HomeMy WebLinkAbout1232 PINE AVE; ; 79-5352; PermitI hereby affirm that I am licensed under provl-
slona of Chapter 9 (commencing with Srotion
7000) of Division 3 of the Busirtess and-Profes
sions Code, and my license 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. TOSI^Business and Professkms Code), Anycity cx'^^^ltty which requires a permit to construct, alter, improve, demolish, or repair anystructure, prior to its issuance also requires theapplicant such permit to file a signed statement tjx-K he is licensed pursuant to the provisions oKfhe Contractor's License Law (Chapter 9oommencing 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-emptkxi. Any vk>iation of Section 7031.5 by an applicant for a permit subjects the applicant to a
cMI penalty of not more than five hundred dollars
(S500).
□ I, as owner of the property, or my employeeswith wages as their sole compensation, will do
the work, arxl the structure is not Intervded or offered for sale (Sec. 7044, Business and Profes
sions Code: The Contractor's License Law doesnot apply to an owner of property who builds orimproves thereon and who dc^ such work
himself or through his own employees, provided
that such Improvements are r>ot Intended or of
fered for sale, if, however, the building or improve
ment is sold within one year of completion, theowner-builder will have the.burden of proving thathe did not build or Improve for the purpose of
sale).
Gl, as owner of the property, am exciuslveiy contracting 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 projects with a contractorfs) license pursuant to the
contractor's License Lavr).
i am exempt under Sec. , B, & P.C.
for this reason
Date Owner
WORKERS' COMPENSATION DECLARATIONI hereby affirm that i have a certificate of consent to 8eif-ifi8urerbr~S" (Srtiflcate of Workers'
Compensation insurance, or a certified oopy
thereof (Sec. 3800, Labor Code),
POUCY NO,COMPANY
□ Copy IS filed with the city.
□ Certified copy is hereby fumished.
CERTIRCATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not t>e completed If 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 anyperson in any manner so as to become subji^ to
the Workers' Compensation Laws of California.
NOTI9E TO APPUCANT: if, aHer making this Cer-tiflcatVlbf Exemption, you should become subject
to the Workers' Compensation provisions of theLabor Qk>dti, yuim^st forthwith comply with such
ged revoked.
_\>
DN^UCTfONTOltyihGrA^^
i hereby affirm that there is a cohstructldding agency for the performance of the vrork^which this permit Is Issued fSeo. 3097. CMI CodeL""
UbttJALLf-uir.! rc:r.ur.LT 1200 ELM AVENUE (714) 438-5525 fy\M I \Kjn YYM niiN rxcu l-iinco.
NO. ^ J0^,.^DRE3S AY. ST.RD
J_L
OWNER'S PHONE
I I I I
DATE or APPLICATION
OWNER'S MAIL1N9 frPDH^SSy~// ^
BLOCK SUBDIVISION ASSESSOR'S P.AHCEL NO. ' . ^ \\Q\X0\ 1
PRIME CONTRACTOR yQ STATE LICENSE
CONTRACTOR'S ADMESS CONTRACTOR'S
DESCRIPTION OF WOR/ fP )( ^ \
CENSUS TRACT SPLA^USE ZO^Q CJ■m'i
QTY. PLUMBING PERMIT
/ /
•V'
72
EACH FIXTURE TRAP
EACH BUILDING SEWER
EACH WATER HEATER AND/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
Issued
STA
DESlONER'a ADDRESS
RES. UNIT7
NDARD PLAN #
AMT.
^2.
3OT
TOTAL PLUMBING
CONTRACTOR
QTY,
Z
f.T.
ELECTRICAL PERMIT
NEW CONST EA AMP/SWT/BKR
1 PH 25
EXIST BLDO EA AMP/SWT/BKR y- —
1 PH 25
REMODEL/ALTER PER CIRCUIT
TEMP POLE 200 AMPS
OVER 200 AMPS
TEMP OCCUPANCY (30
■Icsuanoe-2,00
TOTAL ELECTRICAL
CONTRACTOR
QTY.
y' INSTALL FURN. DUCTS UP TO 100,000 BTU
OVER 100
PARKING SPACEsq. ft
#
BUS. LICENSE
Ism
PHONE
state LICENSE
DESIGNER'S PHONE
NUMBER OF STORIES
/
TYPE CONST
-j/M.
