HomeMy WebLinkAbout2614 VIA MASADA; ; CB881676; Permit"' z 0 .:: C II: C ..,
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0 I hereby affirm 1ha1 I am llcensad under
provlalona of Chap1er 9 (commencing wl1h
SecUon 7000) of Division 3 of 1he Business
and Profualons Code, and my license Is In
full force and effect
I hereby atllrm that I am exempl lrom the Contrac-1or s License law tor the foUowmg reason (Sec 7031 5
Business and ProtesSK)OS Code Any city 01 county whict. re-quires a per~t 10 consrruct. alter. Improw. dtmohsh. or
repair any structure. prior to I1s issuance also requues !heap· plttanl lor such permit to Me a signed slalemenl Iha! he 1s
hcensed pursuanl to the pr0Y1s10ns ol the t.:ontraclor • s
license Law !Chapter 9 commencing w11h Setlt00 7000 of
Otv1sK>n J OC the Business and PtolesSIOt\s COde) or 1na11s ex emp1 therefrom and the basis ror the anegea exempoon Any
violation of Stc:110n 7031 5 by an appl1can1 lor a perm,1 sub·
,ect1 !he appt,can1 to a crv,I penalty ot not more than ltve hun•
dreo dollars ($500)
I as owner ol II•• property. or my •mplOyees w,1h wages
as their sole compensalKN'l. will do the wOfk and 1he struc·
ture 1s not intended or ollered for sale (Sec 7044 Business ancl Profes5'on5-Code The Contraclof' s Lteense Law does
nol appty to an owner ot properly who builds Of ,mprOYes
!hereon and who does sudl work himself Of through hrs own employees proVtded that such improvements are nol mlend-
ed or offered !or sale II, however. the ou1k1tng or improve· ment ,s sold w11tnn one year of complehon. the owner-ou1!def
will nave the burden ot proving lhal he. chO not build Of 1m· prove tor lhe purpose ol saleJ
I. as owner of the property, am exclusively cootraclmg
with hcenstti contractOfs to construct the pro,eet (Set 7044,
Bus mess ano Proless10ns Cooe The con1rac1or' s License
Law does not apply to an owner of property who builds or 1m· proves thereon. and who contracts fOf" each prqe-cts w11h a conuactor(s) hcense pursuant 10 the Conuactor·s license Law)
I r As a homeowner I am 1mprnvmg my home a!ld lhe lollow
mg coodIlIons e,ust 1 The work 1s being performed prior to sale 2 I have hved in my name to, twelve months
pr.or 10 completion ot rrus work 3 I have nol claimed this exemption during the last lhree years
D I am exempt under Sec ______ . 8 & P C
lor this reason ____________ _
C I hereby affum ttlat I have a certificate of consent to
self insure. or a cen1t1cate of Workers Compensalion ln--
wrance. or a cernhed copy !hereof lSeC 3800. LabOf Code)
POLICY NO
COMPANY
--, -Copy IS hied with the city
0 Cer!lfled copy 1s hereby furnished
CERTIFICATE OF EXEMPTION FROM
WORKERS· COMPENSATION INSURANCE
(Th,s section need not be completed 11 the permit
,s for one hundred dollars 1SH>O) or lf'SS)
::J I cen1ly ttlal ,n the performance of lfle work 10< which
this perm11 ,s 1ssuea. I shall not employ anv person 1n any ,
manner so as to become sub1ect to the Workers Compen-
sation Laws of Cahtom1a.
NOTICE TO APPLICANT: It. after making this Cerhficate
of Exemption. you should become subJect to the Workers·
Compensation prov1s1ons ot the Labor Code. you must
for1hw1th comply with such pro-v1s,ons Ot" lh1s permit shall
be deemed revoked.
0 I hereby affirm lhat theie Is a construction tending
agency !or the performance ol tt,e work tor which this per-1 mil ,s issued (Sec 3097. C1vtl Code)
Lenders 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
• 2075 Las Palmas Dr., Carlsbad, CA 92009-1915 (619) 438-1161
JOB ADDRESS AV ST.RO. THOMAS BROS NO. I DD~~ AP;SCA;;J
BUSINESS LICENSE # VALUATION PERMIT NUMBER
"').bl'-/ ' L)/A f'1A5A 1)t\ 'f" ,4N Ir &.flit; to 1:> • crJ8~f ~7l? zr21 BL02 L I 57~~r::02 s I ASSESSOR PARCEL NO. LJ CONTRACTOR CONTRACTORS PHONE • ZONE
I ~7 I.I 2,. ~3 0
OWNE R"S NAME OWNER'S PHONE
Q ScotT 4=?4 b79o CONTRACTOR'S ADDRESS STATE LICENSE NO. BUILDING SO. FOOTAGE
OWNER'S "'A . •NG ADDRESS
2.fol'-t Vl~ M45ADA CAgt..SBA DC A CJ).ol'g DESIGNER DESIGNER'S PHONE
OESC~1PT10N OF WORI(
0ESIGNE ... S ADD" ESS STATE LICENSE NO.
