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Home My WebLink About1013 FOXGLOVE VW; ; 80-119; PermitLICENSED CONTRACTOR'S DECLARATION I hereby affirm that J am licensed under provi- sions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profes· s'1ons Code, and my ncense is in full force and ef- fect OWNER-BUILDER DECLARATION ~I hereby affirm that I am exempt from the Con- tractor's License Law for the following reason (Sec. 7031.5 Business and Professions Code), Any city or county which requires a permit to con- struct, alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed state- ment that he is licensed pursuant to the provi· sions of the Contractor's License Law (Chapter 9 commencing with Section 7000 of Oivls·1on 3 of the Business and Professions Code) or that is ex· empt therefrom and the basis for the alleged ex. emption. Any violation of Section 7031.5 by an ap· plicant for a permit subjects the applicant to a civil penally of not more than five hundred dollars ($500). [_ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or of. lered for sale {Sec. 7044, Business and Pro/es· sions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through his own employees. provided that such improvements are not intended or of. fared for sale. 11, however, the building or improve· men! is sold within one year of completion, the owner·bui!der will have the burden of proving that he did not build or improve for the purpose of sale}. -::1, as owner of the property, am exclusively con- tracting with ncensad contractors to construct the project (Sec. 7044. Business and Professions Code: The Contractor's License Law does not ap- ply to an owner of property ·•ho builds or im- proves thereon, and who contracts for such pro· jects with a contractor(s) license pursuant to the contractor's License Law} I am exempt under Sec. ______ , B. & P.C. for this reason, ____ _ Date -------Owner WORKERS' COMPENSATION DEC I hereby affirm that I have a certili' sent to self-insure. or a certificate Compensation Insurance, or a ce thereof (Sec. 3800, Labor Code) POLICY NO }=~ COMPANY_ vopy is tiled .with the city. t,5 ~ertified copy is hereby fum1 CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed ii the per- mit is for one hundred dollars ($100) or less} I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. NOTICE TO APPLICANT: II, alter making this Cer· tilicate of Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction len- ding agency for the performance of the work for which this perm·11 is issued (Sec. 3097, Civil Code). CITY OF CARLSBAD-BUILDING DEPARTMENT USE BALL POINT PEN ONLY APPLICATION & PERMIT 1200 ELM AVENUE (714) 438-5525 so. JOB ADDRESS I APPLICANT TO FILL IN INFOR - MATION WITHIN RED LINES. All. ST. NUMBER ,o 343 777 ,.-// q OWNER'S MAIL ING CONTRACTOR'S \t11·, ~~.-.1.. C:,i_r.\Js·, 1J4r,<i E'1\r/1n A1,c,. '"0 "' co, BLOCK I SUBDllllSION I 1-..ASSTfOR'S ''RJE:L NO. "'4./1¥1 1 "f1 01 I OE:SCR]PTION OF WORK -S0U1R... lb, \,11'11< • \ \t\ 1"1 G f\ i\oo _t CENSUS TRACT GP LAND USE DESIGNER STAT£ LICENSE: I I DESTGNER'S ADDRESS DESIGNER'S PHONE '°"'" l "'· oms l '"""' '"°' l -"M"' o, srnms Not Vahd Unless Machine Cartified BLDG SO. FT. BLDG USE ClTY. I PLUMBING PERMIT EACH FIXTURE TRAP EACH BUILDING SEWER EACH WATER HEATER ANO/OR VENT EACH GAS SYSTEM 1 TO 4 OUTLETS EACH GAS SYSTEM 5 OR MORE EACH INSTAL., ALTER, REPAIR WATER PIPE EACH LAWN SPRINKLER SYSTEM WATER SOFTNER TOTAL PLUMBING CONTRACTOR QTY. ELECTRICAL PERMIT NEW CONST EA AMP/SWT /BKR 1 PH .25 3 PH EXIST BLOG EA AMP/SWT/BKR 1 PH .25 3 PH REMODEL/ALTER PER CIRCUIT TEMP POLE 200 AMPS OVER 200 AMPS TEMP OCCUPANCY 130 DAYSI occ. c, I SO"""" "'" • / "" IO • l "" AMT. QTY. ~- ... MECHANICAL PERMIT INSTALL FURN. DUCTS UP TO 100,000 BTU OVER 100,000 BTU BOILER/COMPRESSOR UP TO 3 HP BOILER/COMPRESSOR 3-15 HP BOILER/COMPRESSOR 16-30 HP VENT FAN SINGLE DUCT MECH EXHAUST -HOOD/DUCTS RELOCATION OF EA FURNACE/HEATER TOTAL MECHANICAL 5.-I\ CONTRACTOR AMT. QTY. MOBILE HOME PERMIT AWNING PORCH SET-UP .,. . RAMADA, CABANA FENCE OVER 6' TOTAL MOBILE HOME -2. - CONST l OCC. COAD I AMT. :t,Qo<7 - BUILDING PERMIT SIGN PERMIT PLAN CHECK ALL INCLUSIVE PERMIT AMT. I TOTAL PLUMBING ELECTRICAL I I MICO-FILM I : c.;',IV1 I TOTAL ELECTRICAL CONTRACTOR 7_-TOTAL FEES PAYABLE I I I_. 1~1 I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT, AND DO HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED;TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM- LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEOUENCE OF THE GRANTING OF THIS PERMIT. •AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER 5'-0" DEEP AND DEMOLITION OR CONSTP.UCTIQN OF STRUCTURES OVER 3 STORIES IN HEIGHT "'_('\ C\c,," ) ~" ~ " ' ) APPLICANT'S SIGNATURE• OWNER0 AGENT~ /' CONTRACTORO IAPt<?YBY BYPHONEQ.. ~..I -+-- ... I I I I I I : : ;~~~ I I I I I I I 1/~ DATE -Z..fl..ft' • = ,-. < Cl ~ > ~ ;:: V = c.. V) ~ I SITE _E..DDRESS: ' INSPECTION b, WOOD FLOOR FOUNDATION• FORMS• SET BACK• TOILET UNDER FLOOR PLUMBING UNDER FLOOR HEATING OK TO INSTALL SUB FLOOR SLAB FLOOP UNDER SLAB PLUMBING FOOTING• FORMS• SETBACK• TOILET OK TO POUR CONCRETE FRAME ROUGH ELECTRICAL ROUGH PLUMBING ROUGH HEATING/VENTILATING FRAME OK• PLACE INSULATION INSULATION OK • PLACE WALLBOARD WALLBOARD OK• PLACE TAPE EXTERIOR LATH OK• PLACE STUCCO .... .,.._· ... ., Fl REPLACE DAMP~.-6:STEEL PLATE TIES/HEIGHT OF CHIMNEY 10THER TEMP POWER (POLE) SEWER GAS TEST SWIM POOL • STEEL BONDI NG • PRE DECK • FENCE PREPLASTER SHOWN" • FRAME I • PAN i FINAL iNSP BY BLDG DEPT OTHER DEPT'S REQ COMPLETED 1 ELEC METER-PERM-TEMP ! SAS METER-PERM-TEMP i ' i ' !-----! CERT OF OCCUPANCY ISSUED OWNER PERMIT NO: %0-1 t 9 ~~- FIELD INSPECTION RECORD • DATE INSPECTOR INSPECTOR'S NOTES - . / , -'7'"/;//k' , , , I/ ( -==J