HomeMy WebLinkAbout1677 James Dr; ; 80-616; 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 ef-
fect.
OWNER-BUILDER DECLARATION
D I hereby affirm that I am exempt from the Con-
tractor's license Law for the following reason
(Sec. 7031.5.Buslness and Prolessions 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 provl·
slons 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 five hundred dollars
($500).
DI, as owner of the property, or my employees
with wages as their sole compensation, will do
the work, and the structure Is not intended or of-
fered for sale (Sec. 7044, Business and Profes-
sions Code: The Contractor's License Law does
not apply to an owner of property who builds or
Improves thereon and who does such work
himself or through his own employees, provided
that such Improvements are not Intended or of-
fered for sale. If, however, the building or Improve-
ment Is sold within one year of completion, the
owner-builder will have the burden of proving that
he did not build or Improve for the purpose ol
sale).
'.JI, as owner of the property, am exclusively con-
tracting with licensed contractors to construct
the project (Sec. 7044, Business and Professions
Code: The Contractor's license Law does not ap-
ply to an owner of property ••ho builds or im-
proves thereon, and who contracts for such pro-
jects with a contractor(s) license pursuant to the
contractor's License Law).
I am exempt under Sec-----8. & P.C.
for this reaso ~------------
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of con-
sent to self-Insure, or a certificate of Workers'
Compensation Insurance, or a certified copy
thereof (Sec. ~/'t,a~~ .a-<>
POLICY NO.~\;. -/ -3'7 /
COMPANY . lt(!.ll•~:$(4ft~:f:.6
-~PY Is flied with the city.
~ertlfied copy Is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(TIiis section need not be completed If the per-
mit l&.qor 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 any manner so as to become subject to
the Worters' Compensation Laws of Callfomla.
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.
CITY OF CARLSBAD-BUILDING DEPARTMENT
USE BALL POINT PEN ONLY APPLICATION & PERMIT
1200 ELM AVENUE (71 4) 438-5525
APPLICANT TO FILL IN INFOR-
MATION WITHIN RED LINES.
/ HO. iJ,i~;.-:,.,.U-'1.il" ~e ADDRESS AV.ST. DATE OF APPLICA~ON BUS. LICENSE
/(J:'17.7i I I I It I I I It t I I I I I I I I I 7 /-~-'l /<f'Jl?K
o~ ~r ~ 7;;R;;;;rRIM~ -~-~ ~jl~rr1
C~ACTOR'S p~~~
PERMIT NUMBER
/>tJ,,.6/I
(130-(qGJ
C
STATE ~E
s -e-zDESIGNER'S PHONE
~£-1£1~
CENSUS TRACT V GP LANo"uSE
4 ,7 11
C-r. 77-7 ZONING £-/ EUNITS)~•--v:1:~ S;AC'21Jjlfol N~B:R/ STORIES
Not V•lid Unlllss Abchine C«tifi,d
BLOG SQ. FT.
/~~~ BLOG:~rP l 7
i;z; STA•;; p~ # PLn TYP~;v, ~"d ,
"'ll
QTY.I PLUMBING PERMIT AMT. II QTY. MECHANICAL PERMIT AMT.
