HomeMy WebLinkAbout2705 VIA JUANITA; ; 86-982; PermitIll z 0 ~ II: ~ c., "' 0
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D I hefeby affirm thlt I am llclhaed under
pro,,lalona of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Profeaalona Code. and my license Is in
full force and effect.
I hereby amrm that I am exempt trom lhe Contrac· lof s l,cense I.aw for the lollow1ng reason (Sec 7031 5
Business and Professions Code Any city or county whict. re-quires a pemut to construe!. alter. unprove. demohsh. Of repa1r any structure, prior to I1s issuance also requues ?heap· pht1flt tcw suet, per1n11 to file a s.igned sta1emen1 Iha! he is
ucensed pursuant to the provIs~s o1 lhe Contractor s License Law {Chapter 9 COrNnenc,ng wilh Sec110n 7000 ol
Ow1s10n 3 of the 8uSU'leSS and ProfeSSIDnS COde) or lhat IS ex· empt the<efrom and the bas,s lor the alleged eJ<ffllption , Any
vi01al10n of Section 7031. 5 by an apphcant tor a perm,_1 sub· 1ects lhe appUcant to a cMI ptnally of not more than liyt hu'l· dred ddlars ($500)
I, as OWrtef of the property. Of my employees with wages
as 1h11r • compenguon. w,U do the work. and the struc· ture ,s not intended or o11ered lo, sale (Sec 7044 Business
ano Professions Cooe The ContractOJ's License Law does
not ap~y 10 an owner ot property who butlds OJ improves
thereon and who does such work rumseH Of through his own employees, provided lhat such WT!provements are ool intend·
ed o, o!IOJed tor sale It. however. the building o, ,mprDYe-ment ,s SO(d w1lhin one year o1 completion. the owner-builder
w,11 have the burden of provtng that he did not build « im-
prove lot the purPose of salt)
r I, as owner of lhe property, am exclusively contracting
With licensed contractors to construct the project {Sec 7044. Business and Professions Code. The Con1rac1or·s License Law does not apply 10 an owner of property who builds o, ,m-proves thereon. and who contracts for each proiects with a
contractOf(S} license pursuant to lhe Contractor's Ucense Law).
0 As a homeowner tam ,mp1ovIng my home. and the tallow
Ing condIhons exIsI 1 The -k 1s bemg perto,meo proor to sale 2 I have hvtO in my home fo, twelve months
pnor 10 complehon of lhis work 3 I have not claimed this exempnon durmg the last three years
D I am exempt under Sec ______ . B & P C
for this reason -------------
0 I hereby .alhrm thill 1 have a certificate of consent to
self-insure. or a cemhcate ot Workers Compensation In-
surance or a certified copy thereof lSec 3800. Labor Code)
POLICY NO
COMPANY
::J Copy Is Med with the clty
D Certified copy ls hereby fum1She<2
CERTIFICATE OF EXEMPTION FROM
WORKERS" COMPENSATION INSURANCE (This section nee<:t ool be completed if the permit
Is for one hundred dollars (S 100) or less}
D I certify thal in the performance of lhe work fo_r which
th+s permit is issued, I shall not employ any person In any
manner so as to become subJec1 to the Workers· Compen-
sation Laws of Callforn,a.
NOTICE TO APPLICANT: 11, after maktng this Cerlificate
of Exemption. you should become sub1ect to the Workers
Compensation provisions of the Labor Code. you must
forthwith comply w,th such provisions or this permtl shall
be deemed revoked.
0 I hereby altirm that there ls a construction lending
aoenc-, fOf Ute per10fTT'lance of the work for which this per-
mit 1s issued {Sec 3097 Civil Code)
Lender's Name ________ ...,,. ___ _
Lender's Address ___________ _
USE BALL POINT PEN ONLY & PRE}S HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT ~
Carlsbad, California 92008-4859
JOB ADDRESS • • "\11 ...... v. ST.RO. NEAREST CROSS ST.
l°Ar : i~:~;;;ON1 BUSINESS LICENSE # VALUATION PERMIT NUMBER
-i-7c ~" v ,,41iE/a~i#TA M 4--rz_,,eoµ RD ><I".,,, ... .--• .;, : .. ~... . .... ~ ,w_., ..,,
LOTJ "J,.OC".l"''-"_.,,.,,, ~o~f1OHG I ASSESSOR. ~PARCEL NO CONTRACTOR CONTRACTORS PHONE • ZONE c,s L-lo Ice~--'·" //;. 7 • / /\ • "24 ~ o .o 5et-F
OWN;;~;~ ~#'--6)D~1(~ OWNE R'S PHONE
7"2'-] --7-Z 7c../ CONT RACTOR"S AOORESS STATE LICENSE.NO. BUILDING SO. FOOTAGE
~;.u)/t}/::IL
OWNER"S MAf.l NC ADDRESS·. ~• \: ',Jr. ff ., ... 'A). 'l4 DESIGN£ R"S PHONE ::Z...7 <;-~-~ .. ~71'~: -~-· DESIGNER
•. 0 . ,,J ou..;~ttt...
OESCRl!'T•ON OF WOl'li<". ·~ wul3 P-6-P 4-1 R.. OESIGNER"S ADDRESS _ STATE LICENSE NO.
