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Home My WebLink About1301 FOREST AVE; ; 80-928; Permit~ LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provl· s ons of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profes· stons Code, and my license is In full force and el· feet. OWNER-BUILDER DECLARATION D I 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 provl· slons of the Contractor's License Law (Chapter 9 commencing with Section 7000 of Division 3 of the Business and Professions Code) or that ls ex· empt therefrom and the basis for the alleged ex- emption. Any violation of Section 7031.5 by an ap· pllcant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). D 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· slons 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 of sale). '.JI, 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 ,,..., hereby affirm that I have a certificate of con· sent to self-Insure, o• a certificate of Workers'. Compensation Insurance, or a certified copy thereof (Sec. 3800, L~~ Code). i') POLICY NO. r~ 'le , \,..~ (). 31 C9MPANY ' \1 'jl(copy Is filed with the city. ·o Certified copy Is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed If the per· mil Is for one hundred dollars ($100) or less). I certify that In the performance of the work for which this permit Is Issued, 1 shall not employ any person In any manner so as to become subject to the Workers· Compensation Laws of California. NOTICE TO APPLICANT: II, after making this Cer· tlflcate 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 thel'll ls a construction ten· Alnn •nonrv fnr thA nArfnrmRnr.A of the WOrk for CITY OF CARLSBAD-BUILDING DEPARTMENT APPLICATION & PERMIT USE BALL POINT PEN ONLY 1200 ELM AVENUE (714) 438-5525 NO, JOB ADDRESS ~\r· 1D,i ~;?;~ION , , ~11>, 1 , ,l=i n tP,cS:~1r1 1./J.i tf I I I I I I I t _J_ V-1 I I I I I OWNER ~H~~ PRIME CONTRACTOR .\A-mes i W1;..J,v,.J /ll ."'5'/J u T/-li!:IX.. ~/i) _\r .. 1,.~ie"-~N.Sr. OWNER'S MAILING ADDRESS V "> c;;,0CTOR~A~R;~,_, (.Al2L5 < ~IH»e- BLOCK DESIGNER APPLICANT TO FILL IN INFOR- MATION WITHIN RED LINES. llUS. LICENSE PERMIT NUMBER !9"Jc z. f5o., 9-v1 STATE LICENSE -_,. CONTRACTOR'S) '"72E9-t1 F3¥' : t /.:. I ,,·.;r,, L2/ I SUBDIVISION I ASSESSOR'S PARCEL NO. I 1.!>7,1-1 / I J t11,-1AC'} I I ~ LICENSE ) cri----.r p. w • , · I:.'"/ : ,. • . .,. DESCRIPTION Of" WORK PA.rd, t.J I t:rNr/"'CJ,r?€ ,D , 'i A, /SXf7 L at.'I' >.. DESIGNER'S ADDRESS DESIGNER'S PHONE 4-x. 7 ,~n, ,J ,,. /-IN? fHMJ(s.-~~~ 'S-r.i:= r:J;lYJ±· I .,, ·1 --~ -·-~ ~Fu!t',) ~/14--. ZONING I RES. UNITS I PARKING SPACE I NUMBER Of" STORIES Not V1/id Unlest MlchiM Clrtifild ~S~f"T, 1, BLDG~ occ. GP I STANDARD PLAN# I~;;:.:~ iY I TYPE CONST I occ. LOAD I --VS'.> --t""" , D '-' ClTY. ..... 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 ANO/OR VENT BOILER/COMPRESSOR UP TO 3 HP EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP -EACH GAS SYSTEM 5 OR MORE BOILER/COMPRESSOR 16·30 HP ,~, EACH INSTAL, ALTER, REPAIR WATER PIPE VENT FAN Sl~!GLE DUCT EACH LAWN SPRINKLER SYSTEM MECH EXHAUST -HOOD/DUCTS //" /J~. ,,,. r ~-,-L, /~~ -' WATER SOFTNER RELOCATION OF EA FURNACE/HEATER BUILOIN"-.. ---r-... 