HomeMy WebLinkAbout2738 VIA TULIPAN; ; 80-689-I; Permit;fJ
LICENSED CONTRACT0'fl'S DECLARATION
I hereby affirm that I ali'i licensed under provi-
sions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Profes-
sions Code, and my license Is In full force and ef-
fect.
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 county which requires a permit to con-
struct, alter, 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).
0 1, 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 construct
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 reaso,~------------
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of con-
sent to self-Insure, ot a certificate of Workers'
Compensation Insurance, or a certified copy
thereof (Sec.~~el,-/
POLICY NO • ...,.=~~-...... -~-'~----
COMPANY G '-obc
~opy Is mlidwl1htadt; •
□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.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there Is a construction len-
ding agency for the performance of the work for
,.,.,_,..,..., tkl ..... arr'ftlt le loe1ta.A /f'.:,,,..,.. "lllno'7 ,...1.,11 (',..,,ta\
CITY OF CARLSBAD-BUILDING DEPARTMENT
USE BALL POINT PEN ONLY
APPLICATION & PERMIT
1200 ELM AVENUE (7 14) 438-5525
2 7 1· 8 V i et JOB ADDRESS N tRr IDAT7;io;'ftolON a e eern,t:,9-
I I I I I I I I I I I I I I I I I 1\~YP,~ I I I I I
OWNER OWNER'S PHONE PRIME CONTRACTOR The Highland Company 729-7108 Highland Company
OWNER'S MAILING ADDRESS CONTRACTOR'S ADDRESS 3105 Avenida de Anita, Carlsbad 3105 Ave. de Anita
LOT BLOCX I SUBDIVISION I ASSESSOR'S PARCEL NO. DESIGNER
20 72-21 1 1 11 7 ... 11 , ,1 , n1 ... A r1. ,, i-. Sidney M. Drasin
DESCRIPTION OF WORK
l Townhon!=:P Pl::::in ?r\21. t'ei!fss "tf&W't::ura Bl.
Encino, CA.
CENSUS TRACT GP LAND USE ZONING sf
APPLICANT TO FILL IN INFOR -
MATION WITHIN RED LINES.
BUS. LICENSE PERMIT NUMBER 19210
/IJ~rr;J STATE LICENSE 342407
CONTRACTOR'S
7'2>~7108
ST ATE LICENSE
C-1798
DESIGNER'S PHONE
986-8890
,:u -., ..,
l_, -~
I RES, UNITS I ~ARKING SPACE I NUMBER OF STORIES
Not V1lid Unktss lbdlin1 c.rtifild
BLOG SQ. FT. BLDG USE occ. GP I ST AN OARD PLAN II Wo~fr I TYPE CONST I occ. LOAD I
QTY. PLUMBING PERMIT AMT. QTY. MECHANICA(pERMIT AMT. e:::Pv -,
4 EACH FIXTURE TRAP tK.OC 7 INSTALL FURN. DUCTS UP TO 100,000 BTU ~OU
I EACH BUILDING SEWER .!:T:d'JJ OVER 100,000 BTU •.
I EACH WATER HEATER ANO/OR VENT ,, ~ t/J) BOILER/COMPRESSOR UP TO 3 HP
I EACH GAS SYSTEM 1 TO 4 OUTLETS "'J ,t/l) BOILER/COMPRESSOR 3-15 HP ,
EACH GAS SYSTEM 5 0 R MORE BOILER/COMPRESSOR 16-30 HP
EACH INSTAL., ALTER, REPAIR WATER PIPE " VENT FAN smGLE DUCT d.. t/1) 7'6)080--EACH LAWN SPRINKLER SYSTEM I MECH EXHAUST -HOOD/DUCTS ~-~ VALUATION :
WATER SOFTNER T RELOCATION OF EA FURNACE/HEATER BUILDING PERMIT I . Jiru..n,o
TC:::C:::TlF. 3 . .00 TCCTlD 3.00 SIGN PERMIT Jo I . I I I
TOTAL PLUMBING TOTAL MECHANICAL tf_tl) PLAN CHECK// f', 6a -iA'-...o t i.t>JoO I 1QvJ.-OiO
CONTRACTOR 3~.(/7) CONTRACTOR ALL INCLUSIVE PERMIT I ' I I
AMT.