75 I EACH FIXTURE TRAP :21-11 / INSTALL FURN. DUCTS UP TO 100,000 BTU ¥.-
/ I EACH BUILDING SEWER s-:-OVER 100,000 BTU
EACH WATER HEATER ANO/OR VENT BOILER/COMPRESSOR UP TO 3 HP
EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP
EACH GAS SYSTEM 5 OR MORE BOILER/COMPRESSOR 16-30 HP
EACH INSTAL, ALTER, REPAIR WATER PIPE ~ VENT FAN SINGLE DUCT #--
EACH LAWN SPRINKLER SYSTEM MECH EXHAUST -HODO/DUCTS ~-'-~IJ9/~
.~~0'!"'1" WATER SOFTNER RELOCATION OF EA FURNACE/HEATER BUILDING PERMIT -;;,,
() ---~
CONTRACTOR
"7 ,n--()
TOTAL PLUMBING '3'1~
n__..,. .,_"
TOTAL MECHANICAL
CONTRACTOR
~ SIGN PERMIT t,
PLAN CHECK /'17 ~ Y/bJ>
ALL INCLUSIVE PERMIT
QTY. ELECTRICAL PERMIT AMT. QTY. MOBILE HOME PERMIT AMT. TOTAL PLUMBING
ELECTRICAL
NEW CONST EA AMP/SWT/BKR AWNING MECHANICAL
1 PH .25 3 PH PORCH -------MOBILE HOME
EXIST BLDG EA AMP/SWT/BKR SET-UP 7 ,.., SOLAR
1 PH .25 3 PH RAMADA, CABAN}( V
REMODEL/ALTER PER CIRCUIT FENCE OVER 6'
TEMP POLE 200 AMPS
~/ . of z
TOTAL MOB.ILE HOME -°" r7✓~f J MICO-FILM
OVER 200 AMPS " ,,.,Y,7. L. 7 /, £._
TEMJ!.DCCUPANCY (30 DAYSI i ~\KVV _ ,,y I 2-Z,~ fiiA,,wZ
~.,,. ~-I -~ \Y '4 I > ti
\ / -/ TOTAL FEES PAYABLE TOTAL ELECTRICAL
CONTRACTOR \ 7 l . I
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT. AND DO
HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I
FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED;TO COMPLY WITH ALL CITY.
COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER
SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM-
, cce Tue r1Tv nc r 6 R1 c.:RAn A!;AINST ALL LIABILITIES. JUDGMENTS, COSTS AND
"-=7 ..
'AN OSHA PERMIT IS REQUIRED ~~4t 5~-• DEEP ANO DEMOLITION o:~~NES~~AVATIONS OVER "';,/ , ,_ j _.A,
STR TURES OVER 3 STORIES IN HEIGHTUCTION OF ~ ....--v
14~~7~
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SITE
ADDRESS: --OWNER: PERMIT NO: ,
FIELD INSPECTION RECORD
INSPECTION DATE INSPECTOR . INSPECTOR'S NOTES
WOOD FLOOR
FOUNDATION • FORMS• SET BACK • TOILET .
UNDER FLOOR PLUMBING ' \ \ \ ~ ' . I llll: J tiL.. -ft ,. C C --. --UNDER FLOOR HEATING ' . . ..,,L' :. ' I I, ' ~ ' . · .. OK TO INSTALL SUB FLOOR ~ ·• ,. . ....... _ I(.• •. "" !'t..a"
~ ' ·, \ . ' ~ •.. I 1 ' , ~ -~"" . < .,;~ ' ,,
SLAB FLOOR -,; ' ~ .>\, ' • \ 17" " UNDER SLAB PLUMBING " ,h , I
FOOTING • FORMS• SETBACK • TOILET ( ·.' r-.. ' -~-1.-... . .
OK T O POUR CONCRETE :-'· t'. • !. . -• ' .. ' ' ~
FRAME
ROUGH ELECTRICAL --. . ~ -
ROUGH PLUMBING ..
ROUGH HEATING/VENTILATING
FRAME OK• PLACE INSULATION .
INSULATION OK • PLACE WALLBOARD
WALLBOARD OK • Pl,.ACE TAPE ' ·, . .
EXTERIOR L ATH OK • PLACE STUCCO
,,..
FIREPLACE ~-,. " •L -
DAMPER & STEEL . -l -
PLATE TIES/HEIGHT OF C HIMNEY '
OTHER
TEMP POWER (POLE)
SEWER
GAS TEST
SWIM POOL • STEEL BONDING
• PRE DECK
• FENCE P REPLASTER
SHOWN • FRAME
• PAN .
.
FINAL INSP BY BLDG DEPT -
OTHER DEPT'S REQ COMPLETED 1
ELEC METER-PERM-TEMP
GAS METER-PERM-TEMP , ,
,. -.
'. r ·'• \ {• ,...) ... ~ ... CERT OF OCCUPANCY ISSUED ,.ti'... _, •-·--.. .._ J,' .... , .,. _.