['U! ,,,u8'2-. ~
' ....... -----F1P FLRELEV NO OCCGP EDU STORIES
vO "'O --
-1 I PARKING SPACE I RES UNITS I GRADING PERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRE SPR uii22 iiiil U':II .1~/t:Jbt'r<r,i _i U • I AREA CONST
y D ND ,□ NO vQ NQ Not Valid Un!f:Ss Ahchine Cmili~
QTY. PLUMBING PERMIT -ISSUE 7~ QTY. MECHANICAL PERMIT -ISSUE 3 --SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP INSTALL FURN DUCTS UP TO 100.000 BTU BUILDING PERMIT 001-810-00·00·8220
EACH BUILDING SEWER OVER 100.000 BTU SIGN PERMIT 001-810·00·00·8221 --------
EACH WATER HEATER ANDiOR VENT BOILER COMPRESSOR UP TO 3 HP PLAN CHECK 001-810-00·00·8806
I EACH GAs SYSTEM 1 TO 4 ounETs R~r1 ...,_,c BOILER/COMPRESSOR 3 15 HP TOTAL PLUMBING 001-810·00·00·8222 to-=. -
EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE ELECTRICAL 001-810-00·00·8223
EACH INSTAl . ALTER. REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 001-810-00-00-8224 --'---
EACH VACUUM BREAKER MECH EXHAUST HOOD •OUCTS MOBILEHOME 001-810-00-00-8225
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER SOLAR 001 ·810·00-00-8226
EACH ROOF DRAIN IINSIDEl DRYER VENT STRONG MOT ION 880·519·92·33 --
TOT i<L MECHANICAL FIRE SPRINKLERS 001 ·810-00-00-8227
TOIAL PLUMBING I //1--PUBLIC FACILITIES FEE 320-810-00-00-87 40
5 -BRIDGE FEE QTY. ELECTRICAL PERMIT • ISSUE QTY. MOBILE HOME SETUP PARK-IN-LIEU (AREA )
NEW CONST EA AMP SWT BKA CAR PORT TIF 001-810·00-00-8835
I PH 3 PH AWNING ,..., ,. LICENSE TAX 001-810·00·00·8162
EXIST BLOG EA AMP•SWT SKA GARAGE '--' -lf A -h MFF 880-519·92·5 7
I PH 3 PH -4 l..J.\. -t_ I"\
REMODEL AL HR PEA CIRCUll \ .... r, ~ -
TEMP POLE 200 AMPS -'-~ TODt
OVER 200 AMPS -lll.i1f1, _ .
TEMP OCCUPANCY {30 DAYSI wcYfloo.b . • ~"»•-
-~" 'PRnr~ .. ---""::-,EDIT DEPOSIT
TOTAL ELECTRICAL I TOTAL --, .... SffVspTAL FEES PAYABLE I . in-
I HAVE CAREFULLY EXAMINED THE COMPLETED' 'APPLICATION ANO PERMIT" ANO DO HEREBY Expiration Every perm•t issued by u,e 8u1td1ng Offic111 unde< the proV1s,1Jns of this * AN OSHA PERMIT IS AEQUIAED F0A EXCAVATIONS OVER
I CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shaJI expire by hm,tation and become nuJl and void If ttie building o~ work ~•o·• DEEP AND DEMOUTION OR CotfSTRUCTION OF
DECLARATIONS" ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT I~ authorized by such perm,t ,a not commenced within 180 days from the date or such STRUCTVRES 0\/ER 3 STORIES IN HEIGHT I perrn11, or tf the bu1td1~ or work au1hor•zed by such permit 1, suspended or
I ISSUED TO COMPLY WITH ALL CITY COUNlY AND ST"-TE LAWS GOVERNING BUILDING CON abandoned al anv lime a ler the work ,s commenced for a '''"'od of 180 davs
I STRUCTION WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND APPLICANT'S SIGNATURE lfo OWNER□ CONTRACTOR 0 APPROV1/41 reA/ l DATE KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS. COSTS AND ;, ~" I EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE BY PHONE 0 10-1.S-* I GRANTING OF THIS PERMIT
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TYPE I
I
:, BUILDING I
OUNDITION I
EINFO .. STEEL I
I
IASON ,, I
iUNITE O'AiGROUT I
F
R
M
G
s
s
F
UB FRAME □ FLOOR D CElllNG
HEATHIN~-□ ROOF D SHEAR
RAME I
I EXTERIOR LATH I
INSULATION I
INTERIOR LATH & DRYWALL I
I
PLUMBING I
□ SEWER AND BUCO □ ~UCO
UNDERGROUND D WASTE D WATER
TOP OUT D WASTE D WATER
TUB AND SHOWER PAN ' ' GAS TEST I
D WATER HEATER D SOLAR WATER
I
I
ELECTRICAL I
D ELECTRIC UNDERGROUND uJ UFFER
ROUGH ELECTRIC I
' D ELECTRIC SERVICE D TEMPORARY
D BONDING D POOL I
I
MECHANICAL I
D DUCT & PLEM., D REF. PIPilNG
HEAT -AIR COND. SYSTEMS I
VENTILATING SYSTEMS I
I
I
DATE INSPECTOR
CALL FOR FINAL INSPEOTION WHEN A~~PROPRIATE ITEMS ABOVE HAVE BEEN APP o r:, ...
FINAL -...,~« "" .... I
PLUMBING I <: C-i -·~ .
ELECTRICAL I -· ~ v 19R;:
MECHANICAL I -~ .. ---GAS I -~ ~J
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS
INSPECTION REQ IF IN SPECTOR'S
CHEC KED APPROVAL
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRES TRESSED
CONCRETE
POST TENSIONED
CONCRETE
FIELD WELDING
HIGH STRENGTH
BOLTS
SPECIAL MASONRY
PILES CAISSONS
~ .
\ .
BUILDING I ---·-tJ:: II -
SPECIAL CONDITION~ ' -I
I
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INSPECTOR'S NOTES
DATE , ·"" -:irf.l!\~ .,.-· la --.... ~r,·, '-'-... ~ r
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