HomeMy WebLinkAbout141 Hemlock Ave; ; CB880794; Permit"' z 0
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O I hereby affirm that I am licensed under
Pf0¥11ion1 of Chap1er 9 1cornmencing w1tt,
Section 70CKl) of Division 3 of the Business
and Profeaalons Code, and my license ,s ,n
full force and effect
I hereby alt,,.,, That I am exempr lrorr me Co1r,ac
t~r s License Law tor the following reason !Sec /03' ~
Business and Proless,ons Code ~n1 c ty ,Jr :a.,s·y wh-cr ·e qu1,es a perm,· •o conslrucl ailer ,mprove derrol,sh or
repair any structure pr,or to ,ts issuance also requ,res 'heap p,,canl for such ;rnrm,t 10 hie a s,qned sldlement lhat se ,s
I censed p~rsuanl to the pro~1s1ons Jt The :.on•·acw o ;.cense Law ,C'1apter g commenc,ng w,10 SerJ,on 7000 QI
rr.rsror 3 ~1 the Business and Proless,0°,; Co~e, or lhal 1s e, empt iherefrom a~d the basis lor tie a11egec e,empt,on An,
,·,olat,on o1 Sect,or 703' ~ by an appl-can1 'or a pwrr111 sJb 1ects lhe ap~l,canr 1~ a :rv,I penalty ~1 no· m01e Tran lr·,e r "r
ared dol,ars :1soo,
as owner 01 ·ie ~roperty, or my ernplo•1eeo w I' wages
as the1' sole comoensar,un w,I do t'1e work ana !he sTruc lure rs nol 11tendec or ~t•ered for sa·e ,sec 7144 Bus,ne;o
and P•oless1orc Code The Cont·ac!o··s L,cen~e I aw does
not apply to an owner ol prope•t·1 wro bur.ds or ,rr,pro,es thereon and wro does suer wor> n,rrselt O' tnrouqh hrs own
employees orov,oed Iha! such '"'pravemenh are not intend-
ed or 011e,ed tor sa•e 11 however the bu1ld1ng or 1"1•ro,e-
menl 1s SOid w•ttw one yea· of ~O'Tiplet,o~ the owner bur Ide· w,1, have lhe bu·den ct orov,nr; !haT hf did not ou,ld or ,rr-
prove •or 1ne pu'pose o• sa1e1
I, as owner 01 the properly dm exclus,ve,y con:r;ie1,ng
w,tn 1,censed cortracto·s 10 cons:ruct the pro1ect: Sec 7044 Business and Proless,ons Code ;~e Conrracto,·s License
law does not apply to an owner of rrope'l'I who bur•ds or ,rr-oroves tnereo~ ard who contracls 'or eac~ pro1ects w,·s a contractor1s1 1ce~se ••Jrs~ant ta the l,ootractor s ',r.ense Law1
As a homeowner I am '"'P'Ovinq my hnme and 'he follow ,nq cono,hons e,,s1
l I T~e won, ,s be,~g pe•formed pr,or to sale
2 I ha,c 1,ved ,n my ro"'c for lwcl\lC '!lon1t,5 prior :o comp,et,on al tn,s wor,
3 I have nol cla,rned t~,, exema1,on d,r,ng :ne
lest 'h'ee yea1s
tor i'h~~ r~:~~r usde" Sec -----~ 8 & PC ------------
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__ I heret\ a1'rrr--i trat I have a ce,t,1,cate o' consent to
se f-.nsu·e o• a ce•trf,ca:e of Wo•kers Compensat,on In
