HomeMy WebLinkAbout1236 LAGUNA DR; ; 84-142; Permitr1[ 0 I hereby affirm that I am licensed under
prOYlalona of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Profeaalons Code, and my license is In
full force and effect. lie No ______ Class
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I hereby affirm that I am exempt lrom the Cootrac• tor's License Law lor lhe fOllowlng reason {Sec 7031 5
Business and ProfesSJOns Code Any city or county whtth r~
quires a permll to construe!, aJler, improve. demohsh, or repair any Slructure. prior to ,ts issuance atso requires !heap-
phcant for such perm,t to file a signed statement that he 1s hcensed pursuanl to the prov,sklfls of the Con1rac1or· s License Law (Chapter 9 commencing with Sect,on 7000 of
Dtv1S-1on 3 of !he Busmess and Professions Code) or that is ex-empt lherefrom and the basis for the allegeo exemption Any VIOia iion of Sect,on 703 U by an applocant l0< a permit sub-
1ects the applicant to a civtl penalty ot not more lhan t1ve hun-
dred dollars ($500).
□ I, as owner of lhe property. or my employees with wages
as lhe,r sole compensation, will do the work, and the struc-lure is not intended or offered !Of sale (Sec 704'4. Business
and Professions Code: The Contractor's Ucense Law does nol apply to an owner of property who builds or improves
!hereon and who does such work hunsett or through his own
employees, provided that such improvements are not inlend-ed or offered for saie. II, however. the bui\ding or improve-
ment fs sold witl'lin one year o1 completion, the o-.vner bUilder
will have lhe burden ol provmg that he did not build or im-
prove l0< lhe pucpose ol sale).
D I. as owner of the property, am exclusively contracting
with licensed contractors to construct the project (Sec. 70.U ,
Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds 0< im-proves thereon, and who contracts tor each projec.ts with a conlractor{s) license pursuant to the Contractor's License Law).
!,As a homeowner I am improving my home, and lhe lollow· conditions exist:
1. The work is being performed prior 10 sale. 2. I have lived in my home 10< lwffie months
prior to comptetion of this work.
3. I have not claimed this exemption during the last three years.
D I am exempt under Sec. ______ , B & P.C.
for this reason
0 I hereby affirm that I ha.-e a cert1t1ca1e of consent to self-insure, or a cert1f1ca1e ol Workers·
Compensation Insurance. or a cert1t1ed copy thereof
(Sec 3800. Labo< Code)
POLICY NO
COMPANY
□ Copy IS filed with the city
0 Cer11!1ed copy ,s hereby tum1shed
CERTJFICATl OF EXEMPTION FROM
~
AKERS· COMPENSATION INSURANCE
section need nol be completed ,, the permit '°' one hundred dollars (S 1001 or less)
rt1ty that 1n lhe performance ot the work to,
which th,s permit 1s issued. I shall not employ any
person in any mainner so as to become sub1ect 10
lhe Wor1ters· Compensation Laws ot Cahtorn,a
NOTICE TO APPLICANT II. atte, makin1 ttus Cer11
hcate ot E:cempt,on, you should become sut>1ec1 t,:, lhe WOf'kers· Compensation prov,st0ns of the Laoor
Code, you must torth._.1th comply w,1h sucn
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sions o, this permit shall be deeme<J revoked ~-
hereby attirm thal there 1s a con~uuctton
lending agency tor the pertormance ot lhe won.. 10,
which lh1s permit ,s issued tSec 3097 c,..,11 Code1
Lenders Name ___________ _
Lende(s Address __________ _
USE BALL POINT PEN ONLY & PRESS HARD ----~. APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
CARLSBAD BUILDING DEPARTMENT ' APPLICATION & PERMIT 1200 Elm, Carlsbad, California 92008-1989 (619) 438-5525
JOB AOORESS LMVNA AV. ST RO. NEAREST CROSS ST. I ;T,E ,s:a+ONI
BUSINESS LICENSE It VALUATION t-PERMIT NUMBER It¾ f 14-z LOT I BLOCK J sueo,v1s10N I A.!5l2~cf~
04--5"b CONTRACTOR CONTRACTORS PHONE • ZONE
O\Aflt:::'.P OWNE R·s NAME l1vf:u10E Jo'f \/{)l'"'J\_.L.. CONTRACTOFf'S AObRESS LICENSE NOc PLAN 1.0 . # BLOG USE COOE
-J;;J.Jq O>'l"'<ER'S MA•L•NG ADDRESS --l
~ DESIGNER LIClcNSE • STANDARD PLAN # BUILDING SO. FOOTAGE
OESCRIPT•ON OF WORII;
DESIGNER'S ADDRESS DESIGNER'S PHONE
~_NaN ~~ fi¥!WL-:&-i,/ lblbwc,;;,.,:i::, • -F/P FLA ELEV. NO OCC GP EDU OUU'l 6520 ,.Jl~l ,_i. " STORIES •
