HomeMy WebLinkAbout1055 PALM AVE; ; CB890748; Permit.,, z 0 ;:::
C a: C ... u Ill ,a
2 [-d I hereby affirm that I am licensed under U P.1on1 ol Chapter 9 (commencing with
: Section 7000) ol Dlvlalon 3 or the Business
i-and ProleHlona Code, and my license is in ~ full force and eflect.
u
a: Ill 0 ... 3 I Ill z ~
t-nereby aflttm lhal I am exempt from the Conlrac--
to(s License Law !or the following reason (Sec 7031 5 Busmess and Professions Coae Any city or counIy whItt, re• quires a _perm,1 ro conslruct, a her. improve, demohsh or ,~,, any-structure, prtOf 101ts issuance also requires !heap•
pliQnl lor su</1 Pl!flNI 10 tile a Signed stalemenl lhit ho-IS licensed pursuant to the p1ov1sI0ns of !he t.:ontractor s License law (Chapter 9 tommencing with Sec110n 7000 of Oiv1st0n 3 ol the Business anifProless,ons COde} or l~t 1s t)I.•
empt lherelrom and 11'11 basts 10l lhe allegeo' exemptton Any
v!Olat""' O! Seel/On 7031_ 5 by a/I applicanl tor a perm,1 sub
JOCIS lhe apphcant IOatlVll penalty otnot m0<e ttian livt hUO·
dred dol~rs ($500)
.t .. 1 .. as ownet of ttie property., ormy employees wnt,· wages
as !hell SQje compensaJIOQ. Writ dd ·~ WOfk, and lhe SlrUC• lute ,s not intended oc offered lor .sale I Sec 7044~--Bu.siness
and .ProftSStOn!i,, Code Tt,e Contractor's-Lianse Law does
nol apply lo an ownef O! property who buolds or Improves
thereon and who does such work 1umself or !Jlrough his own emP,avees. provided' that such Improvemei;ns are not intend•
ed or O!le,ed IO< sate ~I, -.er Ille buoldmg o, ,mpro,e,.
menl Is sold within one Vear ot completion. the1JtWner·bu11der
w1U have the burden of prOV1n.9 that he did not build Of" 1m• prO\le lor the purpose ·01 saie1 ·
-1 l I, as owner of the property, am exctus1vety contrac11ng
with l,censed contractors to constriJct the prOject (Sec 7044,
Business and PrnlessIons .Code. the .Contractor· s Lic.eose Law doe_s nol app~y _to an owner oJ property who buifds « 1m-p·roves theteol'I, ahcrwho contracts 1or each p,qecrs wdh a
con1ract0f(S) hcense pursuant lo the Contractor's License Law)
n As a llomeownerTam 1mpr0\ling my bOO)e1 and.the lol'low
ing col'ldttlons ex,st. • 1~ Jhe...work Is be.Ing per!ormed poor to.sale4
2 I have· .lrved In my ·tiome tor twelve months roor 10-completion of this work 3, have not claimed lh1s eKempttOn d'Uring !he
las! tnree years
0 -tamexemptunder5ec. ______ . B&P.C.
for lhfS~reason-"---• ,....,.
0 I hereby affirm that I have a certificate of consent to
self-insure. or a ce111Hcate of Workers· Compensation ll'l-
surance,9~ a cerfilJed copy thereof lSec_;.3800. Labor C.ode)
POtlCY NO
0 -zl ~o PA.NY ~
;: -y IS Med w(th the cily i . O Certllled copy 1!: hereby furn,st,ed
w Q. ~ 0 0 .,,
~ w "' a: 0 3
CERTlflCAtE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(Tnts 68Chon need not be completed if the perm,t
-lS tor one hundred dollars {$100tor less)
0 I certify that in the performance of the work lor which
1h19' perm,! 1s issued. I shall not employ any person in any
rnanner so as to become sub1ect 10 lhe Workers· Compen-
sa1100 Laws of California.
