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Home My WebLink About1704 EVERGREEN CIR; ; 81-114; Permitf LICENSED 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 c,1 hereby affirm that 1 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 tt,e 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 live 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. II, 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) :::,I, 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 rm· iects with a contractor(s) license pursua th contractor's License Law). t \ am exempt under Sec._____ B . for this reason_______ __ Date ______ Owner X WORKERS" COMPENSATION DECLARATION I hereby affirm that I have a certificate of con- sent to sell-insure, or a certificate of Workers· Compensation Insurance. or a certified copy thereof (Sec. 3809, Labor Code). POLICY NO. 'f~~~ COMPANY A t3? ..,.,,.....,,.1,.. - ~PY is filed with the city. ,JCertified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section r.~ed not be completed if the per- mit 1s for one hurL1red dollars ($100) or less). \ certify that in the performance of the work for which this permit is issued, I shall not employ any person in any man1·er so as to become subject to the Workers· Comi,&nsation 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 SJCh provisions or this permit shall be deemed revo.,ed. CONSTRUCTION LENDING AGENCY I hRrRhv affirm that there 1s a construction len- CITY OF CARLSBAD-BUILDING DEPARTMENT APPLICATION & PERMIT USE BALL POINT PEN ONLY 1200 ELM AVENUE (714) 438-5525 "· JOB ADDRESS AV.ST. !DATE Of APPLICATION RO I ,1 17,n,1,1 ,,:, ,'1 ,,:, JR f'! T 1' ..-U I ' ' I I I I I ' ' ' ' I , , _ -- OWNER OWNER'S PHONE PRIME CONTRACTOR - WARREN F, CHAPMAN BOBS PLUMBING SERVICE OWNER'S MAILING ADDRESS CONTRACTOR'S AODRESS 1704 Evergreen 2501 State St,, Carlsbad LO• BLOCK i SUBDIVISION i ASSESSOR'S PARCEL NO, DES!GNER ' ' ' ' ' ' ' ' ' ' ' OESCRlPTl'f OF £a5::L • ns ation of Gas Water Heater DESIGNER'S ADDRESS C ENSUs TRACT GP LAND USE ZONING UNITS APPLICANT TO FILL IN INFOR- MATION WITHIN RED LINES. BUS. LlCENSE PERMIT NUMBER 21471 11f ST ATE LICENSE 24~"0? CONTRACTOR'S "'29-2055 STATE LICENSE 3103/8 ! 61li9 DESIGNER'S PHONE oc ~:-103~9 3 /fJ:~ I ~ . ' .. I "'· I PARKING SPACE I NUMBER OF sTOR\ES Not Vahd Unlesr Machine CartifitJd SLOG SQ. FT. BLOG USE occ. GP I STANDARD PLAN 1t I PLAN ID;,-! TYPE CONST ! OCC. LOAD I ClTY. PLUMBING PERMIT AMT. UTY. MECHANICAL PERMIT AMT. EACH FIXTURE TRAP INSTALL FURN. DUCTS UPTD 100,000 BTU EACH BUILDING SEWER OVER 100,000 BTU 1 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 Sl~!GLE DUCT EACH LAWN SPRINKLER SYSTEM MECH EXHAUST -HOOD/DUCTS ')/A./=-""tJ-:, ; WATER SOFTNER RELOCATION OF EA FURNACE/HEATER BUILDING PERMIT I I I I / A A~• • J' 0 (1 , . . <.,,-,e,1 SIGN PERMIT I I I I TOTAL PLUMBING 5 00 TOTAL MECHANICAL PLAN CHECK I I I I CONTRACTOR CONTRACTOR ALL INCLUSIVE PERMIT I I -~ ELECTRICAL PERMIT TOTAL PLUMBING I t./ . ....... UTY. AMT. UTY. MOBILE HOME PERMIT AMT. ELECTRICAL I u./ NEW CONST EA AMP/SWT/BKR AWNING MECHANICAL I I I 1 PH .15 3 PH PORCH MOBILE HOME I I I EXIST BLOG EA AMP/SWT/BKR SET-UP SOLAR I I I I 1 PH .15 3 PH RAMADA, CABANA ,---re-. -, T, I I I I REMODEL/ALTER PER CIRCUIT FENCE OVER 6' c;.,-I I I I TEMP POLE 200 AMPS TOTAL MOBILE HOME MICO -FILM ! I I I OVER 200 AMPS I I I I TEMP OCCUPANCY (30 DAYS) I I I I J ... 't.._L...-.,2....--(}U I I I TOTAL ELECTRICAL TOTAL FEES PAYABLE I I~ ~ CONTRACTOR I I I ........ ~ I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT,ANO 00 "AN OSHA PERM OT IS REQUIRED SOR EXCAVATOONS OVE~~ ::;-..u.-,/ HEREBY CERTIFY THAT ALL INFORMATION HEREON 15 TRUE ANO CORRECT AND I 5'-0" DEEP AND DEMOLITION OR CONSTRUCTION OF .., FURTKER CERTIFY ANO AGREE IF A PERMIT IS ISSUED;TO COMPLY WITH ALL CITY, STRUCTURES OVER 3STOAIES IN HEIGHT COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM LESS THE CITY OF CARLSBAD AGAINST A LL LIABILITIES, JUDGMENTS. COSTS ANO I EXPENSES WHICH MAY IN ANY I/VAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE . . OF THE GRANTING OF THIS PERMIT ~CANT'S SIGNATURE" .// OWN ERO CONTRACTORQ !APPROVED BY l WI; l'/-i Cl ., c .. :r ,If;-);? " . AGENT 0 BY PHONED J r : r - ,_ SITE ADDRESS: WOOD FLOOR INSPECTION 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 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 OTHER DEPT'S REQ COMPLETED I ELEC METER-PERM-TEMP i GAS METER-PERM-TEMP DATE INSPECTOR "1 ~--------------+-----+------ f-------------------- ' CERT OF OCCUPANCY ISSUED ------'-----'----- OWNER· PERMIT NO· FJELD INSPECTION RECORD INSPECTOR'S NOTES I I l -----