HomeMy WebLinkAbout2744 VIA TULIPAN; ; 80-689-F; PermitZ,;1
/7'_,~ (. ~\ CITY OF CARLSBAD-BUILDING DEPARTMENT
p,,r, APPLICATION & PERMIT
LICENSED o ACTOR: ECLARATION USE BALL POINT PEN ONLY 1200 ELM AVENUE (714) 438-5525
APPLICANT TO FILL IN INFOR-
MATION WITHIN RED LINES. I hereby affirm that I am hcensed under provl•
slons of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Profes•
slons Code, and my license Is In full force and ef·
feet.
OWNER-BUILDER DECLARATION
0 1 hereby affirm that I am exempt from the Con·
tractor's License Law for the following reason
(Sec. 7031.5 Business and Professions Code), Any
city or cou~ty which requires a permit lo con•
struct, after, improve, demolish, or repair any
structure, prior to its issuance also requires the
applicant for such permit to file a signed state-
ment that he Is licensed pursuant to the provi•
sions of the Contractor's License Law (Chapter 9
commencing with Section 7000 of Division 3 of
the Business and Professions Code) or that Is ex·
empt therefrom and the basis for the alleged ex•
emption. Any violation of Section 7031.5 by an ap-
plicant for a permit subjects the applicant to a
civil penalty of not more than five hundred dollars
($500).
D I, as owner of the property, or my employees
with wages as their sole compensation, will do
the work, and the structure is not intended or of·
fered for sale (Sec. 7044, Business and Profes·
sions Code: The Contractor's License Law does
not apply to an owner of property who builds or
Improves thereon and who does such work
himself or through his own employees, provided
that such improvements are not intended or of-
fered for sale. If, however, the building or improve-
ment Is sold within one year of completion, the
owner-builder will have the burden of proving that
he did not build or Improve for the purpose of
sale).
:JI, as owner of the property, am exclusively con-
tracting with licensed contractors to construe!
the project (Sec. 7044, Business and Professions
Code: The Contractor's License Law does not ap-
ply to an owner of property <•ho builds or im-
proves thereon, and who contracts for such pro-
jects with a contractor(s) license pursuant to the
contractor's License Law).
I am exempt under Sec. B. & P.C. for this reason, ____________ _
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of con-
sent to self-insure, or a certificate of Workers'
Compensation Insurance, or a certified copy
POLICY NO-....,.~~~'=',...c7.,,.::-.l-.,. '-..,.....i.---
thereof (Sec.i &; yq,JJ)e-~
_C9MPANYi ,W.. '(J/ e;e:
~PY Is fil~h~e city.
D Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the per-
mit is for one hundred dollars ($100) or less).
I certify that in the performance of the work for
which this permit is Issued, I shall not employ any
person In any manner so as to become subject to
the Workers' Compensation Laws of California.
NOTICE TO APPLICANT: If, after making this Cer-
tificate of Exemption, you should become subject
to the Workers' Compensation provisions of the
Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
NO. .• JOB ADDRESS AV. ST. IOATE Of" APPLICATION BUS. LICENSE PERMIT NUMBER
2 I 7 I 4 14 ·1 Y-~ la I 1 le I q ? fl ltl e-;-i-;-ulLI\ 1P,A.ti1 I I I I I I R~ 7 /1 0/80 1 9210
OWNER OWNER'S PHONE PRIME CONTRACTOR STATE LICENSE ~ ./ f>f!J~ //
The H i ghl a n d Company 7 29-7108 Highl and Company 42407 / u/(0/ ,r JI.!$ 1ti ",:.,-... 1
OWNER'S MAILING ADDRESS CONTRACTOR'S ADDRESS CONTRACTOR'S
310 5 Aveni da de Anit a , C arlsba d 105 Ave . de Anit a l911.E']l 08 •
2°b BLocK lsuBPo/~~~l I ],As~s1':.; P1.Rc~L N~. t-1411100 ~!3.'ff~y M. Drasin (:!.!"'17-t.fSNsE
fESl.,l!IPTION,OF WORK
T ownnouse P lan 5 0 AR 1re'2~ss V &nlifur a B l. DESIGNER'S PHONE •
Encin o, CA. 9 86-889 0
cENsus TRACT GP LAND usE zoN1NG ;/ _ I REs. uN1Ts I PARKING SPACE s f I NUMBER oF sToR1Es
P.-,,-3 / # ~ r C::::, Not Vd.d Unwss Machin# CmifiwJ
