HomeMy WebLinkAbout1044 PALM AVE; ; CB880366; Permit"' z 0
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O I ,,.,eby affirm that I am licensed under
provlalona of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Profeaalone Code, and my license is In
full force and affect.
I hereby athrm !hat I am exemp1 lrom the Contrac· 1or·s L,cense Law 10< Ille following reason (Sec 7031 S
Business and Proless'00s COde My city or coonly whK.r. re-quires a perm11 to conslruct. alter, ,mp rove. demolish. or
repau any struclure, poor to 11s 1ssuaoce also requires !heap·
plica,nl to, such permit to file a s1qned statement lhal he 1s
1icense<1 pursuant to lhe prov,sk>ns ol the t:on1rac1or s License Law (Chapter 9 commencing with Section 7000 of
Otv1s1on 3 of lhe Business alld Professions Code} or lhat 1s eJC·
empt the,etrom and the basis fo, the allegea exemp11on Any v,otall()n of SechOn 7031.5 by an apphc.anl tor a permit sub· ,eels lhe apphcant 10 a c1v1I penalty of no! more than f,ve hun·
dred dollars {$SOOI
1, as owner ot !he property. Of my employees with wages as !heir sole compensation will do lhe work. and lhe slruc·
ture Is not intended or ol1ered tor sale {Sec 7044. Busmess
and ProfessK>ns Code The conuactor's License Law does nor apply 10 an owner ol property who bu1IC1s or improves
thereon and who does suc.h work himself or through his own employees. provided thal such improvements are not intend• ed or ollered 101' sale If. however. lhe bu1khng or improve·
ment ,s sold within one year ol complehon, lhe owner-builder
will have the burden of proving that he did not build or 1m·
prove tor the purpose of sale)
I I I, as owner of the property, am exclusively contracting
with hcensed contractors lo construct the protect (Sec 7044.
Business and Protesst0ns Code: The Conlractor's license
Law does not apply to an owner ol prcperty who builds or im-proves thereon, and who contracIs fOf each prOjects with a con1racIor(s} license pursuant to the Con1rac1or·s License Lawl
11 As a homeowner I am ImprovIng my home. and lhe tooow
ing CondlllOOS exist· t The work ,s being perfDfmed pnor to sale 2 I have hved In my home tor twelve months
pnor 10 compleuon of IhIs work
I have nol clatrned lh1s exemphon during the tast lhree years
• 0 lamellemptunderSec ______ ,B&PC
for lhlS ,eason -------------
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0 I hereby affirm 1hat I have a cert1hcate of consent to
self-insure. or a cer1ilicate of Workers· Compensation In-
surance Of a certified copy lhereot {Sec 3800. labor Code)
POLICY NO
COMPANY
:::; Copy IS hied with the city
0 Ceri1t1ed copy 1s hereby furnished
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This seclion need not be completed if the permit
1s for one hundred dollars {$100) or less)
0 I certify that in the performance of the wo,k for which
nus permit 1s ,ssued. I shall nol employ any person 1n any
manner so as to become subject to the Workers· Compen•
sa11on Laws of California
NOTICE TO APPLICANT If. after making lh1s Cef1if1cale
ol Exemption. you should become subject to the Wofke,s·
Compensa11on provisions of the Labo, Code. you must
forthwilh comply with such provisions or this perm,t shall
be deemed revoked
0 I hereby affirm that there is a construction tend•no
agency tor lhe performance ot the work for wtuch this pet•
mil is issued (Sec. 3097. C1v,I Code)
Lender's Name ____________ _
Lende(s Address ___________ _
USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
CARLSBAD BUILDING DEPARTMENT
2075 Las Palmas Dr., Carlsbad, CA 92009-1915 (619) 438-1161 APPLICATION & PERMIT
JOB ADDRESS AV--ST. RO. THOMAS BROS NO. BUSINESS LICENSE# VALUATION
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LOT I ASSESSOR PARCEL NO CONTRACTOR CONTRACTORS PHONE. lo-51qoo;\-8-0
OWNER'SNAME I OWNER'SPHONE I Qtµv<e,,-
~~Q\o 1-b,rr•.J bc~e.~c.,. ~'?4-S ~lJ, CONTR CTOR'SAOORESS
OWNER'S M ILING ADDRESS
c;, A 1 he.A "? '?'?} ~/le /)..,.
