HomeMy WebLinkAbout2706 VIA PLATO; ; 84-582-446; PermitII) z 0 ~ C a:: C ..J 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 lhe Business
and Profeaalons Code, and my license is in
full force and effect.
L,c No ______ Class
I hereby alhrm thal I am exempt lrom lhe Con1rac-
1or's l,cense Law lor the 10now1ng reason (Sec 7031 5 Business and Professions Code Any cny or coun1y whictl re-
quires a permit to construct. alter improve. demolish, or
repair any structure. prior to I1s issuance also reQuires !heap-pticant for such permI1 to !tie a s19ne<i sta1emen1 thal he 1s hcensed pucsuanl 10 the prov,.sions ol the Con1ractor s
~:;.: }:1~~:f~~e;s ~~:e';Jo~;ig~~•=~h~~e:~
empt lherefrom and the basis for the allegeo exemplt0n Any
v1olatt0n ol Section 7031.5 bv .an apphcanl '°' a perm,! sub-Iects the applicant to .a crvi penalty of not more lhan f1ve hun-
dred dollars (S500)
I, as owner of the property. or my employees with wages
as 1heIr sole compensat,on. will do the work, and lhe sHuc·
ture 1s not ,ntended or ottered tor sale (Sec 7044 Business and Prolessions. Code Tne Contraclor's License Law dOes
not apply 10 an owner 01 property whO builds or improves !hereon and who does such work himself or lhrough his own employees, provided that such improvements are not mtend•
ed or offered for sate II. however, the bu1klrng or improve-ment ,s sold wIthm one year of complet,on, lhe owner-builder
wm have the burden of provmg that he did no1 build or im·
prove 10< lhe purpose ol sale)
D I. as owner 01 the property, am excluswely contractmg wilh licensed conlractors 10 construct the pro1ect (Sec. 7044,
Business and Professions Code The Contractor's license law does nol apply 10 an owner of property who builds or ,m-ptoves thereon, and who contracls 10' each protects wIlh a
contractor(sl license pursuant to the Contractor's LK:ense Law).
.J As a homeowner I am improving my home. and !he follow
mg condIhons exisl 1 The work Is being performed prior to sale 2 I have lrved m my home for twetve months
prior to completton of ll'tts work
3 t have not claimed this exemption during the
last lhree years
0 I am exempt under Sec ______ . B & P C
for ttus reason ____________ _
D I hereby alfirm Iha! I na.,e a cen,tica1e ot consent
to seU·insure, or a cenit1care ot Workers
Compensallon Insurance. or a cen1!1ed copy !hereof
(Sec 3800 L.allOr COdel
POLICY NO
COMPANY
□ COpy IS hied with the c•I)'
0 Cer11hed copy 15 heceby lurn,shed
CERTIFICATl OF EXEMPTION FROM
WORKERS COMPENSATION INSURANCE
(This section need not be compteled 11 1ne perm11 ,s tor one hundred dolla,s IS 1()01 or less)
0 I cer11ly that ,n 1he performance ot the wor>. 1or
which 1h1s perm,1 Is issued. I shall n01 employ any
person 1n any manner so as to t>ecome subIec1 10 the WoBers· Compensa11on Laws ot C.alltorn1a
NOTICE TO APPLICANT It, al!er maktnJ trus Ceni hcate ot Exemption. vou sh<>uld oec.ome sub1ec1 1
the woni.ers· Compensation prov,s,ons ol !he LabOr
COde you must tonn~1th comply with sucf'l
prov1s1ons or !his perm,l shall be oeemeo re1;oke<J
0 I hereby alt,rm !Ml there ,s a cons11uct1on
1end1no ~ency tor me performance ot !he won.. 10, wn,ch rn,s oerm,t ,s issued 1Sec )097 C1v11 Cooe1
Lenoer s Name ___________ _
Lenoer s Address __________ _
USE BALL POINT PEN ONLY & PRESS HARD I
APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
I CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT
I 1200 Elm, Carlsbad, California 92008-1989 (619) 438-5525
I 1°:;1~;1as l I JOB ADDRESS AV ST.RD. NEAREST CROSS ST.