+-o.n-r-\ ~ ~ ~ ,!fl)(L ~«.J "t"0-'2-.E -F p F LR ELEV NO DCC GP EDU
~Ar , ,~ r'... ,ru ~ ~-~ STORIES
vO NO
\J I CENSUS TRACT I PARKING SPACE RE S UNITS GRADING PERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRE $PR 368112/15/88 0001 01 02 AREA CONST
y D ND ,□ .. o vO NO Not Valid Unll!fs 4',l~tdied 10-0<
QTY. PLUMBING PERMIT • ISSUE 7.0() QTY. MECHANICAL P~~VsuE 16-00 SUMMARY/ACCOUNT NUMBER I
EACH FIXTURE TRAP INSTALL FURN Dd;ltH~~ 100.000 BTU BUILDING ·cn,~II UUl·ijlU·UU·UU·HUU /rJ
EACH BUILOING SEWER ~, 1V OVER lp~lt(~TU SIGN PERMIT 001·810·00·00·8221
EACH WATER' HEATER ANO OR VENT BOILER/~A°ESSOR UPJ)O) H'F-' _ ... ~ ·" PLAN CHECK 001·810·00·00·8891
EACH GAS SYSTEM I TO 4 OUTLETS BOILER/COMPRESSOR 1 l5 HP ... ~~· (.! ~~ .. TOTAL PLUMBING 001·810·00·00·8222
EACH GAS SYSTEM 5 OR MORE MET AL FIREPLACE -~-►~A_C...,\'\\'->. ELECTRICAL 001 ·810·00·00·8223
EACH INST AL . ALTER. REPAIR WAT ER PIPE VENT FAN SINGLE D~c-O-• _ n~O..,. MECHANICAL 001 ·810·00·00·8224 -
EACH VACUUM BREAKER MECH EXHAUSG~d'..oo1l}ohs MOBILEHOME 001·810·00·00·8225
WATER SOFTNER RELOCATION p.(\~'-fl.JRNACE1HEA TE R SOLAR 001 ·810·00·00·8226
EACH ROOF DRAIN ll~SIDEI DRYER VENT v'" STRONG MOTION 880·519·92·33
TOTI.L MECHANICAL FIRE SPRINKLERS 001 ·810·00·00-8227
TO I Al PlUMBINL I PUBLIC FACILITIES FEE 320·810·00·00·87 40
BRIDGE FEE 360·810·00·00·8740
QTY. ELECTRICAL PERMIT· ISSUE ,z;-: M) QTY. MOBILE HOME SETUP PARK·IN·LIEU (AREA l
NEW CONST EA AMP SWI HKR CAR PORT TIF 312·810·00·00·8835
1 PH 3 PH --AWNING LA COSTA TIF 311·810·00-00·8835
EXIST BLDG EA AMP1SWT BKR GARAGE FMF
l PH 3 PH LICENSE TAX 001"810·00·00·8162
REMOOEL ALTt R PER CIRCUIT MFF 880·519·92·57
TEMP POLE 700 AMPS
OVER 700 AMPS
TEMP OCCUPANCY 130 OAYSI
CREDIT DEPOSIT -
TOTAL ElELIRICAL I " ], TOTAi TOTAL FEES PAYABLE JO
I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION ANO PERMIT •• ANO DO HEREBY E.:ptrahon Every per met ,uued by 1he Bu,ldtng Ottte••• undef the pr0vts,on1 of ,n,s * AN OSHA PU .. :T IS REQUIRED FOfl EXCAVATIONS OYER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall expire by 1tm1tat1on and become null and void If the bu1'd11"1g o, work S O" DEEP ANO DEMOLITION Ofl CONSTRUCTION Of
DECLARJ\TIONS ARE TRUE ANO CORRECT ANO I FVRTHER CERTIFY ANO AGREE IF A PERMIT I', authorized by such perm,t 11 not commenced w1thm 180 days rrom the date \lf such STAUCT\JRES OYER 3 STOAIES IN HEIGHT
1SSUE0 TO COMPLY WITH ALL CITY COUNTY AND STATE LAWS GOVERNING BUILDING CON =~~ '!, t~y ~~·~-~~':~r:"r!':!:1~led~~~ r~~ ~ 'r:,r!.~ 0
'
STRUCTI0N WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY ANO
APP\.ICC(1/• TS SIGS;{URErl /} OWNER[] CONTRACTOR [J
AP~~
OATE
KEEP HARMLESS THE CITY OF CARLSBAD AGAINST A-.L LIABILITIES. JUDGMENTS. COSTS AND 11¾1r E)'.(PENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE ~
GRANTl"IG OF THIS PERMIT /ta-1./l BY PHONE rJ
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TYPE ! DATE INSPECTOR
BUILDING I
I
FOUNDATION I
I
REINFORCED STEEL I
MASONRY .
!
GUNITE OR GROUT I
I
SUB FRAME D FLOOR D CEll!.ING
SHEATHING D ROOF D SHEAR
FRAME I
EXTERIOR LA TH ' INSULATION I
INTERIOR LATH & DRYWALL 1
I
I
PLUMBING I
I
D SEWER AND BUCO D P~CO
UNDERGROUND D WASTE □•WATER
TOP OUT D WASTE D ½fATER
TUB AND SHOWER PAN I .
GAS TEST I
D WATER HEATER D SOLAR W/\TER
I
ELECTRICAL I
0 ELECTRIC UNDERGROUND □; UFFER
ROUGH ELECTRIC ' D ELECTRIC SERVICE D TEMPORARY
D BONDING D POOL • I
MECHANICAL I
D DUCT & PLEM ., D REF. PIPING ...
HEAT -AIR COND. SYSTEMS I -' VENTILATING SYSTEMS I ;
:
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE BEEN APPRQVED.
FINAL
PLUMBING
ELECTRICAL
MECHANICAL
GAS
BUILDING
SPECIAL CONDITIONS
eA'ifi \(o1y
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTION REQ IF INSPECTOR'S DATE CHECKED 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
I
i PILES CAISSONS I I
I
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