ZONE
STATE LICENSE NO.
DESIGNER DESIGNER'S PHONE
PERMIT NUMBER
c~rgo3t-G
BUILDING SO. FOOTAGE
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0 oesCR1PTlON OF w 6RK
DESIGNER'S ADDRESS ... -------------------------------1 STATE LICENSE NO. 0052 03/23 0101 02BloPmt 13-1"'~ Ql
P/n -b.,.... / i:; 1,k I. ruC.
7 ,,/JJ1 7i OAJ /0 1J7-2. Z-e:,
F/P FLR ELEV,
vO NO
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STOR I ES l CEl'ISOS"'TR'ACI l PAAKING SPACE I RES UNITS l GRADING PERMIT ISSUED
y D ND F VELOPMENT
A
vO NO
TYPE
CONST
QTY. PLUMBING PERMIT -ISSUE 1~ QTY. MECHANICAL PERMIT· ISSUE (S:<xJ
QTY.
EACH FIXTURE TRAP 5 . INSTALL FURN DUCTS iJP TO 100,000 BTU
EACH BUI LUING SEWER I II I OVER 100,000 BTU
EACH WATER HEATER ANO OR VENT I II I BOILER/COMPRESSOR UP TO 3 HP
EACH GAS SYSTEM 1 TO 4 OUTLETS I II I BOILER/COMPRESSOR 3 1~ HP
EACH GAS SYSTEM~ OR MORE I II I METAL FIREPLACE
EACH INSTAL . ALTER, REPAIR WATER PIPE I II I VENT FAN SINGLE OUCT
EACH VACUUM BREAKER I II I MECH EXHAUST HOOOIOUCTS
WATER SOFTNER I II I RELOCATION OF EA FURNACE/HEATER
EACH ROOF DRAIN !INSIDE! I II I DRYER VENT
TOI AL PL UMBING I
ELECTRICAL PERMIT · ISSUE
NEW CONST EA AMP SWT BKR
1 PH 3 PH
EXIST BLDG EA AMP,SWI BKR
I PH 3 PH
REMODEL ALTER PER CIRCUIT
TEMPPOLE ?OOAMPS
I'-If#
s,D'DII QTY.
TOT t.L MECHANICAL
CAR PORT
AWNING
GARAGE
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r.ffi: dtrro,~;;-.;..
CARLS!3.(0, CA
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OVER 200 AMPS ~lfn. I ~ia"'7
TEMP OCCUPANCY 130 DAYSI ~0811-~
TOTAL ELECTRICAL ] TOTAL
ace GP EDU
OCC LOAD FIRE SPA
vO NO Nor Valid Unkss ~chine Certilitd
SUMMARY/ACCOUNT NUMBER
emcrmm~mm lllll-BIO•!IO-llll-mll
SIGN PERMIT 001-810-00·00·8221
PLAN CHECK 001·810·00·00-8891
TOTAL PLUMBING OOi ·810·00·00·8222 ,~-
ELECTRICAL 001-810·00·00·8223
MECHANICAL 001·810-00-00·8224
MOBILEHOME 001-8 10·00·00-8225
SOLAR 001-810-00·00-8226
STRONG MOTION 880-519-92·33
FIRE SPRIN~LERS 001 ·810·00-00-8227
PUBLIC FACILITIES FEE 320·810·00-00-8740
BRIDGE FEE 360-810·00·00·8740
PARK-IN-LIEU (AREA )
TIF 312·810-00-00·8835
LA COSTA TIF 311·810-00-00-8835
FMF
LICENSE TAX 001 ·810·00·00·8162
MFF 880-519·92·5 7
CREDIT DEPOSIT
TOTAL FEES PAYABLE l /3 ..0
PPLICATION AND PERMIT AND DO HEREBY Exptrat1on Every perm,t issued by the Bu1ld1ng Ott,c,al un<ler the prov,s,ons ofth,s I HAVE CAREFULLY EXAMINED THE COMPLETED A Code shall exptre by 1!mItat1on and become null and vo,d II the bu1ld,ng or work * AN OSHA PE,_.:T IS AEOUIAED FOA EXCAVATIONS OVER
