HomeMy WebLinkAbout2715 YORK DR; ; 81-259; PermitII) z 0 ;::
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a: ~ I hereby affirm that I am licensed under o ~lalona of Chapter 9 (commencing with ti [ Section 7000) of Division 3 of the Business c and Professions Code, and my license Is In ~ full fore, 1.nd effe<;l. C _,.-3 z lie No __!lP 9~ 8-L Class __ ;.> __
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I hereby affirm lhat I .,, exempt from the Con
=:o;·e~;~~n,s: ~ ~t~e::~c!2~~~
county whteh requires a pem,11 to construct
alter, improve, demohsh, Of repatr any structure.
P,K)f' to its issuance •lso requtres the apphcant IOf such permit to tile a signed statement that he ,s
hcensed pursuant to the Pf0Y1st0ns of the Con-
tractor's Lteense U.w tCnac>ter 9 commencing wtth SectlOf'I 7000 ol O.v,stOfl 3 of the Bus,ne-ss and Pro-fes.s,ons Code) or that ,s exempt therefrom and the
basis f0f the alleged exempttOn Any vt0latt0n ot
Sectoon 7031 5 by an applocant tor a permit sut>tects 1ne appl,eant to a c,v,1 pen,Jly ot not more than hve
hundred 0011= (S500)
□ I. as owner ot the pr01)8<ty, or my emplOyees
-.,1h wages as their sole compensation. will do the
work. and the structure 1s not tntended OI" ottered '°' sale (Sec 70,U, Busoness and Professions Code The Contractor's lteense Law does not appty to an owne< of Pf'operty who bu1kJs °' ,mp,oves the,eon and who does such wonc himself or throuoh his own
employees. provtded that such 1mproveme.its are
not ,ntende1 or offered fOf sa~ If. however. the bu1khng or ,mproveme-nt Is sold within one year of
con,plet1on. the owner-bu1k1er will have the burden
of proY1ng that he dtd not build or improve for the purpose ot sale)
O I, as owner of the pr0C)tny, am exclusively
contracting with hceosed contractors to construct the pro,ect (Sec 70U, Business and Protesstons
Code The ContractOf's Lteense Law does not apply to an owner of propeny who builds or improves
thereon, and who con1rac1s tor each pro1ects w1lh a contractorts) lteense pursuant to the Contractor's
Lteense Law)
D I am exempt under Sec ____ ,8 &PC
10f this reason __ _
D I he,eby affirm ttlat I na.-e a cen1hcate at consent
10 self-insure, or a cen1t1ca1e of Wonters· Compensalt<>n lnsu,ance. Of a cen1hed cooy !hereof (Sec 3800, Labor Code)
POLICY NO
~MPANY
r:Y Copy 1s hied with the city 6 1 f-1-i
D een,tied copy Is neret>y furnished J
CERTIFICATl OF EXEMPTION FROM
WORKERS" COMPENSATION INSURANCE (This section need not be completed 1t the pe:rm,t
,s tor one hundred ck>llars (S100) or less)
0 t cen,ty lhat In the pertormance ot the work tor
which this pemut ,s issued, I shall not employ any person in any manner so as 10 become sut>1ec1 to
the Wotkers • Compens.alton Laws of Cahtorn~
NOTtCE TO APPLICANT It, after makm;i ltus Cen1
fteate of Exemption. you should become subfecl I? the WOO.ers Compens.atlon prOY1sions ot the Labof Code. you musl f0f1hw1th comply with such
pro~1st0ns or this pemut shall be deemed revokeo
