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HomeMy WebLinkAbout1232 PINE AVE; ; 84-520; Permitqr «o z o h- 3 u iU o I h«r«by afflrrri that 1 am llcanaad utvder provlalona of Chapter 9 (commencing with Section 7000). of. D Mel or 3 of the Business and Profeeslont Code, and my iicersa Is In full force and effect. be No. Class 1 hafsby afflm that i am o(empt from tria Corrtrac- tor's Uceoss Law lor ttis tolowing rvason (S«c. 7031.5 Busmra and ProfBssloos CoctB Any city or county which re quires a pemri to construct, after, improve, demolish, or repair any structure, pnor to tts issuance atso requires the ip-pticam for such permtt to tile a signed statement (hat he is hcensad pursuant .to tht provfsions of ttw Contractor's-License Law (Chapter 9 commendrg with Section 7000 dDrvftjon 3 o( the Busmess and Professnns Code) or that is ex empt therefrom and the bass for the alleged exemption AnyvwiatDn of Sector 7031,5 by an applicant for a perrmt sub-—^ 'he apptcant to a ctvi!'penalty of not more than five hun- '-'lars.fJSOO).: . as owne'r of the property, or my employees with wages r sole compensation, will do the work, and the struc- ' not Intended or offered tor sate (Sec 7044. Business - and Professfons Code: The Contractor's Lxense Law does- not apply to an owner of property who builds x-improvesthereon and who does such work hlmaeff or through ha own employees, prtwided that such fTTprovements are noi Intend ed Of offered for sate if, however, the biutdmg or imphwe- • menMs sold vntfwi one year of compfetion, the owner-buider wl have the burden of proving that he did riot budd or sn- pTwe for the purpose of..sate). □ I, as wmer of the property, am occhisfvefy contractingwtthbcensedcontractore to construct the prQ)ect (Sec 7044,Busmess and Professtons Code. The Contractor's bcenaeLaw does not apply to an owner ol property who bufds or Im-prcwes thereon, and who contracts tor each projects wdh agritr^r(s) license pursuant'to the Contractor's bcense □" As a homeowner I am'improving my home, and the foflow-ing coTKfetions exist- , . ^ ' .,1. The work IS being performed prior to safe.'2. I have lived In my home for- twefve months•pnor to compWibh of IhB work". • •3 I have not clanted ties axempbon duniig thelost three yeare. ->RAPf:□ I am exempt cmdar Sec..«for tlw.raason n I hereby affirm that I have a certificate of consentto self-insure,■ or a~ certificate ol Workers' .Compensation Insurance, or a certified copy thereof. (Sec. 3800, Labor Code) •POUCYNC' ■ '• COMPANY • ' Q Copy ts filed with the city □ Certified copy is hereby furnished' CCRTIFiCATL OF-EXEMPTKDN FROM WORKERS' COMPENSATION INSURANCE(This section'r^eed rwt be completed if the permitcs for one hundred dclLars (StOO) or less) • ^ I certify ttnat in the performance of the work lorwhich this permit is issued, I shall rx)1 employ arty • person in arry manner so as