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Home My WebLink About1415 FOREST AVE; ; 80-739; PermitJ,CENSED CONTRACTOR'S DECLARATION ..l't,iereby 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 ef- fect. OWNER-BUILDER DECLARATION DI hereby affirm that I am exempt from the Con- tractor's License Law for the following reason (Sec. 7031.5.Buslness 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 pursuan1 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 1hat 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). 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- 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). ':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) llcense pursuant to the contractor's License Law). I am exempt under Sec. , B. & P.C. for this reason, ____________ _ Date Owner ~ ORKERS' COMPENSATION DECLARATION hereby affirm that I have a certificate of con- t to self-Insure, or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Lail-Oote). l ~~~~~Yo. qrt f J;.., J _gopy is filed with the city. OCertifled 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 ($10!)) or less). I certify that in the performance of the work for which this permit Is Issued, I shall not employ any person'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 Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CON5fRUCTION LENDING AGENCY I hereby affirm that there Is a construction len- ding agency for the performance of the work for ...... ,_._ •'-•-----t• ,_ 1--··""" ,c-.,.,,.. '1nCl7 t""l"II r,.,..,4..,,\ CITY OF CARLSBAD-BUILDING DEPARTMENT USE BALL POINT PEN ONLY APPLICATION & PERMIT 1200 ELM AVENUE (714) 438-5525 NO. JOB ADDRESS tRr· 1Df li?;;ATION I 1~l i_t;"i 1\:10 1f2.1G1,6rr-1 ·"1V 1~ I I I I I I I I I I I I I I OWNER OWNER'S PHONE PRIME CONTRACTOR /I I A'I ,t m IL t-J,""' /.JJU 72o/·J.di} .)o1+NS0N &wt;, OWNER'S MAILING ADDRESS CONTRACTOR'S ADDRESS 14-IS r-1'1'~ T Avg-Ro .. BoK. -t(rf) r~n~ i<"" BLOCK I SUBDIVISION ;I ASSESSOR'S PARCEL NO. DESIGNER II "'~'"''ft NI~ "JC75 / 1~ la-ii I ,/"1 1-1 l 1 . .c:ri I DESCRIPTION Of WORK If {2Btnv, ~>(!/ ' ~-........ ,).. BArf.4 1tL J.t ,t:)e"" DESIGNER'S ADDRESS "' APPLICANT TO FILL IN INFOR- MATION WITHIN RED LINES. BUS. LICENSE PERMIT NUMBER Jq~o-z._ ~-1Jq STATE LICENSE -Z,()/r5D7 J j ~RS D E '77 ~-o ~ :r;,. STATE LICENSE L ' DESIGNER'S PHONE ' ;53 30. -- 1::.10 /An ~n. ~-::1.P.c/J CENSUS TRACT GP LANO USE ZONING I RES. UNITS I ~ARKING SPACE sf I NUMBER Of STORIES Not V11id Un/Ms Mlcflin• fMtifild BLOG SO. FT, BLOG USE occ. GP I STANDARD PLAN It I PH~~?3 1 I TYPE CONST I occ. LOAD I UTY. PLUMBING PERMIT AMT. UTY. MEC~~HCAL PERMIT AMT. -J. EACH FIXTURE TRAP q ,/11 INSTALL FURN. Dll'6lS UP TO 100,000 BTU EACH BUILDING SEWER "1.l._VER 100,000 BTU EACH WATER HEATER AND/OR VENT BOILER/COMPRESSOR UP-~3 HP I EACH GAS SYSTEM 1 TO 4 OUTLETS '} .lfD BOILER/COMPRESSOR 3-15 HP~ - EACH GAS SYSTEM 5 0 R MORE BOILER/COMPRESSOR 16-30 HP " EACH INSTAL.. ALTER. REPAIR WATER PIPE VENT FAN SINGLE DUCT " 6qo, --EACH LAWN SPRINKLER SYSTEM MECH EXHAUST HOOD/DUCTS " VALUATION: WATER SOFTNER RELOCATION OF EA FURNACE/HEATER I\.. BUI LDING.Jlc1{fiiT "' I"',._ I ' I I //Vft ISSUE 3.00 ISSUE , 3.00 SIGNj£RMIT J i'-X ,Yo '-1\ '""' I I I TOTAL PLUMBING TOTAL MECHANICAL PLA~ CHEr/A;/) /) -#~ ~~-#1 CONTRACTOR 9 -dl> CONTRACTOR All fN..£LUSNrPERMIT V I I I TOTAL PLOMiJ""' -~ I j ."fin UTY. ELECTRICAL PERMIT AMT. OTY . MOBILE HOME PERMIT AMT. ELECTRICAL I I ~IA t NEW CONST EA AMP/SWT/BKR <.rn AWNING "' MECHANICAL I I I 1 PH .25 3 PH PORCH "' MOBILE HOME I I I EXIST BLDG EA AMP/SWT/BKR SET-UP " SOLAR I I I I 1 PH .25 3 PH RAMADA, CABANA '\.. I ' I I I REMODEL/Al TEA PER CIRCUIT FENCE OVER 6' '\. I . I I I TEMP POLE 200 AMPS TOTAL MOBILE HOME '\. MICO·FILM I ' I I I OVER 200 AMPS '\.. I . I I ; I TEMP OCCUPANCY (30 DAYS) '\.. I . I I I TSSTTF ?. ()( " STRONG MOTION: I . II~ ·-. TOTAL FEES PAYABLE ... .. -< ~ -< ::: ~ j:: ~ C ~ ., TOTAL ELECTRICAL '\ I CONTRACTOR /, (I{) "" . I I ' I I :r, LS.~ OVt'4.c,I/IIA~ -:2-m:: I HAVE CAREFULLY EXAMINED THE COMPLETED "'APPLICATION ANO PERMIT, ANO 00 'AN OSHA PERMIT IS REQUIRED FOR E XCAVATIONS OVER -,-trf"/A l,~t,. 54 ~ HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE ANO CORRECT ANO I 5'-0" DEEP ANO DEMOLITION OR CONSTRUCTION OF FURTHER CERTIFY ANO AGREE IF A PERMIT IS ISSUED; TO COMPLY WITH ALL CITY, STRUCTURES OVER 3 STORIES IN HEIGHT ,., COUNTY ANO STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER SCHOOL FEE: SPECIFIED HEREIN O R NOT. I.ALSO AGREE TO SAVE INDEMNIFY ANO KEEP HARM- LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS. COSTS ANO EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. A~T'S SIGNJJ:ft. OWNERO CONTRACTORO ,A~O BY DATE h~ ~ L AGEN~ BY PHONED ~ ,..,,.~ Ir.-~ v I / y . SITE ADDRESS· INSPECTION DATE INSPECTOR 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• PLACE TAPE EXTERIOR LATH OK• PLACE STUCCO Fl REPLACE DAMPER & STEEL PLATE TIES/HEIGHT OF CHIMNEY OTHER TEMP POWER (POLE) SEWER GAS TEST SWIM POOL • STEEL BONDING • PRE DECK • FENCE P REPLASTER I... l • /' SHOWN • FRAME !Ill I I ,H -"' ! •PAN \\Yi\ :v ~ ! FINAL INSP BY BLDG DEPT ! J v ! OTHER DEPT'S REQ COMPLETED \ IELEC METER-PERM-TEMP ------+-----!-------~ I GAS METER-PERM-TEMP L_ ·------!-----+--------, ! i G_E_RT OF oCcuPANCY 1ssuEo -_J OWNER: · PERMIT NO: </0 -7 FIELD INSPECTION RECORD INSPECTOR'S NOTES t= __ _ ~-~---~-~