HomeMy WebLinkAbout2605 VIA MASADA; ; 84-582-412; PermitCl) z 0 ;:: < a: < .... <.> "' 0
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0 I hereby affirm that I am licensed under
provisions 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.
Lie No ______ Class
I hereby affirm thal I am exempt from lhe Con1rac-1or·s Ucense Law for lhe following reason (Sec 7031 5
Business and Professions Code Any oly or counry which re-Quires a permI1 to conslruct. alter improve. demohsh, or repa,r any structure, pr IOI' to 11s issuance also requires !heap-
pUcant lor such permit 10 hie a signed statement Iha! he 1s
licensed pursuant 10 1ne provmons ol the con1rac10f s License Law (Chapter 9 commencing with Section 7000 at 01v1s1on J ol tne Business and PfofesSJons Code) or that 1s ex-empt therelrom and !he basis for the al!egeo exemp11on, Any
vt0lallon of Section 7031.5 bv an apphcant tor a perm,1 sub-
Jecls the aopllcant to a civil penalty of 001 more tha.n hve hun·
dred dollars ($500)
r I. as owner of lhe property. or my employees with wages
as 1he1r sole compensation. wlll do the work. and the struc-
ture 1s 001 intended or ottered for sale (Sec 7044. Busmess
and Profess10n~ Code The Contraclor s License law aoes
not apply to an owner of property who bu1kls or improves
!hereon and who does such work himsetf or through h1s own employees. provided that such improvements are not intend-ed or offered tor sale If. however the bu1ldmR or 1mprove-
men1 Is sold w1thm one year of complet100 the owner·bwlder will have the burden of proving Iha! he did not build or Im· prove for the purpose ot sale)
0 I. as owner of the property. am exclusively conlractmg with licensed conrractors lo construct the proJect (Sec 7044,
Busmess and Professions Code The Contractof's License law does not apply to an owner of property who builds or im-
proves thereon. and who contracts for each pr01ects with a contractoc(s) license pursuant lo the Comractor's Lteense Law)
D As a homeowner I am Improvmg my home. and !he follow ing conditions exist.
1 The work Is bemg perlormed pnor lo sale.
2 I have hved In my home for twelve months pnor to comp1e11on of this work
3 I have no1 clamled this exemption dunng the last three years
D I am exempt under Sec ______ , 8 & P C
for this reason
0 I hereby affirm 1hat I na.,e a certificate or consent
10 self.insure. or a cen1t,cate of Workers
Compensation Insurance. or a cen,hed copy !hereof
(Sec 3800. LallO< Code!
POLICY NO
COMPANY
0 Copy 1S f1ted w1lh 1he Ctly
0 Cen,heo copy 1s hereby lurn1shed
CERTIFICA Tl OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE
{This section need not be completed 1! u,e permit
1s tor one hundred dollars (S HX>I or 1ess1
0 I cen,ty that m !he performance ot !he woMI. ,o,
which this perrn1t is issued. I shall not employ any
person +n any manner so as 10 become sub1ec1 10 the Wonie,s Compensa11on Uws al Ca11tornia
