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HomeMy WebLinkAbout1352 Magnolia Ave; ; 80-469; PermitLICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provi- sions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profes- sions Code, and my license is in full force and el• feet. OWNER-BUILDER DECLARATION Ol 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 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 live 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-builder will have the burden of proving that he did not build or improve for the purpose of sale}. =.1, 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 I hereby affirm that I have a certificate of con- sent to self-insure, or a cert1f1cate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Labor Code). POLICY NO. COMPANY ::_ Copy is filed with the city :....: Certified copy is hereby furnished CERTIFICATE OF EXEMPTION FROM WORKERS" COMPENSATION INSURANCE (This section need not be completed if the per- mit is for one hundred dollars ($100) or less). I certify tha1 in the performance of the work for which this permit is issued, I shall not employ any ~rson in any manner so as to become subject to the Workers· Compensation Laws of California. NOTICE TO APPLICANT: If, after making this Cer- tificate of Exemption, you should become subject to the Workers· Compensation provisions of the Ld'!lor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY CITY OF CARLSBAD-BUILDING DEPARTMENT APPLICATION & PERMIT USE BALL POINT PEN ONLY 1200 ELM AVENUE (714) 438-5525 NO. ~ / • JOB ADDRESS AV, ST. IDA_}i't/O(*LICATIDN / 3 ., J /.?l., ,ufJ , , I RD I ,' ti, f, -, I I J/1-I /r ·(/1 I I I I I I I I ' ' ' I I I I l /J//!. (; ':?:' /_ ,/,-,_,,, , OWNER'S PHONE PRIME CONTRACTOR i i OWNER'S MAILl'l'fG ADDRESS CONTRACTOR'S ADDRESS "h BLOCK l'~~~ff V I ASSESSOR'S PARCEL NO. DESIGNER _.,.,, ' ' ' ' ' ' ' ' ' ' ' DESCRJPTIO~)F WORK ' , DESIGNER'S ADDRESS /,~-A, -:::r /1,AI';/ ,.,.,,t!d C../..Z,f., ~- / GP LAND USE , ZO~ING PARKlNG SPACE CENSUS TRACT APPLICANT TO FILL IN INFOR - MATION WITHIN RED LINES. BUS. LICENSE PERMIT NUMBER STATE LICENSE ?o-lt1 CONTRACTOR'S PHONE STATE LICENSE DESIGNER'S PHONE I RES. UNITS I NUMBER OF STORIES Not Valid Unless Machine C.rtified BLOG SQ. FT. BLDG USE occ. GP I STANDARD PLAN# IPLANID# I TYPE CONST I occ. LOAD I ..... QTY. -,.ttllOl~W~6 PERMIT AMT. UTY. MECHANICAL PERMIT AMT. I EACH fif)l:I DRE I R~P <:." L.LEd o,,,, ( ... INSTALL iJ.ilRN. DUCTS UP TO 100,000 BTU EACH BllllaQltlG SEWER .,S --~ ?• --......_ OVER 100,000 BTU EACH WATER HEATER ANO/OR VENT BOILER/COMPRESSOR, ~PT03HP EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR -15 HP EACHGIIISS1Sll!!llll!lfllll.U:UIE '-~---;-J ~-;L -BOILER/COMPRESSOR f'&..._30 HP EACH lNSTAL., ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT 1 EACH LAWtil SE!Brn~I EB SY:SIEM pv~ 2-MECH EXHAUST HOOD/DUCT~ WATER SOFTNER RELOCATION Of EA FURNACE/HE".TER BUILDING PERMIT ,r. I I I f---• -. :...-~ SIGN PERMIT I \. I TOTAL PLUMBING /i~ TOTAL MECHANICAL PLAN CHECK I .'