surance or a cer11'1eo ~cp·, I hereof ,.Sec 3BOO. Labor C~de1
POLICY \JO
COMPA\JY
Coo·, ,s 'lej '"In lhe c,ty
CertrlreO ~op•, ,s nerety furn1sned
CERTIFICATE OF EXEMPTION FROM
',VORKERS COMPE"JSATION INSURANCE
,Tr s sect,o.s aeej not be completed If the perrr ·
,s 10, one hundred do' ars .s1:io, or 1e5s>
• certrly t~al 10 the pe,lorma~ce o• the work <o, wh,ch
rh,s permit ,s ,ssued I sha I not employ ao; person'" ao-,
manne· so as To become suDJect to \he Workers Corn pen
satron Laws of Ca:,'~rc·a
NOTICE TO APPL,CANT If. after making th,s Cert,l,cate
of E>erl'pl1os yoc should become sub Jee to tr,e Workers
I
Compensat-or pov,s,ons ol the ~abor Code ,·ou r--iust
lorthwrtr> comply w,th such pro,,s,ons O' th,s perrr 1! shal' L De deen1eo ·e,oke•J
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'S SS.JPC ,s.,--sg-::;,.,, c,JdPI
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I,, Ce· s A,y•p~s
USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT 2075 Las Palmas Dr, Carlsbad, CA 92009-1915 (619) 438-1161
JOB ADDRESS lo ck_
AV ST. RO, THOMAS BROS NO. 1°·;;;.;;Lle'0J BUSINESS LICENSE # ~ALUATION PERMIT NUMBER
I '-I I f/c,,,.,, !:JU€ f:tiv
? 9CJ0'1<ft/ LO• BLOCK I SUBDIVISION I ASSESSOR PARCEL NO. u CONTRACTOR ' ~ CONTRACTORS PHONE# ZONE ~ ,;t}'-j ~,=;; ~ \' 0
OWNER'S NAME
1 JJ,, /J<ln J/1 OWNER'S PHONE
~ l;/Z..I C. 'isY~1 J z,_, CONTRACTOR'S ADO RESS STATE LICENSE NO. BUILDING SQ FOOTAGE
OWNER'S MAILING ADDRESS V
,<;"'7....~ ~ DESIGNER DESIGNER'S PHONE . ·:-;· .. ;.. ' .,,, A-1./(= t A-r7-'-,:) a, (l-,0 :;,__' ·::~. -38 JOt::.. ( .: -
DESCAIPTIOV...F WOR'l )-::•._j::•:,.~: .., ...
e i<:-, Sri ,-,,, -5 7ZJ I 12. c.v,;'11'
" --'A._cd"' DESIGNER'S ADDRESS STATE LICENSE NO
, .J '.----~ ,rr () a ,e<-.._,1 J_ • -,
~,'L,
e ' FLRELEV NO ace GP EDU
-z._µ.ll_pLoon STORIES
~ V\_ ,,-t.-A,,VC <a" TO ,-c '-<O
I CENSUS TRACT ! PAFlK1NG SPACl-RES UNITS GRADING PERMIT ISSUED I REDEVELOP..,,ENT TYPE ace LOAD FIRESPR
AREA CONST ,• ' • ,:::::; ,• YO"'• Not Valid Unless Machine Cemfied
QTY PLUMBING PERMIT -ISSUE 15' QTY. MECHANICAL PERMIT -ISSUE ;sotJ SUMMARY/ACCOUNT NUMBER
EA[H ~IXfURE TRAP INSTALL FURN DUCTS UP TO 100 ODO BTU •u1l_ul1~''-' ~·tr1r. I 'JIJ' 6''J-0C-IJ0-8??: ,_JI
EACH BUILUING SFWER . OVER 100 000 BTU SIGN PERMIT :Jo· s·rJ :,o ~,-~ sn1
EACHWAlEK HEATER Ari.I) OR VE:Nl . tlOILER·COMPKESSOR UP TO 3 HP PLAN CHECK 001-81 0-00-00-8891 /~
EACH GAS SYSTEM l lU-1 LiUl LETS BOILFR COMPRESSOR 3 1~ HP TOTAL PLUMBIIIJG OG: -31 C1-0IJ--J0-822:!
