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Home My WebLink About1134 KNOWLES AVE; ; 80-394; Permit~ENSED CONTRACTOR'S DECLARATION ~~~reby affirm that I am licensed under provi- sions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profes- sions Code, and my license is in full force and ef- fect. OWNER-BUILDER DECLARATION DJ 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 Division 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 penalty of not more than five hundred dollars ($500). r 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- fered for sale (Sec. 7044, Business and Profes- 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- fered for sale. If. however, the building or improve- ment is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose ol sale) :::: I, as owner of the property, am exclusively con- tracting with licensed 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 DECLARATION I hereby affirm that I have a ce~ica_ te of con- sent to self-insure, or a certif1cal of ,.W; Compensation insurance, or a ce 11, thereof {Sec. 3800, labor Code). POLICY NO. ,{"> '\l 'I'' COMPANY ---------~',,-:,_-'-'1,-----'C~ ¢'opy is Ii-led with the city. 4. ~Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS" COMPENSATION INSURANCE (This section need not be completed if the per- mit is for one hundred dollars ($100) or less). \ 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: If, after making this Cer· tificate 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- 1ing agency tor the performance of the work for ·,ich this Dermit is issued (Sec. 3097, Civil Code) CITY OF CARLSBAD-BUILDING DEPARTMENT APPLICATION & PERMIT USE BALL POINT PEN ONLY 1200 ELM AVENUE (714) 438-5525 APPLICANT TO FILL IN INFOR - MATION WITHIN RED LINES. "· Joe ADDRESS 1A-~;;ii~r 4/z~e~N '")"#:];';.. ~ PERMIT NUMBER / I J ,-::r ,.d__, . ;/, • • -, {,.,e,~ I I I I ' ' ' ' ' I I I I I I I '8o-3iy OWNER OWNER'S PHONE PRIME CONTRACTOR STATE LICENSE L1;.J/l/l€f/.4 L. c~ 72,?-~y JoftdSo,,/ etJ/t"Sr. ZCrYS'Dl OWNER'S MAILING ADDRESS CONTRACTOR'S ADDRESS CONTRACTOR'S tl.34-P'A/1:Jttk• /1.'"J /Jt/e P,. 0' .SoJc 7/W c,qR.t-3 ,SO~ t;, 8 1'.Z -o :3 '~ BLOCK l SUBOIVlSION I ASSESSOR'S PA~~~ NO. .4 DESIGNER STATE LICENSE / /.5.~--,,. z.-,/ ' ' OESCRIPT!ON OF WORK WI r H ~ "'"' .;. ,:::,,,,+,.4;t)(J/J /:ZX.'5" t,v~b 77!/" PA-r,;o DESIGNER'S ADDRESS DESIGNER'S PHONE t::,~ /( /~ti H :.: c;,-,c,t~ , /,'loo CENSUS TRACT I GP LAND USE , 1 RES, UNITS I P;RKING SPACE 1 NUME!ER OF STORIES ZONING sf Not Valid Unless Machin. Cartifi«J BLOG SQ. FT. BLOG USE occ. GP I STANDARD PLAN II IPLANID"/t I TYPE CONST l occ. LOAD I QTY. PLUMBING PERMIT AMT. QTY_ MECHANICAL PERMIT AMT. EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100,000 BTU EACH BUILDING SEWER OVER 100,000 BTU EACH WATER HEATER AND/OR VENT . -BOILER/COMPRESSOR UP TO 3 HP EACH GAS SYSTEM 1 TO 4 OUTLETS "1/ BOILER/COMPRESSOR 3-15 HP BOILER/COMPRESSOR 16-30 HP - EACH GAS SYSTEM 5 OR MORE EACH INSTAL., ALTER, REPAIR WATER PIPE v.-VENT FAN SINGLE DUCT :).,-r,-,----: --- EACH LAWN SPRINKLER SYSTEM MECH EXHAUST -HOOD/DUCTS VALUATION: / WATER SOFTNER RELOCATION OF EA FURNACE/HEATER BUILDING PERMIT I I r-.