HomeMy WebLinkAbout2603 VIA MASADA; ; 84-582-413; PermitfJl z 0 ~ < re C ..J u w 0
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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 ______ Clm
I hereby affirm lhat I am exempl horn lhe Contrac-tor's License Law tor the totlowmg reason (Sec 7031 5
Business and Professt0ns COde Any c,ty or county wh.ch re-quires a permit to conslruct. alter. improve demolish or
repair any structure. pnOf to I1s issuance also requires !heap· pkcant tor such permn 10 Me a s1Qned statement that he 1s
licensed pursuant 10 Ille prov1st00s of lhe conrrac.tor s License Law (Chapter 9 commencing w11h Sechon 7000 of O1v1s10n 3 of the Busmess and Profess10ns Code) or Iha I Is ex•
empt therefrom and the basis for the allegeo exemplton Any v1ola11on ol Section 7031.~ bv an apphcant fOf a permI1 sub·
}eels the applicanl to a av1I penalty of no1 more than hve hun·
dre<l dollars (S500).
7 I. as 01tner ol the property, or my employees wllh wages as their sole compensation. will do !he wOfk. and the struc· ture 1s not intended Ot' offered lor sale (Sec 7044 Business
and PtolesStOns Cooe· The Contractor's Ucense Law does
no! apply to an owner ol property who builds Of improves
thereon and who does such work hlmsel1 or lhrough h,s own
employees, prov+ded that such improvements ate not 1n1end· ed or ollered !or sate II. however lhe t>u1tding o, 1mprove-
men1 ,s sotd wllhm one year ot compIe11on. lhe owner-builder
will have the burden of prOV1ng lhal he did not build Of im-
prove lor lhe purpose ot sale)
0 I. as owrler of lhe property. am exclusively con1rac1mg with t.censed contractors to construct the pro1ec.1 (Sec. 7044. Business and Proless~ns Code: The Contraclor's license
Law does not apply to an owner ol property who builds or UTI· proves thereon, and who contracts IOI' each pro,ects w11h a contractor(s) hcense pursuanl lo !he Contractor's License Law)
D As a homeowner I am improving my home. and the follow ing cond1t1ons exist 1. The work 1s being per1ormed poor lo sale
2 I have lived in my home for rwelve months
prIDr to completion of lh1s work 3 I have not claimed this exemption during the last three years
g llh~:,::t under Sec ------' B & p C -------------
□ I nereby alf1rm lhat I ha..-e a cet11ftca1e of consenl
to sett insure or a certil,cate ol Workers
Compensa.11on lnsuraoce. Of a cen1fled copy lhereot
(Sec 3800. Laoor Code)
POLICY NO
COMPANY
0 Copy ,s filed with the city
O Cert1hecl copy 1s hereby furnished
CERTIFICATl OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE
(Ttus section need not be completed 1I me permit ,s IOJ one hundre<l dOllars IS HX>1 or less,
0 I cert,ly that 1n tne performance of !he wori( lor
which this permn Is ,ssuecl I shall nol employ any person ,n any manner so as 10 become subIec1 to