5· O" DEEP AND DEMOLITION 0A CONSTRUCTION OF
STRUC'I\JAES OVER 3 STOAIES IN HEIGHT CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE authonzed by such perm,t ,snot commenced w1th1n 180days from lhe date,>I such
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY ANO AGREE IF A PERMIT lb permit or ,t the bu1ld1ng or work authonzed by such permit 11 suspended or
ISSUED TO COMPLY WITH ALL CITY COUNlY AND STATE LAWS GOVERNING BUILDING CON· L.!•~b!;&n~do~n!!ed!!!Ja!!l_!a!!n!lJl[!!1me!!!_.!•!!!lt•r~th!!e~w!!:o!!!rc!!k.!1ls.!:c2o:!'.!m!!;m~en~c:!!e2d.!f2o!..r !.•.l!:!!!!"c!!od!!.J0!!.I.Jl,!!80!!..!i!IY.L---p~~~~~~------------::-~~------,
STRUCTION WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND APPLJTEI:·s SIG ATURE JJ OWNER[] CONTRACTOR O APPRO&v-oD BY DATE
KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES JUDGMENTS. COSTS AND q/ ~ 0
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE BY PHONE o I 3 , ., . 4,. tY
GRANTING OF THIS PERMIT ,..._.,.._ _ _,.._::_-_-______ ,. -"Y1 > ')/~ (
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TYPE DATE INSPECTOR
BUILDING Ci:>%&::>~ .. (-
FOUNDATION -. FIELD INSPECTION RECORD
REINFORCED STEEL
MASONRY REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES .
GUNITE OR GROUT INSPECTION REQ IF INSPECTOR'S DATE CHECKED APPROVAL
SUB FRAME □ FLOOR □ CEILING
SHEATHING □ ROOF □ SHEAR
FRAME
SOILS COMPLIANCE . ,,. ' iit'c,~ PRIOR TO .if:. ... ', •• ~(.,
FOUNDATION INSP ,' iv' ,,.. ' L.,_·, "" \.
EXTERIOR LATH STRUCTURAL CONCRETE , l • ~\ ! OVER 2000 PSI ,.
INSULATION ~
INTERIOR LATH & DRYWALL ' ,, .
PRES TRESSED ~ •. 'I
CONCRETE a ,, ~J
POST TENSIONED ~~ -~ 'F"O •; CONCRETE ,. '
PLUMBING
□ SEWER AND BUCO D PL/CO
UNDERGROUND □ WASTE □ WATER
~J,,..
-1 FIELD WELDING ,;f.>7/
HIGH STRH;!GTH ~ ~ i'P' BOLTS ' s,:
TOP OUT □ WASTE □ WATER SPECIAL MASONRY
TUB AND SHOWER PAN
GAS TEST PILES CAISSONS
D WATER HEATER □ SOLAR WATER .
ELECTRICAL \ . -.
□ ELECTRIC UNDERGROUND □ UFFER
ROUGH ELECTRIC .
□ ELECTRIC SERVICE □ TEMPORARY
□ BONDING □ POOL "
MECHANICAL
□ DUCT & PLEM., □ REF. PIPING ' . . . \ . . ' HEAT -AIR COND. SYSTEMS .
VENTILATING SYSTEMS
.
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HA VE BEEN APPROVED. -----. ---····-----·· .... ··----·
FINAL \
PLUMBING u...,.
ELECTRICAL '-)
MECHANICAL • l"'-.. ~
GAS \.) \ \' . .
BUILDING "\j \f'--v
SPECIAL CONDITIONS \. -~ ---