HomeMy WebLinkAbout2613 VIA VERA; ; 84-582-467; Permit.,, z 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.
L+c No ______ Cliss
I hereby athrm !hat I am exempt lrom the Conlrac· tor's Ltcense Law for the following reason (Sec. 7031 5
Business and Professions Code Any city Of county whicti re-
quires a pennit to conslruct. all er. 111lprove _ demohsh. or repair any s1ruc1ure pr,or to 11s tSsuance also requ1res !he ap-plicant tor such t,erm,t 10 hfe a s.qned statement 1ha1 he ,s
hcensed ptjrsuanl to lhe prCMS!OOS of the Contractor s License Law (Chapter 9 ccmmencing w1!h Seclt00 7000 of Ow1s1on 3 ot the Business and PrOfess,ons Code) Of 1hat 1s ex-empt therelrom and the basis tor the anegeo exempllOo Any
violation of Section 7031.5 by an apphcanl lor a permil sub·
tetts lhe apol1cant to a civil penilly of not more lhan live hun·
dred dollars (5500)
l I, as owner of the property. or my employees with wages
as their sole compensat.on, will do lhe work. and !he strut· lure 1s not mlended or ollere<:1 tor sate (Sec. 7044 Business
and Profess,ons Code The Contractor's lttense Law dOes not apply to -an owner of property who builds or improves
thereon and who does such work n,mseN or through his own
employees. provided lhal such improvements are not intend• ed or offered tor sale If. however. lhe bu11d,ng or 1mpr0Ve
ment 1s sold within one year ol complehon, the owner-builder will have lhe burden ol pravtng tha1 he did not build or im-
prove lor the purpose ot sale)
n I, as owner of the property. am exclusively contraclmg
with lteensed contractors to construct lhe pro,ec1 {Sec 7044,
Business and ProtesSfOns Code The contractor's license
Law does not apply to an owner ol property who builds or im-proves thereon, and who contracls IOf each pro,ects with a
contractor(s) license pursuant lo lhe Contractor's License Law)
D As a tlOO'ltOwner I arn 1mprovmg my home, and the follow•
Ing condihons exist l The work IS being perfOJmed pnor lo sale
2. I have lived m my home for twelve months
pnor 10 completion of this work 1 have not clarmeel lh1s exemp11on during the last three years
0 1 am exempt under Sec. _____ _ B&PC for this reason ____________ _
D I hereby athrm tha11 f\a,1e a cen1f1ca1e ol consent
10 sett insure. or a cer11tica1e ot Workers
Compensation Insurance. or a cert1f1ed copy tnereol
!Sec 3800 Labor Code)
POLICY NO
COMPANY
□ Copy ,s hle<l with the c,1y
□ Cert111ed copy IS hereby lutn1She<l
CERTIFICA Tl OF E~EMPTION FROM WORKERS COMPENSATION INSURANCE
(Th,s section need not be compIe1ea 11 lhe p.erm,1 ,~ '°' one hunoreo 0011a,s 1S HX)I °' less)
D I cert,ty that 1n 1he performance or the work tor
...,i,1ch 1h15 pemul 1s issued 1 shall no! employ any
person m any manner so as to become sub1ect 10
the Workers· Compensa1,on Laws ol Cahlorn,a
NOTICE TO APPLICANT It alter m.akm~ lh1S Cen1
ttca1e of Exemption you sl'\Ould become subIec1 I'>
the Workers Compensation pro..-1s1ons ot lhe LabOr
Code you must lorth-.-.,lh compty w,iri such
pro..-1st0ns °' th,s perm,1 shall be deemed ,e.,,oked
0 I hereby atfum lhat !here 1s a construc11on
1eno1ng agency tor !he performance ot the -....or11. lof
wh,ch lh1s permit ,s Issueo tSec 3097 C11111 Code!
