HomeMy WebLinkAbout2724 WATERBURY WAY; ; 84-177; Permit(I[
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~eby 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
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I hereby affirm that I am exempt from the Contrac-tor's License Law tor the lollowmg reason (Sec 7031 5
Business and ProlesSJons Code Any c,ry or county whicll re-quires a permit lo construct. aller. improve, demohsh. or
repair any structure, puor to I1s issuance also requires !heap-
phcant for such permit 10 hie a signed statement that he Is licensed pursuant to !he prov,s1011s of lhe <.:ontractor s License law (Chapter 9 commencing with Section 7000 of
Orv1sK>n 3 of the Business and Professions COde) or thal Is ex.-empt therefrom and the basis for the allegeo eKemptIon Any v~ahon ol SecttOO 7031.5 by an apphcant for a permit sub·
iects lhe applicant to a civil penalty of not mOfe than lrve hun-dre<I dollars (SSOO).
0 I, as owner ol the prnperty_, or my employees with wages
as their sole compensat10n. 'MIi do the work. and the slruc-ture Is no1 intended or offered IOf sale (Sec 7044. Bus,ness and Prolessions Code: The Cootractof's L1Cense Law does
not apply to an owner ot property who builds or improves thereon and who does such work himself or through his own
employees. provided that such imprcwements are not intend· ed or offered tor sale. II, however. the build mg or improve· menl ,s sold wIth1n one year ot compJetlon, the owner-builder will have the burden of provmg th.al he did not buIki or im-
prove for the purpose of sale).
D I, as owner of lhe Pfoperty, am exclusivefy contracung with ticensed contractors to construct the project (Sec. 704◄. Business and Profess10ns Code The Contractor's l icense
l aw does not apply to an owner ol property who builds or im-
proves thereon_, and who contracts for each pro,ects with a contractor(s} license pursuant to lhe Contractor's l icense Law).
□ As a homeowner I am improving my home, and lhe toltow-ing conditions exist: 1. The work is being performed prior to sale.
2. I have ltved m my home for twelvi! months prior to completion ot this work.
3. I have not clatmed this exemption dur,ng the last three years
g ~h1s,:e;:1underSec. ------· B&P.C.
□ I hereby afhrm that I ha ... e a cert1t1cate of consent to seII.1nsure. or a cer11l,cate ot Workers Gompensa11on Insurance. or a cen,f,ed copy thereot
(Sec 3800. LabO< Code)
POLICY NO
CO~Y
ef Copy IS hied with the city
D Cen1hed copy 1s hereby furnished
CERTIFICATl OF EXEMPTION FROM
WORKERS" COMPENSATION INSURANCE
(This s.ectton need not oe completed ,t lhe perm11
Is tor one hundred OOllars {$100) or less)
0 I cert,ty !flat ,n the perlormance ot the work !or
-Nh1ch th,s permit 1s issued. I shall no1 employ any
person ,n any manner so as 10 beeome subIecI to
the Wor1te,s· Compensa11on L1ws of Cahtornia
NOTICE TO APPLICANT II. af1er malunJ 1t11s Cen,
licate of Exempllon. yOY ShOYld become SUbJKI I')
the Wor1ters· Compensation pro'll1S1ons ol lhe LabOr
Code. you must torth-.·tth comply with such
PfO'IIISIOOS or this permit shall oe deemed re'IIOked
O I hereby atlum !hat there •S a COM!tuchon
1end1ng aoency tor the perto,mance ol the won,. lor
-Nl"IICh this perm,1 1s ,ssued tSec 31.137 C,v11 Cooe1
lenders Name __ ---0--,---------
Lenoer"s Address ---'NL•~~-d ...... _.F' ____ _
,.,-n11.,AN t t O FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT ) 1200 Elm, Carlsbad, California 92008-1989 (619) 438-5525 1021:-4 AV ST.RO. NEAREST CROSS ST.
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BUSINESS LICENSE " VALUATION PERMIT NUMBER lM"f~~)eY-l_~_L ln .. ooo M-/77 ~~((' ll~~t'0
~ 1~ bi~~2.°-05 CONTRACTOR CONTRACTORS PHONE • ZONE I
<1\IVMR"S NAME • l,~:~=;;r /)Al)RE. LJc,,)..S N6 l-,6~-
\:=~A~\\t Mr. At,,ooN CONTRACTOR'S ADORESS LICENSE NO. PLAN 1.0 . # BLOG USE COOE
qo "J<? hJ A./l tL).4 "3 4 '?1'79' t2 ,PooL OWNER'S MAILING ADDRESS //~· -~~~~ DESIGNER LICENSE ,: ST ANDA RO PLAN# BUILDING SO. FOOTAGE
SOolfl OESCRIPTION OF WORK
OESIGNER"S ADDRESS DESIGNER'S PHONE
~J~lr,-e fuoL -F/P FLR ELEV. NO OCC GP EDU
STORIES
vO NO ----
CENSUS TRACT I GP LANO USE I PARKING SPACE I AES UN ITS I GRADING PERMIT ISSUED
I
REOEVELOPMENT TYPE DCC LOAD FIRE SPA AREA CONST
YO ND vO NO v O NO N!r Vat,'d Unlm M~chine Cntifi«J
QTY. PLUMBING PERMIT -ISSUE -~v-QTY. MECHANICAL PERMIT -ISSUE ~ __. SUMMARY/ACCOUNT NUMBER ---EACH FIXTURE TRAP I INSTALL FURN. DUCTS UP TO 100.000 BTU BUILDING PERMIT 01-00-00-8220 ve,.,.:::::,u
EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT 01-00-00-8221
EACH WATER HEATER ANO/OR VENT BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01-00-00-8806 '.'YL.,~5
EACH GAS SYSTEM 1 T0 ,4 OUTLETS BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING 01-00-00-8222 '"• hO EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE ELECTRICAL 01 -00-00-8223 r 1'1.,cn
EACH INSTAL. ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01-00-00·8224 '
J EACH VACUUM BREAKER /'/--~t ME CH EXHAUST -HOOOIOUCTS MOBILEHOME 01 -00-00-8225 .
