HomeMy WebLinkAbout2665 WILSON ST; ; 84-440; Permit"' z 0 ;::
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O I hereby affirm that I am licensed under
provisions of Chapter 9 (commencing with
S.Ctlon 7000) of Division 3 of the Business
and Proleaalons Code, and my license is in
lull force and effect.
lie No ______ Class
I hereby alhrm that I am exempl from the Contrac-tor's License law for the fOllowrng reason {Sec 7031.5
Business and Professions COde Any city OJ county which re-quires a permit to construe!, aller, improve demolish, or
repair any structure pr10r to I1s issuance also reQuires !heap-phcan1 for such permit to hie a s1qned statement lhat he ,s licensed pursuant to Ille prov1s1ons of the Con1rac1or s
license Law (Chapter 9 commencing with SectlOn 7000 ol
Oiv1s1on 3 ol the Business and Professions Code) or that ,sex-empt therelrom antt the basis for the allegea exemption Anv
vIolat1on ol Section 7031 5 by an apphcant tor a perm11 sub·
Jects the apphcant to a c1v11 penalty or not more than five hun-
dred dollars ($500).
r I, as owner ol the property, or my employees w1lh wages
as their sole compensation, w111 do the work, and the struc-
ture 1s not 1n1ended or offered tor sale (Sec 7044 Business and Protess,ons Code The Contractor's L,cense Law does
not apply to an owner of property who builds or 1ml)(oves
thereon and wh~ does such work himself or through his own
employees. provided lhat such improvemenIs are not intend•
ed or offered lor sale. If. however, the building or Impr0\le-ment 1s sold w1th1n one year of complehon, the owner-builder
will have I1'\e burden ol proving that he did nol build or Im• prove tor the purpose ol sale)
D I, as owner of the property, am exclusively contractmg with licensed contractors to construct the prOject (Sec 7044,
Business and Profess10ns Code: The Conlractor·s license Law does not apply to an owner ol property whO builds or im-
proves thereon, and who contracts lor each pr01ects w1lh a contractor{s) hcense pursuanl to the Contractor's License Law).
□ As a homeowner I am 1mprov1ng my home, and !he lollow mg condtt,ons exist 1 The work 1s being performed pnor to sale
2 I have hved in my home !or twetve monlhs prior to completion al lhIs WOfk
3. I have not claimed !his exemption during the last three years
D I hereby affirm tha1 I ha .. e a ert1ftcate ot consent
t°oms~~::t~~eins~~a~e. r1 c1~~:~~P~~~;~,
(Sec 3800. Labor Cooe)
POLICY NO
COMPANY
□ Cocy IS hied With !he c,ty
0 Cen1hed copy is hereby fur ,shed
CERTIFICATl OF EXEMPTION FROM
WORKERS COMPENSATION INSURANCE
(This sechon need no1 t>e completed ,t ine perm,1
,s to, one hundre<l dollars (S1001 or less)
0 I cen,ty that m the performance ol !he won,. tor
wtuch lh1s perm,t ,s ,ssued I shall no1 employ any
person ,n any manner so as 10 t>ecome suo1ect 10 the Wot1ters· Compensa1,on Laws ot Cahforn,a
NOTICE TO APPLICANT It. after mal11.1n'j ttus Cert,
hcale of Exemp!lon yOtJ should become subJecl t')
lhe Workers· Compensation prov,s,ons of the La.bOr
COde. you mus! lorthv.,in comply with such
prov,s,ons or lh1s perm,1 shall be deemed revoke<J
O I hereby alfum 1ha1 there ,s a construc11on
1end,ng agency tor !he performance of !he work tor
wh,ch irus perm,1 1s 1ssueo 1Sec 3097 C1vrl COOe)
Lenders Name ___________ _
Lenoe, s 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
1200 Elm, Carlsbad, California 92008-1989 (619) 438-5525
APPLICATION & PERMIT
J?i? ~ ta /4LW AV.ST.RO. NEAREST CROSS ST. tZ:E OF APPLICCMTION BUS7YNSE :t VALUATION ot.f .;AMIT NUMBER
I .,,;., 8
LOT BLOCK I SUBDIVISION I ASSES,,OR PARC~L NO c 0 CONTAACTT:;fjR / / / -~ A~ CONfRACTORSPHONE • ZONE ~Yo 5Tu I o 17 c :?697 , ,////,h . 7;1'/-0~ /
o?t,;;;2~,/~ '//]~/~ I f1i,:NE;: fY'<t ;;&;;~;;;_ &/Mk LICENSE NO. • PLAN 1.0. # BLOG USE CODE
,,2~8;)?0
o w31;iN?/// ~p?u {~ DESIGNER / LICENSE zr STANOARO PLAN# BUILDING SO. FOOTAGE
DESCRIPTION Of WORK ,, DESIGNER'S ADDRESS OESIGNE A'S PHONE
-po0 ~ ~ '/rh/----F/P FLA ELEV. NO OCC GP EDU STORIES O U~~~ I I I • .. vO NO ---7 I I 4 I • CENSUS TRACT I GP LANO use I PARKING SPACE RES UNITS I GRADING PERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRE SPA (J' I I AREA CONST
YO ND vO "O vO NO Not Valid Unl~s Machine Certified
QTY. PLUMBING PERMIT -ISSUE ~.e::n QTY. MECHANICAL PERMIT -ISSUE ,~-SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100.000 BTU BUILDING PERMIT 01·00-00-8220
EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT 01·00-00-8221 --;µ -
EACH WATER HEATER ANO/OR VENT BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01-00-00-8806 -
EACH GAS SYSTEM I TO 4 OUTLETS .c"f/ L/" BOILER/COMPRESSOR 3 15 HP TOTAL PLUMBING 01·00-00-8222 ./0~
/ EACH GAS SYSTEM~ OR MORE ~-METAL FIREPLACE ELECTRICAL 01-00-00-8223
~ EACH INSTAl . ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01-00-00· 8224 --~-
EACH VACUUM BREAKER MECH EXHAUST HOOD DUCTS MOBILEHOME 01·00-00-8225
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP
EACH ROOF DRAIN flNSIOEJ ,,, SOLAR 01-00-00-R??IS
I U/ TOTt.L MECHANICAL STRONG MOTION 80-92-33-0519
TOTAL PLUMBING I /0 ~ FIRE SPRINKLERS 01·00-00-8227 .