MECHANICAL PERMIT
,000 BTU
BOILER/COMPRESSOR UP TO 3 HP
BOILER/COMPRESSOR 3-15 HP
BOILER/COMPRESSOR 16-30 HP
VENT FAN SINGLE OUCT
MECH EXHAUST - HOOO/DUCTS
RELOCATION OF EA FURNACE/HEATER
Issuance
PERMIT NUMBER
S72a/79PI5S lO'j-U I -:''
Hot VoM Unhts Uachino Cartifitd
AMT.
"3TUD"
TOTAL MECHANICAL
CONTRACTOR
QTY.MOBILE HOME PERMIT
AWNING
PORCH
_SET_-UP
RAMAOA, CABANA
FENCE OVER G'
TOTAL MOBILE HOME
Issuance
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. [.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 CONSEQUENCE
OF THE GRANTING OF THIS PERMIT.
AMT
VZ\LUAnCN: -
BUILDING PERMIT
SIGN PERMIT
PLAN CHECK
ALL INCLUSIVE PERMIT
TOTAL PLUMBING
ELECTRICAL
MECHANICAL
MOBILE HOME
SOLAR
MICO-FILM
TOTAL FEES PAYABLE
3®
I • I
19
1
zo
•AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER
B'-O" DEEP AND DEMOLITION OR CONSTRUCTION OF
STRUCTURES OyER 3 STORIES IN HEIGHT''
SOiOQL FEES:
JCANT■3 SIGNATURE OWNERQ CONTRACTO
AGENT □ BY phoned
DATE
f
SITE
ADDRESS:: OWNER:• ''V .PERMIT NO: 5'3_S^'^
FIELD INSPECTION RECORD ;
- INSPECTION . .- DATE,INSPECTOR."
WOOD FLOOR
FOUNDATION* FORNIS • SET BACK •TOILET , .
UNDER FLOOR plumbing .. ,,
-UNDER FLOOR HEATING -, n
OK TO INSTALL SUB FLOOR --
- n - -
sLab floor
_ UNDER SLAB PLUMBING '. r .
FOOTING . FORMS . SETBACK • TOILHT .
OK TO POUR CONCRETE .
FRAME
ROUGH ELECTRICAL'
ROUGH PLUMBING ,,
ROUGH HEAtIng'/VENTILATING
FRAME OK • PLACE INSULATION
INSULATION OK • PLACE VVALLBOARD .
WALLBOARD OK* PLACB-TApE— V-^
EXXERIOR LATH OK* PlXcE STUCCO '■
^ .
J ■ - -
FIREPLACE ; . , .
. D'ASlPERVaWSTEEL ■ ■
PLATE TIES/HEIGHT OF CHIMNEY - ,
OTHER . - . , .
TEMP POWER (POLE)
SEWER
GAS TEST
SWIM POOL • STEEL BONDING
. . * PRE DECK ,
*.FENCE PREPLASTER
SHOWN * FRAME
* PAN
final'INSP-BY BLDG DEPT /
OTHER DEpV'S'REQ COMPLETED i
ELEC METER-PERM-TEMP
GAS METER-PERM-TEMP
'
' jX-CERT OF OCCUPANCY ISSUED
INSPECTOR'S NOTES
-trr
J '
4
<
REQUESTER
INSPECTOR ^ ^
SPECTION
OWNER.
PERMIT NO
TIMEl
.DATE
ADDRESS-
BUILDING ELECTRICAL
□ FOUNDATION
□ REINFORCING STEEL ,□ TEMPORARY SERVICE
□ MASONRY □ ELECTRIC UNDERGROUND
□ GROUT - GUNITE □ ROUGH ELECTRIC
□ FLOOR AND CEILING FRAME □ POOL BONDING
□ SHEATHING □ ELECTRIC SERVICE
□ FRAME □ CEILING HEAT
□ EXTERIOR LATH □ G.F.I.
□ INSULATION □ si^ke-deji;ector
□ M^lT-ERTCrR-bi^H OR DRYWALL
FINAL ) !