WATER SOFTNER -RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP
EACH ROOF DRAIN (INSIDE) SOLAR n1-nn-nn-R??fi
TOTI.L MECHANICAL STRONG MOTION 80-92-33-0519 ::Ji:)_ I "'• .Al.~
TOTAL PLUMBING I J t-.J•t;I'-FIRE SPRINKLERS 01-00-00-8227
QTY. ELECTRICAL PERMIT -ISSUE 4"'~ QTY. SOLAR -ISSUE PUBLIC FACILITIES FEE 32-00-00-8933
BRIDGE FEE
NEW CONST EA AMP/SWT BKR COLLECTORS SCHOOL FEE • DISTRICT
I PH 3 PH STORAGE TANKS Carlsbad 80-92-21-0519
EXIST BLOG EA AMP/SWT 'BKR ROCK STORAGE Encinitas 80-92-22-0519
I PH 3 PH PUMP San Dieguilo 80-92-23-0519 l REMODEL ALTER. PER CIRCUIT ~ _,..
PLAN CHECK FEE San Marcos 80-92-24-0519
TEMP PO LE 200 AMPS -
OVER 200 AMPS LICENSE TAX 01-00-00-8162
TEMP OCCUPANCY (30 DAYSI L"2PY / -\
'CREDIT DEPOSIT \ '7~,uo 1
TOTAL ELElTRICAL I 10 00 TOTAL SOLAR TOTAL FEES PAYABLE I [ 'eJJ. 135 '
I HAVE CAREFULLY EXAMINED THE COMPLETED ··APPLICATION AND PERMIT AND 00 HEREBY E>tpirat,on Every permit issued by the Bwld1ng Ott,c1at under the provIsIons of thts * AN OSHA ili..t:T IS REQUIRED FOR EXCAVATIONS OVER CERT,FY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall expire by hmitat,on and become null and vo,d If the building or work 5' 0" DEEP ANO OEMOl.lTION OR CONSTRUCTION OF DECLARATIONS ARE TRUE ANO CORRECT AND I FURTHER CERTIFY ANO AGREE IF A PERMIT IS authorized by such perm,t ts not commenced within 180 days from the date of such
ST"1(:T\JR£S OVER 3 STORIES IN HEIGHT permit. or 1f the bu1ld1nPi or work authonzed by such permit ,s suspended or ISSUED TO COMPLY WITH All CITY COUNlY ANO STATE LAWS GOVERNING BUILDING CON abandoned at any time a ter the work Is commenced for a penod of 180 d'--Y.S STRUCTION, WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY ANO
APPLICANTS; ✓IGN JUR~ OWNER □ CONTRACTOR 0 ip OVED :.(l kirk DATE KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS. COSTS ANO
1+t1,M-EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE al. . -t: BY PHONE 0 GRANTING OF THIS PERMIT OJ,/1_ --
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TYPE I DATE INSPECTOR
BUILDING I
I
FOUNDATION I
REINFORCED STEEL I
MASONRY ' I
GUNITE OR GROUT I
FLOOR & CEILING SUB FRAME I
SHEATHING D ROOF D SH~AR
FRAME I
EXTERIOR LATH I '
INSULATION ' I
INTERIOR LATH & DRYWALL I
I
PLUMBING I
I
SEWER AND BUCO DIPUCO I
UNDERGROUND D WASTE D WATER
TOP OUT D WASTE D WATER
TUB AND SHOWER PAN I
GAS TEST I
D WATER HEATER D SOLAR W,t.TER
I
ELECTRICAL l
D ELECTRIC UNDERGROUND □:UFFER
ROUGH ELECTRIC I ,f 4~y4' ~
D ELECTRIC SERVICE D TEMPORARY
D BONDING D POOL I
I
I
MECHANICAL ' I
D DUCT & PLEM., D REF. PIPlt'-JG
HEAT -AIR COND. SYSTEMS I
' VENTILATING SYSTEMS I -. ' I
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE BEEN APPROVED.
FINAL I " PLUMBING I : /'\ M I/
' fl I
ELECTRICAL I V V "-.!/r_ -( V MECHANICAL I V ' .
I ' t GAS ~ \ i
BUILDING I \
SPECIAL CONDITIONS I \
I
...... .,.
~-0177 '
FIELD INSPECTION RECORD ..
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES :. .
' ' REO IF INSPECTOR'S INSPECTION CHECKED APPROVAL DATE .
\_'
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 < f.J/uit ,{~ ~ ~. ' ;tfi;_ ~Af) e ,/AA
'-;1,,1) _/1A1-/ 1/YL, finAJA _f]'_. ~•-.1 ~ ~ ,A~;; -A a.
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