HomeMy WebLinkAbout2014 PINTORESCO CT; ; 80-784; 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
DI hereby affirm that I 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•
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).
D I, as owner of the property, or my employees
with wages as their sole compensation, wlll do
the work, and the structure Is not Intended or of•
fered for sale (Sec. 7044, Business and Profes•
slons 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•
tractlng 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 contractorjs) 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, o< a certificate of Workers'
Compensation Insurance, or a certified copy
thereof (Sec. 3800, Labor Code).
POLICY NO ___________ _
COMPANY ____________ _
□Copy Is filed with the city.
□Certified copy Is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed If the per•
mlt 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 Workers' Compensation Laws of Callfomia.
NOl'iCE TO APPLICANT: If, after making this Cer•
tlflcate of Exemption, you should become subject
to the Workers' Compensation provisions of the
Labor Code, you must forthwith comply with such
provlslci.ns or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
1 h&f'•hv •ffirm th.•• thArA I~ a construction len•
CITY OF CARLSBAD-BUILDING DEPARTMENT
USE BALL POINT PEN ONLY APPLICATION & PERMIT
1200 ELM AVENUE (714) 438-5525
NO. JOB ADDRESS
~·R~T. IOAT~/~;: l2 1,-,., ,+. If,, ,AJ.-r,D,e ..s: ~.c.o. {1+1, I 1 I I I I I I I I I
OWNER OWNER*S PHONE
PRIM; 5tl)C~ _. • f"~-h ~ {)U~Ll, ~~+
OWNER'S MAILIIIG ADDRESS
;;}C/4 p,tJ-to ~e-s~o c._+-. CONTRACTOR'S ADDRESS ~-.0, C/RJ/J
7370 rm,.,, T;;,: 71-_ .
~ BLOCK l SUBDIVISION I ASSElSOR'S q,RCEL NO. ·,~ DESIGNER G AA f.. J , ::2, I , , -, 8, I , -rOO
DESCRIPTION OF WORK rJi '{)rnt-C '8 -<C) ~~ DESIGNER'S ADDRESS \ T -
CENSUS TRACT GP LANO USE ZONING
APPLICANT TO FILL IN INFOR-
MATION WITHIN RED LINES.
BUS, LICENSE PERMIT NUMBER
ol.OQ <Jq
Pt-7fj/ STATE LICENSE
~01,S?
CONTRACTOR'S
PHONE 'Jf t .;J.'"'J?-7/IT)
STATE LICENSE ----
DESIGNER'S PHONE
.e1 G'•.u:.:
I RES, UNITS I PARKING SPACE I NUMBER OF STORI ES
Not V•lid Unwss Machin, c.rtifiad
BLOG SO, FT. BLOG USE OCC. GP 1 STANDARD PLAN II
1 ra1
:
11
7 iv I TYPE CONST I occ. LOAD I
QTY. PLUMBING PERMIT AMT. QTY. MECHANICAL PERMIT AMT.
EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100,000 BTU
EACH BUILDING SEWER OVER 100,000 BTU
EACH WATER HEATER ANO/OR VENT ,,,L,)/J 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 8,11c;f ~ EACH LAWN SPRINKLER SYSTEM MECH EXHAUST -HOOD/DUCTS I
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER BUILDING PERMIT
., -' Vi ..LiJ.V.nr. . .~,ia. A .l'JO SIGN PERMIT ~ ·~ --~ , I /1 , 11 I I
TOTAL PLUMBING -,. 00 TOTAL MECHANICAL PLAN CHECK / ol"f-;/ ~ '11 ' I I I I .
CONTRACTOR CONTRACTOR ALL INCLUSIVE PEn,,n', I I I
ELECTRICAL PERMIT AMT. AMT. TOTAL PLUMBING I '·"~ QTY . QTY. MOBILE HOME PERM IT ELECTRICAL I ::..~
NEW CONST EA AMP/SWT/BKR 5«) AWNING MECHANICAL 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 MICO·FILM I I I I
OVER 200 AMPS I . I I ; I -
TEMP OCCUPANCY (30 DAYS) ~t--rnna Mnt-;nn I I I ...S."'T
1c;9')g-t,.~
..,
I I . I I
TOTAL ELECTRICAL 7.0() TOTAL FEES PAYABLE I ,,? . .ti'/ CONTRACTOR . I I .