O I ne,et>y altirm tllal there 1s a cons1ruc1ton 1eoo,ng agency lo, the perlorfT\Mlce ol the w()(t{ lo,
which 11'1•5 permit 15 ,ssued lSec YIJ7. c,v,1 Code)
Lende< s Name __________ _
Lender'! Ad<Jre5s _________ _
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 (71-4) '438-5525
JOB ADORESS
A~·i_T l°A2 ;;:18/0NI
BUSINESS LICENSE # VALUATION PERMIT NUMBER
~7tS-\J,-.. ll j:__ Rel ~3 le'( 1400 ~l -zs q OWNER'S NAME / I OWN[ R'S PHONE PRIME CO•,TR~A/OR CONTRACTORS PHONE • ZONE
-~,--~ 0eie_M A..., '13'-/-3P9/ S-t.., I (:., tn ci.vi~f-P-, ;~ If~~ -b <7'11
OWNER'SrAILING AODRESS CONTRACTOR'S AODRESS LICENSE NO. PLAN 1.0. # BLOG USE CODE
<11,.,,, ~ /'j3t..( So l, "'" ~~ 2 .;,s A-.... l-4,.,0 w~'l
LOT I BLOCK I SUBOIVISION I AS1~,~~lfz.-#
DESIGNER Cl CA; 0 ..-, STATE LICENSE " STANOAR0 PLAN# BUILDING SO. FOOTAGE ,
OESCRIPTI~:; OF ~lR'.+.K' -r/Jc. . ..., I IA'., c,,,., nlj ~,'/9-~' -..: .. -IC 111.......,,, I \ OESIGNER'S ADDRESS DESIGNER'S PHONE -Af31i1!6U\S6 6/30/81'4134 43.0 ~ ---F/P FLR ELEV. NO OCC GP EDU 000 r4 I 3Q -6/~0/ 8 I LiJ.O STORIES
vO NO ---
CENSUS TRACT I GP LANO USE I PARKING SPACE RES UNITS I GRADING f'.ERMIT ISSUED I REOEVELOPMENT TYPE OCC LOAD FIRE SPA AREA CONST
YO N D vO NO vO NO Nor Valid Unlt!ss Ahchine Ctrtifi«I
QTY. PLUMBING PERMIT -ISSUE 7,5£ QTY. MECHANICAL PERMIT· ISSUE SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP INSTALL FURft. DUCTS UP TO 100,000 BTU BUILDING PERMIT ,, -"7, 1-.,,-u
EACH BUILDING SEWER \ OVER 100,000 BTU SIGN PERMIT -
-1 BOILER/COMPRE~OR UP TO 3 HP PLAN CHECK /c._.~ Odl, /,1-'7_&J --1-i l EACH WATER HEATER AND/OR VENT "7 .Cc ., EACH GAS SYSTEM I TO 4 OUTLETS 9 ,t::;l BOILER/COMPRESS~ 3-15 HP TOTAL PLUMBING • l'7~ 1=0
EACH GAS SYSTEM 5 OR MORE -METAL FIREPLACE \. ELECTRICAL • '7,t'JO ---
V ENT FAN SINGLE DUCT\_ .. EACH INSTA~ .. ALTER, REPAIR WATER PIPE MECHANICAL
EACH VACUUM BREAKER MECH EXHAUST -HOOD/O~TS MOBILEHOME
WATER SOFTNER RELOCATION OF EA FURNACEM,_EATER MOBILEHOME PARK INSP
EACH ROOF DRAIN (INSIDE) ~ SOLAR
TOTAL MECHANICAL STRONG MOTION --------' -77l,~ TOTAL PLUMBING FIRE SPRINKLERS
1~0(. SOLA~SSUE
PUBLIC FACILITIES FEE
QTY. ELECTRICAL PERMIT -ISSUE QTY. BRIDGE FEE
NEW CONST EA AMP/SWT /BKR COLLECTORS '\. SCHOOL FEE • DISTRICT
I PH 3 PH STORAGE TANKS '\. Carlsbad
EXIST BLOG EA AMP/SWT/BKR ROCK STORAGE '\. Encinitas
1 PH 3 PH PUMP '\. San D1egu110
t REMODEL/ALTER PER CIRCUIT -r::..~ /J l PLAN CHECK FEE '\. San Marcos
TEMP PO LE 200 AMPS ✓ '\. ------'\. OVER 200 AMPS -~ "' TEMP OCCUPANCY (30 DAYSI ----
I --->------
TOTAL ELECTRICAL i lJO TOTAL SOLAR TOTAL FEES PAYABLE I 4~,00
I HAVE CAREFULLY EXAMINED THE COMPLETED .. APPLICATION AND PERMIT ANO DO HEREBY Exp1r1tton EYery ~rm,t issued by the Bu1ld1ng Offlc1al under the prov1sIons of this * AN OSHA PERMIT IS REQUtAEO FOR EXCAVATIONS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall expire by l1m1t1hon and become null and void If the budding or work 5' 0" DEEP ANO DEMOl.lTION OR CONSTRUCTION OF
