HomeMy WebLinkAbout2691 WATERBURY WAY; ; 84-516; PermitII) z 0 ;:: < a: < ..J u ... 0
I hereby affirm thal I am licensed under
provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Busl ness 1 and Professions Coda, and my license is Tin
full force and effect. I
lie No ______ Clm ______ I
I hereby alhrm thal I am exempt from the Conlrac·
tor's license Law tor the following reason (Sec 7031.5 Business and Protess1ons Code· Any city or county which re· quires a permit to construct. alter, improve, demolish, or repair any structure. prior to IIs issuance also requires !heap-
phcant tor such perm,t to hie a s19ned statemenI that he Is hcensed pursuanl to lhe provIsIons ol the con1racIo(s License law {Chapter 9 commencing w,th Section 7000 ol Division 3 of the Business and Professions Code) Of that 1s ex-
empt therefrom and the basis for the allegeo exemp1Ion Any vlOlat,on of Section 7031.5 by an apphcant !Of a perm11 sub-Iects !he applicant to a c1v1I penalty of nol more lhan t1ve hun·
dred dollars ($500)
• ~-as owner at-the pro°perty, Of my employees with wages ffi eIr sole compensation. will do the work. and lhe struc·
o ture Is not 1nIended or ottered for sale (Sec 7044. Business -' and Professt0ns Code The Contraclor's license law does 3 no! apply to an owner of property who bU1\ds or improves m !hereon and who does such work himself or through his own i employees. provided ttlal such improvements are not intend•
M.I ed or ottered for sate. U. however. the butldmg or improve· Z men! Is sokj within one year of complellon, the owner-builder 3 will have the burden of provm Iha! he did not bu· or 1m-
O prove lor the purpose of sale)
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D I, as owner of the property, am exclus1ve1y contracting
with hcensed contractors to conslruct the proIect (Sec 7044, Business and Pfoless,ons Code. The Contractor's license
Law does not apply to an owner of property who builds or un• proves thereon. and who contracls tor each pro,ects with a contractor(s} license pursuant lo the Contractor's l icense law).
D As a homeowner I am improving my home, and the follow· ing conditions exist t. The work 1s bemg performed prior to sale. 2. I have lived m my home lor twelve months
pnor to completion ot this WOfk. 3. I have not claimed this exemption during the last three years
D I am exempt under Sec ______ . 8 & P C.
for this reason ____________ _
0 I hereby all1rm lhal I ha.-e a cert11tca1e ol consent
to self-insure. or a cert1t1cate ot Wor)l.ers
Compensa11on Insurance. Of a cen,hed copy thereof !Sec JSOO Lat>or Cooe)
POLICY NO
COMPANY
D Copy 1s filed with the city
O Cen1fted copy tS heretly furnished
CERTIFICATl OF EXEMPTION FROM WORKERS" COMPENSATION INSURANCE (This section need not be comoteled 11 the perm,1 ,s !Of ooe hundred dollars (S 100) or less)
O I cen,ty that m lhe performance ot lhe wo,1,; tor
which 1h1s perm,1 ,s issued. I shall not employ any
person ,n any manner S-O as 10 t:>ecome sub1ec1 10
lhe Wo~ers· Compensa11on Laws of Cahtorr11a
NOTICE TO APPLICANT II. afler mai...sn~ 1n1s Cen1
licale of Exemption you shoulcJ t>ecome sut>1ect I') the w o111;ers • Compensation prov,s,ons ol tne Labor
COde. you must tonh..,.1!h comply with such
prov1s1ons or lh,s perm11 shall be deemed revokeo
O I hereby aflum lhat !here 1s a construcllon
1encJ1ng agency tor !he perto,mance ol the wot1o. to,
which lh,s perm11 ,s ,ssued (Sec 'J(Y37 C1v1I Godel
l enders Name ___________ _
lenders Address __________ _
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USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT . 1200 Elm. Carlsbad. California 92008-1989 (619) 438-5525
JOB ADDRESS AV. ST. RO. NEAREST CROSS ST. l0
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BUSINESS LICENSE d VALUATION tfERMIT NUMBER ~ 6 f I ful}-fl:£),n, JsJ J..1 /././A±:_ ELRJ/& l~(')~D 41,p ~ ig6 LOT BLOCK I sueo1vIS10N I ASSESSOR PARCEL NO , CONTRACTOR CONTRACTORS PHONE • ZONE
/'.7tu111 Et!:.. '
~:;;~s i-ffhM<'A-M/,/Nemi /.f3:;2;7~E
CONTAACTOA"S ADDRESS LICENSE NO. PLAN 1.0. # BLDG USE CODE
~ OWNER'S MAILING ADDRESS
1.-2 /49/ it.,;-; 1 c=-£ /JULJ /,,1 L.li'!L DESIGNER LICENSE :z STANDARD PLAN# BUILDING SO. FOOTAGE
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"O 0 (.?
