HomeMy WebLinkAbout2709 VIA JUANITA; ; 81-429; Permiten z 0 .:: < a: < _,
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O I hereby affirm 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 ______ Class ____ _
t hereby attmn that I am e,cempt from the Con·
~~<>;-~!~r::: ~w ~~t~':,~':«c!l,~8:~~
county which requires a pemut to construct alter. ,mp,ovre, demohsh, or rep,111r any structure,
p,,or to its issuance also requires I.he apphcant tor such pemut to hie a signed statement that he ,s
hcensed pursuant to the pro11Is1ons of the Con
tractor's License Law (Chapter 9 commencing w1tb Section 7000 of D,v,s,oo 3 ot the Business and Pro-
fessions Codet or that 1s exempt therefrom an<1 the basis for the alleged exemplt<>n Any v10latton of
Sechon 7031 5 by an applicant tor a permit subjects
tne applicant to a c1v1I penalty ol not more than live
hundred dollar, ($500)
□ I, ~ a...ner of the p,-QP8ny, or my employees
.. ,1h wages as their soie compensation. will do the
WOl"k, anCI the structure 1s not intended Of offered tor sate (Sec ~. Business and Professions Code
The Contracto,'s License Law does not apply to a.n
owne< of property who butlds or improves thereon
and who does such wortt himself or throuoh h,s own
employees. prOYided tha1 such improvements are not 1ntende1 or offered fDf sale II, however. the
bu1ldmg or improvement 1s sold within one year of complellon, the owner,bullder will have the burden
of p,ovIng that he did not build or improve for the purpose of safe!
C I, as owner of the propeny, am exclusively contracting with hcensed contractors to construct
the protect (Sec 70U, Business and Professions Code· The Contractor's Ltcense Law does not apply
to an owner of propeny who builds or improves
thereon, and who contracts tor each proJects w1lh a contractorts) license pursuant to the Controetor's
license Law)
□ I am exempl under Sec
for this reason
_, B & PC
□ I hereby affirm that I have a cer11hcate of consent
to self.,nsure. or a cet11t,cate of Workers· Compensation Insurance. or a cer11f1ed copy thereat
(Sec 3800. Labor Code) e
COMPANY _
0 Copy IS hied WI
CERTIFICATl OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed 11 the perm,t 1s for one hundred dollars {S 1()0) Of' less)
0 I certify that 1n the performance ot the worit lo,
wtuch this permit 1s issued. I shall not employ any
person m ~Y ~nner so ~ to beeome sub1ec1 to
the Workers· Compensa1ton Laws of Callfo<nia
NOTICE TO APPLICANT If. af1er makin1 this Ce.rt•
hcate of Exemption, you should beeome sub1ect t? the Workers· Compensation prnv,s1ons of lhe L.abof
Code. you must tortttw,th comply with such
provisions or this permit shall be deemed revoked
O I heteby afhrm that there ,s a cons1ruc1ion
1eno1ng aoency '°' lhe perlormance of the work !or
which this permit ,s issued tSe<; 3097 C,v,I Code)
LenOer s Name ___________ _
Lenders Address __________ _
I.IS~ 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 (71•) •38-5525 -
JOB AOORESS
{ ?v1 I' i 5 /:Ji.?,/ AV.ST.,DATE OF APPLICATION! BUSINESS LICENSE ,. VALUATION PERMIT NUMBER
.1 r> ,,r, ~ v, ·;, -y C{ U Pl/+ Cf RO. 1·· -; -'ef'I :,_:· -' L I c _,... -8 I -I '-/ lf~; OWNER•s NAME I OWNER'S PHONE Pl\!ME CONTRACTOR CONTRACTORS PHONE• ZONE
{,.. ·.-, Ir , /1A, /, /5 r}H,,,, -j, ( J"t,"11;,/j I lt111,if-.;, 'H j
OWNER'S MAILING AODRESS /)_J, CONTRACTOR'S AOORESS LICENSE NO. nAN 1.0. # BLOG USE CODE
C'j l/ -/..1,,si O 1-·q1-11e S&'fnf-11 0hfl'I ;).(..qt'; ~/q-l~ 5 f. {10.Js/,.,,1
LOT I BLOCK I SUBDIVISION I ASSESSOR PARCEL NO DESIGNER STATE LICENSE# STANDARD PLAN# BUILDING SO. FOOTAGE
J '-l<o 2. <j C1 OESCRIP_I.(ON OF WORl)I( --lr5T ~ ---.