Lenders Name ___________ _
Lender, Address __________ _
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT
1200 Elm_.i:~lsbad, California 92008-1989 (619) 438-5525
JOB AOOAESS
o:;~1~ \/;c,,J Ver-1
AV. ST AO. NEAREST CROSS ST 1 i:~a5NI BUSINESS LICENSE "
.....5804'
VALUATION PERMIT NUMBER
b8SS.<1 84--SB.2.-
ASSESSOR PARCEL NO ,.,... CONTRACTOR
I C.,-7 ~ I ,c; 0 (_I ~~BLOCK CONTRACTORS PHONE •
OWNER'S NAME
ZONE I
4-d:::>"7
i I OWNER'S PHONE "1'7',e ~ ,I,.;,. e M · h l..:iad <1o. 4 2,4-: 45q4 coNTAACToA· ADDAess ~-.... -~ ~LAN 1.0. It \\ I BLDG USE COOE
ow .. eR·s ... ~ooAess &,r l..:s fud C!..~ , ,
() + DESIGNER LICENSE,, ·-. ., -•
~~'!--::--,-i..-.~~.LL...1.!,,LLL.!L.!---.:~,ii,,!_1-,li~....l:i.il.U!!!l!l!,.L____. l:=r'hl ,· rorvne:::n/-..:J I
µ_L.Jc;;l,1~'£/._L..U."'~C.-C.:L.!!oil'LL..:~~~:__--------1 OES•GNEA'S -.ooAESS
L
"''JJ'A'\\' BUILDING SO. FOOTAGE
9~
6-,a ,·/J;-/-c,J;S. CA 9~~.;J.
FiP F LA ELEV. NO
STORIES
OCC GP EDU 7/1:Joi:tl,ib/ 2::,u•, •
v□ ._0 l7a'1
CENSUS TRACT GP LANO use PARKING SPACE AES UNITS GRADING PERMIT ISSUED REDEVELOPMENT
AREA
QTY.
77 z L 7.
QTY.
44-o I
PLUMBING PERMIT -ISSUE
EACH FIXTURE TRAP
EACH BUILDING SEWER
EACH WATER HEATER ANO OR VENT
EACH GAS SYSTEM I TO 4 OUT LETS
EACH GAS SYSTEM~ 0 R MORE
EACH INSTAl . ALTER, REPAIR WATER PIPE ---EACH VACUUM BREAKER
WATER SOFTNER
EACH ROOF DRAIN { l'ISIDE I
TOTAL PLUMBING l
~
Y.
Q
o:JSc
c2.5c. L~
4Z-v
ELECTRICAL PERMIT -ISSUE I ~~--QTY.
YO ND ,□~
MECHANICAL PERMIT -ISSUE
INSTALL FURN DUCTS iJP TO 100.000 BTU
OVER 100.000 BTU
BOILER/COMPRESSOR UP TO 3 HP
BOILER /COMPRESSOR 315 HP
METAL FIREPLACE
VENT FAN SINGLE OUCT
MECH EXHAUST HOOD OUCTS
RELOCATION OF EA FURNACE /HEATER
TOT.t.L MECHANICAL
SOLAR -ISSUE
2
TYPE CV/\/
3....-
4.-:---
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/<..3 I
occ LOAD I FIRE SPR
vO Nb(. Nor Vii/id Unl~s M~chine Certified
SUMMARY/ACCOUNT NUMBER
BUILDING PERMIT 01·00·00-8220 ~-
SIGN PERMIT 01-00-00-8221
PLAN CHECK 01-00-00-8806 -TOTAL PLUMBING 01-00-00-8222
ELECTRICAL 01-00·00-8223 -MECHANICAL 01-00-00· 8224 1-~-
MOBILEHOME 01-00-00-8225
MOBILEHOME PARK INSP
SOLAR J!lQ0-00-8226 I
J-STRONG MOTION 80-92-33-0519 4-.J. Bn
FIRE SPRINKLERS 01-00-00-8227
PUBLIC FACILITIES FEE 32-00-00-893:l
BRIDGE FEE
1 NEW CONST EA AMP SWI BKR -COLLECTORS ;,1.,nvuL rt C"l"'unnt er:~ • DISTRICT
L-n::2. v' I PH 3 PH STORAGE TANKS Carlsbad 80-92-21-0519
EXISTBLOGEAAMP1SWTBKR I :1 IROCKSTORAGE Encinitas 80-92-22-0519
I PH 3 PH I II I PUMP San D1egu1to 80·92-23-0519
REMOOELALTER PER CIRCUIT I !! !PLANCHECKFEE San Marcos 80-92-24-0519
TEMPPOLE 200AMPS
OVER 200 AMPS LICENSE TAX 01-00-00-8162 /.~ 7/-
TEMP OCCUPANCY <30 OAYSl MFF8o-92-57-051s /@ AAn t:/Rn-
CREDIT DEPOSIT