BLDGSQ.1 ✓1t BLDG~/,t? iz:;j5TANDARDPLAN# lplo1:~g9 ITYPE;?'# loc£Pd / I
, ,
QTY. PLU M BING PERMIT AMT . QTY. MECH ANICAL P ERMIT AMT. --// EACH FIXTURE TRAP _;/ ,.L. v -/ INSTALL FURN. DUCTS UP TO 100,000 BTU ,Y-. ¥ ~
/ EACH BUILDING SEWER -.5(/'V OVER 100,000 BTU
/, EACH WATER HEATER AND/O R VENT y7'(/ BOILER/COMPRESSOR UP TO 3 HP
/ EACH GAS SYSTEM 1 TO 4 OUTLETS y.r17 BOILER/COMPRESSOR 3·15 HP
EACH GAS SYSTEM 5 OR MORE BOILER/COMPRESSOR 16-30 HP
EACH INSTAL.,ALTER,REPAIRWATERPIPE ,,.,2 VENT FAN SINGLE DUCT ?"trV / L£6 /' ---
EACH LAWN SPRINKLER SYSTEM / MECH EXHAUST -HOOD/DUCTS ~ VALUATI ON : (0 /, I/ j ' •
WATER SDFTNER RELOCATION OF EA FURNACE/HEATER BUILDING PERM(T ' I , _.:A /I 1/, ~
Tc:c:rn;, 1 nn ISSUE J . uu SIGN PERMIT ... .--fl 1 , 1 1 1 _
TOTAL PLUMBING :2 r tJ4___ TOTAL MECHANICAL U~ PLAN CHECK / If/, tJ,>'1 -/t/5/,b 1-"f"' 1:3°1 ):-f J
CONTRACTOR 7 . 1/ CONTRACTOR / 7 · ALL INCLUSIVE PERMIT I I I
TOTAL PLUMBING I <'I Y. t,ru
QTY. ELECTRICAL PERMIT AMT. _ QTY. MOBILE HOME PERMIT AMT. ELECTRICAL I-A-?~
[/~ NEW CONSTEA AMP/SWT/BKR 'JJ. v_;:;, AWNING MECHANICAL I /11,.f ~
1 PH .25 3 PH PORCH MOBILE HOME ( I (
EXIST BLOG EA AMP/SWT/BKR SET-UP SOLAR I I I I
1 PH .25 3 PH RAMADA. CABANA I , I I j
REMODEL/ALTER PER CIRCUIT FENCE OVER 6' I I I I
TEMPPOLE 200AMPS TOTALMOBILEHOME MICO-FILM I, 1 I I
OVER 200 AMPS I , I I : I
TEMP OCCUPANCY (30 DAYS) I , I I I
ISSTTR 2 .00 ,--, K\ ""' _ IVl JI' 11 J\l. 1 , 1 1-1/ ~
TOTALELECTRICAL 17tr'.,, ... Tf-----,f----------------+------II TOTALFEESPAYABLE I ..., I ~~"'
CONTRACTOR (7'--, I I .~ 3 Y"i,..-
1 HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION ANO PERMIT, AND 00 •AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER
HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE ANO CORRECT ANO I 5'-0" DEEP AND DEMOLITION OR CONSTRUCTION OF
FURTHER CERTIFY ANO AGREE IF A PERMIT IS ISSUED; TO COMPLY WITH ALL CITY, STRUCTURES OVER 3 STORIES IN HEIGHT
COUNTY ANO STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER SCHCX)L FEE.
SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY ANO KEEP HARM-0
LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO _,,., _,,; __...--,,
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE J~-:-:-'.-:--:::;~!:-"::--:::;~~-"7""7'::...._-----::::,,_.~,:::...._~ _/~-------a.:-=-2"-:--=-::c::-==:::--::-:7-:::;-;,-;;------===---f
i ~
~ i= ~ a. V)
~
CONSTRUCTION LENDING AGENCY
I hereby affirm that there Is a construction len·
ding agency for the performance of the work for
which this permit Is Issued !Sec. 3097. Civil Godel.
OFTHEGRANTINGOFTHISPERMIT. I APP~~E:...-:---/..:;..._ ~ 0 0 CONTRACT~APPROVE~~,,/z: '~ V ~ ~ __.;_/ ,-~ \.. J ~ AGENT □ BYPHONEQ I' / ~/.,..,Z -1 ],1/',.,...,¾'
,. ---\. --c::, ,~ '--./ \
SITE . <a-0~~8-Gt -r-. ADDRESS: OWNER: r ~ ' I I , ~ ·PERMIT NO:'
' ' FIELD INSPECTION RECORD ·-.. .-
INSPECTION DATE INSPECTOR INSPECTOR'S NOTES
. WOOD FLOOR .
FOUNDATION • FORMS• SET BACK • TOILET . . . ' • -. ~ . -~ : ..
UNDER FLOOR PLUMBING . -" . -. --
UNDER FLOOR HEATING • F ,, •,• .. . ,,
OK TO INSTALL SUB FLOOR . . . .
SLAB FLOOR ' .
\ .... . I UNDER SLAB PLUMBING .
FOOTING • FORMS• SETBACK • TOILET ' r
OK TO POUR CONCRETE -, .
FRAME ..
ROUGH ELECTRICAL ~ '
ROUGH PLUMBING ,. :-... _
.,
ROUGH HEATING/VENTILATING ' FRAME OK• PLACE INSULATION
INSULATION OK • PLACE WALLBOARD
WALLBOARD OK• PLACE TAPE. . ·,
EXTERIOR LATH OK• PLACE STUCCO '
FIREPLACE
DAMPER Be STEEi: -·. .. -~ ..
PLATE Ti Es/HEIGHT OF CHIMNEY
OTHER ,
TEMP POWER (POLE)
SEWER
GAS TEST
SWIM POOL • STEEL BONDING
• PRE DECK '
/ • FENCE PREPLASTER
\ ,.
SHOWN • FRAME /~V
• PAN A I\/)_,/' -
FINAL INSP BY BLOG DEPT \., 3/ -
OTHER DEPT'S REQ COMPLETED ' ~X' . ~
ELEC METER-PERM-TEMP '\( '/ v'\'
GAS METER-PERM-TEMP P"
CERT O F OCCUPANCY ISSUED
I ·1
, . ______ ........_ ................... ......__
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