DECLARATIONS ARE TRUE ANO CORRECT ANO I FURTHER CERTIFY AND AGREE IF A PERMIT IS authonzed by such permit 1s not commenced w1thIn 180 days from the date of such STRUCTUR£S OVER 3 STORIES IN HEIGHT permit. or If the bwldinff or work authorized by such permit 1s suspeinded or ISSUED TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING BUILDING CON abandoned at anv time a er the work ,s commenced tor a oeriod of 180 davs
STRUCTION WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND
z;_s:EJE
• OWNER□ CONTRACTOR 9-p1~Ji DATE KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS. COSTS AND
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE ---BY PHONE 0 10-"tJo-8 I GRANTING OF THIS PERMIT
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INSPECTION TYPE DATE INSPECTOR
BUILDING
F0UNDATION
REINFORCED STEEL
MASONRY
GUNITE OR GROUT
FLOOR & CEILING SUB FRAME
SHEATHING
FRAME
EXTERIOR LATH 1NSULATION
INTERIOR LATH & DRYWALL
PLUMBING
SEWER AND BL/CO
PLUMBING UNDERGROUND
PLUMBING TOP OUT
TUB AND $HOWER PAN
GAS TEST
ELECTRICAL
TEMPORARY POWER
ELECTRIC UNDERGROUND
ROUGH ELECTRIC
ELECTRIC SERVICE
BONDING
G. F. I. -SMOKE DETECTOR
MECHANICAL
DUCT & PLEM., REF. PIPING
HEAT -AIR COND. -SOLAR SYSTEMS
VENTILATING SYSTEMS
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE BEEN APPROVED.
JOB SITE FINAL
PLUMBING
ELECTRICAL
MECHANICAL
GAS
BUILDING
SPECIAL CONDITIONS
CERT OF OCCUPANCY ISSUED
~ I ., "J-::)-t:j
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTION REO IF INSPECTOR'S DATE CHECKED APPROVAL
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
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INTERDEPARTMENTAL INFORMATION SHEET
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BUILDING DEPARTMENT DATE:a ECEIVED
BUILDING ADDRESS:
Bulldlng Deptirtmeol
PLANNING DEPARTMENT
ZONE __________ LOT SIZE _________ LOT WIDTH _________ _
UNITS ALLOWED ____________ UNITS PROVIDED ____________ _
PROVIDED PARKING SPACES REQUIRED ----------------------____________ PROVIDED __________ _ % COVERAGE ALLOWED
BUILDING HEIGHT ALLOWED
FRONT SETBACK:
ALLOWED
PROVIDED -------
INTRUSIONS
-----------
SIDE SETBACK:
LA NDSCAPE & IRRIGATION PLAN COMMENTS:
ENVIRONMENTAL PROTECTION REQ:
PROVIDED
REAR SETBACK:
FINAL ________ DATE ____ _
ENGINEERING DEPARTMENT
R.O.W. INDUSTRIAL WASTE IMPROVEMENTS _______ _ -------------
SEWER CONNECTION ________ DRIVEWAY LOCATIONS ____________ _
GRADING PERMIT EASEMENTS _________ DRAINAGE _____ _
LEGAL DESCRIPTION.4:.L-~.!L..,;;:;::...~----==~-,.L..!;~_.L-...,:!-~---:-----,9-----------,::--,iiL---....
ADDITIONAL COMMENTS-L..L&.~~::::::!::::::_-5:1.:.....t:.~~~:1&~=::::..~~~:..__ ________ __,.~
FIRE DEPARTMENT
SPRINKLING SYSTEM ____________ FIRE PROTECTION EQUIP. ___ _
FIRE ALARMS EXITS _____________ -=---------""la...
FIRE HYDRANTS ___________ LOCATION _______________ -111111a.:c---
ADDITIONAL COMMENTS
OK TO ISSUE: _____ DATE _______ OK TO FINAL ______ DATE
WATER DEPARTMENT
REQUIREMENTS OF APPROPRIATE DISTRICTS MET __ _.~s:-_._---~