HomeMy WebLinkAbout1749 FOREST AVE; ; 87-697; Permit"' z 0 \i "' .. ~ u ...
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O I hereby affirm that ! 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
I hereby a1hrm that I am exempt from the Contrac
tor·s License Law tor the tollow1ng reason (Sec 7031 5
Business and Pro1ess1ons Code Any city or county wh,c~ re
qwes a permit to cons!ruc!. alter ,mprove, demolish. or
repa,r any structure. prior to its issuance also requires !he ao
pl,canl for such perm,t to hie a s,9ned statement lhal he ,s
licensed pursuant to the prov1s1ons o1 the contrac10, s License Law (Chapter g commencing with Section 7000 ot o,v,s,on 3 o1 the Business and Professions Code) or !hat ,sex
empl therefrom and the basis 1or the allegeo exempt>On Any
,iola11on ot Section 7031.5 by an applicant lor a permit sub 1ects lhe appl1cant 10 a c1v1I penalty 01 not more than five hun
dred dollars ($500)
I_ as owner ol the property. or my employees w11h wages
as lhe11 sole compensation. will do the work. and the struc-
ture ,snot ,ntended or oltered for sale (Sec 7044. Business and Profess,ons Code The Con1rac10,·s License Law does
not apply to an owner of property who builds or improves
thereon and who does such work h1msel1 or through his own employees. provided that such improvements are not intend
ed or altered for sale 11. however. the building or 1mprove-
men1 ,s sold w,thin one year ot completion. the owner·bu1lder
w1II have the burden o1 proving that he did not build or 1m-pr0\le for the purpose ot saleJ
I, as owner 01 the property, am e,clus1vely contracting
w,th 1,censed contractors to construct the pro1ecr 1sec 7044 Business and Professions Code The Contractor's License
Law does nol apply to an owner of properly who builds or 1m proves thereon, and who contracts for each pro1ects with a
con1ractor(sJ license pursuant to lhe Contrac1or's License 1 Law)
I i As a homeowner I am 1mprov1ng my home and the follow
1ng cond1t1ons exist 1 The work 1s being performed prior to sale 2 I have lived 1n my home 1or twelve monlhs
prior to completion o1 !his work I have no1 claimed this exemption durmg \he
last three years
C I am exempt under Sec ------B & P.C
lor this reason-------------
L I hereby allirm that I have a cer11focate of consent to
self-insure. o, a cert1flca1e of Workers Compensation In
surance. or a cer\1f1ed copy thereof 1Sec 3800. Labo, Code!
POLICY NO
COMPANY
Copy 1s 11 led with the city
C: Cer1,f1ed copy 1s hereby furnished
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
1Th1s section need not be completed 1/ the permit
1s tor one hundred dollars ($100) or less)
~ I certify that 1n the performance ot the work !or wh,ch I
this perm1t 1s issued. I shall not employ any person 1n any
manner so as to become sub1ect to the Workers· Com pen
sat,on Laws ol Cal1fom<a
NOTICE TO APPLICANT: 11. alter making this Cert1f1cate
of Exemption. you should become sub1ect to the Workers
Compensat,on provisions of the Labor Code. you must
!orthw,th comply w1!h such provismns or this permit shall
be deemed revoked
'.J I hereby af!Lrm that there 1s a construction lending
agency for the performance of the work tor wh•ch this per
m,t 1s issued \Sec 3097 Civil Gode)
Lender's Name ________ _
Lender's Address
USE BALL POINT PEN ONLY & PRE~S HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT 2075 Las Palmas Dr., Carlsbad, CA 92009-4859 (619) 438-1161
JOB ADDRESS
~e.rr~~
AV. ST.AO. NEAREST CROSS ST. _p 1°·:r~~;; BUSINESS LICENSE # VALUATION PERMIT NUMBER
/7~, #~3 d .. L'4 J/y 1 /fp7 LOT BLOCK 1 SVBDlVISlON ASSESS/R PAiEL NO. (/ , / CONTRACTOR CONTl"IMv)f'n•PHONE# ZONE
,.,,, /,:JO-:;>:,
OWNER'S NAME ~ £·-.r--1,YJ;:.;"p;"-3 • •
..,P4,1,l! d r-£ CONTRACTOR'S AT "'JJ //J-if-STATE LICENSE NO, BUILDING SQ FOOT.A.GE
OWNE R'Sai,JI,! LING ADDRESS a,,1./.,__k' ---~ DESIGNER V OESIGNE R'S PHONE / ?'Y?' ,,-,, .,<e.r/ re_
OE~NOFWORK
.. -j4!!!.-----¢/-_ ~ .. _._ / OES!GNEA'S ADDRESS ST ATE LICENSE NO.