vO NO --.,
CENSUS TRACT I GP LAND USE I PARK ING SPACE RES UNITS I GRADING PERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRE SPA AREA CONST .,
YO ND vO NO vO NO Nor Valid Unlt!Ss Machine Cerrifi«J
QTY. PLUMBING PERMIT · ISSUE ?fl!.-QTY. MECHANICAL PERMIT· ISSUE s-SUMMAR~ACCOUNTNUMBER
EACH FIXTURE TRAP , INSTALL FURN. DUCTS iJP TO 100.000 BTU BUILDING PERMIT 01 ·00·00·8220
EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT 01 ·00·00·8221
EACH WATER HEATER ANO/OR VENT BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01 ·00·00·8806
EACH GAS SYSTEM l TO 4 OUTLETS 80 I LEA /COMPRESSOR 3-15 HP TOTAL PLUMBING 01 ·00·00-8222
EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE ELECTRICAL 01 ·00·00·8223 '/ .D .CJO
EACH INSTA~ .. ALI ER, REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01 ·00·00·8224
EACH VACUUM BREAKER MECH EXHAUST -HOOO/OUCTS MOBILEHOME 01 ·00·00·8225
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP
EACH ROOF DRAIN (INSIDE) SOLAR Ot ·OO·OO•R??J:;
TOTJ;L MECHANICAL STRONG MOTION 80·92·33·0519
TOTAL PLUMBING I FIRE SPRINKLERS 01 ·00·00·8227
5'° .--' QTY. SOLAR • ISSUE PUBLIC FACILITIES FEE 32·00·00·8933 QTY. ELECTRICAL PERMIT . ISSUE
BRIDGE FEE
NEW CONST EA AMP/SWT 1BK R COLLECTORS SCHOOL FEE · DISTRICT
1 PH 3 PH STORAGE TANKS Carlsbad 80·92·21·0519
EXIST SLOG EA AMP/SWT/BKR ROCK STORAGE Encinitas 80·92· 22·0519
1 PH 3 PH PUMP San Dieguito 80·92·23·0519 '7 REMOOE L'ALHR PE R CIRCUIT ,.~ -~ PLAN CHECK FEE San Marcos 80·92· 24·0519
TEMP POLE 200 AMPS
OVER 200 AMPS LICENSE TAX 01-00-CJ0.8162 )
TEMP OCC UPANCY 130 DAYS> ~p-,:::;. I
CREDIT DEPOSiT
TOTAL ELECTRICAL
I '20-TOTAL SOLAR TOTAL FEES PAYABLE I ~,_oo
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT"' AND 00 HEREBY · Exporalion Every permtt lSSUed bytlMIBuddtngOlfic1atun-thepro"'s,onsol1t1',s· .0, * AN OSHA PERMIT IS RE0UND FOR EXCAVATIONS OVER CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code lhall expire by hmilabon and become null and •Old II the budd,og Of work S' 0-' DEEP ANO 0£MOUTION OR CONSTFIUCTIOH Of DECLARATIONS ARE TRUE ANO CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS authorized by such permit 11 not commenced wilhon 180 da~ the date <>f such STRUCl\lllES OYER 3 STORIES IN HIEIGHT permit, or 11 the bulld•~r woq, autl>Orozed by tuch per 1s suspended or ISSUED TO COMPLY WITH ALL CITY COUNTY ANO STATE LAWS GOVERNING BUILDING CON-■ban-...., al any bme a t~ 1s commenced for a noc:I ol 180 ,.•~•
STRUCTION. WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND ~ , I~ ii:"i 0 1 VE;:~l+ /Z:~~5,Sf KEEP HAflMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS. COSTS ANO I NT S SI N URE OWN O CONTRACTOR
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE BY PHONE Q
GRANTING OF THIS PERMIT. .,.. ' •
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TYPE I DATE INSPECTOR
BUILDING I .
FOUNDATION I
I I
. .. ....
' 8~--,4':). -:r
FIELD INSPECTION RECORD ,
REINFORCED STEEL I
MASONRY
I .
I
GUNITE OR GROUT !
REQUIRED SPEC IAL INSPECTIONS ~ .,,. . INSPECTOR.S.fl!OTES
REO IF INSPECTOR'S ~
INSPECTION CHECKED APPROVAL DATE ~ ....
FLOOR & CEILING SUB FRAME I SOILS COMPLIANCE ...... '"' 't, \-.
SHEATHING D ROOF D SHEAR
FRAME I
I
EXTERIOR LATH I
PRIOR TO
FOUNDATION INSP r
STRUCTURAL CONCRETE
OVER 2000 PSI
INSULATION I
INTERIOR LATH & DRYWALL I
I
PRES TRESSED
CONCRETE
POST TENSIONED ,, CONCRETE .
!
PLUMBING I FIELD WELDING t •
SEWER AND BUCO D IPUCO I ! •
UNDERGROUND D WASTE D WATER
.,
HIGH STRENGTH •
BOLTS , -
TOP OUT D WASTE D W4TER SPECIAL MASONRY
TUB AND SHOWER PAN I
'
GAS TEST I PILES CAISSONS ' ..
D WATER HEATER D SOLAR WAtER
I
ELECTRICAL J ', .. --
D ELECTRIC UNDERGROUND D i;IFFER .. "
ROUGH ELECTRIC I
D ELECTRIC SERVICE D TEMPOfi!ARY
D BONDING D POOL I
I -~
I ---
I
MECHANICAL I ..
D DUCT & PLEM., D REF. PIPING -
HEAT -AIR COND. SYSTEMS I , I ..
VENTILATING SYSTEMS I • f ' ◄•--1 ( c • I, _-....
I
. ' ' I " ,
I
CALL FOR FINAL /NSPECTIC!JN WHEN ALL APPROPRIATE
ITEMS ABOVE HA VE! BEEN APPROVED. ______ _
FINAL
PLUMBING
0 -
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' 5 '
ELECTRICAL
MECHANICAL
GAS
BUILDING
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-SPECIAL CONDITIONS