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Home My WebLink About1301 Pine Ave; ; 80-90; PermitLICENSED CONTRACTOR'S DECLARATION 1 hereby affirm that I am licensed under provi- sions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Prates. sions Code, and my license is in full force and ef. feet. OWNER·BUILDER DECLARATION := 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 lile 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). L'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·buitder will have the burden of proving that he did not build or improve for the purpose of sale). ~\. as owner of the property, am exclusively con· tracting with licensed contractors to construct the project (Sec. 7044, Business e.nd Prolessions 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. lorth1sreason _______ _ Date ______ Owner ______ _ WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of con- sent to self.insure, or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Labor Code) POLICY NO. _____________ _ COMPANY C..:Copy is filed with the city :.JCertified copy is hereby furnished CERTIFICATE OF EXEMPTION FROM WORKERS" COMPENSATION INSURANCE (Tliis section need not be completed if tile per- mit is for one hundred dollars ($100) or less). l certify tliat in the performance of the work for which tl11s permit is issued, I sliall not employ any person in any manner so as to become subject to the Workers',Compensation Laws of California. NOTICE TO APPLICANT: \f, after mak.ing this Ger· tificate of Exemption, you stiould become subject to tile Workers' Compensation provisions of tile Labor Code, yr•1 must forthwith comply with such provisions ort~s permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction len· · ------••"~,.,,.,,le fnr CITY OF CARLSBAD-BUILDING DEPARTMENT USE BALL POINT PEN ONLY APPLICATION & PERMIT 1200 ELM AVENUE (714) 438-5525 '/,?./?, /, I I j), /,M~. , I JOB ADDRESS .Iii' r:a. , I , , 7 J ' I ' ' ' ' ;VR~T • J~E :t}P~LIATDt OWNER (?,S: L /~ r:JCit?11 110WNER'S PHONE PRIME co~_:OR(~ , ' , ' OW'E~M0lN\ ADDvJ ~~ ,I _,; CONTRACTOR'S ADDRESS ( ' ---- '" BLOCK I SUBOIVISION ASSESSOR'S PARCEL NO. DESIGNER ' I ' I I ' I I ' I --- OESCR 711.lOF w_o:, v-·-, , ( ' . -( ·t -../ DESIGNER'S ADDRESS r , ' ~ CENSUS TRACT GP LANO USE SPACE Sq• APPLICANT TO FILL IN INFOR - MATION WITHIN RED LINES. BUS. L lCENSE PERMIT NUMBER 1" ~o-90 STA~ LICENSE -~~~(J 7 S~ ATE LICENSE DESIGNER'S PHONE - ZONI? \ I RES. UNITS I P:RXI NG IruMBER OF STORIES Not Vah'd Unless MachitllJ C.rtifi«J BLOG 2·3FZiV BLOG USE acc. GP ST AND ARD PLAN-# !PLAN ID-# I TYPE CONST I occ. LOAD I QTY_ PLUMBING PERMIT AMT. QTY. MECHANICAL PERMIT AMT. t\_ J:_ ,L EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100,000 BTU EACH BUI LO ING SEWER OVER 100,000 BTU EACH WATER HEATER AND/OR VENT BOILER/COMPRESSOR UPTO 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 StNGLE DUCT VALUATION {/;1g4~ EACH LAWN SPRINKLER SYSTEM MECH EXHAUST -HOOD/DUCTS WATER SOFTNER RELOCATION OF EA FURNACE/HEATER BUILDING PERMIT ' 1 /1 t/: 1 ' I .c; !