.r1 . .),,h '«--~.-2__. .:J a c::> ~ ,,,,, • H FLA ELEV NO OCC GP EDU 0020 08/12 0101 021::ldPmt 55.0 ·' -·---;, STORIES
YD '-.[J
I ! PARKlf\,G SPACf-AES UNITS I GRADING PERMIT ISSUED I REDEVELOPMENT TYPE DCC LOAD FIRE SPP
AREA CONST
,o ND ,c "JO YO ND Not V~lid Unlers Machine Certd,ed
QTY. PLUMBING PERMIT· ISSUE ' '1.50 QTY. MECHANICAL PERMIT -ISSUE /Z'oa SUMMARY/ACCOUNT NUMBER
EACH FIXTURE" TRAP INSTALL FURN DUCTS i.JP TO 100,000 BTU BUILDING PERMIT 001-810-00-00-8220
-~
T EACH BUILDING SEWER OVER 100.000 BTU SIGN PERMIT 001-810-00-00-8?21
---r~------1----- -----------
EACH WATER HEATER ANU.OR VENT BOILER,COMPRESSOR UP TO 3 HP PLAN CHECK iCLE:~11'1· --
EACH GAS SYSTEM I TU40UTLETS . -u._ ---+ BOILER/COMPRESSOR 3 15 HP ~
TOTAL PLUM Bl -'"
-----. ---------·------------------------5'5, .ri) EACH GAS SYSTEM '.l OR MORE' ---+--I 1,1ETAL FIREPLACE -~ ELECTRICAL 001-810-00-00-8223
------------.G.U G orll6ol9ili!722, EACH INSTA!,.. ALTER, REPAIR WATER PIPE -+ VENT FAN SINGLE DUCT --_;.____ MECHANICAL
~ ~------------------------- -----·
EACH VACUUM BREAKER MECH EXHAUST HOOD 'DUCTS MOBILEHOME 001-81 0-00 ·00-8225
WATER SO~TNER RELOCATION OF EA FURNACE:HEATER Cltv ofoC " '
'
SOLAR
~ ---
t.ACt-1 R()()f 1.JHA1\J i''l;S lJL1 DRYER VENT S1 RONG MITTKl!iQJlMENT PRC!lC!iSSDl~ ... ------
L_ ---' TOTi=-L MECHANICAL FIRE SPRl~Jr<.LERS 001 · 810-00-00-8227
--
I I [J l AL PLUMB INC PUBLIC FACILITIES FEE 320-810-00-00-87 40 -
BRIDGE FEE 360-810-00-00-87 40
QTY. ELECTRICAL PERMIT· ISSUE <uo QTY MOBILE HOME SETUP PARK-IN·LIEU (AREA I
NEW CONST EA AMP SWl HKR '
CAR PORT Tlf 134-810-00-00-8835 -----
I PH J PH AWNING LA COSTA TIF 133-810-00-00-8835 -
EXIST BLOG EA AMP,SWT BKR GARAGE FMF -
I PH J PH LICENSE TAX QOi-810-00-0C-8162 ---_L ;;zio <Cr, .<TO. REMODEL AL TfR PER CIRCUIT MFF 880-519-92-57
---
TEMP POLE 200 AMPS -----
OVER 200 AMPS -----------
TEMP OCCUPANCY f30 DAYSI _j -
: . CREDIT DEPOSIT
TOIAL EL(CTHILAl 1 ~:5-l!V !OTAL TOTAL FEES PAYABLE I 5',,r I rro
! HAVE CAREFULLY EXAMINED THE COMPLETED '"APPLICATION AND PERMIT'" ANO 00 HEREBY E)lpiratton. Every permit issued by the Bu1ldtng Ott,cral under the provisions ofttus * AN OSHA PEFIM:T IS REQUlREO FOR EXCAVATIONS OYER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall expire by hmitation and become null and void If the building or work s· o·· DEEP AND OEMOUTK>N OR CONSTRUCTION OF