1 / 1?:-1>1 () ~ _/ .J -I•_. .J , :j' C& ., .JI! --.I~ ~ --i.5 (J (I Sl"GN PER'l/'T / /-/ 2-I ' 1'.I I TOTAL PLUMBING TOTAL MECHANICAL PLAN CHfcKJ'/. /,r/-fJ 7F /b/CJ.:5' I vi h.Iio . CONTRACTOR CONTRACTOR ALL INCL~ERMIT , t..---" I I I ELECTRICAL PERMIT AMT. TOTAL PLUMBING I I I QTY. AMT. QTY. MOBILE HOME PERMIT ELECTRICAL I r-7.~D NEW CONST EA AMP/SWT/BKR AWNING MECHANICAL 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 ,,,-r.. ..... -/YI µ A-,../ I . I I TJt7 REMOOEUALTER PER CIRCUIT J . .,,-FENCE OVER 6' /7 I . I I ( TEMP POLE 200 AMPS TOTAL MOBILE HOME MICO-FILM l ' I I I OVER 200 AMPS --. /'\ .,.., I . I ,I ; I TEMP OCCUPANCY (30 DAYS) C /1~, • .,.-rL Kl>.t..l. I . If V r)V\ I A' .J.A1,4-.1-.tJ 0 IJ I . 1 'i I .. TOTAL ELECTRICAL 7~ TOTAL FEES PAYABLE I ii 4.fii CONTRACTOR . I I . L~,,-R'~ ' , ... __ , __ - I HAVE CAAEFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT, AND DO "AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER"\./ HEREBY CERTIFY THAT ALL INFOAMATION HEREON IS TRUE AND CORRECT AND I 5'·0" DEEP ANO DEMOLITION OR CONSTRUCTION OF FURTHER CERTIFY ANO AGREE IF A PE AMIT IS ISSUED; TO COMPLY WITH ALL CITY, STRUCTURES OVER 3 STORIES IN HEIGHT COUNTY ANO STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY ANO KEEP HARM- LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO II} I EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE ' OF THE GRANTING OF THIS PERMIT. ~M;~1-OWNERO CONTRACTORO t:D.OVEO BY ~t'?j/,. rJ . AGENI.lit" BY PHONE O rA J ~• f 1 I . - ! < 0 ~ ~ ;:: ~ Q. V) ~ SITE 80-'1 ADDRESS: OWNER: PERMIT NO: FIELD INSPECTION RECORD INSPECTION DATE INSPECTOR INSPECTOR'S NOTES I WOOD FLOOR FOUNDATION• FORMS• SET BACK• TOILET UNDER FLOOR PLUMBING UNDER FLOOR HEATING OK TO INSTALL SUB FLOOR ' SLAB FLOOR UNDER SLAB PLUMBING FOOTING o 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 I FIREPLACE DAMPE;:R &STEEL PLATE Tl ES/HEIGHT OF CHIMNEY OTHER TEMP POWER (POLE) SEWER GAS TEST SWIM POOL• STEEL BONDING ·• .PRE DECK • FENCE PREPLASTER SHOWN • FRAME ~ • PAN / J . FINAL INSP BY BLDG DEPT ~v-; / r/J OTHER DEPT'S REQ COMPLETED -v,1n (/tf?V1_ ELEC. METER-PERM-TEMP I /f/ I ' (J GAS METER-PERM-TEMP ' i ~--~ >--~~~~~~--~~~--~~~~~~~~--~~~.~~~~~~~~~~~~~~~--~~~~~~---1 ______ J INTERDEPARTMENTAL INFORMATION SHEET • • I! • • BUILDING DEPARTMENT BUILDING ADDRESS: NDV12 J980 PLANNING DEPARTMENT Parfrnent ZONE LOT SIZE LOT WIDTH -~-----------~-------------- UNITS ALLOWED UNITS PROVIDED -------------------------- PARKING SPACES REQUIRED PROVIDED ------------% COVERAGE ALLOWED PROVIDED --------------~ -----------. BUILDING HEIGHT ALLOWED PROVIDED ------------- FRONT SETBACK: SIDE SETBACK: REAR SETBACK: A'LLOWED ------- P'ROVIDED ------- INTRUSIONS ' LANDSCAPE & IRRIGATION PLAN COMMENTS: ENVIRONMENTAL PROTECTION REQ: ENGINEERING DEPARTMENT ...a-~-tfT• R.o.w. INDUSTRIAL WASTE ______ IMPROVEMENTS _______ ~ I SEWER CONNECTION _/!£,..,'i).._t,_J _____ DRIVEWAY LOCATIONS ___________ _ GRADING PERMIT EASEMENTS DRAINAGE --------------------- LEGAL DESCRIPTION ~ ,/.£~ -//d -() J 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 _______ _ '