NOTtCE TO APPLICANT If. alter makind HHS Cen, lie.ate of Exemp11on_ yOtJ should beeome sub1ec1 I'>
the Workers Compensa11on prov,s1ons ol lhe UbOr
Code you musl tonh .. 11h comply with such
provisions or 1h1s perm11 shaU t>e oeemed ,e.,,ok.e<l
0 I heteby affirm lrl-31 !here •s a cons1ruc11on
1end1t\Q agency to, ine per1ormance ot ine wof1o. 10,
which th,s permit •S ,ssued (Sec 3097 C1v11 COdeJ
Lender s Name ___________ _
Lender s Aooress __________ _
USE BALL POINT PEN ONLY & PRE~S HARO APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT ..... 1200 Elm. Carlsbad. California 92008-1989 (619) 438-5525
JOB AOORESS AV. ST.RO. NEAREST CROSS ST
I:;T;9~~A~NI
BUSINESS LICENSE it VALUATION PERMIT NUM~t""\,"
.:::?~ OS v'Ja> /VI.,,;;, .5.,,;:) de;;, 88~0 686'~2./
1{4'~ .;f;_;,l BLOCK I s,z,::,.s I ASSESSOR PARCEL NO. '-I-V CONTRACTOR CONTRACTORS PHONE • ZONE I _t,, 7 <../ / '2.:, ~ 0 /h~ U;,,J .. L-,,"-1 (">,., 4d4-46CJ4-OWNER'S NAME ~;;sq~ 77-le-l/JoAl~cl Co CONTRACTO~AOORESS LICENSE NO. PLAN 1.0 . # BLOG USE COOE
{1 ~,l.s h_;,di C4 ..3~4-07 OWNER'S MA, ING "-OORESS
I0/5 C.Ae.....,-fbU-1-/lveK~ c' .. :Y-1..::sb~d OESrGNER LICENSE# STANOARO PLAN # BUILDING SO FOOTAGE
G, v;ron/Y'k:r'li-~I ~.Slq" C!.1798 /49~ OESCRIPTION OF WORJ< Pf-v.i < r,L3_ / -r-'h., ,-J,, r,; ,~-OESIGNER'S AOORESS OESIGNE R'S PHONE
{/vv V 6,c:;.,,;-/4,::,s; c!A 94.:) ~ .:2 ,..:i ,__ FIP FLA ELEV NO OCC GP EDU
vO N0 /7~
STORIES I ~ .12-.3 r_ .1n.1_ .,_-.
CE NSUS TRACl I GP LANO USE I p#~CE I RES;N1TS I GRADING PERMIT ISSUED
I
RED E VELOPMENT TYPE OCC LOAD FIRE SPR -JCi.~.3 AREA CONST
y D ND y O N"b( Vrl vO N)(' Not Valid Unless Machine Certified
QTY. PLUMBING PERMIT • ISSUE 7~~ QTY. MECHANICAL PERMIT · ISSUE 3-SUMMARY/ACCOUNT NUMBER
/I EACH FIXTURE TRAP --2_7__ • L"'\r'.: / INSTALL FURN DUCTS i.JP TO 100.000 BTU 4-......,.. BUILDING PERMIT 01 ·00·00·B220 , -f40-
I EACH BUILDING SEWER ~ So OVER 100.000 BTU SIGN PERMIT 01·00·00·8221
I EACH WATER HEATER ANO OR VENT -2 5c BOILER/COMPRESSOR UP TO 3 HP
--
PLAN CHECK 01 ·00·00·8806 -2..:::, I-
I EACH GAS SYSTEM 1 TO 4 OUTLETS ~-~t" BO ILER/COMPRESSOR 3-15 HP TOTAL PLUMBING 01-00-00·8~ 2 ~-6........:Sa._
EACH GAS SYSTEM 5 OR MORE MET AL FIREPLACE ELECTRICAL ~01 -~0-00•Bf 1\1 '--5"r,
EACH INSTA~. ALTER. REPAIR WATER PIPE -< VENT FAN SINGLE DUCT L--~ MECHANICAL ~ ·00·00-82 I\ /_~-
EACH VACUUM BREAKER MECH EXHAUS T HOOD DUCTS MDBILEHDME 01 ll)O·OO·i25~
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MDBILEHOME PARK INSP..,. 1o.t..: ' EACH ROOF DRAIN (INSIDE! SOLAR
~
1-00-0, I~,,~
TOT J;L MECHANICAL ~TRONG MOTION 0·92-3 -0519 4-Ro
TOTAL PLUMBING I 4../.. .<r l:3-:-FIRE SPRINKLERS ~~n j\5227
QTY. ELECTRICAL PERMIT · ISSUE .s=-QTY. SOLAR· ISSUE PUBLIC FACILITIES FEE \ \ 32·00·00-89JJ
BRIDGE FEE 'J
NEW CONST EA AMP SWT 8KR /OoA o.<S-COLLECTORS SCHOOL FEE • DISTRICT -I PH 3 PH STORAGE TANKS Carlsbad LTRv 80·92·21 ·0519
EXIST BLOG EA AMPISWT BKR ' ROCK STORAGE Encinilas 80·92· 22·0519
1 PH 3 PH PUMP San Oieguilo 80·92-23-0519