=: THC' ,_ nr T .c;c:rm <·"" SIGN PERMIT I ' ', I , TOTAL PLUMBING TOTAL MECHANICAL PLAN CHECK I I 17. "'i ' CONTRACTOR CONTRACTOR All INCLUSIVE PERMIT I I ELECTRICAL PERMIT AMT. AMT. TOT Al PLUMBING I I QTY. QTY_ MOBILE HOME PERMIT ELECTRICAL I I NEW CONST EA AMP/SWT/BKR AWNING MECHANICAL I I I \ PH .25 3 PH PORCH MOBILE HOME I I I EXIST BLOG EA AMP/SWT/BKR SET-UP SOLAR I I I I \ 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 M1CO-FILM I I I I OVER 200 AMPS I I I I TEMP OCCUPANCY (30 DAYS) J I I ISSUE 2 .• 00 ISSUE I I I I TOTAL ELECTRICAL TOTAL FEES PAYABLE I av.'!:f-CONTRACTOR I I , I HAVE CAREFULLY EXAMINED THE COMPLETED "'APPLICATION AND PERMIT, ANO DO "AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE ANO CORRECT AND I 5·.o" DEEP AND OEMOL!T!ON OR CONSTRUCTION OF SCHOOL FEES FUR1"HER CERTIFY AND AGREE IF A PERMIT IS \$SUED; TO COMPLY WITH ALL CITY, STRUCTURES OVER 3STORIES IN HEIGHT COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY ANO KEEP HARM LESS THE CITY OF CA AL. SBA O AGAINST ALL LIAS ILITIES, JUDGMENTS. COSTS ANO -~ EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT A~ATUr l . ',;?ff OWNE~ coNTRACTORD IAPPA1}o BY DATE / · '·fl I/ ,n' , · AGENT 0 BY PHONED ·,~A :)-~rvO V V <I I SITE 1 ADDRESS OWNER: PERMIT NO: '60 -qu ' FIELD INSPECTION RECORD INSPECTION DATE INSPECTOR INSPECTOR'S NOTES WOOD FLOOR - FOUNDATION• FORMS• SET BACK • TOILET 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• P_LACE T "1PE EXT~RIOR LATH OK• PLACE STUCCO FIREPLACE DAMPER 8: STEEL PLATE TIES/HEIGHT OF CHIMNEY OTHER TEMP POWER (POLE) ~ SEWER I GAS TEST SWIM POOL• STEEL BONDI NG i . PRE DECK ! . FENCE PREPLASTER i ~OWN . FRAME • PAN ' j F!NA.L !NSP BY BLDG DEPT ; -~ OTHER.,bEPT,•s_ REQ COMPLETED 3/d'7fl -. _, ; ---- j E:.LEC METER-PERM-TEMP / 'c3AS .'-"'.~TER-PERM-TEMP L I f -l CERT OF OCCUPANCY ISSUED •---· ------- ~~ 12};;,,-..}-,r1 I '!k# INTERDEPARTMEN')'.'AL INFORMATION "'' SHEET RECEIVED • BUILDING DEPARTMENT BUILDING ADDRESS: PLANNING DEPARTMENT ZONE £-( DATE: _______ _ FEe-4 1980 UNITS ALLOWED ___________ UNITS PROVIDED ___________ _ PARKING SPACES REQUIRED PROVIDED __________ _ % COVERAGE ALLOWED ____________ PROVIDED---------- BUILDING HEIGHT ALLOWED PROVIDED---------- FRONT SETBACK: ALLOWED ?C( PROVIDED "7L:f INTRUSIONS ----- SIDE SETBACK: 'iS.s' REAR SETBACK: 11" LANDSCAPE & IRRIGATION PLAN COMMENTS:---------------- ENVIRONMENTAL PROTECTION REQ: ~re- ADDITIONAL COMMENTS: oK To IssuE:F DATE ztYIID oK To FINAL _______ DATE, ___ _ .::E..:;N..::G..::I.:.:N.:.E.:.E.::R.:.I::.NG.::_D::.;E::.;P:..:A::.:R'°'T:.:M.::E:.:N:..:.T ;P;iJ Ctr~bC R. 0. W . _____ INDUSTRIAl! WASTE IMPROVEMENTS, ______ _ SEWER CONNECTION _______ DRIVEWAY LOCATIONS ___________ _ GRADING PERMIT EASEMENTS _________ DRAINAGE. ____ _ LEGAL DESCRIPTION-----------------------------,. ADDITIONAL COMMENTS'--------------------------~ OK TO ISSUE: m DATE d-"tf.-~ PW,( ____ OK TO FINAL, ____ DATE, ___ _ ' r' 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 _______ _ 8o-8Y