HomeMy WebLinkAbout2684 WATERBURY WAY; ; 84-239; Permit.,, z
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I hereby afl•m Iha! I am exempt lrom lhe Contrac-
tof" s Lrcense Law lo, !he following r .. son (Sec 703t 5 Business alld ProtesStOns Code Any city or coonly wh+ch re·
Quires a permit to construct. alter. improve. demohsh, or repa,r any structure. prlOf to 11s issuance also requires !heap-
plant lor such perrrut to Ille a Signed slalement Iha! he 1s licensed pursuant 10 the prov1s10ns ot lhe conuactor s
L,cense Law (Chapler 9 commenc,ng Wilh Sect!On 7000 of Olvtsion 3 or the Business and ProltsSQ'IS Code) or that 1s ex· empt therelrom and the t,as,s for !he at'egeo e,empt1on Any "'°'"'°" of Secloo 7031 5 by an apPlrcanl lo,, permd sub ,eels Ille apPlrcant to, cMI penalty ol not mo,e thin fr,e hon·
dred dolla<1 ($500)
CJ 1. as owner ol the property_ or my employ,es With wages
ilS their sole compensa11on, vn.11 do the work. and the strut·
lure 1s not ~tended o, ottered to, SMe (Sec 7044 BuSlntss
and Protess,ons Code The Conlractor's L1tense Ulw does ROI appty to an owner ot propeny who builds or improves
lhereon and who does such work himself or through his own
employees, provided that such improvements are not Intend• ed or olfered !or sale. If, however. the build mg or improve-
ment Is 50kt w1th1n one year of complehon, lhe owner-builder will have the burden of proving that he did not bu1kl or im-prove for lhe purpose of sale)
O I. as owner of the property, am exclusNely con1rac:11ng
w,th locensed contracto,s 10 construct lhe proiec1 (Sec 7044.
Business and ProfessJOns Code The Conlrxlor's License liw does no1 appty to an owner of property who 1>uItds or m-proves thefeon, and who conlracts tor each p,o,ecls with a conlrilClor(s) hcense pursuant to the Conlracto,•s L-.e Law).
□ As. homeowner I"" omp<OYlng my home. and Ille follow ,ng conc:htions ex,st·
I The -k IS being per1ormed pt1or 10 sale 2. I have !Md 1n my home for twelve months poor 10 completion of this wOJk
3 I have no1 claimed this exempt,on during the Last three years.
g /J:r::."' under Sec. ______ . B & PC.
D I hereby athrm lhal I ha..-e a cen1hcaIe ot consent
to sell insure. or a cert1t1cate of WOfkers
Con,pens.ahon Insurance. Of a cert1f1ed copy thereof
(Sec 3800. i...alx>t Godel
POLICY NO
COMPANY
□ Coc>y IS filed with lhe c,ty
D Cen1t,eo copy 1s nereby furnished
CERTIFICATl OF EXEMPTION FROM
WORKERS" COMPENSATION INSURANCE
(This section need not be completed 11 lhe pe,mI1
,s to, one hundred ooua,s (1: 100) Of less)
0 I cen,ly that 1n lhe ~onnanee ot lhe w~ IOf
wtuch this permI1 I-s Issueo. I shaH not emptoy any
person In any manner so u lo become sub1ec1 10
the W~~s Compensatt0n Laws of Cahfom1a
NOTtCE TO APPUCANT If. alter ma)o.In;1 It11s Cert,
hcale ol E•emphon. you should Deeome subIect l"J
the WMers Compensation p,o ... ,s,ons ol !ht> UK>Or
cooe you must forthwi.1th comply w11h such provisions or lh1s permit shall be cJeemed revoke<J
0 I hereby altirm lhal the-re ,s i con?truclion
tend1nQ ;tgency IOf !ht> per10fmance-ol the wOO-lor
whoeh ttus permit 1s issued (Sec .3097 C,111I CooeI
lenoet s Name __________ _
lenc:)er s AOO,ess __ ;__ ______ _
USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
CARLSBAD BUILDING DEPARTMENT
1200 Elm. Carlsbad. California 92008-1989 (619) 438-5525
;QB ADDRESS AV ST. RO. NEAREST CROSS ST
-Z.. eo €>4-'-v.._Tfz._ Q. ~ u Q. y
LOT BLOCK I SU8O1VISION I ASSESSOR PARCEL NO
\ tp°I Ul\; \ ;l.~ CU
I OWNE R"S PHONE
4'34--~~o CONTMICTOR"S ADDRESS
OWNER"S MAILING ADDRESS
CENSUS TRACT I GP LANO USE I PARKING SPACE I AES UNITS I GRADING PERMIT ISSUED I REDEVELOPMENT
AREA
vO NO
QTY. PLUMBING PERMIT -ISSUE ),{o QTY. MECHANICAL PERMIT · ISSUE
EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100.000 BTU
EACH BUILDING SEWER OVER 100.000 BTU
EACH WATER HEATER ANO ,OR VENT BOILER/COMPRESSOR UP TO 3 HP
EACH GAS SYSTEM I TO 4 OUTLETS BOILER /COMPRESSOR 3 15 HP
EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE
EACH INSTAl . ALTER. REPAIR WATER PIPE VE NT FAN SINGLE DUCT
EACH VACUUM BREAKER MECH EXHAUST -HOOOIOUCTS
WATER SOFTN ER RE LOCATION OF EA FURNACE/HEATER
EACH ROOF DRAIN (INSIDE)
TOT I.L MECHANICAL
TOTAL PLUMBING I
QTY. ELECTRICAL PERMIT · ISSUE ~o QTY. SOLAR -ISSUE
NEW CONST EA AMPISWT BKR -COLLECTORS
I PH 3 PH STORAGE TANKS
EXIST BLOG EA AMP/SWT/BKR ROCK STORAGE
I PH 3 PH PUMP
REMODEL ALTER PER CIRCUIT PLAN CHECK FEE
TEMPPOLE 200AMPS
OVER 200 AMPS
TEMP OCCUPANCY (30 OAYS)
TOTAL ELECTRICAL I TOTAL SOLAR
APPLICATION & PERMIT
NO
STORIES
TYPE
CONST
BUSIN ESS LICENSE •
CONTRACTORS PHONE •
LICENSE NO.