NOflCE TO APPLICANT~ 11. afler making this Ce!'11fieate
ol Exemphon. you should beeome subJect to the Wor'kers·
CompenHUon provisions of the Labor Code. you must
Jocthwrth complyw1th such prov,stons or this permit shall
be deemed ,evoked.,
l Q-1 hereby affffm fha_! there 1s a construction lending ffi agency tor lt}e performance of the work lor which 1h1s per o -crut Js Issued (Sec. 3097, Civil cooe1 z w Lem,er s Name----~------~ ... -~----~----Lenders Address ___________ _
I
I_USE BALL POJNT PEN O.JLY & PREtS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. -------
: .. I CARLSBAD BUILDING DEPARTMENT f -l , -·-APPCTCATlO'1& PERMIT-------·
I 2075 Las Pa lm as D r., C a rlsbad , CA 92009-1915 (619) 438-1161 1
: J087;s~.5 .r'~'Y/ AV.ST.RD. THOMAS BROS NO. -,D~: i?:;;1 Jslit:;_:_ VALU:O_N---,---,PERMIT ~UM=
IJ
: LOT' I BLOCK I sueo, v1s10N I ASSESSOR PARCEL NO -;--.. CONTRACTOR CONTRACTORS PHONE• ZONE Cb <:J:;?;_.D-7 (Jt,,---
t-;:::;;~-::-:-:-;-;:---'-------'----'.Jo===...;;S.....:.f_G\....;..I ;-a:0'--3;;;;_:;_0_u::..___--t ;.,,ff I , ~ --· --6 {~ /-jG-
: OWNER'S NAME I OWNER'SPHONE ( IJ,huWC r"/i.1w,,,<;;}v/ 7~-.~.!:.J : ~w, ,<;do~(;~l'J--5 .!: ~-~~r c;,N~RACTOR'SAD~RESS /]/,dt~..L ST~:;n:r:/ -------ButLOlNGSO.FOOT-AGE
I OWNER'S MAILING ADDRESS ~tf/Jt.) uliS.1"1,rfi,/tt!..N' ~K::, _ r, A -'"J ~ "b -----~-_ -•-
f / t)l, s-.P~ ('.P'h L • DESIGNER -• DESIGNER'SPHONE
VJ •lf'llhf? • --------· DE~CR•PTION OF W()R K I
-----,"""'~-------,------------------=-·--41 DESIGNER'S ADDRESS 1 ,__ ~ __ STATE LICENSE NO. . _ 7_2.ti_Q5/17/89 00()1. Qi __ Q2_ --~
c~;V~/' ,:(" Acv~ e-~ s ~.,;e ,,,,,--'. BldPmt 14-01 ~
FIP FLR ELEV. NO OCC GP EbO --------·-
STORIES
v□ NO -----·--~------·-------------
-T_ .. jCENSUSTRACT IPARKING SPACEI RESUNITS I GRAOINGPERMITISSUED 1:~~~VELOPMENT _ ·-;~~iT OCC ~AD Fl~~_'.'._R__ _ _ _ -----~---
--+---j-Y D N D v D ND v O NO Nor Vahd Unlffs Machine Cerrified
QTY. PLUMBING PERMIT -ISSUE /_5° QTY. MECHANICAL PERMIT -ISSUE /_j 1 c ---SUMMARY/ACCOUNT NUMBER------·-i-,
• EACH FIXTURE TRAP INSTALL FURN. DUCTS uP TO 100,000 BTU ouILUIN\J~tt1MI I uu,·dIu·uu-vu·o«u -
/ EACH BUILDING SEWER OVER 100,000 BTU ____ . SlgN PERMI! 001-810-00-00-8221
EACH WATER HEATER ANO OR VENT BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 001-810-00-00-8891 ,....