EACH GAS sv:;1 E:M ~ UR \riORF Ml;AL F REPlACt. ELECTR'CAL oG 1-c 1 c,-00-00-8223
EACHINSTAL ALTER REPA1R WAJERPIPE VENT FAN SINGLE OU[T MECHAN:CAL =,c,· S ,J-:·O-OG-8224
EACH VACUUM BREAKUl -' MECH E'XHAUST HOOD DUCTS MOBILEH0v1E 001 8 'J JC-C,rJ-8225
WATER SOFTNER ... . -RELOCATION OF EA ~URNACE HEATER SOLAR :,o 1-31 0-00 ··=·0-82 26
f-tlf:Y ~:',' f l'·RC< \ ·,c::. ··,r . --DRYER VENT . SlRONG MOT'Ori.j 380-'.; 19-92-33 /
. ' TOT.C.L MECHANICAL FIRE SPRl~Ji<LERS ,J01-B1J-OO 0:1-8227
TOlAl Pl1JME1NL I PUBLIC FACILITIES FEE 3/0-31-~ -Q,:)-0)-6-;-40
_soo BRIDGE FEE 360-810-00·00-8740
QTY. ELECTRICAL PERMIT -ISSUE QTY MOBILE HOME SETUP PA.RK-'IIJ-LIEU 1AREA '
NFWCONST [AAMPSl/;l 8KR CAR PORT Tli:: 312-810·00-00-8835
I PH : PH AWNll'.G LA COSTA TIF 311·81 0-00-00-8835
t x IS T bl [JG E ,'I. AMP S\''i'T ll KR GARAGE FMF
I PH 1 PH LICENSE TAX o:,· s·= ,·,_-=,:-s1~"
HE.MOUEL Al TtR PfR l 9[UIT M FF SBD-519-92-57
TF',·1P Pill E JUU ,'.\MP\
OVE:.H }IJU A\r1PS
Tt.MP ll[UJPAN[Y ,30 UAYS1
CREDIT DEPOSIT
T1Jf,\l flFllH•f.r..., I 1CT A' TOTAL FEES PAYABLE l 3~ 0.;;,
I HA'/E CAREFULLY EXAMINED Tf-'E COM PU: fED APPLICATION ANO PEPMIT A.ND DO HEREBY Exp1rat1on Every perm,! issued byttieBu1ldtng Ofl<c,al under the prov,s,ons olth<s * AN OSHA PERM!T IS REQUIRED FOR f.XCAIJAT,ONS OVER
CE;,TiFY UNDEP PE"<AL 'Y CF ;::,f::RJURY THAT ALL INl'"09',IATIOI~ HEREON INCLUDING THE Code shall expire by lrm,tat,on and become null and vo,d 11 the b1nld,ng or wor~ 5· O" DEEP ANO DEMOl.lTION OR CONSTRUCTJON Of
DE:.CLARATIONS ARE T8UE A>.,;f' CORH!:CT ANO F'JPT--tf::'1 CEl'iT•FV ANO AG PEE IF A PERMIT I½ authonzed by such perm,•,. not commenced w,thm 160 days from 1he ddte of such STRUCTURES 0\/ER J STORIES IN 1-4EIGHT permit. or 1f the 1me1~ffe~;h~~,:~tc0~~~e:Je~~~~ :~~~~d'~?~;g~/.~d or IS'."),;~J TO COMPLY 1/','ITH AC.L C·TY COUNIY M,8 sr4TE ,_AWS GO>FR~J"'.JG BUILDING CO'-< abando • 5rP'JCTION. VJHETHEH SPfCl"''E.D HEREIN OR NCT 'A~so AGRFF T() SA\/E INDEMNIFY ANU AP 7d[J'"'K OWNE~ CONTRACTOR[] APPRI VEI BY ?2y/tcr kl::EP HARMLESS -:-f-oE CITY OF CA9LSBAD AGAINST ALL LIABILITIES. JL:JGMEt,TS COSTS AND
EXPf::.t.SES W'-11CH MAY I", A",Y WAY ACCRUE AGAl~.s-SAID CITY IN CC~JSEOUE.NCE OF THE BY PHONE [] f--;;,,.~ ~ G"'A'.T '-JG OF TH:S PERr,.,,·T ~ -
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TYPE DATE INSPECTOR CQi i\sO 7q Lf