!he Wonters· Compens.ahon U ws ol Ca11tom1a
NOTICE TO APPLICANT 11. alter makm1 this Cer11
hcate ol E•empt1on you should become sub1ec1 I'> the Wo111.ers· Compensation prov1s1ons ol the Labor
Code you must torth"'-•lh comply w1!h such prov1s1ons 01 this permit shall be deemed revokeo
0 I hereby athrm lhal there ,s a cons1ruct1on 1end1n1.1 aoency tor lhe pec1ormance ol the won.. to,
which this permit ,s 1ssue<l 1sec 3(87 C•v•I CO<lel
Len<:ter s Name ___________ _
Lenoer 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
J:;~R;;.:3 \/;c:) M~s~d:Ro. NEAREsTcRosssT. 1:;~:;P9~c85 1 eBBL~ # ~BL;;;:o PERMIT ::~~
aJ.3, BLOCK I s7;;..s'J5< I ASSESSO'lt/f~,°g, ..2.S'Ou _ CONTRACTOR CONTRACTORS PHONE • ZONE /) ~~
owNeR·s NAME I o wNER's PHONE t/1e 1-/it::::JA l.:::Jnd ~,... 4.34-4-5(.J.eJ 7J "Me 1-1✓-q)-, l~nd Co. ~ :1.A,459 4. CONT,.ACToR·s ADDRESS LICENSE NO. PLAN 1.0. # BLDG USE CODE
OWNER·s MA•LING AO0RESS a:ir lsh~d. CA-'34-'J+o 7
10/S (::k.__-;fnL.Jf Ave: R ~ 11...=,r-J..:sh "" I DESIGNE~ LICENSE a STANDARD PLAN# BUl~~tG so. FOOTAGE
0EscR1PT10N oF woRK '=r>\llro,vnc/l-k:::ll l:Je.:s,~ar; C!. 17 9 8 '49 ~ J -ro,-.•-.)-..r,.1 ... ~-"Pk:.:>/)-<r-JA~ DESIGNER"SADDRESS ~ DESIGNER'S PHONE 1..r/t.Lilt;:.. (1 ~ --,rf t( £~;,.,;:-:',! C:R ,o :0~~~~.:i
vO N0/7 Q!}_ ST~S R-.:!, /
CENSUS TRACT I GP LAND uSE I PARKING SPACE I AES uN1TS I GRADING PERMIT 1SSUED I REOEvELOPMENT TYPE OCC LOAD FIRE SPR ' A .A -I AREA CONST
---r-t"C.,/ YD N D v D "'~ V ;./ vO N'll( \ Nor Valid Unlm Machine Certified
QTY. PLUMBING PERMIT. 1ssuE 7 ~ QTY. MECHANICAL PERMIT. 1ssuE 3 -SUMMARY1Adcou~,t\NUMBER
I / EACH F1xTuRE TRAP • _..,-, -~ri / 1NSTALL FURN. DucTs uP 10 100.000 BTu ~ BUILDING PERMIT ~ 01-o!Nl '8220 -~_An -
/ EACH BUILDING SEWER l,, -~r OVER 100,000 BTU SIGN PERMIT 01-Q010 ~221 _
1 / EACH WATER HEATER AND OR VENT ~ .<:r BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK \ \, 01-p\;o0-8806 -.J_::J / -
: / EACH GAS SYSTEM 1 TO 4 OUTLETS _ ~ .<"r, BOILER/COMPRESSOR 3 15 HP TOTAL PLUMBING "' ~ Olf~00-8222 4/ <"r
I EACH GAS SYSTEM 5 OR MORE I METAL FIREPLACE ELECTRICAL \ \_ 01~00-00·8223 ~r, -
: EACHINSTAl.ALTER,REPAIRWATERPIPE -+--~ VENTFANSINGLEDUCT L-MECHANICAL \ \ ~0-00·8224 /L~ -
I EACH VACUUM BREAKER MECH EXHAUST HOOD DUCTS MOBILEHDME \J 01~·00-8225
I WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MOBILEHDME PARK INSP
I EACH ROOF DRAIN (INSIDE) SOLAR 01-Q,,,.0-_,,,,_00··.,,.,..A??..._~+------~~---1
1,___~---------.--~--c-.---=-tl TDT.G.L MECHANICAL srnoNG M□noN 80-92.33.o519 4-An 1
TOTAL PLUMBING I 4-b-.Sr / ~ -FIRE SPRINKLERS 01-00-00-8221
5-PUBLIC FACILITIES FEE 32·00·00·89ll QTY. ELECTRICAL PERMIT • ISSUE -QTY. SOLAR • ISSUE BRIDGE FEE
NEW CONST EA AMP SWl BKR / OOA ~< -COLLECTORS SCHOOL FEE. DISTRICT