JW'^INAL^X
'' PLUMBING MISCELLANEOUS
□ UNDERGROUND PLUMBING □ PLENUM AND DUCTS
□ UNDERGROUND WATER □ COMBUSTION AIR
□ ROUGH PLUMBING :□ PATIO
□ TOP OUT PLUMBING '□ SIGN
□ SEWER AND PL/CO □ GRADING
□ TUB OR SHOWER PAN □ DRIVEWAY
□ GAS TEST n CONDITIONED AIR SYSTEMS
□ WATgBJdEATER □ REFER PIPING
□ FINAL
READY FOR INSPECTION:
SPECIAL INSTRUCTIONS.
□ MQiiDAYt-A^
□ P.M.
WEDNESDAY □ THURSDAY □ FRIDAY
STYVN dJiM.tdnn-
PERSON TAKING REPORT
.PHONE NO.REQUESTED BY_aAa/o.
Q fC /d
2 - ^ sy
REQUES:
INSPECTO
OWNER_
FOR INSPECTION ^
'I ' - ^
L PERMIT NO_
TIMEl.
.DATE:
ADDRESS.I 23 Z
BUILDING
Q FOUNDATION j
□ REINFORCING STEEL j
□ MASONRY : !
□ GROUT-GUNITE ,
□ FI^OR^ND CEILING FRAMEQ/S^E?CfHING
□ EXTERIOR LATH j
□ INSULATION ^ j
□ INTERIOR LATH OR DRYWALL
□ FINAL I
PLUMBING
□ UNDERGROUND PLUMBING. i
□ UNDERGROUND WATER
□ ROUGH PLUMBING
□ TOP OUT PLUMBING j
□ SEWER AND PL/CO (
□ TUB OR SHOWER PAN i
□ GAS TEST .
□ WATER HEATER . ' ' ,
□ FINAL ,
ELECTRICAL
□ TEMPORARY SERVICE
□ ELECTRIC UNDERGROUND
□ ROUGH ELECTRIC
□ POOL BONDING
□ ELECTRIC SERVICE ,
□ CEILING HEAT
□ G.F.I.. ■ ,
□ SMOKE DETECTOR
□ FINAL
miscellaneous
- ■- □PLENUM AND DUCTS
□COMBUSTION AIR
- □PATI,0_
- □SIGN ;
□GRADING '
. □DRIVEWAY
□CONDITIONED AIR SYSTEMS
REFER PIPING
, - ■ □FINAL
A.-
READY FOR INSPECTION: □ M^NtfAY □ TUESDAY □ WEDNESDAY □T^HURSDAY. □ FRIDAY
□ P.M.
SPECIAL INSTRUCTIONS.
REQUESTED BY._J PHONE NO
PERSON TAKING REPORT
X -
, ;
REQUEST FOR iNSPECjTlON v'time:—^
iMSPPrrnR ^cSS'^—OArE: ^ ^
OWNER.
h
.ADDRESS-' /oZ ^
BUILDING
I □ FOUNDATION
□ BEINF0RCIN9 STEEL, [T^'mASONRY,
m GROUT - GUNITE , . ^ ,
□ FLOOR AND CEfLrNG FRAME/ ^ 1 , " -• ' y, O SHEATHINGl^FRAME ^
XTERIOR LATH
□ INSULATION
!
I
□ INTERIOR LATH OR DRYWALL
n FINAL >
ELECTRICAL
■ I ■ '. VI'.
□ TEMPORARY SERVICE ;
□ ELECTRIC UNDERGROUND1□ ROUGH ELECTRIC,
□ PqoL^BbNDING
□ ELECTRIC SERVICE -
□ CEILING HEATTi^G.F.I. - " ^ ^ , "■
Xn SMOKE DETECTOR '
□ FINAL '■j/
T
PLUMBING T—i ■
O underground PLUMBING□ UNDERGROUND WATEFI j ^
□ ROUGH PLUMBING
□ TOP out, PLUMBING
,□ SEWER AND PL/CO
□"TUB OR SHOWER PAN
□ GAS TEST
□ WaVeR -HEATER ^
□ .FINAL
i ■
MISCELLANEOUS
V
□ P.M.
SPECIAL INSTRUCTIONS.