EACH GAS SYSTEM I TO 4 OUTLETS BOILER/COMPRESSOR 3 15 HP : r ----TOTAL PLUMBING -OOH10·00-·00·8222 ·-/ /L ~ -
EACH GAS SYSTEM~ OR-MORE-METAL Fl.REPLACE f ) _ ELECTRICAL 001·810-00-00-8223
, EACH INSTAL . ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 001-810·00·00·8224
EACH VACUUM BREAKER -MECH EXHAUST H00070U'CTS --·--MOBILEHOMI: --001·81(M)()-00·'822S· --· --~-,-
1 WATER SOFTNER I RELOCATION OF EA FURNACE/HEATER SOLAR 001-810-00·00-8226
: EACH ROOF DRAIN !INSIDE) DRYER VENT STRONG MOTION 880·519-92-33 • I
I -TOTI.L MECHANICAL -• -----F18E SP.RIN.KLEBS 001-.8-10·00·00·8227 --·-_ __ ~ .. _,
I TO f AL PLUMBING j LY.,.,-_. PUBLIC FACILITIES FEE 320·810-00-00·8740 1 0""" BRIDGE FEE-3o0-810-00·00ll740 ---
: QTY. ELECTRICAL PERMIT-ISSUE • ..!)_ QTY. M_O BILE HOM E SETUP _ • __ __ _ 1~_-J.-~-R-K--IN.:--U-E_U_(A_RE_A_ ___ l _____ -..---------1
: NEW CONST EA AMP SWl 8K R CAR PORT , Tlf . 312·8;0·0~·00-8835 ... . -
I I PH 3 PH ,' AWNING j t . -·· • LA-COSTA Tl, -"311'8l0-00-00--883S------------i-,
' EXISl BLOG EA AMPISWT BKR • ' • GARAGE-~-~ _ _ _; r _ • -~ FMF _
1 IPH ]PH -' LICENSE TAX 001·810·00-00-8162 ---
I REMODEL ALHR PER CIRCUIT •, -• .. r • t MFF ---880·519·92·57-i-----------,--11r,----,.-------------,.--:--~---:--:----1,-.---1'----------------""""1t------•r------------------t----------t I TfMP PUl.E 700 AMPS 1 " · 1 -_
I OVER 200 AMPS , • ~ < •
. TE.MP OCCUPANCY (30 DAYSI I I r-----__ _ _ ----~--·-_ __ _ _ -'
, t--_ ____ __ CREDIT DEPOSIT , f TOTAL ELELlRICAL I ,v, f-'. ~ • -t.,1-)!'$,~ TOTA[ >/lE TOT I ; 0 ----·---t • • t't · · • AL FEES PAYABLE I •• I
1 t HAVE CAREFULLY E;AMINED THE COMPLETED ·APPUCA TION AND PERMIT ANO DO HEREBY Exp,rat,on E .. ry perm,t issued by the Buotdmg Oll,cral undet the prov,Sions ol th,• * AN OSHA P£Rlit:T IS REQUIRED FOfl EXCAVATIONS OVER
I CERTIFY UNDER PENAL TY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall ••P"• by hm,tal,oo and become null and YOJd II the bu1l.d1!1.Q or WO(k ·-s· o·:OEEP ANO DEIIIIOl.lTIOH Ofl CONSTRUCTION Of I I CE . authorized by such perm,t Is no1 commenced within 180 days frorn the date ot sucii DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER RTIFY ANO AGREE If' A PERMIT 15 perm,t or rf the buitd,ng or work authorized by such permit 15 suspended or STRUCT\IAl:S OYER 3 STONES tN HEIGHT
I ISSUEO· TO COMPLY WITH ALL·CITY_-CQUNlY ANO STATE LAWS GOVERNING BUILDING CON abandoned at anv time alter the work ,s commenced tor a DArood of 180 rtav• _
I STRUCTION WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY ANO >i( -. . . _ _
1 KEEP HARM. LESS THE CITY.OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS. COSTS AND "~~T'S ~NATJ,19E ~~-.,.-OWNER O CONTRACTO APPROV~ l OATE
I EXPENSES WHICH MAY IN ANV WAJ.:,ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE~'1 ~ c../ _£,_ .,. ✓ c..-r fJ -. ~ J
GRANTING OF HHS PEA'-'IT ~ --., BY PHONE ,.. , _, _ ~ ----( ~--~·-1 I -
(I)
u:
~
"' 0 C.
E
(I) t-
"O
0
C)
C
Ol 0
C. C.
<(
I
.:,:
C a:
0 (/) (/)
(I) (/)
(/) <(
I
l: 2
ai >
(I) 0
C Ol C u:
;=-
C (I)
~
C)
0 0 (I)
C. (/)
C
(I)
~ ~
TYPE I DATE INSPECTOR I
BUILDING I
' .', ~ Cl!:,~0 I '-f-'6,
FOUNDATION I FIELD INSPECTION RECORD
REINFORCED STEEL !