DECLAAAT!ONS ARE TRUE AND CORRECT AND I FURTHEFI CERTIFY AND AGREE IF A PERM!T 15 authortHd by such permit is not commenced within 180 days from the dale of such STRUCTURES OYER 3 STORIES IN HEtGHT
!$SUED: TO COMPLY WITH ALL CJTY. COUNlY AND STATE LAWS GOVERNING BUILDING CON· ~~~::Or!:ct l~t t;~ .. ~,:::iJ.~~h=~~r:~:h:~:'e~%eJ~~7 r~~!~,s~:rd".~ or
STRUCTION WHETHER SPECIFIED HEREIN OR NOT l ALSO AGREE TO SAVE INDEMNIFY AND ·-,. & OWNERJJJl CONTRACTOR 0 APPROVED BY , / DA TE KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS, COSTS AND AE'!'l\CANT'S SIGN~~
EXPENSES WHICH MAY IN ANY-WAY ACCRIJE AGAINST SAID CITY !N CONSEQUENCE 0~ __/.) ~ _ f1~ft'7 ){jL,f! .. =· GRANTING OF THIS PERMIT. t ,. BY PHONE 0
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TYPE I DATE INSPECTOR
BUILDING I
FOUNDATION '
REINFORCED STEEL I
MASONRY ' I
GUNITE OR GROUT I
SUB FRAME D FLOOR D CEIL.ING
SHEATHING D ROOF D ShlEAR
FRAME I
EXTERIOR LATH I
INSULATION I
INTERIOR LATH & DRYWALL I
I
PLUMBING ' J SEWER AND BUCO _ PL/CO
UNDERGROUND 0 WASTE [l WATER
TOP OUT 0 WASTE D WATER
TUB AND SHOWER PAN I
GAS TEST I
0 WATER HEATER D SOLAR WATER
I
ELECTRICAL I
0 ELECTRIC UNDERGROUND n UFFER
ROUGH ELECTRIC I
0 ELECTRIC SERVICE 0 TEMPORARY
D BONDING D POOL I
I
MECHANICAL !
D DUCT & PLEM., 0 REF. PIP.ING
HEAT -AIR COND. SYSTEMS I
VENTILATING SYSTEMS I
!
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
--· ITEMS ABOVE HAVE BEEN APPROVED.· -.
FINAL I
PLUMBING I , . ...:. . ,
I
ELECTRICAL I ' ' '
MECHANICAL I \ ' ,......,-
' ':--'.) GAS . -I "'--' ........ .
BUILDING I . \ "\
. '"'"' ....., SPECIAL CONDITIONS I "'--.,,,,,,,,_
.
'
r -_-, -----·-,~,::1'--;-v;~<:'.i-=;J_-
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS
INSPECTION REO IF INSPECTORS
CHECKED APPROVAL DATE
--------p-~
SOILS COMPI_IANlf
PRIOR TO
FOUNDATION INSP
----+------·----STRUCTURAL CO".CRE-TE
OVER JOOCJ PSI I !-'RfSTHESSED I --+------
INSPECTOR'S NOTES
---------------------j
:~~~~::~IONEC =r=-± --=1=-~ ==============~ COC,CRETE -·----_
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