-----
LOT.;)/
4;i7 ~~
. (7
BUILDIN~
FOOTINGS
• FOUNDATION I o ...
... --...
""
•
• -...
◄
• .. ..
..
•
◄
•
..
•
..
"" .. .. ..
•
.. ..
MifilO~ED S~EL /0-14
MASONRY
GUNITE OR
SHEATHING
FRAME
INSULATION
EXTERIOR LATH
INTERIOR LATH & DRYWALL
PLUMBING
SEWER AND PL/CO
PLUMBING UNDE"RGROUND
COPPER
TOP OUT
TUB AND SHO~
GAS TEST ~
ELECTRICAL
UNDERGROUND;z::;.:;
ROUGH
CEILING HEAT
BONDING
( 0-la
MECHANICAL
DUCT & PLEM, REF. PIPINGk
IIEAT--AIR
VENTILATING SYS'I'EMS
FINAL: J-2J 4~
... ' ,._
COMPLETE IN DUPLICATE AND POST WITH THE INSPECTION RECORD CARD
THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH THE
CURRENT ENERGY REGULATIONS, CALIFORNIA ADMINISTRATIVE CODE, TITLE 25, STATE
OF CALI FORNI A,
SITE ADDRESS
EXTERIOR WALLS
IN THE BUILDING LOCATED AT:
I lo'l0 Ic\rnQb ~r.
Number Street City
Manufacturer __ O~W~E_N_S~C~O_R_N=IN~G~-Thickness/Type ___ 31/:~,•-•_ R Value
CEILINGS
11
Batts: Manufacturer __ o_w_E_N_s_c_o_R_N_IN_G __ Thickness/Type __ 6'_' _ R Va 1 ue __ 19_
Blown: Manufacturer _________ Thickness/Type ____ No. Bags
Wt./Bag ________ Sq. Ft. Covered ______ R Value __ _
FLOORS
Manufacturer _________ Thickness/Type ___ _ R Value ___ _
SLAB ON GRADE
Manufacturer _________ Thickness/Type ___ _ R Value ----
Width of Insulation ____ Inches
FOUNDATION WALLS
Manufacturer _________ Thickness/Type _____ R Value ___ _
GENERAL CONTRACTOR ______________ LICENSE NUMBER ____ _
BY ____________ TITLE __________ DATE _______ _
INSULATION CONTRACTOR DANA JOHNSON lNSULATION,INC. LICENSE NUMBER 306493
BY ft ---"-T-IT_L_E_A_u_t-ho_r_iz-ed-R-ep-,e-,-en-,a-tive DATE __ 01_/,_/_.l-_/_9_/ __
Bl Form #121
22175
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~ ([1'rttftratr 11f O)rr1t}i;.~1tffi (··.t\ ~
~ CITY OF CAR'SB/\•) 1
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.'"·· ":::> A •j'.'s. -. .~ .... \I•, ,, , " ~ " • t<-• 'l. ,. . \ . \l-' -~ .1-;!> « ,, _. '-.~-•,.;·, ~ j This Certificate issued pursuant to the requirements of Section 306 <,4 ,i.:'-J.; . i
j of the Uniform Building Code certifies that at the time of issuance ~
~ this structure complies with applicable ordinances of the City ~ J regulating building construction use. f
~ Use Classification STNGT.E FAMILY DWELT.ING Bldg. Permit No. 80-616 ►
3 3 » Group R Type Construction VN Fire Zone..= _____ Use Zone______ ~ ' ,:,,;,--
~ Occupant load____________ ---~-----____________ ·------------------\-~ j Owne, of Buildin~Ciu:l.sb.a.d Dev. Corp__,_ __ :Add,es, J' .o._ JJQ)C_IL_~?..L~-~!;>?.~_, _ _Q_A__ t
/4 Building Add,eu .. 1677 James _P:i;ive Locoli1y __ C_s1.J;",1.sbad CA .
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/4[ /4f By .e:=:( (~ -rn a;u,. ~ ______________ o.,c3;Nl /
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