OESCAIPT ON OF WORK
L DESIGNER'S ADDRESS OESIGNE A'S PHONE
P,4-710 ~vc,e_ -IOY/0 1 (for ~ -F/P FLA ELEV. NO OCC GP EDU
'-Ix ~o I STORIES ':,/I7/8+i3I2j 2s.1 vO NO ---OD1Jl.3I2 -·9;171 A/J 2s . ,r CENSUS TRACT l GP LANO USE I PARKING SPACE
1
AE S UNITS j GRADING PERMIT ISSUED
I
REDEVELOPMENT TYPE OCC LOAD FIRE SPA
AREA CONST
YO N D vO NO vO NO Nor Valid Unless M~chine Cerrified
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QTY. PLUMBING PERMIT -ISSUE _'1_$ QTY. MECHANICAL PERMIT· ISSUE g -SUMMARY/ACCOUNT NUMBER 0 (/)
EACH FIXTURE TRAP I INSTALL FURN. DUCTS UP TD 100.000 STU BUILDING PERMIT 01 ·00-00-8220 /~ ~
OVER 100,000 BTU SIGN PERMIT 01 ·00-00-8221 -EACH BUILDING SEWER r
EACH WATER HEATER AND10R VENT BOILER/COMPRESSOR UP TD 3 HP PLAN CHECK 01-00-00-8806 /11~
(/)
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(/)
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EACH GAS SYS TEM I TD 4 OUTLETS BOILER/COMPRESSOR 315 HP TOTAL PLUMBING 01 ·00-00-8222 3
EA CH GAS SYSTEM 5 OR MORE ' METAL FIREPLACE ELECTRICAL 01-00-00-8223 2
ai
EACH INSTAl . ALTER. REPAIR WATER PIPE VE NT FAN SINGLE DUCT MECHANICAL 01-00-00·8224 >-
EACH VACUUM BREAKER MECH EXHAUST HOODtDUCTS MOBILEHOME 01 ·00·00·8225
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP -vi (/)
EACH ROOF DRAIN (INSIDE) SOLAR 01-00-00-A??~
TDTt;L MECHANICAL STRONG MOTION 80·92-33-0519
Q) u 0 a:
TOTAL PLUMBING I FIRE SPRINKLERS 01 ·00·00-8227 Cll -;;;
SOLAR - ISSUE PUBLIC FACILITIES FEE 32·00·00·893'.) QTY. ELECTRICAL PERMIT -ISSUE 5'"-QTY.
BRIDGE FEE
0
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NEW CONST EA AMP SWl BKR COLLECTORS SCHOOL FEE • DISTRICT
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3 PH STORAGE TANKS " 1 PH Carlsbad 80-92-21-0519 Cll
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EXIST BLDG EA AMPISWT BKR ROCK STORAGE Encimlas 80-92-22-0519 u.
1 PH 3 PH PUMP San Diegui!o 80·92· 23·0519 ::::.
REMODEL ALTER PER CIRCUIT PLAN CHECK FEE San Marcos 80·92· 24-0519 C
TEMP POLE 200 AMPS Q)
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OVER 200 AMPS LICENSE TAX 01-00-00-8162 (.?
TEMP OCCUPANCY (30 DAYSI MFF 80-92-57-0519
CREDIT DEPOSIT 0
lOTAL ELEClRICAL I TOTAL SOLAR TOTAL FEES PAYABLE l ~6-~ ti Q) a. (/)
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Expiration Every permit issued by the Bu1ld1ng Oft1c1al under the provisions of this I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION AND PERMIT AND DO HEREBY * AN OSHA PU•m IS REQUIRED FOR EXCAVATIONS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall e,c,pire by ltm,tatton and become null and void If the bulld,ng or work 5· o·· DEEP AND DEMOLITION OR CONSTRUCTION OF
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS authorized by such perm,t 1s not commenced within 180 days from the date of such STRUCTURES 0\/ER 3 STORIES IN HEIGHT
ISSUED TO COMPLY WITH ALL CITY COUNlY AND STATE LAWS GOVERNING BUILDING CON• :~~::On~'!, t=~v ~~=1
~Fte~;h:~~r:~ti~~~e~le~~~~ ro~~~1~fsr:ge;.~~ or STRUCTION WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND APP CONTRACTOR 0 APPROVED BY
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KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS. COSTS AND LICANTS SIGNATURE Jf, OWNER~
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THl7'n,-;,,. , VJf'i . ,ho BV PHONE 0 11a ~ GRANTING OF THIS PERMIT '/.,# A J Jk JO. _,, I". I
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TYPE I DATE INSPECTOR . ~
BUILDING I -· ..
FOUNDATION I FIELD INSPECTION RECORD
REINFORCED STEEL I
MASONRY I
GUNITE OR GROUT I
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTION AEO IF INSPECTORS DATE CHECKED APPROVAL -
FLOOR & CEILING SUB FRAME I
SOILS COMPLIANCE
SHEATHING D ROOF D SHEiAR PRIOR TO
FRAME I
I
EXTERIOR LATH I
FOUNDATION tNSP
STRUCTURAL CONCRETE
OVER 2000 PSI
INSULATION I
I PRESTRESSED
CONCRETE INTERIOR LATH & DRYWALL I POST TENSIONED I CONCRETE
PLUMBING I FIELD WELDING
SEWER AND BUCO DIPUCO I
UNDERGROUND D WASTE D WATER
HIGH STRENGTH
BOLTS
TOP OUT D WASTE D W),HER SPECIAL MASONRY
TUB AND SHOWER PAN I
GAS TEST I
I PILES CAISSOl'.S
D WATER HEATER D SOLAR WAifER
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ELECTRICAL I
D ELECTRIC UNDERGROUND D ~FFER
ROUGH ELECTRIC I
D ELECTRIC SERVICE D TEMPO~ARY -
D BONDING D POOL I
I
MECHANICAL I
D DUCT & PLEM., D REF. PIPIN,G . . HEAT -AIR COND. SYSTEMS I
VENTILATING SYSTEMS I
I
,.
I
CALL FOR FINAL INSPECT(iN WHEN ALL APPROPRIATE
ITEMS ABOVE HAV BEEN APPROVED.
FINAL I I
PLUMBING I _V\ \
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-
ELECTRICAL I XX> \ \
MECHANICAL I ,, " .
GAS ~\ -I '\
BUILDING I -\ "\...N •
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SPECIAL CONDITIONS -I ~') '\.. I --