to become subfect tothe Workers' Compensation Laws of California NOTICE TO APPLICANT If. after making this Certilicate of Exemption, you should becorrte subiect to. the Workers' CompensatKXi provisiortt of the LaborCode, you rmjst forthwith comply with suchprovisions or this permit shall be deemed revoked Q-|.hereby affirm that ihere is a construction.l#r>jtr9 agency 'or the pertormancc of the work (or.v^ich this permit is issued (Sec 3097, Civil Code). LerxJer s Name ^ Leniper's Address . USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. ^ - ^ ^ CARLSBAD BUILDING DEPARTMENT1200 Elm, Carlsbad, Calltomla 92008-1989-(619) 438-5525 APPUCATION & PERMIT JOB ADDRESS— AV.ST.RD. NEAREST CROSS ST.1^5^' 'pine fi ve. eim SUBDIVISION ASSESSOR PARCEL NO. OWNER'S NAME Kr'is -Shiil<v OWNER'S PHONE OWNER'S MAILING ADDRESS DESCRIPTION OF WORK'pnvck. fjQ .3* cAi-^ -rtwrr QoiAergd Ljo'ifk CENSUS TRACT QTY. GP LAND USE .PARKING SPACE PLUMBING PERMIT - ISSUE EACH FIXTURETRAP EACH BUILDING SEWER EACH WATER HEATER AND/OR VENT E-ACH GAS SYSTEM 1 TO H OUTLETS EACH GAS SYSTEM.5 OR MORE . EACH INSTAl. , ALTER, REPAIR WATER PIPE EACH VACUUM BREAKER Water softneR' EACH ROOF DRAIN (INSIDE) TOTAL PLUMBING QTY. CONTRACTOR DATE 06 APPUCATION■?BUSINESS LICENSE # CONTRACTOR'S ADDRESS DESIGNER'S ADDRESS F/P FLR ELEV. yQ N\J GRADING PERMIT ISSUED Y □ N □ ELECTRICAL PERMIT - ISSUE . NEW CONST EA AMP/SWT/BKR I PH 3 PH EXIST BLDG EA AMP/SWT/BKR 1 PH 3 PH •REMODEL/ALTER PER CIRCUIT TEMP POLE 200 AMPS OVER 200 AMPS TEMP OCCUPANCY 130 DAYS) TOTAL ELECTRICAL QTY. REDEVELOPMENT AREA yD nD MECHANICAL PERMIT - ISSUE INSTALL TURN. DUCTS UP TO 100,000 BTU .OVER 100,000 BTU BOILER/COMPRESSOR UP TO 3 HP BOILER/COMPRESSOR 3-15 HP 'METAL FIREPLACE VENT FAN SINGLE DUCT MECH EXHAUST - HOOD/OUCTS RELOCATION OF EA FURNACE/HEATER TOTAL MECHANICAL QTY. NO STORIES TYPE CONST CONTRACTORS PHONE# , UCENSe NO. LICENSE 9 DESIGNER'S PHONE FIRE SPR yQ nO VALUATION ZONE \ PLAN l.D. # STANDARD PLAN # PERMIT NUMBER BLDG USE CODE BUILXHNG SO. FOOTAGE 9/JQ/BwaatjDuqi'daBS—y/iB/BH Not VoBd UntBS Mtchint Cirtifiod 'Ml 3-—SUMMARY/ACCOUNT NUMBER BUILDING PERMIT 01-00-00-8220 SIGN PERMIT 01-00-00-8221 PUN CHECK 01-00-00-8806 SOLAR - ISSUE COLLECTORS STORAGE TANKS ROCK STORAGE. PUMP PUN CHECK FEE TOTAL SOUR I HAVE CAREFULLY EXAMINED THE COMPLETED -APPLICATION AND PERMIT" AND DO HEREBY CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE DECURATIONS ARE TRUE AND CORRECT AND !■ FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED YO COMPLY WITH ALL CITY. COUNTY AND STATE LAWS GOVERNING BUILDING CON STRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY ANDKEEP HARMLESS THE Cip/ OF CARLSBAD AGAINST ALL UABILITIES, JUDGMENTS, COSTS ANDEXPENSES WHICh'mAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. TOTAL PLUMBING 01-00-00-8222 ELECTRICAL 01-00-00-8223 MECHANICAL 01-00-00-8224 MOBILEHOME 01-00-00-8225 MOBILEHOME PARK INSP . SOUR 01-00-00-8226 STRONG MOTION 80-92-33-0519 FIRE SPRINKLERS 01-00-00-8227 PUBLIC FACILITIES FEE 32-00-00-8930 • BRIDGE FEE SCHOOL FEE - DISTRICT Carlsbad 80-92-21-0519 Encinttas 80-92-22-0519 San Oieguito , 80-92-23-0519 San Marcos 80-92-24-0519 UCENSE TAX 01-00-00-8162 MFF 80-92-57-0519 CREDIT DEFKJSIT TOTAL FEES PAYABLE Expirahon. Every permit raaued by the Bui1du>g Official under the provfaionsof thiaCod© ahaJI expire by Ifmitation arid become null and void. If the bmWing or workauthofiied by auch permjt is not commenced within 100 days from the date of .suchpermit, or if the buddiiip or work authorized by' such permit is ausponded orabanctoned at any time after the work ts commefK^ for a period of 180 davs TS SI OWNER CONTRACTOR □ BY PHONE n * AN OSHA PERMrr 18 REQUmEO FOR EXCAVATIONS OVER 5' 0" DEEP AND DEM0UT10N OR CONSTROCDON Of . STRUCTURES OVER 3 STORIES IN HEIGHT • APPROVI TYPE f DATE INSPECTOR BUILDING i « FOUNDATION ' R^iNForced STEEL 1 -VI MASONRY 1 GUNITE OR GROUT i FLOOR & CEILING SUB FRAME | SHEATHING □ ROOF □ SHEARFRAME - 1 EXTERIOR LATH IINSULATION [ INTERIOR LATH & DRYWALL i - 1 PLUMBING i SEWER AND BUCO □IPL/CO ' UNDERGROUND □ WASTE □ WATERTOP OUT □ WASTE □ W/|kTER TUB AND SHOWER PAN iGAS TEST ] □ WATER HEATER □ SOLAR WATER 1 I ELECTRICAL i□ ELECTRIC UNDERGROUND □ IjlFFER ROUGH ELECTRIC , □ ELECTRIC SERVICE □ TEMP0F|1ARY □ BONDING □ POOL i 1 MECHANICAL i □ DUCT & PLEM., □ REF. PIPING HEAT — AIR COND. SYSTEMS , VENTILATING SYSTEMS |. "• i 1 > , ^ . CALL FOR FINAL INSPECn ITEMS ABOVE HAV, WHEN ALL APPROPRIATE FINAL 1 PLUMBING 1 ELECTRICAL MECHANICAL ' GAS I BUILDING ' SPECIAL CONDITIONS 1 FIELD INSPECTION RECORD REQUIRED SPECIAL INSPECTIONS - INSPECTOR'S NOTES INSPECTION REG IF CHECKED INSPECTOR'S APPROVAL DATE SOILS COMPLIANCE PRIOR TO FOUNDATION INSP STRUCTURAL CONCRETE OVER 2000 PSI PRESTRESSED CONCRETE POST TENSIONED CONCRETE FIELD WELDING HIGH STRENGTH BOLTS SPECIAL MASONRY PILES CAISSONS 3 - \ ■ PLAN CHECK NUMBER PLANNING:TYPE OF STR SCHOOL FEES: SA % COVERAGE_ BUILDING HEIGHT FENCES/WALLS N DIEGUITO // ARLSBAD TWO CAR GARAGE COMMENTS: <oc. a CO z o Q u ac. a: o- O LU oe I I REDEVELOPMENT Afl !□ _ I I LANDSCAPE PLAN (JpMMENTS PROVAL ENVIRONMENTAL RE ADDITIONAL COMME OK TO ISSUE: DATE: ^<%^>>^0K TO FINAL: ENGINEERING a: (x a toz o•-< Qh- UJo ex LUoc =3 O LU O CX □ □ □ LATERAL: GRADING PERMIT: DRAINAGE: EASEMENTS: OK TO ISSUE: ENGINEERING INSP PUBLIC WORKS INS FINAL OK: JCTURE ADDRESS ZONBu-^ 1 8 md ENCINI TAS^^(n^jj£j-^aL3^ SAN MARCOS REQUIRED SETBACKS FRONT_ SIDE_ REAR REQUIRED: QUIRED: VTS: DATE: LEGAL DESCRIPTION VERIFIED?, PARK IN LIEU IMPROVEMENTS: a.p.n. checked?. P.F.F. R.O.N: SEWER DRIVEWAY: ADDITIONAL COMMENTS: IF THIS ITEM IS (driveways, CURB DATE: CTION REQUIRED: ECTOR: DATE: OT CHECKED, BUILDING DEPARTMENT WILL MAKE ALL INSPECTIONS CUT, DRAINAGE, ETC.)