HomeMy WebLinkAbout1448 FOREST AVE; ; 82-519; Permit"' z 0 ~ ~ ~ u w C
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0 I heret,1 affirm that I am licensed under
provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Professions Code, and my license Is in
full force and effect.
l,c No ____ ___ Clas,
I hereby affirm that I am exemp1 horn the Contrac-
tor's License Law for the following reason {Sec 7031.5
Business and Protess1ons Code: An'! city or count)' which re· qu,res a permit to construct. alter, improve, demolish, or
repair any structure, prior to its 1ssua~ce also requires the ap-plicant for such permit 10 Ille a s1gne<l statement that he 1s
licensed pursuant to the prov1s1ons ot \he Contractor's
License Law !Chapter 9 commencing with Sectmn 7000 ol
D1vis1on 3 o1 !he Business and Profess,ons Code) or that ,sex-
emp11here1rom and the basis for the alleged exemption. Any
violation of Sectoon 7031 5 by an applicant for a permit sub-
Jects the applicant to a c1v1I penalty ol not more than five hun-
dred dollars ($500)
J I, as owner of the property, or my employees with wages
as their sole compensation, will do the work. and the struc-
ture is not intended or o!fered tor sale {Sec. 7044, Business
and Professions 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 mtend-
eo or offered for sale 11, however, the building or ,mprove-
m_ent 1s sold wi1hin one year o1 completion._ the owner-builder
will have the burden of proving that he did not build or im-
prove for the purpose ot sale)
:.J I, as owner of the property, am exclusively contracting
with licensed contr2ctors to construct the pro1ect (Sec. 7044,
Business and Proless1ons Code: The Contractor's License Law does not apply to an owner of property who builds or im-proves thereon, and who contracts for each pro1ects with a
contractor(s) license pursuant to the Contractor's license
Law)
[j As a homeowner I am 1mprov1ng my home, and the follow-
ing conditions exist: 1. The work 1s being perlormed prior to sale.
2 I have live(! in my home for twelve months
pnor to complet1on of this work
I have not cla1meo this exemption during the
last three years
D lamexemptunderSec , B&P.C lor this reason ____________ _
0 I hereby affirm 1ha1 I ha~e a ce'11flcate of consen1 to sell-msure, or a cer111,cate of Workers
Compensation Insurance, or a cert,f,ed copy thereof
(Sec 3800. labor Code)
POLICY NO
COMPANY
D C-Opy ,s hied with the c,ty
0 cer1,11ed copy ,s hereby furn,she<l
CERTIFICATE:. OF EXEMPTION FROM
WORKERS" COMPENSATION INSURANCE
(Th,s sect,on need not be completed ,f the permit
,s for one hundred dollars IS100) or less)
0 I cer11!y tha! in !he performance of the worls for
which this permit ,s ,ssued. I shall not employ any
pe1son ,n any manner so as to become sub1ect 10
• the Workers· Compensa11on Laws of Ca1,torn,a
NOTICE TO APPLICANT It. alter makrn;i 1h•s Cer1,
1,cale of E•empt1on. you should become sub1ec1 l'J
1he Wor'o:.ers· C-Ompensa1,on pro111s,ons ot the Labor
Code. you must fomiw,th comply with such
prov,s,ons or th,s perm,t shall t>f' deemed re11oked
D I hereby affirrT' Thal tnere ,s a cons1ruc1,or
1end,ng agency lor the pPrtorrnance o' tl\e wof\, tor
wn,ch 1h,s pe<m,1 ,s ,ssued ,Sec Yl97 c,.-,1 Code,
Ler"lder s Name------------
Lenders Address-----------
USE BALL POINT PEN ONLY & PRESS HARD ---------------------'A.::P...:P..:Lc.lC:cA.cNc.:.T.c._T<' ~ILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS
CARLSBAL-JUILDING DEPARTMENT APl"'LICATION & PERMIT
1200 Elm, Carlsbad. California 92008-1989 (619) 43B-?52L
VALUATION PERMIT NUMBER ,o{;;;. kE~T /ftJ
o~y·s NAME ~ l
~~IN \d Z,71;9 d. -~mAJ "b;:;;;~~
AY~ST,j DATE OF A1°f\lCATION
AP•' ;
CO,N"t~AC'rOA
/Uh.._ l'J
bUSINESS LICENSE #
, CONTRACTOflS PHONE. LONE bf 5 / .1
OWNER'S MAILJNG ADDRESS ~ CONTRACTOR'S ADDRESS LICENSE NO.