BUILDING
FOUNDATION FIELD INSPECTION RECORD
REIN FORCED STEEL 1-------R-E_Q_U_I R_E_D_S_P_E_C_IA-L-IN_S_P_E_C_T_IO_N_S----~~----1-N-SP_E_C_T_O_R_'S_N_O_T_E_S ________________ ----j
MASONRY REQ IF INSPECTOR s
GUNITE OR GROUT INSPECTION CHECKED APPROVAL DATE
SUB FRAME • FLOOR • CEILING SOILS COMPLIANCE
SHEATHING • ROOF • SHEAR ' PRIOR TO
.1,.. FOUNDATION INSP
FRAME uv -----+-----l---------4-------< 1----------------------------1 STRUCTURAL CONCRETE EXTERIOR LATH I OVER 2000 PSI 1---------"_:_.:.._ ___ +-__ --+ ____ --+ __ --J INSULATION PRESTRESSED
CONCRETE INTERIOR LATH & DRYWALL f--Po~s_T_T_E_Ns-10-N-E-0---+---l------l-------l
CONCRETE
PLUMBING FIELD w,LDING
'---------'-----+---• SEWER AND BUCO • PL/CO HIGH STRENGTH
BOL Ts UNDERGROUND • WASTE • WATER
TOP OUT • WASTE D WATER 1--S-PE_c_iA_L_M_A_so_N_R_v ___ +-----+------+----J 1-----------------------~------~
TUB AND SHOWER PAN 1-----------_....j_ __ -J ____ __j.. __ _, >------------------------------!
GAS TEST PILES CAISSONS \ \ / / • WATER HEATER • SOLAR WATER
1
/--J,'---.-
1
--+--~
ELECTRICAL 7,.-7/ '-'.: · 0 1--------------------~
• ELECTRIC UNDERGROUND • UFFER A ~V/ 1 11
ROUGH ELECTRIC 7 ~
• ELECTRIC SERVICE • TEMPORARY 1-----L ./_' __ 1--i~'.4-:f-+_-"'\:_i.._--1---+---.--I----' 1----------------------------1 • BONDING • POOL ./ / /( \ \ L \
MECHANICAL / .'.\ -\ \ \ 1', / _ __,__ _ _J 1------------------------j
• DUCT & PLEM., • REF. PIPING ? \ ---,.+,<~-'le: ,-1\)1----1-------1 1-----------------------------,
HEAT -AIR COND. SYSTEMS / \ , , . ' '1-f
VENTILATING SYSTEMS .•\-i \ '' f.l
f \ I \ \ •
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATfr . \\ {•
ITEMS ABOVE HAVE BEEN APPROVED. / ) , \
FINAL / 1-------t=-+---++---+-___j 1------------------------------4
PLUMBING / \
ELECTRICAL • '-\
MECHANICAL /
GAS L,,
BUILDING
SPECIAL CONDITIONS
--, '--
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APPROVE;;
By~
JU:l 2 0 1988 ·
-,-~-
City of CARLSBAL
~UttiLDnN~ !!')!:-•.-,-·
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J..i8 :Jo\~+~ /t/ oc... Aff0-L(eJ;;_/J.c
:1 &alJ..A5. w \'ic.--\ _s-,~~on. --JcJsf ~~rs
d--'i6 P.e& 1JJC()c. 0.,.:C:.i Cf~~ Cl
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APPROVE1.;
By ~ -
JUM 2 0 1988
City of CARLSBAl> . D"N"" neir:i'"'.' aUU-~ ~ '11'·-i; ~ ·
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