\. I I CONTRACTOR CONTRACTOR ALL INCLUSIVE PERMIT I EL~CTRICAL PERMIT AMT. AMT. TOTAL PLUMBING I\ I UTY. • UTY. MOBILE HOME PERMIT ELECTRICAL I l I NEW CON(r EA AMP/SWT/BKR AWNING I MECHANICAL I I I 1 PH .25 ......._ 3 PH PORCH l MOBILE HOME I I I EXIST BLOG EA AMl'?'!lillT/BKR SET-UP ........__ SOLAR I i./0. ~ 1 PH .15 3 PH RAMAOA, CABANA ' I 1-,..., I REMODEL/ALTER PER RCUIT FENCE OVER 6' I I 1\ I TEMP POLE 200 AMPS " TOTAL MOBILE HOME I MICO-FI LM I I I OVER 200 AMPS .....__ \. I I I TEMP OCCUPANCY (30 DAYS) \ ~ I I ,l . I ' I I I I TOTAL ELECTRICAL TOTAL FEES PAYABLE I r/.:L'T-CONTRACTOR I I I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT, AND DO "AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I 5 0 DEEP AND DEMOLITION OR CONSTRUCTION OF FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED;TO COMPLY WITH ALL CITY, STRUCTURES OVER 3 STORIES IN MGHT COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER /1 fli/1"', SPECIFIED HEREIN OR NOT. I.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 APPLICANl~fGN~ URE" V l V _ \i ~ I ow/tu CONTRACTOR□ I APPROVED BY fA. -~ DATE I J .A I -J:> z-1r-'- Ill ~ :.t > ts j:: ~ "-"' ~ ' SITE ------·----------------------------------------~ ADDRESS: OWNER: ___ P~E=R-"M-'l"T-'-'N.::Oc.: __________ -j FIELD INSPECTION RECORD INSPECTION DATE INSPECTOR INSPECTOR'S NOTES WOOD FLOOR FOUNDATION• FORMS• SET BACK• TOILET UNDER FLOOR PLUMBING UN DER FLOOR HEATING r--------------------------------------------------------------------- OK TO INST ALL SUB FLOOR r----------------------------------------------------------------------, 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 • PLACE TAPE EXTERIOR LATH OK• PLACE STUCCO FIREPLACE DAMPER & STEEL PLATE TIES/HEIGHT OF CHIMNEY OTHER TEMP POWER (POLE) SEWER I GAS TEST I SWiM POOL • STEEL BONDING I • PRE DECK 1 • FENCE PREPLASTER ! SHOWN • FRAME j • PAN i FINAL INSP BY BLDG DEPT OTHER DEPT'S REQ COMPLETED I ~i::LEC METER-PERM-TEMP i GAS METER-PERM-TEMP i I 1-•---------------------i------t------- I I I' I !r-----------------------------------------------------------------, • ':~Rl OF OCCUPANCY 1.sc~UED -------j----+--------7 ~ ------------·--------~----~-----~ "---------------------------------· --------------------------------------_______ _J REQUEST FOR INSPECTION INSPECTOR ~ PERMIT NOfi-'-f// TIME:-~· ~A"'7'----- DATE:___,f?_-~-~-- OWNER _______________________________ _ ADDRESS / 3 £:::?, ~ BUILDING 0 FOUNDATION i_-:] REINFORCING STEEL LJ MASONRY C GROUT· GUNITE 0 FLOOR AND CEILING FRAME [:J SHEATHING Cl FRAME D EXTERIOR LATH 0 INSULATION 0 INTERIOR LATH OR DRYWALL FINAL PLUMBING 0 UNDERGROUND PLUMBING 0 UNDERGROUND WATER 0 ROUGH PLUMBING 0 TOP OUT PLUMBING 0 SEWER AND PL/CO 0 TUB OR SHOWER PAN 0 GAS TEST 0 WATER HEATER D FINAL ELECTRICAL 0 TEMPORARY SERVICE 0 ELECTRIC UNDERGROUND 0 ROUGH ELECTRIC 0 POOL BONDING 0 ELECTRIC SERVICE 0 CEILING HEAT D G.F.1. D SMOKE DETECTOR D FINAL MISCELLANEOUS 0 PLENUM AND DUCTS D COMBUSTION AIR D PATIO D SIGN D GRADING D DRIVEWAY D CONDITIONED AIR SYSTEMS D REFER PIPING D FINAL READY FOR INSPECTION: D MONDAY D TUESDAY □WEDNESDAY DA.M. O FRIDAY )(l'.M. SPECIAL INSTRUCTIONS _________________________ _ R~QUESTED BY,~/ PHONE NO. 7),9'--_j>_/?£ ;. ' PERSON TAKING REPORT ~ ,. rt))_ f2 ~ ~ __/~ ~ o k 7J '-;/-~ ~ 5-2r-h