~<i"'rl?nF.
LOT I BLOCK I SUBDIVISION ASSESSOR PARCEL NO. DESIGNER LICENSE#
OESCAfPTION OF WORK
1---..._.._~-~~~---------~-~-~----~------:._~0ESIGNE~'SAODFIESS OESIGN-Efl'S PHONE
_Ptu. f' t-._Cm,~~~,y__ __ ___:__J--;:::--;-:-;;~~--,r-::M-=-::~-=""""' ~~~ ~~ ) -f/P FLA ELEV. NO OCCGP EDU I
, "' STORIES
GP LAND USE PAAKING~PACE GRADING ~ERMIT ISSUED
vO NO
TYPE
CONST
DCC LOAD FIRE SPR
PLAN 1.0. # BLOG USE CODE
STANDARD PLAN# BUILDING SQ_ FOOTAGE
CENSUS TR Ar RCS UN'TS T
y D ND I
REDEVELOPMENT AREA
vO NO vO NO Nor Valid Unless Machine Cerrified
QTY. PLUMBING PERMIT -ISSUE -; ~ QTY.[ MECHANICAL PERMIT -ISSUE [ 3 ~ 1 SUMMARY/ACCOUNT NUMBER
I PERMIT EACH FIXTURE TRAP I ' ~' INSTALL FURN. DUCTS i.JP TO 100.000 BTU BUILDING
EACH BUILDING SEWER I b -:-OVER 100,000 BTU SIGN F
EACHWATERHEATERA~~}~ -_1_ --~---~ER/~OMPRESSORUPT03HP____ PLANI
ERMIT
----
:HECK ----t,_. _ . BOILER/COMPRESSOR 3-15 HP TOTALP
--=+
METAL FIREPLACE ELECl
EACH GAS SYSTEM 1 TO 4 0 UT LETS --------
_UM BING
RICAL EACH GAS SYSTEM 5 0 R MO RE -------------------------
1
EACH INSTA~ .. ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT MECH! ,NICAL
-MECH EXHAUST -HOOOIOUCTS -~
L. _ __J_E:CA~H_V_A_C_U_U~~~-E~~-
-----
:HOME t· --RELOCATION OF EA FURNACEIH,Y"lER .. 7 WATER SOFTNER
L--+ EACH R0_9F DRAIN !INSIDE~---__ ----~ -
TOTr..L MfCHA~
t___J_ TOTAL PLUMBING / f11 ELECT_Rl~AL PER-~I~ -ISSUE <~~~~~~~~-S~OLAR -ISSUE
NEW CONST EA AMP/SWT·BKR
I PH
ROCK STORAGE ----------'-----JL_ 1 PH PUMP
\--+--PLAN CHECK r"EE -----
----
-----
-
MOBILEHOME PARK INSP
§_OL~R
1--STRONG MOTION
FIRE SPRINKLERS ---r-PUBLIC FACILITIES FEE
BRIDGE FEE . ------
SCHOOL FEE -DISTRICT -------------
Carlsbad
Encinitas
San Die~uito
San Marcos
01-00-00-8226
80-92-33-0519
01-00-00-8227
32-00-00-8923
80-92-21-0519 c..+-
80-92-22-0519
80-92-23-0519
80-92-24-0519
----
----
----'
__ _l__TEMPOCCUPANCYl30 __ ---~---;:;-AL:0~-----~""'""""" I I 7,~]
~E C:Af3EFULLY EXAMINED THE COMPLETED "APPUCATION AJD PERMIT'" AND 00 HEREBY Ex:pi.ration. E~ryper_mi_li.s~9dbythe8uilding. Otticialun~rlheprovisionsofthis
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CERTIFY UNDER PENAL TY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall ex:pire by hm1tat1on and become null and void. If the building or work
*-AM.JlSHA PERMJT IS REQUIRED FOR EXCAVATIONS.OVER
5' o•· DEEP AND OEMOLITK>N OR CONSTRUCTION Of
STRUCT\IRES OVER l STOAtES IN HEIGHT DECLARATIONS ARE TRUE ANO CORRECT AND I FURTHER CERTIFY ANO AGREE IF A PERMIT !S aut~~:1z~d ~y such ~r'!Jit ts not commenca.d within 180 days lrom the date of such
ISSUED TO COMPLY WITH All CITY COUNTY AND STATE LAWS GOVERNING BU!LDlNG CON-~ d() r if the b~ilding or work a~thorized by such P8 it is suspended or
