo OESIGNER -, STATE LICENSE# STANDARD PLAN# BUILDING SQ. FOOTAGE
DESIGNER'S PHONE I 0 t//f""'0
~ fliiiiie__ ClftM:r/(-l oes1GNER'S ADoRess
oe,er 10/(5/61 916 10.
F/P FLA ELEV,
vO NO
REDEVELOPMENT AREA
~
STORIES
TYPE
CONST
OCC GP EDU
OCC LOAO FIRE SPA CENSUS TRACT I GP LANO USE PARKING SPACE RES UNITS GRADING ~EAMIT ISSUEO
YO ND vO NO vO NO Not Valid Unlffr lhchine ~rtifi«f
QTY. PLUMBING PERMIT· ISSUE 7-/5'Q QTY. MECHANICAL PERMIT· ISSUE 3-DD SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP . INSTALL FURN. DUCTS i.JP TO 100,000 BTU . BUILDING PERMIT 1 I I EACH BUILDING SEWER . OVER 100,000 BTU • . SIGN PERMIT I I
/ I EACH WATER HEATER ANO/OR VENT -~ :<ti BOILER/COMPRESSOR UP TO 3 HP . PLAN CHECK
EACH GAS SYSTEM 1 TO 4 OUTLETS . BOILER/COMPRESSOR 3-lS HP . TOTAL PLUMBING 7a_, ,,,,.
EACH GAS SYSTEM s OR MORE I I _lMETAL FIREPLACE I I ELECTRICAL
EACH INSTAl .. ALTER, REPAIR WATER PIPE 7 T vENT FAN SINGLE oucT MECHANICAL
EACH VACUUM BREAKER I i I MECH EXHAUST -HOOD/DUCTS I I MOBILEHOME
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER M0BILEHOME PARK INSP
EACH ROOF DRAIN (INSIDE) 1 n 1 _ 1 7 7 1 SOLAR
TOTAL PLUMBING
lOTJ.L MECHANICAL -, Jn.dl
~ ./ STRONG MOTION ~ / FIRE SPRINKLERS
QTY. ELECTRICAL PERMIT · ISSUE -;J -o~ QTY. SOLAR -ISSUE ~½17 PUBLIC FACILITIES FEE
/ \-) BRIDGE FEE
NEW CONST EA AMP/SWT 'BKR
1 PH 3 PH
STORAGE TANKS ( ~ _;L' /rt I SCHOOL FEE . DISTRICT I
Carlsbad J COLLECTORS
EXISTBL0GEAAMP/SWT/BKR 1 11 IROCKSTORAGE J ~ /r:::t.. v r Encinilas
1 PH 3 PH I Ii I PUMP ,NY/ -~ . V /'I./ San Oieguilo
:~::::::~~,' ,:,:• :•cmr I i I"'""'" FEE ,¾ ~ 6' I I I I
TEMP OCCUPANCY (30 DAYS)
San Marcos
-17
TOTAL ELECTRICAL l TOTAL SOLAR TOTAL FEES PAYABLE 1 /O,.--t
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT'"' AND DO HEREBY Expiration Every permit ISSued bylhe Bu1ld1ng Off1c1al underlhe prov,s,ons olth,s
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall expire by llm1tallon and become null and void II the bu1ld,ng or work DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS aulhonzed by such permit ,snot commenced w1thm 180 days from the date ol such
ISSUED TO COMPLY WITH ALL CITY COUNT" ANO STATE LAWS GOVERNING BUILDING CON permit. or ti the bulldinx or work aulhor1zed by IOCh perm11 11 auapended or
STAUCTION, WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND abandoned at an time I er the work ,s commenced for• nod of 1
KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS, COSTS AND &LICANT'S SIGNATU~E OWNER O CONTRACTOR aa,'
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEOUENCE OF THE \ }_j _ _jJ ---GRANTING OF THIS PERMIT. .11.J.J.1 ~ BY PHONE 0
* AN OSHA P£Mil1T IS AEOUIAED FOR EXCAVATIONS OVVI
5' O" DEEP ANO OEMOLITIOH OR CONSTRUCTION Of
STFIUCTURES OVER 3 STORIES IN HEIGHT
APPAOV~ DATE 1/0 ✓,f---~)
~ u:::
>-~ 0 0. E Q) f-
l
-0
0 (!J
c
<ti ,g
0.
0. <{
I
-"' C a:
0 rt)
rt) Q)
rt) rt)
<{
I
3: .2
~ >-
,Ji
rt) Q)
0 0 a:
<ti
<ii
Cl
ff
Q)
0
C CII C u:::
!:.
C Q) ~
(!J
0 0 Q)
0. rt)
C
~
.r. ~
INSPECTION TYPE DATE INSPECTOR ,. ~ . BUILDING
FIELD INSPECTION RECORD
FOUNDATION .. REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES REINFORCED STEEL
MASONRY INSPECTION REQ IF INSPECTOR'S DATE CHECKED APPROVAL
GUNITE OR GROUT SOILS COMPLIANCE
FLOOR & CEILING SUB FRAME PRIOR TO
FOUNDATION INSP
SHEATHING STRUCTURAL CONCRETE
FRAME OVER 2000 PSI \,
EXTERIOR LATH lNSULATION PRESTRESSED CONCRETE I
INTERIOR LATH & DRYWALL POST TENSIONED CONCRETE --.':
PLUMBING ' '· --FIELD WELDING
SEWER AND BL/CO \ HIGH STRENGTH ' . PLUMBING UNDERGROUND BOLTS >
PLUMBING TOP OUT I SPECIAL MASONRY
I
TUB AND ~HOWER PAN I
GAS TEST I PILES CAISSONS
ELECTRICAL
TEMPORARY POWER
ELECTRIC UNDERGROUND --
ROUGH ELECTRIC
ELECTRIC SERVICE i "
C ~
BONDING A
G. F. I. -SMOKE DETECTOR'.
MECHANICAL
DUCT & PLEM., REF. PIPING
HEAT -AIR COND. -SOLAR SYSTEMS -
VENTILATING SYSTEMS -. ,,
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE ~ . '
ITEMS ABOVE HAVE BEEN APPROVED.
JOB SITE FINAL . ..__, ~ ~ .
,, .
PLUMBING
ELECTRICAL I n _y· . I ,. I . . • I;.,. ' " ' ---< I ~ -
MECHANICAL A. . .J ii J/f -'
GAS JI 0 '6 ' fa L r = ' \ . ' • I --~-, I
BUILDING ~ I
SPECIAL CONDITIONS
CERT OF OCCUPA • ISSUED "' ('"\ .,.__J--' ' ' u