1 PH 3 PH STORAGE TANKS Carlsbad L 7"Jf< .,/ 80·92·21·0519
EXIST BLDG EA AMP SWT BKR ROCK STORAGE Encinitas 80·92·22·0519
1 PH 3 PH PUMP San D1eguilo 80·92-23-0519
REMODEL Al HR PER CIRCUIT PLAN CHECK FEE San Marcos 80·92·24·0519
TEMPPOLE 200AMPS
OVER 200 AMPS LICENSE TAX 01-00-00-8162 / ... ~7 /-
TEMP occuPANCY ,30 oAYs, MFF so.92.51.0519 /(;)A ~0 _ aeo-"
I CREDIT DEPOSIT
TOTAL ELELTRICAL I \ ..:;, TOTAL SOLAR TOTAL FEES PAYABLE -,,2 ~ '-..;)o~ -~~. ~,o~~o
I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION AND PERMIT'" AND DO HEREBY Expiration Every perm,t issued bylhe Building Official unde<the provis,onsollhis * Af'O'>~~~-RMIT IS REQUIRED F0A EXCAVATIONS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall exp,re by limitation 8nd become null •nd void It th8 bu,lding or work 5 O'-DEE! AND DEMOLITION OR CONSTRUCTION OF . authorized by such permit 1s not commenced w1th1n 180days from the date ot such DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS perm,1. or if the building or work authonzed by such permll 15 suspended or STRUC S OVER 3 STORIES IN HEIGHT
ISSUED TO COMPLY WITH ALL CITY, C0UNl Y AND STATE LAWS GOVERNING BUILDING CON-abandoned at anv 11me after the work ,s commenced lor a oenod of 180 davs ~
STRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND APPLICANT"S SIGNATUA~ • 0 ~ APPRO\IE°l;..Yil ~¼ KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS. COSTS AND~ ~ OWNER CONTAAOT0A .-
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE _ ~ _:z;,--//4&,e".~ BY PHONE O -,...-<'-i'
GRANTING OF THIS PERMIT ., .,,._ ,.. _ ~ ~~----I O v
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TYPE I DATE INSPECTOR
BUILDING I
I
FOUNDATION I
REINFORCED STEEL I
i
MASONRY I
GUNITE OR GROUT I
I
FLOOR & CEILING SUB FRAME I
SHEATHING □ ROOF □ SH~AR
FRAME I
EXTERIOR LA TH I
I
INSULATION i
INTERIOR LATH & DRYWALL I
i ,
PLUMBING I
i
SEWER AND BL/CO □IPL/CO I
UNDERGROUND □ WASTE □ \YATER
TOP OUT □ WASTE □ WATER
TUB AND SHOWER PAN I
I
GAS TEST f
□ WATER HEATER □ SOLAR WAlER
I
ELECTRICAL I
I
□ ELECTRIC UNDERGROUND □ l!JFFER
ROUGH ELECTRIC I
I
□ ELECTRIC SERVICE □ TEMPOfllARY
□ BONDING □ POOL I
I
f
MECHANICAL I
□ DUCT & PLEM., □ REF. PIPING
HEAT -AIR COND. SYSTEMS I
VENTILATING SYSTEMS 1
I
I
CALL FOR FINAL INSPECTICJJN WHEN ALL APPROPRIATE
ITEMS ABOVE HA VEi BEEN APPROVED.
FINAL
PLUMBING
ELECTRICAL
MECHANICAL
GAS
BUILDING
SPECIAL CONDITIONS
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS
INSPECTION REQ IF INSPECTORS
CHECKED APPROVAL
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRESTRESSED
CONCRETE
POST TENSIONED
CONCRETE
FIELD WELDING
HIGH STRENGTH
BOLTS
SPECIAL MASONRY
PILES CAISSONS
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INSPECTOR'S NOTES
DATE
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