STRUCT10N, WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY ANO L~'~';;"~"~edij'i'a~t~'"~~bm~e~aft:••~l~h~e~w~o~•k!..!!"~o~o~m~me!!!!"~oed~;;fm~~f,;~od~~f:l80~d~:;::-nt.:::::mwesoii';°--"'::'f'.°A:"'"-----;~~'"':r~r'-~
KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL UABIUTIES, JUDGMENTS, COSTS AND • '$ SIGNA~URE OWNER CONTRACTOR O APPROVED BY DAT.E x-i,,i
I !YryfY1';: EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF TH.f"··_,,.A,....,)".:; .... ,.-, GRANTING OF THIS PERMIT. -BY PHONE 0
~ V
INSPECTION TYPE DATE INSPECTOR
BUILDING -
FOUNDATION
REINFORCED STEEL
MASONRY
GUNITE OR GROUT
FLO,OR & CEILING SUB FRAME
SHEATHING
FRAME
EXTERIOR LATH lNSULATION
INTERIOR LATH & DRYWALL
PLUMBING I / ---
SEWER AND BL/CO Al Jr'J -~
PLUMBING UNDERGROUND ., . V
PLUMBING TOP OUT
TUB AND SHOWER PAN
GAS TEST
ELECTRICAL
TEMPORARY POWER
ELECTRIC UNDERGROUND
ROUGH ELECTRIC
ELECTRIC SERVICE
BONDING
G. F. I. -SMOKE DETECTOR
MECHANICAL
DUCT & PLEM., REF. PIPING
HEAT -AIR COND. -SOLAR SYSTEMS
VENTILATING SYSTEMS
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE BEEN APPROVED.
JOB SITE FINAL
PLUMBING
ELECTRICAL
MECHANICAL
GAS
BUILDING
SPECIAL CONDITIONS
CERT OF ocr• 'PANCY ISSUED
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTION REQ. IF INSPECTOR'S DATE CHECKED APPROVAL --
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRES TRESSED
CONCRETE
---~ POST TENSIONED
CONCRETE
FIELD WELDING
-. ----1-ilGH STRENGTH
BOLTS --L ----
SPECIAL MASONRY
' !--------------
I
PILES CAISSONS
I
-~ -----------~
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-------------
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--~
-----------------~
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--L__
' --------------------
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----· -------
~ ----------·--
----- - ---
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APPLICATION FOR PERMIT TO CONNECT TO CITY SEWER SYSTEM.
CITY OF CARLSBAD SE ENGINEERING DEPARTMENT
438-5541 ' IJJ
ISSUED BY -. --FOR APPLICANT TO FILL IN ~ I " ( --DATE ISSUED
BUILDING
ADDRESS VALIDATION
OWNER
MAILING
ADDRESS
LATERAL CHARGE COMPUTATION
CONTRACTOR STANDARD 4" (Max. H. 30', V. 10')
OVER 30' H. @ FT.
CONTRACTOR'S OVER 10' V. @ FT.
ADDRESS STANDARD 6" (Max. H. 30', V. 10')
OVER 30' H. @ FT.
NEW BUILDING I EXISTING BUILDING I OVER 10' V. @ FT.
LEGAL DESCRIPTION TOTAL CONSTRUCTION COST --r -"~
SERVICE CHARGE (REPAVING ETC.) -
TOTAL LATERAL CHARGE c.-l (.
REMARKS: LINE COST DATA
ASSESSMENT DIST. NO.
FRONTAGE COST PER FT. TOTAL
OTHER
LATERAL LOCATION I CONNECTION FEE
..: I I ..:
V) V) NO. UNITS COST PER UNIT TOTAL
'' ' '\ PUMP STATION FEES
\..j \.../
NO. UNITS COST PER UNIT TOTAL
I ST. I ro
TOTAL CHARGES (LATERAL ETC.)
LATERAL NO. INSTALLATION DATE
WHITE: Engineering GREEN: Finance YELLOW: Sanitation PINK: Building GOLDENROD: Permltter