.."■V ' ,
■ N
□ PLENUM AND'DUCTS
□ COMBUSTION AIR
^ □PATIO ^ -/
□ s;iGN
□ grading. )
□ DRIVEWAY-' , , , r□ CONDITIONED AIR SYSTEMS
□ REFER PIPING '
□ .FINAL
' . ^ f ' , . ,READV for INSPECTION: □ MONDAY , □ TUESDAY WEDNESDAY^ □ THURSDAY □ FRIDAY
' . □ AJW. '
I <
' I
/REQUESTED BY^.PHONE NO.
,PER^6n TAKIf^lG report.
REQUEST FOR INSPECTION TIMEi
INSPECTOR
OWNER_
«_ PERMIT NO
:}2x
ADDRESS.
BUILDING 1 ELECTRICAL
□ FOUNDATION |
□ REINFORCING STE^L □ TEMPORARY SERVICE
□ MASONRY □ ELECTRIC UNDERGROUND
□ GROUT-GUNITE |□ ROUGH ELECTRIC
□ FLOOR AND CEILING FRAME □ POOL BONDING
□ SHEATHING □ ELECTRIC SERVICE
□ FRAME c □ CEILING HEAT
□ EXTERIOR LATH □ G.F.I.
□ INSULATION □ SMOKE DETECTOR
□ INTERIOR LATH OR DRYWALL □ FINAL
□ FINAL }
PLUMBING j MISCELLANEOUS
□ UNDERGROUND PLUMBING □ PLENUM AND DUCTS
□ UNDERGROUND WATER f □ COMBUSTION AIR
□ ROUGH PLUMBING □ PATIO
□ TOP OUT PLUMBING 1 □ SIGN
□ SEWER AND PL/CO 1 □ GRADING
□ TUB OR SHOWER PAN 1 □ DRIVEWAY
□ GAS TEST 1 □ CONDITIONED AIR SYSTEMS
□ WATER HEATER □ REFER PIPING
□ FINAL □ FINAL
READY FOR INSPECTION: □ MONDAYD^i
SPECIAL INSTRUCTIONS
□ WEDNESDAY □ THURSDAY □ FRIDAY
»
REQUESTED BY_.PHONE NO
PERSON TAKING REPORT.
a, _J(L.j\^c>~^vA-i,
;JL 2 '^iM ^tAjz^
(?^<-«/ ■^aJ^ £«-*-«-
C - ^
'7x1-3/ fs
INTERDEPARTMENTAL INFORMATION SHEET
BUILDING DEPARTMENT
BUILDING ADDRESS:/ <3 3 oJ. ,
DAif?JECEIVEO
3 f'EC 5 1579
crry OF carls^
Building D
PLANNING DEPARTME
LOT SIZE
epamm
ZONE
\
LOT WIDTH
^^UNITS ALLOWE
PARKING SPACES REQUIRED
% COVERAGE ALLOWED
UNITS PROVIDED
BUILDING HEIGHT ALLOWED
FRONT SETBACK:
ALLOWED
PROVIDED
_PROVIDED_
PROVIDED
PROVIDED
iTliUi WiulA
SIDE SETBAQK:REAR SETBACK:
INTRUSIONS
LANDSCAPE & IRRIGATION PLAN COMMENTS: /fA
ENVIRONMENTAL PROTECTION REQ
r\
ADDITIONAL COMMENTS
OK TO ISSUE:uWljOK TO FINAL DATE
ENGINEERING DEPARTMENT / f~r~xj ,
IMPROVEMENTSR.O.W. INDUSTRIAL WASTE
SEWER CONNECTION DRIVEWAY^ LOCATIONS_
GRADING PERMIT na EASEMENTS
LEGAL DESCRIPTION
DRAINAGE Ajl
ADDITIONAL COMMENTS
OK TO ISSUE: DATE PWI OK TO FINAL DATE
FIRE DEPARTMENT
SPRINKLING SYSTEM
FIRE ALARMS
FIRE HYDRANTS
ADDITIONAL COMMENTS
_FIRE PROTECTION EQUIP.
EXITS
LOCATION
OK TO ISSUE:DATE OK TO FINAL DATE
.WATER DEPARTMENT "
REQUIREMENTS OF APPROPRIATE DISTRICTS MET_DATE