(
MASONRY I
GUNITE OR GROUT I
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTION REO. IF INSPECTOR'S DATE CHECKED APPROVAL
SUB FRAME D FLOOR D CEILINQ SOILS COMPLIANCE
SHEATHING D ROOF D SHEAR PRIOR TO
FRAME I
EXTERIOR LATH I
I
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
INSULATION ! PRESTRESSED
CONCRETE
INTERIOR LATH & DRYWALL I -
POST TENSIONED I CONCRETE
PLUMBING I FIELD WELDING
D SEWER AND BUCO 0 PUCQ
UNDERGROUND D WASTE D WA.1"ER
TOP OUT D WASTE D WATER
HIGH STRENGTH.
BOLTS
SPECIAL MASONRY
TUB AND SHOWER PAN I
GAS TEST I
I PILES CAISSONS
D WATER HEATER D SOLAR WAT8R .
I
ELECTRICAL I
' D ELECTRIC UNDERGROUND D UPFER
ROUGH ELECTRIC ; '\
D ELECTRIC SERVICE D TEMPOR~RY
D BONDING D POOL I ' '-~. \ ~;
I
MECHANICAL I
D DUCT & PLEM., D REF. PIPING
HEAT -AIR COND. SYSTEMS I " . VENTILATING SYSTEMS I . ,
I \-,
I ---'. r·q· -:::: r
CALL FOR FINAL INSPECT/OJ, WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE EEN APPROVED.
--·• t...:. it~ -11 '-1_:) 1..J'Wv.J ;,_·. i.·:. .. .
FINAL I . .
PLUMBING I t...
. ,,,_-. \ , ' X C, '' ·' 1. '-"I • 1 ... \ ...
ELECTRICAL I \\' I .
MECHANICAL I -\,") ~-. --GAS I • \ \ ·'' " BUILDING I ''\) \.\"" I
' ' ' --~ -....
~ .,. . . \ ' -. \ . \ . ~-·~ -. ... .... , ....
SPECIAL CONDITIONS I ': " ~ -I
C
C
C I T Y 0 F C A R L S B A D
DEVELOPMENT PROCESSING SERVICES
APPLICATION ANO COST ESTIMATE OF
SANITARY SEWER LATERAL CONNECTION
WORK ORDER NO. :
PART I -TO BE COMPLETED BY DPS
SEWER LOCATION: BUILDING PLAN CHECK NO.: -----ADDRESS: lo55 p,,, LM APN: --------LEGAL DESCRIPTION: _______________________ _
CONTACT PERSON: ,1\d,i'l E-"5 NO oB eA 'S s PHONE NO.: 7 2.C, -75C:,o/
1
-~INIMUM 4 INCH ABS SEWER PIPE IN PLACE -NOT TO EXCEED $ G, °1 0, °" {I M 10 rm ocEP AND 3□ LINEAL FEET H□RIZ □NTAL DISTANCE. -.
ADDIITONAL CHARGES FOR ANY DISTANCE EXCEEDING 30 LINEAL
FEET HORIZONTALLY ____ FEET AT ____ PER FOOT
ADDITIONAL CHARGES FOR ANY DEPTH EXCEEDING 10 FEET
____ FEET DEEP AT ____ PER FOOT
ADDITIONAL CHARGES FOR PLUGGING EXISTING SEWER LATERAL
TOTAL CHARGES FOR CONSTRUCTION
ADDITIONAL CHARGES FOR CITY Of CARLSBAD SERVICES AT 50% OF
ABOVE CHARGES
TOTAL CHARGE~
1911 ACT A.D. NO.: DWG. NO.: RECT. NO.:
PART II -TO BE COMPLETED BY UTILITIES DEPARTMENT
FOR SEWER LOCATION
$ ____ _
$. ____ _
$. ____ _
$ ____ _
$ ____ _
$ C,;,'iO .op
BY:
Main Depth:
Lateral Depth at Property:----
DP02: FOR"1: DPD8