TOTAL PLUMBING L~l/l-""ll/'l
QTY. ELECTRICAL PERMIT AMT. QTY. MOBILE HOME PERMIT ELECTRICAL I -91 "1. A l /')
NEW CONST EA AMP/SWT/BKR AWNING MECHANICAL I J ~-l'.:V••::
JI/) 1 PH .25 3 PH ~,,,._m PORCH MOBILE HOME (1 I
EXIST BLOG EA AMP/SWT/BKR SET-UP SOLAR I , I I I
1 PH .25 3 PH RAMADA, CABANA 4502:>-TVTAL-I , ~Al ,. A/)
REMODEL/ALTER PER CIRCUIT FENCE OVER 6' (tu.d.. l'C ~ I , /1 ,~. /·_10
TEMP POLE 200 AMPS TOTAL MOBILE HOME MICO-f.K'M ~' 1 I I J-I
OVER 200 AMPS ,e:: 11 b ,f 6" 1.:,,,q, L,f) /;. 'F6"G I . t t/)_J"'J :At(
TEMP OCCUPANCY (30 DAYS) '<._ I . I I I
TC..C:::TW. ?.nn STR)NG IDI'ION: I . I 1S1..::iir
TOTAL ELECTRICAL ~7.~ TOTAL FEES PAYABLE I .{h~I0.711 CONTRACTOR I I .
I HAVE CA REF ULL Y EXAMINED THE COMPLETED "'APPLICATION AND PERMIT, ANO DO •AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER
HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I 5'-Q"' 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 SCHCX)L FEES:
COUNTY ANO STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER ~ SPECIFIED HEREIN OR NOT. l,ALSO AGREE TO SAVE INDEMNIFY ANO KEEP HARM-
LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND --~ / -/ EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE
OF THE GRANTING OF THIS PERMIT. APP -_,...~ ,,('~ERQ CONTRl~AIPPRl~V .~~'H ff: 1/iATf?'·-4 ~~~~,/ -✓-AGENT □ BY PHONE □ v ·1 ✓Jif
<---'--' -.._... ---7
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SITE
ADDRESS:
...
INSPECTION DATE INSPECTOR
WOOD FLOOR
FOUNDATION• FORMS• SET BACK • TOILET!
UNDER FLOOR PLUMBING 1
UNDER FLOOR HEATING
OK TO INSTALL SUB FLOOR
SLAB FLOOR
UNDER SLAB PLUMBING
FOOTING • FORMS• SETBACK • TOILET
OK TO POUR CONCRETE
FRAME
ROUGH EL ECTRICAL
ROUGH PLUMBING
ROUGH HEATING/VENTILATING
FRAME OK • PLACE INSULATION
INSULATION OK • PLACE WAL LBOARD
WALLBOARD OK·• PLACE TAPE
EXTERIOR L ATH OK • PLACE STUCCO
FIREPLACE
DAMPER 8: STEEL
PLATE Tl Es/HEIGHT OF CHIMNEY
OTHER
TEMP POWER (POLE)
SEWER
GAS TEST
SWIM POOL • STEEL BONDING
•. PRE DECK
• FENCE PREPLASTER
SHOWN • FRAME
• PAN
FINAL INSP BY BLDG DEPT
OTHER DEPT'S REQ COMPLETED
ELEC METER-PERM-TEMP
GAS METER-PERM-TEMP
CERT OF OCCUPANCY ISSUED
..u7
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OWNER: • I\ i J PERMIT NO: '3'0-&>~ :f'
FIELD INSPECTION RECORD
INSPECTOR'S NOTES
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illrrtt-firatr nf ®rr1tµa1try
CITY OF CARLS BAD
This Certificate issued pursuant to the requirements of Section 306
of the Uniform Building Code certifies that at the time of issuance
this structure complies with applicable ordinances of the City·
regulating building construction use.
80-689I
0 cc upont Lood " •• ,...
Owner of Buildinrr· ..... The-,Highland.-·co ... .. • Ai:Mress _3_l_O_S __ A_v_e.....;:_n_i_d_a_· ..... d_e_A_n_i_t_a ___ _
Building Address" •• !.~ -~;:~~1.)~~p-~~-:: .. ~ ~-L-:coltty_C=a;.::;r:;;.;l=s.;;;.b:;..;a;.:.d~(-C;;:;,A:.:.:..;.;.__ __ • ·~• -------
(Post in contpie:uou~ plcs-co)
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