TOTAL ELELTRIC.AL 1 '3o-.--i TOTAL SOLAR TOTAL FEES PAYABLE I ~qol:,...3o
I HAVE CAREFULLY E)(AMINED THE COMPLETED APPLICATION AND PERMIT"' AND 00 HEREBY Exporat,on Everyperm,11ssueobytheBu,ld1ngOff1c1a1underlheprov,s1onsof1h,s
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CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFQRl,<ATION HEREON INCLUDING THE Code shall exp,re by ltm111t1on and become null and vo,d II the bulld,ng or work
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS aut:;:,nzed by such permit IS not commenced w1thtn 180 days from the dale of such
ISSUED TO COMPLY WITH ALL CITY COUNTY AND STATE LAWS GOVERNING BUILDING CON per ti or tf the butldtn~ or work aulh0ftZ&d by such perm,t ,s suspended or
* AN ~:l IS REQUIRED FOfl EXCAVATIONS OIIER
5· 0" DE. EP.. D 0£MOLITION OR CONSTRUCTION OF STRUC S OVER 3 STORIES IN HEIGHT ;!:
STRUCTION WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND abandoned at an tome a er the work •• commenced for a rtod of 180 da s
KEEP HARMLESS THE CITY or CARLSBAD AGAINST ALL LIABILITIES., JUDGMENTS, COSTS AND APPLICANT"S SIGNATURE • OWNER D CONTAACTO~
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE~~~ ~ ~~
GRANTING OF THIS PERMIT -/ / ~~ ~ &. ~ BY PHONE 0
APPROVED~
~
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TYPE I DATE INSPECTOR
BUILDING I
FOUNDATION I
REINFORCED STEEL I
I
MASONRY I
GUNITE OR GROUT I
FLOOR & CEILING SUB FRAME I
SHEATHING □ ROOF □ SHE;AR
FRAME I
EXTERIOR LATH I
INSULATION I
INTERIOR LATH & DRYWALL i
I
PLUMBING I
SEWER AND BUCO □IPUCO I
UNDERGROUND □ WASTE □ \/YATER
TOP OUT □ WASTE □ WATER
TUB AND SHOWER PAN I
GAS TEST I
□ WATER HEATER □ SOLAR WA1ER
I
ELECTRICAL f
□ ELECTRIC UNDERGROUND □ l!JFFER
ROUGH ELECTRIC I
□ ELECTRIC SERVICE □ TEMPORARY
□ BONDING □ POOL I
I
MECHANICAL I
□ DUCT & PLEM., □ REF. PIPING
HEAT -AIR COND. SYSTEMS I
VENTILATING SYSTEMS I
I
I
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVB BEEN APPROVED.
FINAL I
PLUMBING I .
ELECTRICAL I ,
I -..
MECHANICAL I _, --a -~
GAS .
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BUILDING I I II
SPECIAL CONDITIONS ,
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FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTION REO IF INSPECTORS DATE 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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cuii e:n t energy 1cguL1U on , C;iJifm nja /\d111 jni st ratjvc Code, THJe 25 , State o f
Caljfornia , jn 1Jic bujJcijng Jocatcd at:
SITE /\DDRESS _ ~lo\3 Via Vera.1_Gari _§bad CA
CE] LIN(;S 01\•cns/Cornj ng
Ccru inTced
Type [i b_c1~l o ss_ J,tmufacturcr ::_hnvi 1 l_g__
Bl rnm : Type
EXTLR lOR 1','.I\ LLS
Manufacturer
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