REMODEL AL HR PER CIRCUIT PLAN CHECK FEE San Marcos 80·92·24-0519
TEMP POLE 200 AMPS
OVE R 200 AMPS LICENSE TAX 01-00-00-8162 /.87/-
TEMP OCCUPANCY 130 DAYSI MFF 80-92-57-0519 / ~ E 80 -880-
CREDIT DEPOSIT
TOTAL ELECTRICAL
I Jo-TOTAL SOLAR TOTAL FEES PAYABLE -2 <? O{:. . ..:3 o
I HAVE CAREFULLY EXAMINED THE COMPLETED ' APPLICATION AND PERMIT · ANO DO HEREBY Exptrat1on. Every permit issued by the Bu1ld1ng Off1c1al under the prov,s,ons of this * AN OS~IS REQUIRED FOA EXCAVATIONS OVER CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall exptre by hm1tahon and become null and vo,d If the building or work ~· O" N MOUTION OR CONSTRUCTION OF DECLARATIONS ARE TRUE ANO CORRECT ANO I FURTHER CERTIFY ANO AGREE IF A PERMIT IS authorized by such perm,t 1s not commenced within 180days from the date of such STRUCTUM. ER 3 STORIES IN HEIGHT permit. or ,r the bu1ldinr. or work authonzeo by such permit ts suspended of ISSUED TO COMPLY WITH ALL CITY COUNlY ANO STATE LAWS GOVERNING BUILDING CON abandoned at anv ttme a ter the w ork 1s commenced for a oeriod of t 80 davs STRUCTION, WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY ANO APPLICANT'S SIGNATURE 1f. OWNER O CONTRACTOR~ APPROVED B~ ~ 1o/~fer 1
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 ~;_?;' ~~y PHONE 0 GRANTING OF THIS PERMIT.
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TYPE I DATE INSPECTOR
BUILDING I
FOUNDATION I
REINFORCED STEEL 1
I
MASONRY I
GUNITE OR GROUT I
FLOOR & CEILING SUB FRAME I
SHEATHING D ROOF D SH6AR
FRAME I
EXTERIOR LATH I
INSULATION I
INTERIOR LATH & DRYWALL I
I
PLUMBING I
SEWER AND BUCO DIPUCO I
UNDERGROUND D WASTE D WATER
TOP OUT D WASTE D WATER
TUB AND SHOWER PAN I
GAS TEST I
D WATER HEATER D SOLAR WATER
I
ELECTRICAL I
D ELECTRIC UNDERGROUND D l'JFFER
ROUGH ELECTRIC I
D ELECTRIC SERVICE D TEMPO~ARY
D BONDING D POOL I
I
MECHANICAL I
D DUCT & PLEM., 0 REF. PIPll'IG
HEAT -AIR COND. SYSTEMS I
VENTILATING SYSTEMS I
I
I
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAY_f!. BEEN APPROVED.
FINAL
PLUMBING
ELECTRICAL
MECHANICAL
GAS
BUILDING
SPECIAL CONDITIONS
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS
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
BOL TS
SPECIAL MASONRY
PILES CAISSONS
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INSPECTOR'S NOTES
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Blown: Type Manufacturer Thickness R-Value -------------~-----Owens/Corning 3½11
EXTERIOR WALLS C . T d 321 II erta1n ee
Type Fiberglas s Manufacturer Manville Thickness 4 11 R-Value 11
FLOORS Type Manufacturer Thickness R-Va lue ------------------
General Contractor License # ----------------
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By ____________ Title _________ Date _________ J (
Schmid Insulation Contractors , Inc. License # 221517 C-2 I·.
By{J;o~ i). B~ Title Vice President Date ________ ~-':
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