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Home My WebLink About1826 Magnolia Ave; ; 79-5311; PermitLICENSED CONTRACTOR'S DECLARATION f ~ereby affirm that I am licensed under provi• ns ol Chapter 9 (commencing wllh Section 7QOO) ol Division 3 or the Business and Profes• slbns Code, and my llcense is In full force and el- le I. OWNER-BUILDER DECLARATION 1:)1 hereby affirm that I am exempt from the Con• lractor'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, demollsh, or repair any s1ructure, prior lo Its Issuance also requires the applicant for such pennlt to file a signed state• ment that he is llcensed pursuant to the provi- sions 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 perm t subjects the applicant to a civil penalty of not more than five hundred dollars ($500). □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 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). '.JI, as owner of the property, am exclusively con• tracling with licensed contractors to construct the project (Sec. 70«, 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 wllh a contractor(s) license pursuant to the contractor's License Law). I am exempt under Sec ____ ~ B. & P.C. for this reason ___________ _ Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of con• sent to self-Insure, or a certificate ol Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Labor Code). POLICY NO ____________ _ COMPANY ____________ _ □Copy IS llled with the city. □Certified copy Is hereby lurnlshed. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed If the per• mil Is for one hundred dollars ($109) or less). I certify that In the pertonnance 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 Workers' Compensation Laws of California. NOTICE TO APPLICANT: U, after making this Cer· llflcate 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. CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction len• ding agency for the perfonnance of the work for CITY OF CARLSBAD-B UILDING DEPARTME NT USE BALL POINT PEN ONLY APPLICATION & PERMIT 1200 ELM AVENUE (714) 438-5525 / Y ~l,1 ,/.1, 21 f ~ Lf4 /f.v , JOB ADDRESS tRr li~R~,oN I I I I I I I I I I I I I I I ow77 Tlli<Yr"i: w-;; LllP-~ OWNER'S PHONE PRIME CONTRACTOR / "/ ,. 7~f' -/I/KS.,,,, ~~~/.✓-=== OWN~~ MAILING ADDRESS h£2A;~M-W~ -:},12.,,-c,_ LOT BLOCK I SUBDIVISION I ASSESSOR'S PARCEL NO, DESIGNER ,. I I I I I I I I I I I DESCR IP C'NnORK L ~L~ /.Jnr> ~u DESIGNER'S ADDRESS ,. ·1 .... -- CENSUS TRACT GP LAND USE ZONING APPLICANT TO FILL IN INFOR - MATION WITHIN RED LINES. PERM IT NUMBER II\ LICENSE ?f-s31/ STA\ICENSE CONTRAC\S PHONE I I STATE LICEN\ 0 I 0 I Li DESIGNER'S PHONE\ • /14/ ·.or 9 I I ~I I RES. UNITS I ;RKING SPACE s. f . I NUMBER OF STORIES Not V•lid Unlffs Machin, c.rtifi«J 1 i.ci t13c..r "> eLsusF.6 OCC. GP I STANDARD PLAN It . I PLAN ID II I TYPE CONST I occ. LOAD I QTY. PLUMBING PERMIT AMT. QTY. MECHANICAL PERMIT AMT. '-.... ~A.CH FIXTURE TRAP '....._ INSTA LL FURN. DUCTS UP TD 100,000 BTU EACHlllrH.QJNGSEWER ............. OVER 100.000 BTU EACH WATER H~ANO/OR VENT BOILER/COMe.(lESSOR UPTO 3 HP EACH GAS SYSTEM 1 TO .f'o-yJJ.ETS BOILER/COMPRES'SOR..3_•15 HP EACH GAS SYSTEM 5 OR MORE -.....--.... BOILER/COMPRESSOR 16·3~ EACH INSTAL , ALTER, REPAIR WATER PIPE ............... VENT FAN SINGLE DUCT ----.....