-2 70" v✓·~ Pk:J to
BUSINESS LICENSE d VALUATION
88Sn ~855'6
PERMIT NUMBEA44~
tfA--~-v-
RI oi 0
WJBLOCK I SUBDIVISION I ASSESSOR PARCEL NO 0 CONTRACTOR CONTRACTORS PHONE • ZONE
7+-.z.:;-'"'7 4 \~ S"fs' 0 ?r,e rl,ah ~.n d C!.o. ~4-4594 OWNER'S NAME 14344594 7h~ I-I/ q h k;,n d <!o. CONTRACTOR'S ADDRESS LICENSE NO PLAN 1.0. # e'r!:DG USE CODE
t'l::>1-l:S b~ d cl,,q ..342.40 7 OWNER'S MA LING ADDRESS
101.S Ch~..s..Jnu--f Av~ 83 C!.:;,,-~6,:;:}d DESIGNER , LICENSE~ STANDARD PLAN# BUILDING SO. FOOTAGE
G,v i rohn-lc:'?/l+...J /V~Q.., (]1798 /49~ DESCFIIPT•ON OF WORK
/ ""'"7-"~ .i ,.,., ~ r, j J ~ ~ P i:Jr\ -~ oA DESIGNER"S ADDRESS DESIGNER'S PHONE
cr>c;r, ;'74a>...s; C!A 94--7 ~ ..2".:J
~ --,, F/P FLA ELEV. NO OCC GP EDU b/11!./6odOLI v□ NO na_c,
s.:,Es ,<23 I -..... -:;:-2906 •. ~
CENSUS TRACT I GP LAND USE
1
PA+:1-oCE
I
FIES 7TS 1
GRADING PERMIT ISSUED
I
REDEVELOPMENT TYPE OCC LOAD FIRE SPP
AREA Cy}./ ~ D ND vO ~ vO NV" . Nor Valid Unl~s M~chine Cerrd1ed
QTY. PLUMBING PERMIT -ISSUE -J!!l-QTY. MECHANICAL PERMIT -ISSUE -~-SUMMA~ i'ACCOUNT NUMBER
n EACH FIXTURE TRAP ')760 I INSTALL FURN DUCTS uP TO 100.000 BTU .,a, -:-BUILDING PERMIT ,, I 01-00-00-8220 -.., -~ ·-
I EACH BUILDING SEWER ~.Sr OVER 100,000 BTU SIGN PERMIT .w rl\ "°1-00-00-8221 -
I EACH WATER HEATER ANO OR VENT c;;i..sl'. BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK \\ . \1 )\. .._01-oo-oo-00os ~/-
I EACH GAS SYSTEM I TO 4 OUTLETS .-:J .S,,, BOILER/COMPRESSOR 3 15 HP TOTAL PLUMBING \ \J J.' -01-00-00-8222 4,_L Sc
EACH GAS SYSTEM 5 OR MORE r---METAL FIREPLACE ELECTRICAL[\ V I'll'-01-00-00-8223 .... "-?'""'-
EACH INSTAl . ALTER, REPAIR WATER PIPE -~ VENT FAN SINGLE DUCT £..--MECHANICA~ 01-00-00-8224 / .... ~-_.._
MOBILEHOME \.. \\I EACH VACUUM BREAKER MECH EXHAUST HOOD DUCTS 01 ·00-0Q-8225
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSPq
I EACH ROOF DRAIN (!~SIDE) SOLAR 01.:_00-00-R??fi
TOTJ;L MECHANICAL ~STRONG MOTION 80-92-33-0519 <t..~s;:::).O
TO I AL PLUMBING I 4--b :5,,.. /.3--: FIRE SPRINKLERS 01-00-00-8227
5'-SOLAR -ISSUE PUBLIC FACILITIES FEE 32-00-00-893)
QTY. ELECTRICAL PERMIT • ISSUE QTY. BRIDGE FEE
NEW CONST EA AMP SWT BKR l<'>OA ,.J<-COLLECTORS SCHOOL FEE • DISTRICT
1 PH 3 PH STORAGE TANKS Carlsbad / .7'1< L/' 80-92-21-0519
EXIST BLOG EA AMP1SWT BKR ROCK STORAGE Encinitas 80-92-22-0519
I PH 3 PH PUMP San Dtegu1I0 80-92-23-0519
REMODEL Al HR PER CIRCUIT PLAN CHECK FEE San Marcos 80-92-24-0519
TEMP POLE 100 AMPS
OVER 100 AMPS LICENSE TAX 01-00-00-8162 / .... ~ ")/-
TEMP OCCUPANCY !30 DAYSI MFF 80-92-57-0519 /C4'2,,t::?~r) aAo -
CREDIT DEPOSIT
TOTAL ELELT RICAL l c:.30-"' 'TOTAL SOLAR TOTAL FEES PAYABLE I c:2qo{::, . .3o
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT" ANO 00 HEREBY Ell:p,ratton Every permit issued by 1he Building Off1c1al under the prov1s1ons of this * AN --~·;-·-REQUIRED FOR EXCAVATIONS OVER
CERTIFY UNDER PENAL TY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall expue by 1tm1ta1ton and become null and void If the building or work 5· 0' 1>fEP ANO MOUTION OR CONSTRUCTION OF
DECLARATIONS ARE TRUE ANO CORRECT ANO I FURTHER CERTIFY ANO AGREE IF A PERMIT IS
authorized by such permit ,snot commenced w11h1n 180days from the date of such STRUCTURES ER 3 STOf'HES IN HEIGHT 1 ISSUED TO COMPLY WITH ALL City, COUNTY ANO STATE LAWS GOVERNING BUILDING CON· :~~~"~ '!t t=~Y ~~:1~ffei~h:C:~,:~!~~!~e~f~~~7 :>8~~~1~,S~:g~~~~ or
STRUCTION WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND I A T O R~ APPl'IOVEDiJ--" ;l/8 KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS COSTS 'IND ~APPL C N S S!GNAT-Z:-:URE lf-OWNER CONTRACTOR
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE -,~ ~~y PHONE 0 I ~J,--GRANTING OF THIS PERMIT 'l--•~
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TYPE I DATE INSPECTOR
BUILDING I I ,•:\..,_-..... ii ... , --<is<f-.S-~i:;1.-4 4 ~ ' I. '-,,
~-,.,
~-~,.._ ' ' '), •'!