\-1~ Issue 3.00 Issue 3.00 SIGN PERMIT I I I TOTAL PLUMBING 1,:>-TOTAL MECHANICAL PLAN CHECK I I I/(/ 1--- CONTRACTOR CONTRACTOR ALL INCLUSIVE PERMIT I I ELECTRICAL PERMIT AMT. TOTAL PLUMBING I ,~J ,_ QTY_ AMT. QTY. MOBILE HOME PERMIT ELECTRICAL I I :.,,_ ,r- NEW CONST EA AMP/SWT/BKR I./ AWNING MECHANICAL I i >: I 1 PH .25 3 PH --PORCH MOBILE HOME I I I EXIST BLOG EA AMP/SWT/BKR SET-UP SOLAR I I I I 1 PH .25 3 PH RAMADA, CABANA I I I I REMODEL/ALTER PER CIRCUIT FENCE OVER 6' I I I I TEMP POLE 200 AMPS TOTAL MOBILE HOME MICO-FILM I I I . I OVER 200 AMPS I I I I TEMP OCCUPANCY (30 DAYS) STRONG MOTION: I I I • <; 10 I I I ' ' ' ' ' ( i i.-: ' ' I/ Issue 2.. Or TOTAL ELECTRICAL ?-9' TOTAL FEES PAYABLE I Ii ~-~ ~ ~ CONTRACTOR I I SCHOOL FEES: ' I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT. AND DO •AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I 5'-0" DEEP AND DEMOLITION OR CONSTRUCTION OF FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED;TO COMPLY WITH ALL CITY, STRUCTURES OVER 3STORIES IN HEIGHT COUNTY ANO STATE LAWS GOVERNING SUILDING CONSTRUCTION, WHETHER SPECIFIED HERE!N OR NOT. 1,ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM- LESS THE CITY OF CARLSBAD AGAINST ALL LIASILITIES. JUDGMENTS, COSTS AND ~· EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. A~~S~~NAl/4~ OWNER□ CONTRACTOR v§ DATE AGE"'~ BY PHONE /I~ / I SITE ADDRESS: . OWNER: PERMIT NO: <;;n ~39 '-+ FIELD INSPECTION RECORD INSPECTION DATE lNSPECTOR l NSPECTOR'S NOTES WOOD FLOOR FOUNDATION• FORMS• SET BACK • TOILET I UNDER FLOOR PLUMBING UNDER FLOOR HEATING OK TO INSTALL SUB FLOOR SLAB FLOOR 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 FIREPLACE DAMPER &STEEL PLATE TIES/HEIGHT OF CHIMNEY OTHER TEMP POWER {POLE) SEWER GAS TEST SWIM POOL • STEEL BONDING • PRE DECK • FENCE PREP LASTER I SHOWN • FRAME .. • PAN ! Fl NAL I N;jP f?Y BLOG DEPT I / OTHER D6P'T"S-REQ COMPLETED , /),:, IA'J / "· • /J ', i ELEC METER_::PERM-TEMP / // 'GAS METER-PERM-TEMP CERT OF OCCUPANCY ISSUED BUILDING ADDRESS: 1-,.R PLANNING DEPARTMENT SHEET DATff.ECEIVED APR22N> ZONE. __ -Jf""-_3 ____ LOT SIZE. _________ LOT WIDTH ________ _ UNITS ALLOWED ___________ UNITS PROVIDED ____________ _ PARKING SPACES REQUIRED PROVIDED __________ _ % COVERAGE ALLOWED --------,.,L--.+---hc.._--PROVIDED __________ _ BUILDING HEIGHT ALLOWED PROVIDED FRONT SETBACK: REAR SETBACK: ALLOWED J.v.,,, PROVIDED ______ _ INTRUSIONS LANDSCAPE & IRRIGATION PLAN COMMENTS: ENVIRONMENTAL PROTECTION REQ: ~ad~Jt1&!!!'4"~d-e:.J..w~r!.-J-1 ____________ _ ) SCHOOL FEES: $ ADDITIONAL COMMENTS: p ________ DATE ____ _ ENGINEERING DEPARTMENT R.o.w. ______ INDUSTRIAL WASTE _______ IMPROVEMENTS _______ _ SEWER CONNECTION ________ DRIVEWAY LOCATIONS ___________ _ GRADING PERMIT . ~ EASEMENTS _________ DRAINAGE ____ _ LEGAL DESCRIPTIONGO~~""'==-~/_,~s,.c_-_____________________ _ ADDITIONAL COMMENTS ____________________________ _ P.F FEE: OK TO ISSUE: FIRE DEPARTMENT SPRINKLING SYSTEM ___________ FIRE PROTECTION EQUIP. _______ _ FIRE ALARMS EXITS, _______________ _ FIRE HYDRANTS LOCATION _________________ _ ADDITIONAL COMMENTS OK TO ISSUE: _____ DATE _______ OK TO FINAL ______ DATE ____ _ WATER DEPARTMENT REQUIREMENTS OF APPROPRIATE DISTRICTS MET ________ DATE _______ _