LICENSE •
DESIGNER"S PH ON E
ace GP EDU
ace LOAD FIRE SPR
ZONE
PLAN I.D. #
STANDARD PLAN #
b/18/ 4271 5/ I d/Vbc:7 t
PERMIT NUMBER
BLDG USE CODE
BUILDING SO. FOOT AGE
• •
Not 'rv11id Unkn Machine Certlfi«J •
3,oo I. I
SUMMARY/ACCOUNT NUMBER
.,
I I 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
MOBILEHOME 01-00-00-8225
MOBILEHOME PARK INSP
SOLAR 01-00-M.O??~
STRONG MOTION 80-92-33-0519
FIRE SPRINKLERS 01-00-00-8227
PUBUC FACILITIES FEE 32-00-00-8933
BRIDGE FEE
SCHOOL FEE -DISTRICT
Carlsbad 80-92-21-0519
Encinitas 80-92-22-0519
San 01egu1to 80-92-23·0519
San Marcos 80-92-24-0519
LICENSE TAX 01-00-00-8162
,
CREDIT DEPOSIT
TOTAL FEES PAYABLE ~ '-/D. ~ ()
I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION ANO PERMIT" ANO DO HEREBY Expo-E-v pe,mol -bylhe8u1ldtng0ff1c1ol under lheprov,s,ons ofth,s
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code allall e•p,re by ltmttel,on end become nuU ana vood II the building or work
~ * AN 06HA PERMIT IS AEOUlflED FOR EXCAVATIONS OVER
5 o·· DEEP ANO DEMOLITION OR CONS~TION OF
-
euthor1Zed by auch permit II not cOfftmenced wrthtn 180 days from the date of svcn DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY ANO AGREE IF A PERMIT IS _,,.,1. o, ,I 1f>e buadong Of worlo aulhorozild by O<Jch perm,t 19 suspended or
ISSUED TO COMPLY WITH ALL CITY COUNTY ANO STA TE LAWS GOVERNING BUILDING CON L.!-:::=:::'°°'~~•=::a1:...::en:.:wt...:bme~~•=:fle<:.._ll>e~..!wor~!.k _!!IS~c~orn~men~.!!ci!ed~lo~•:...•!!..~oe1r'-3,0d~o~l:...t!.l!:!!80..!tl! d•ill.••--=➔~~~~~~-----------~7'--~,--.,
ST RUCTION WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY ANO APPLICANT"$ SIi~ • • 'Kl/ DA 'PPROve7r~y II ~l,,J I~,,/¥--KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS COSTS ANO URE -OWNER~ CONTRACTOR -I_
STRUCTURES OVER 3 STORIES IN HEIGHT
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE I / I, Ji ___. .... _._ , • BY PHONE 0 GRANTING OF THIS PERMIT ~ \; _ _ .
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TYPE I DATE INSPECTO"R -
BUILDING I
.\ ' ,
,· ' I
FOUNDATION I FIELD INSPECTION RECORD
REINFORCED STEEL I
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
MASONRY I
GUNITE OR GROUT I
REQ IF INSPECTOR S -INSPECTION DATE . -CHECKED APPROVAL ., --_ _,:_,_.,,
FLOOR & CEILING SUB FRAME I ' SOILS COMPLIANCE ..
SHEATHING D ROOF D SHBAR
FRAME I
EXTERIOR LATH I
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
INSULATION I
INTERIOR LATH & DRYWALL ' I
PRESTRESSED
CONCRETE
POST TENSIONED
I CONCRETE
PLUMBING I FIELD WELDING
SEWER AND BUCO DIPUCO I
I
UNDERGROUND D WASTE D \JYATER
TOP OUT D WASTE D WATER
HIGH STRENGTH
BOLTS
SPECIAL MASONRY
TUB AND SHOWER PAN ' l
GAS TEST I PILES CAISSONS
D WATER HEATER D SOLAR WATER ' .
l '
ELECTRICAL I
D ELECTRIC UNDERGROUND D li.lFFER
ROUGH ELECTRIC I
I
·,
D ELECTRIC SERVICE D TEMPOAARY . ..
D BONDING D POOL I
:
MECHANICAL I
D DUCT & PLEM., D REF. PIPING -
HEAT -AIR COND. SYSTEMS I I
~ . \ .
VENTILATING SYSTEMS I ll .. '
I
CALL FOR FINAL INSPECT~f N WHEN ALL APPROPRIATE
ITEMS ABOVE HAV BEEN APPROVED.
FINAL I
PLUMBING ' I
ELECTRICAL I
MECHAN ICAL I
GAS lN
BUILDING ~-~ F>~7AM AA-"
.. ~
SPECIAL CONDITIONS "'f'-Y I "'
I
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