HomeMy WebLinkAbout1642 James Dr; ; 81-294; PermitLICENSED CONTR,-._ JR'S DECLARATION
I hereby affirm that ! 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
~ 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 file a signed state-
ment that he is licensed pursuant to the provi-
sions of the Contractor's License Law (Chapter 9
commencmg w11n 5ecHon 7000 oi D1vis1on 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 tor 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 rmprove-
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)
-= I, as owner of the property, am exclusively con-
tracting with licensed contractors to construct
the project (Sec. 7044, Business end 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 thrs reason ___ _
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of con-
sent to self-insure, or a certificate of Workers'
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 that in the performance of the work for
which this permit is issued, I shall not employ any
person in iny manner so as to become subject to
the Workers' Compensation Laws of California.
NOTICE TO APPLICANT: If. after making this Cer-
tificate ot i::-·.:ript1on, you should become subject
to the Work~' Compensation provisions of the
Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
CITY OF CARLSBP.r"I-BUILDING DEPARTMENT
APPLIC.. ION & PERMIT USE BALL POINT PEN ONLY 1200 ELM AVENUE (714) 438-5525
/,LL.1, ,J:r: ---,,;, JOB ADDRESS tR~T. l°?E-/ip~~~iTION ,n.,.., ,(1,(), r, /,c;, ~.,..-1, I I I I I I
OWNER ·,h'1 r J,:.;} ,-,/ ~Pt,
OWNER'S PHONE PRIME CONTRACTOR Dri,-,/~ .... I) ,.LL -"'I" Prv-1 "'-
OWNER'S MAILING ADDRESS CONTRACTOR'S ADrESS //. ;,/-') . 1 .,, ,,,,, ,;, < 'Dr-. ,-,..A h1 • ,+ S-.D --v JI ,rrw.rvJAJ
7 BLOCK J..;.:B~l,~S)O~ -'11 ASS:El,OR'S PARCEL NO. ...;";° DESIGNER -~ L. IL 77-/,5. .• , -i. 1 ,/ , -, , , , nr
0ESC~'1-.ION Of WORK j
f"',, i/ . !"'..-·u-----~ i -.,..-~ .-.,,--. 7/7 .7r· vc.:,,,.,r,c.r,'" ""'"'"-""
I I I .
CENSUS TRACT GP LAND USE ZONING -
APPL IC
MATION
r TO FILL IN INFOR -
WITHIN RED LINES.
BUS. L 1CENSE PERMIT NUMBER
;?8~81/" 7/Jf STATE LICENSE fl /(/DJ'7C/
CONTRACTOR'S
b"~~ L.4//
STATE LICENSE
cn:.:,iUNc.ti' ~ i"'l1UNE. . , . , . ' . ,.
' ; /, ; . -· . l RES. UNITS 1:.~,Kl;;:A,CE ! NUMBER OF STORIES
Not Valid Unless Machine c.rtifi«J
BLOG SQ, FT. BLDG USE OCC. GP ! STANDARD PLAN II IPLAN1Dlt y, TYPE CONST I acc. LOAD
I
UTY. PLUMBING PERMIT AMT. UTY. MECHANICAL PERMIT AMT.
EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100,000 BTU / EACH BUILDING SEWER ·-OVER 100,000 BTU / / EACH WATER HEATER AND/OR VENT 1.-BOILER/COMPRESSOR UPTO 3 HP ,v
EACH GAS SYSTEM 1 TO 4 OUTLETS A• BOILER/COMPRESSOR 3-15 HP ./.
