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Home My WebLink About1853 LILAC CT; ; 80-99; 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 el• feet. OWNER·BUILDER DECLARATION C'I hereby affirm that I am exempt from the Con· tractor's License Law for the following reason I (Sec. 7031.5 Business and Professions Code), Any clty or county which requires a permit lo con· struct, alter, improve, demohsh, or repair any structure, prior to its issuance also requires the ·'!)plicant 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 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). r_· 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• fared 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). --::.1, as owner of the property, am exclusively con• tracting with licensed contractors to construct the project (Sec. 7044, Business <'.nd 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 w+th 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 of Work.a·~· Compensation Insurance, or a certiped c thereof (Sec. 3800, Labor Code). \~ POLICY NO. ~~ COMPANY ~ LCopy is filed with the city. C...:Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS" COMPENSATION INSURANCE (This section need not be completed if the per- mit is for one hundred dollars ($100) or less) I certify that in the performance of the work. for which this permit is issued. I shall not employ any person in any manner so as to become subject to the Work.ers' Compensation Laws of California. NOTICE TO APPLICANT: If, after mak.ing this Cer· tilicate of Exemption, you should become subject to the Work.ers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked CONSTRUCTION LENDING AGENCY t hereby affirm that there is a construction len- ding agency for the performance ot the work. for which this permit is issued (Sec. 3097, Civil Code). CITY OF CARLSBAD-BUILDING DEPARTMENT USE BALL POINT PEN ONLY APPLICATION & PERMIT 1200 ELM AVENUE (714) 438-5525 "· JOB ADDRESS AVRi>T. DATtE;F APPLICATION / , .ir,~, 3, ,L,J,L,F\C.., ,,,-,;-' , (·. ii K, L, .::, ~ ,l, 0 , I (', i,, I I I , , I -3 ;)8C OWNER OWNER'S PHONE PRIME CONTRACTOR • Kr:x h, iL·r:: i' I>'. A-/. ;__7:i J -5-;). s,-'l tvhl Sda,-Cc,~+', l OWNER'S MAil iNG ADDRESS C ,._.'-l)v ,-A CONTRACTOR'S ADDRESS ..$'..) IJ..Jh\ I '5' S 5 (_, 1,c C-t CA ' 7 ", 7c C•c~t:.__fc,. °T ~) co, BLOCK I SUBDIVISION l ASSESSOR'S PARCEL NO. DESIGNER '' j ;2,l ,'S",-,.Y,;l,1,--, 1,L I DESCRIPTION OF WORK <:;: ,_/~;-,'.);:_~1qo_l~ ~\ s Lo_, DESIGNER'S ADDRESS ANn S"/~ .... ' k/2 Ha~IVA-Ti R PA ,,,-a Is APPLICANT TO FILL IN INFOR - MATION WITHIN RED LINES. BUS. LICENS;_O /, "'9fMIT NUMBER ' ---_;>/ . ~ STATE LICENSE <?o--9~ I ·7 5'3 (,, ti bl CONTRACTOR'S I ~HONE i"i--,,, L) STATE LICENSE DESIGNER'S PHONE ~ CENSUS TRACT PARKING SPACE NUMBER OF STORIES 4 ,c GP LANO ust ~f '°'p,t&(/,V T~ JI '"· '"'' Not Valid Unless Machine CMtifitld BLOG SQ. FT. BLOG USE OCC. GP ST AN DARO PLAN ti IPLANIDtl I TYPE CONST I acc. LOAD I (!TY. PLUMBING PERMIT AMT. QTY. MECHANICAL PERMIT AMT. "c"ACA FIXi Gitt TltAP . 1'---' " ~ INSTJi.Ll FURN. DUCTS UP TO 100,000 BTU EACH BUILDING SEWER :,;, 7C../ Q'Yv" OVER 100,000 BTU EACH WATli,A IIE~fEII )!ii!U,1BR VEJP\,V// .1.. . BOILER/COMPRESSOR UP TO 3 HP EACH GAS SYSfEM 1 TQ 1 Olttt:HS--.;:L .. ::....-:.. BOILER/COMPRESSOR 3-15 HP EACH GAS SYSTEM 5 0 R MO RE ' I BOILER/COMPRESSOR 16·30 HP EACH INSTAL., ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT -2 (Jt :' -•·::: EACH LAWN SPRINKLER SYSTEM MECH EXHAUST -HOOD/DUCTS .. WATER SOFTNER RELOCATION Of EA FURNACE/HEATER BUILDING PERMIT SitJ<".,4-,2..., I 1/0. -i-=-~-' \..7.C'~ SIGN PERMIT I I I . I TOTAL PLUMBING /0 e..-TOTAL MECHANICAL PLAN CHECK I I 'p .-I CONTRACTOR CONTRACTOR All INCLUSIVE PERMIT I I . I ELECTRICAL PERMIT AMT. TOTAL PLUMBING I I . I QTY. AMT. QTY. MOBILE HOME PERMIT ELECTRICAL I I . I NEW CONST EA AMP/SWT/BKR AWNING MECHANICAL I I . 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 REMODEL/ALTER PER CIRCUIT FENCE OVER 6' I I I . I TEMP POLE 200 AMPS TOTAL MOBILE HOME M!CO-FILM ' I I . I OVER 200 AMPS I I I . I TEMP OCCUPANCY (30 DAYS) I I I . I I I I . I TOTAL ELECTRICAL TOTAL FEES PAYABLE I ,l,~-y CONTRACTOR I I I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT, AND DO "AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER 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 ISSUED;TO COMPLY WITH ALL CITY, STRUCTURES OVER 3 STORIES IN HEIGHT COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER A ----.---µrth._;, SPECIFIED HEREIN OR NOT. 1,ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM- LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND ' EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. APPLICANT·S SIGNATURE" OWNE}~; CONTRACTOR □ IAPPZVED BY DATE AGENT BY PHONE O lt,_.lf.,,() 2-5" 11r;fi; ' , ! ~ 0 ~ 15 i= u w Q. V, ~ ~ SITE 80-q'r ADDRESS, OWNER: PERMIT NO: FIELD INSPECTION RECORD INSPECTION DATE INSPECTOR INSPECTOR'S NOTES • WOOD FLOOR 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 I ~ w '/j?r' OTHER DEPT'S REQ COMPLETED I 'U' ' ELEC METER-PERM-TEMP i GAS METER-PERM-TEMP CERT OF OCCUPANCY ISSUED -