-1''1> VC'S-5/JY-t DESIGNER'S ADDRESS DESIGNER'S PHONE ' tUWV\J
'J __ ,,Jw-"" ,..,,..,,,di I 0,:1;, ---F/P FLR ELEV. NO OCC GP EDU 00019803 0~ i0/81/6 STORIES
vO NO --
CENSUS TRACT I GP LANO USE I PARKING SPACE : RES UNITS I GRACING f'.ERMIT ISSUED
I
REDEVELOPMENT TYPE OCC LOAD FIRE SPR ' AREA CONST
YO ND vO NO v□ NO Not Valid Unless Machine Certified
QTY. PLUMBING PERMIT· ISSUE ?,c._.!:j(J QTY. MECHANICAL PERMIT· ISSUE ~.t)o SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100,000 BTU BUILDING PERMIT
EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT --
EACH WATER HEATER ANO/OR VENT 801 LE A/COMPRESSOR UP TO 3 HP PLAN CHECK
EACH GAS SYSTEM 1 TO 4 OUTLETS /) ("'<1 BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING /()_crU
EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE ELECTRICAL ~
·e--
EACH iNSTAl .. ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL
EACH VACUUM BREAKER MECH EXHAUST -HODO/DUCTS MOBILEHOME
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP
EACH ROOF DRAIN (INSIDE) SOLAR
TOT,t;L MECHANICAL STRONG MOTION
TOTAL PLUMBING -·1 /0 (JO FIRE SPRINKLERS
2. t)('\
PUBLIC FACILITIES FEE
QTY. ELECTRICAL PERMIT· ISSUE QTY. SOLAR • ISSUE BRIDGE FEE -NEW CONST EA AMP/SWT,BKR COLLECTORS . SCHOOL FEE • DISTRICT
1 PH 3 PH STORAGE TANKS Carlsbad
EXIST BLDG EA AMP/SWT/BKR ROCK STORAGE Encinitas
1 PH 3 PH ·-PUMP -San o,egu,10
REMOOE LIA L TE R PER CIRCUIT PLAN CHECK FEE San Marcos -·
TEMP PO LE 200 AMPS
OVER 200 AMPS -
TEMP OCCUPANCY 130 OAYSI --
TOTAL ELECTRICAL -i--TOTAL SOLAR TOTAL FEES PAYABLE I /<J -~ . . E•ptrat,on Every permit ,aaued by the Butldtng Othc1al under the prov,s,ons ofth11 I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT' ANO DO HEREBY * AN 06HA P£AMIT IS AEQUIREO FOA EXCAVATIONS OYEJI
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall .. p,re by hm1ta1,on and become null and void If tlle building or work 5' O" DEEP .t.NO DEMOUTION OR CONSTIIUCTION Of' authorized by such permit 11 not commenced w1th1n 180 days from the date of such DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS permit, or 1f Ille butldI~ or won< authorazed by such permit II suspended or STAUC'l\ffS OYER 3 STORIES IN HEIGHT
ISSUED: TO COMPLY WITH All CITY. COUNT'(, AND STATE LAWS GOVERNING BUILDING CON abandoned at any time a er the work ,s commenced for a oenoc:t of 1110 "•u•
STRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND ;J;;;PP !CANT'S SIGNATu~• OWNER □ CONTRACTORJq APPROVED~ -DATE KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO ,
1/0-(---8] EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE BY PHONE 0 GRANTING OF THIS PERMIT.
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' INSPECTION TYPE ... ----
, BUILDING
DATE INSPECTOR ~J•t.f~
FIELD INSPECTION RECORD
FOUNDATION
REINFORCED STEEL ' -REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES -MASONRY I INSPECTION REQ IF INSPECTOR'S DATE CHECKED APPROVAL
GUNITE OR GROUT SOILS COMPLIANCE
FLOOR & CE ILING SUB FRAME PRIOR TO
FOUNDATION INSP
SHEATHING STRUCTURAL CONCRETE
FRAME OVER 2000 PSI
EXTERIOR LATH lNSULATION PRESTRESSED
CONCRETE r
INTERIOR LATH & DRYWALL POST TENSIONED
CONCRETE
PLUMBING I --FIELD WELDING
SEWER AND BL/CO ' . HIGH STRENGTH
PLUMBING UNDERGROUND BOLTS
PLUMBING TOP OUT SPECIAL MASONRY
-' TUB AND ~HOWER PAN I .
GAS TEST PILES CAISSONS
ELECTRICAL -
TEMPORARY POWER I
I .
ELECTRIC UNDERGROUND I
ROUGH ELECTRIC I r
ELECTRIC SERVICE --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
JOB SITE FINAL
PLUMBING
ELECTRICAL -MECHANICAL
GAS ,__
BUILDING .
SPECIAL CONDITIONS
CERT OF OCCUPANCY ISSUED ,,