/ EACH GAS SYSTEM 5 OR MORE ),: ~ BOILER/COMPRESSOR 16-30 HP /
/' EACH JNSTAL., ALTER, REPAIR WATER PIPE ,,, ) V VENT FAN Sl~/GLE DUCT µ
, EACH LAWN SPRINKLER SYSTEM MECH EXHAUST -HOOD/DUCTS / (/dL.-~-/.2, 'It-'/-
WATER SOFTNER . --RELOCATION OF EA FURNACE/!;:tr'AI ER BUILDING PERMIT I ,~~-=
_,/_,,_.,,~ -1~';' .,, . .. -s--SIGN PERMIT ,,. I ,t I I
TOTAL PLUMBING TOTAL MECHANICAL I. l.f';_y-, ,I , I I PLAN CHECK I . 'I I-:;:' /;I} CONTRACTOR CONTRACTOR ALL INCLUSIVE PfRMIT I I I
TOTAL PLUMBING -I A.:,"7"" ,c•
UTY. ELECTRICAL PERMIT AMT. UTY. MOBILE HOME PERMIT AMT. , ELECTRICAL -/~
/ NEW CONST EA AMP/SWT/BKR .c:. :--AWNING MECHANICAL I/ I f I
1 PH .25 3 PH PORCH MOBILE HOME I I
EXIST BLOG EA AMP/SWT/BKR SET"UP SOLAR I I I I
1 PH .25 3 PH RAMADA, CABANA I I I I
REMODEL/ALTER PER CIRCUIT FENCE OVER 6' ;;, . .IL .,"T . I I I _,,,. 17
TEMP POLE 200 AMPS TOTAL MOBILE HOME MICO-fl.l!W I I I . 1'
OVER 200 AMPS I I I I
TEMP OCCUPANCY {30 DAYS) I I I . I
, . , ~ ~ I I I I -TOTAL ELECTRICAL / C,~ TOTAL FEES PAYABLE I ' IL~I / .-!./-CONTRACTOR / -I I
"AN OSHA eeRMOT ,s arnu,arn eoa excA VATION{tl~/ ! . ,
I HAVE CAREFULLY EXAMINED THE COMPLETED "'APPLICATION AND PERMIT, AND D0
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 ISSUE □;TO COMPLY WITH ALL CITY, STRUCTURES OVER 3STORIES IN HEIGHT
;;}!;;,;/, COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER ~. I) £. SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY ANO KEEP HARM 1
LESS THE CITY OF CARLSBAD AGAINST ALL LIA81 LIT I ES. JUDGMENTS. COSTS AND
/·~~ .. .,,.., ' _,1 EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE
OF THE GRANTING OF THIS PERMIT. APPLICANT'S SIGNATURE" OWNER □ CONTRACTOR~ jAP~fYEJi 8~ _J D1,T__E
• = ,_
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SITE
ADDRESS:
WOOD FLOOR
INSPECTION DATE
I
FOUNDATION• FORMS• SET BACK • TO!LETI , , LJI
UNDER FLOOR PLUMBING I /
UNDER FLOOR HEATING
OK TO INSTALL SUB FLOOR
SLAB FLOOR
UNDER SLAB PLUMBING
FOOTING • FORMS• SETBACK • TOILET
OK TO POUR CONCRETE
FRAME .7
ROUGH ELECTRICAL I t /),(
ROUGH PLUMBING 7
ROUGH HEATING/VENTILATING
FRAME OK• PLACE INSULATION
INSULATION OK • PLACE WALLBOARD
WALLBOARD OK • PLACE TAPE
EXTERIOR LATH OK • PLACE STUCCO
FIREPLACE
DAMPER & STEEL
PLATE Tl ES/HEIGHT OF CHIMNEY
OTHER
TEMP POWER (POLE)
SEWER ' GAS TEST --.«~
SWIM POOL • STEEL BONDING --,
• PRE DECK
• FENCE PREPLASTER
SHOWN • FRAME
• PAN
FINAL INSP BY BLDG DEPT -
1 OTHER DEPT'S REQ COMPLETED x)\/ r ELEC METER-PERM-TEMP ,~'W"
j GAS METErt-PERM-TEMP 7,.~~
INSPECTOR
; . -f--,
A
,,---VI'[//
7
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1TTJ.
7
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"I( \' I I 1,\ 91 iffT,.\;'\
I I V 'I \ \
L~~RT OF OCCUPANCY ISSUED
OWNER: PERMIT NO: ~[ -';)..,0,4
FIELD INSPECTION RECORD
INSPECTOR'S NOTES
. J_ 1
75/lil/J{ ~-
'!j9Jfll'~ w
'/ / V' • •
>-----------------------------------------j -
I I
I '--------------~-------~
INTERDEPARTMENTAL INFORMATION SHEET .•
BUILDING DEPARTMENT RECEIVED DATE:
BUILDING ADDRESS:
'
/4~ _)-~~.-\.-• -JU-L 1-6-llll-. --
crrv 8F, CARLSBAD Bulld!ng Department
PLANNING DEPARTMENT
ZONE _________ LOT SIZE _________ LOT WIDT~---------
UNITS ALLOWED UNITS PROVIDED ------------------------',.
PARKING SPACES REQUIRED PROVIDED -----------
% COVERAGE ALLOWED PROVIDED -----------BU IL DING HEIGHT ALLOWED __________ PROVIDED __________ _
FRONT SETBACK: SIDE SETBACK: REAR SETBACK:
ALLOWED -------
PROVIDED ______ _
INTRUSIONS
LANDSCAPE & IRRIGATION PLAN COMMENTS:
ENVIRONMENTAL PROTECTION REQ:
ADDITIONAL COMMENTS~
'OK TO ISSUE:t--71± DATE 7--/(-61 TO FINAL DATE I ------------
ENGINEERING DEPARTMENT
R.o.w. INDUS ------WASTE
·. (~ (eo~
IMPROVEMENTS ---------------
SEWER CONNECTION ________ DRIVEWAY LOCATIONS ___________ _
GRADING PERMIT __ _,_.,--__ EASEMENTS _____ ,_ ___ DRAINAGE ____ _
LEGAL DESCRIPTION j&:::t:;7 ?2-4. 7 /4U -;}.£/ -($,-
ADDITIONAL COMMENTS ____________________________ _
____ OK TO FINAL ____ DATE ___ _
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 ________ _
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