. FOUNDATION I FIELD INSPECTION RECORD
REINFORCED STEEL I
I
MASONRY I
GUNITE OR GROUT I
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTION REO IF INSPECTORS DATE CHECKED APPROVAL
FLOOR & CEILING SUB FRAME I
SHEATHING □ ROOF □ SH~AR
FRAME I
SOILS COMPl ANCE --... _
PRIOR TO -' -,, FOUNDATION INSP
EXTERIOR LATH I
i
STRUCTURAL CONCRETE
OVER 2000 PSI
INSULATION I PRES TRESSED
INTERIOR LATH & DRYWALL I
I
CONCRETE
POST TENSIONED .. ,
CONCRETE .
PLUMBING I FIELD WELDING
SEWER AND BUCO 0 \PUCO I
UNDERGROUND □ WASTE □ WATER
TOP OUT □ WASTE □ WATER
HIGH STRENGTH•
BOLTS
SPECI AL MASONRY ..
' .. .
TUB AND SHOWER PAN I
I
GAS TEST I
□ WATER HEATER □ SOLAR WATER
I PILES CAISSO"-S . \ I ,) ,... ,• .
i . I !
ELECTRICAL I
I
.... ~.-, r -
< f'! ,.,. ·/ l.
., ' □ ELECTRIC UNDERGROUND □ WFFER
ROUGH ELECTRIC I
I
□ ELECTRIC SERVICE □ TEMPORARY
I, n :,f', --' ~ I, . , , . I . . n ·, -\ I I; -" .
□ BONDING □ POOL I
I
-J\ ~ •:...._ ----""-~ .
i
MECHANICAL I
I
~,
'--! ., ' .,
□ DUCT & PLEM., □ REF. PIPING
HEAT -AIR COND. SYSTEMS I
I
VENTILATING SYSTEMS i . -I
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE -. ---c' ~ ' ' ITEMS ABOVE HA VB BEf/'i AP_PR_S)~V~E=D~. __ _ .
FINAL ---'· PLUMBING ' V
ELECTRICAL
MECHANICAL ,~ ... ,..
GAS
' . ) .
. •. -. '1' ... , ~
. , .. I .:, -~~ ·.~ • "" .! l
BUILDING t '"-:,~i:··
' 1
SPECIAL CONDITIONS
CEILINGS Owens/Corning 6¼ 11 !#]»'
Batt 5 : Type Fiber gla 55 Manufacturer ~::;;~~ fi'~eed Thiclme 5 5 ~ l;; R-Val ue 19 ,f!IZ.~-~-; ',:;
Blown: Type _____ Manufacturer ---~---Thickness ___ R-Value ___ ,~
Owens/Corning 3
3 1
1
1
1 -~P,~: <·. EXTERIOR WALLS //. CertainTeed ~-
Type Fibe rglass Manufacturer Manville Thickness 4 11 R-Value 11 -~\~ ;
l
FLOORS Type Manufacturer Thickness R-Value ------------------
General Contractor License# --------------------------
By Title Date -------------------------------
Schmid Insulation Contractors, Inc . License# 221S17 C-2
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'
By{t);o~ b. 8%,A..u Title Vice President Date ________ ·_·, I
,zA-:_·-~l~Y~~\;~~;"··_·:· _ ~~~~~~~~~~~~~~,.~ ~