__ valuation: "3~yo -=-- EACH LAWN SPRINKLER SYSTEM ---· MECH EXHAUST -HOOD/DUCTS .............. WATER SOFTNER -RELOCATION OF EA FURNACE/HEATER --......._, BUILDING PERMIT I '(}•q'7 i--. .; __ ,. .. _ ~ (\(\ ; .,..,.,, .... i .on SIGN PERMIT I "(" IJ I . . TOTAL PLUMBING TOTAL MECHANICAL 1~ ':F.~~ PLAN CHECK I . CONTRACTOR CONTRACTOR ALL INCLUSIVE PERMIT i I ELECTRICAL PERMIT AMT. ~ AMT. TOTAL PLUMBING I I I QTY . !'--...... MOBILE HOME PERMIT ELECTRICAL I 'f/ . ...,...- NEW CONST EA AMP/SWT/BKR AWN~ MECHANICAL I 1 I 1 PH .. 25 3 PH PORCH ........__,__ MOBILE HOME I 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 I -. I REMODEL/ALTER PER CIRCUIT .C 0~ FENCE OVER 6' "--I I I I . TEMP POLE 200AMPS TOTAL MOBILE HOME ............ MICO-FILM I . I I I OVER 200 AMPS ,, I . I I ; I TEMP OCCUPANCY 130 DAYS) "--I . I I I issue 2.00 I . I I I TOTAL ELECTRICAL 7..!!!:-TOTAL FEES PAYABLE I ~Cl' CONTRACTOR . I I . I I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION ANO PERMIT, ANO 00 •AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER school f ees: HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE ANO CORRECT ANO I \~~:~e"o/ •mo=•P• ~ FURTHER CERTIFY ANO AGREE IF A PERMIT IS ISSUED; TO COMPLY WITH ALL CITY, ""~ .'.~"'""'·"'"' ~ COUNTY ANO STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I,ALSO AGREE TO SAVE INDEMNIFY ANO KEEP HARM- LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO -EXPENSES WHICH MAY IN ANY VVAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE - OF THE GRANTING OF THIS PERMIT. APPLICANT'S SIGNATURE'(/ OWNER9", CONTRACTORQ l""~O~ . .L /,~ ~ > AGENT D BY PHONED / ·--,, "I I ~~ ,F / SITE• 7'):_~~I I ADDRESS: OWNER: PERMIT NO: FIELD INSPECTION RECORD - INSPECTION DATE INSPECTOR INSPECTOR'S OTES WOOD FLOOR FOUNDATION• FORMS• SET BACK • TOILET UNDER FLOOR PLUMBING UNDER FLOOR HEATING OK TO INSTALL SUB FLOOR - -SLAB FLOOR UNDER SLAB PLUMBING FOOT! NG • 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 T APE ,. EXTERIOR LATH OK • PLACE STUCCO FIREPLACE . DAMPER &STEEL PLATE Tl Es/HEIGHT OF CHIMNEY OTHER T EMP POWER (POLE) SEWER GAS TEST SWIM POOL• STEEL BONDING • PRE DECK • FENCE PREPLASTER SHOWN • FRAME • PAN I I FINAL INSP BY BLDG DEPT lU ! r~ ,( ,A}/" V - OTHER DEPi''S REQ COMPLETED 1/Y 0 Io [ ELEC METER-PERM-TEMP GAS METER-PERM-TEMP CERT OF OCCUPANCY ISSUED ,,. \J.i ., {, JS..,. 411).o/,-/ BUILDING DEPARTMENT INTERDEPARTMENTAL INFORMATION SHEET DATRECEIVED BUILDING ADDRESS: DEC 1 4 197q ' y I C 7 c:J s-Q ~ 12'i tl-v if..-,,' CITY OF CARLSBAD 8uildi11g Depa1 tment PLANNING DEPARTMENT ZONE ·l-:-( LOT SIZE LOT WIDTH ------------------- UNITS ALLOWED UNITS PROVIDED ------------------------ PARKING SPACES REQUIRED PROVIDED ---------------------- PROVIDED ------------------------% COVERAGE ALLOWED BUILDING HEIGHT ALLOWED PROVIDED --------------------- FRONT SETBA~ ALLOWED _ __,,_~~---- PROVIDED ______ _ INTRUSIONS SIDE SETBACK: &rt LANDSCAPE & IRRIGATION PLAN COMMENTS : ENVIRONMENTAL PROTECTION REQ: SCHOOT, PEES : DISTRICT: ADDITIONAL COMMENTS: REAR SETBACK: erA .AMOUNT :. . OK TO ISSUE: o//4._,l,, DATF/lf 1!/ltoK TO FINAL _______ DATE ___ _ ENGINEERING DEPARTMENT ~ JJ,..,...12.., 3 ".(J Q R.O.W. INDUSTRIAL WASTE ------_______ IMPROVEMENTS _______ _ S~WER .CONNECTION DRIVEWAY LOCATIONS GRAD I NG PE RM IT _______ EASEMENTS ', :~ ~ =e?_.A.:¼-: __ <'J_~....,..D-R_A_I_N_A_G_E ____ _ LEGAL DESCRIPTION ______________ ~--------------- ADDITIONAL COM~TS __________________________ _ FIRE DEPARTMENT SPFitiKLING 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 _______ __.