PUBLIC FACILITIES FEE 32·00-00·89ll QTY. ELECTR)CAL PERMIT • ISSUE '"c;--QTY. SOLAR • ISSUE
BRIDGE FEE
NEW CONST EA AMP SWT BK R COLLECTORS SCHOOL FEE • DISTRICT
l PH 3 PH STORAGE TANKS Carlsbad 80·92-21-0519
EXIST BLOG EA AMP'SWT BKR ROCK STORAGE Encinitas 80·92-22-0519
l PH 3 PH PUMP San D1egu1to 80-92-23-0519
REMODEL AL HR PER CIRCUIT PLAN CHECK FEE San Marcos 80-92-24-0519
TEMP POLE 200 AMPS
OVER 200 AMPS LICENSE TAX 01-00-00-8162
TEMP OCCUPANCY 130 DAYSI MFF 80-92-57-0519
CREDIT DEPOSIT
TOTAL ELEORICAL I TOTAL SOLAR TOTAL FEES PAYABLE I /CJ!!;:!.--
I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION ANO PERMIT ANO DO HEREBY Expiration Every permit issued by the Building Off1c1al under the prov1s,ons of this * AN OSHA PERM:T IS REOU~EO FOR EXCAVATIONS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall expire by ltm,tation and become null and vo,d If the bu,ld,ng or work 5· o· DEEP ANO DEMOLITION~ CONSTRUCTION OF
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS authonzed by such perm,t~s n ommenced w1th1n 180 days from the date of such STRUCTURES OVER 3 ST~IES IN HEIGHT permit, or 1f the bu1ld1n rk authorized by such permit 1s suspended or ISSUED TO COMPLY WITH ALL CITY COUNlY ANO STATE LAWS GOVERNING BUILDING CON-aba~ at anv 1,me afi r w.ork ,s commenced for a penod ol 180 davs /
STRUCTION. WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY ANO;~ ~ OWNER□ COOTRACTOR D APPROVEO BY & I D~g,;
KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS. COSTS AND PUC T S~I AT Jf,
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE ,/_. ~ / d;//~ 8 ;y,e, r ' GRANTING OF THIS PERMIT '/. 1/~ ,..,, , I ' ,
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TYPE I DATE INSPECTOR
BUILDING I g-4 ... <f.il/JD
FOUNDATION I FIELD INSPECTION RECORD
REINFORCED STEEL I
MASONRY I
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
GUNITE OR GROUT I INSPECT ION REO IF IN SPECTO R S DATE CHEC KED APPROVAL
FLOOR & CEILING SUB FRAME I
SHEATHING □ ROOF □ SH!;AR
FRAME I
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
EXTERIOR LATH f
I
STRUCTURAL CONCRETE
OVER 2000 PSI
INSULATION I PRESTRESSED
INTERIOR LATH & DRYWALL I
I
CONCRETE
POST TENSIONED
i CONCRETE
PLUMBING I
I FIELD WELDING
SEWER AND BUCO □IPUCO I
UNDERGROUND □ WASTE □ 1/yATER
TOP OUT □ WASTE □ WATER
HIGH STRENGTH
BOLTS
SPECIAL MASONRY
TUB AND SHOWER PAN I
I
GAS TEST I PILES CAISSONS
□ WATER HEATER □ SOLAR WATER
I
ELECTRICAL I
I
-
D ELECTRIC UNDERGROUND □ l!JFFER
ROUGH ELECTRIC I
□ ELECTRIC SERVICE □ TEMPORARY ..
□ BONDING □ POOL ' I
I
MECHANICAL I
I
□ DUCT & PLEM., □ REF. PIPING
HEAT -AIR COND. SYSTEMS ' I
VENTILATING SYSTEMS I
I
'
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVB BEEN APPROVE..D
FINAL I ,,
PLUMBING I ~r I\ \ .~ '
ELECTRICAL I ~, < \ V\\t> .
MECHANICAL .. y \ ' I
GAS I '\.) " ' .
BUILDING I
SPECIAL CONDITIONS I
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