\
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION ANO PERMIT, ANO 00 •A OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER SCHOOL FEES:
HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE ANO CORRECT ANO I -0" DEEP ANO DEMOLITION OR CONSTRUCTION OF
FURTHER CERTIFY ANO AGREE IF A PERMIT IS ISSUED; TO COMPLY WITH ALL CITY, TRUCTURES OVER 3 STORIES IN HEIGHT
COUNTY ANO STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER
SPECIFIED HEREIN O R 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 WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE
OF THE GRANTING OF THIS PERMIT. ,. APPLICANT'S SIGNATURE' OWNERQ CONTRACTOR□ rPPR~ ~ J7 DATE
AGENT D BY PHONE O "~ I_.., r -I
~ -c(
0 ~
~ .:= ~ 0.
V)
~
"
SITE ' -=80 -7ff<f ADDRESS: -' . ... OWNER: , PE;RMIT NO:
' FIELD INSPECTION RECORD -
INSPECTION DATE INSPECTOR INSPECTOR'S NOTES
WOOD FLOOR j ;
FOUNDATION• FORMS• SET BACK • TOILET -
-' ~ ,. , . ' ...
UNDER FLOOR PLUMBING ., ~-. ., ~-'' -.. --~ .
UNDER FLOOR HEATING -. •· .
L • ' , -.
OK TO INSTALL SUB FLOOR -~
l I
SLAB FLOOR
UNDER SLAB PLUMBING
FOOTING • FORMS • SETBACK • TOILET r ..
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 :---... .l ----~
' . ._
DAMPER 8' STEEL .. ,
PLATE TIES/HEIGHT OF CHIMNEY
' '
OTHER ·, •.
TEMP POWER (POLE) ,,\.:' ~~.
SEWER
GAS TEST
SWIM POOL • STEEL BONDING
• PRE DECK
• FENCE PREPLASTER
SHOWN • FRAME I \
• PAN . , _\ .\ \, V / ,., " . ~-t ,.._ . j
FINAL INSP BY BLDG DEPT \ \J\ .. I\ L ./ ..... c,;.'
OTHER DER.T'S REQ COMPLETED \, \ ' I\ V •'f .... ,
''-
ELEC'Ml::T~:R-PERM-TEMP \.
GAS METER-PERM-TEMP -
\
' ' ' CERT OF OCCUPANCY ISSUED \ -. ..
1?00 f:LM .t.VENUE
CARLSO/,CI, CALlf'ORNIA 92008
TELE:PHOl~E:
(714) 729-1161
This document will certify that I am aware ~f the provisions of the
California Administrative Code, Title 24, ~~c tion T20-l406(c),
"Swimming Pool He a ting ", a.s shown on f orm DP"/.. ¥.297 . I u n derstand
tha t neither u swimming poo 1 building permit 1:tsing cl fos s i 1-fueled
heater nor a plumbing/electrical permit for a new or replacement
fossil-fuele~ i1~ater will be issued until this c ertification is
execL~ted .
For the swim.min~ pool located at~O/l/-f' ~ C:::f .
(site address) I certify that all of the followfnsr .requirements for
fossil-fueled (or electric) swimming pool heaters \d.11 be met :
l. Outdoor pool.s shal 1 be equipped w.i th a. pool cc,~~~-.
2 . ON-OFF sHi t ch on outside of hea t2r to a.J.low shu tdcwn '.tli tl1out
adjusting thermosta t and start-up witho ut r elighting pilot liyht .
3. 36 " minimem l e r.-':jth of plumbing p rovided betwee n fi lter and
hea t e r to allow future solar installation .
4. After J anuary 1 , 1982, new heaters insta lled must have 75%
thermal efficiency .
5 . Time clocks installed to allow p ump operation during off-peak
demand periods (unless pump usec1 for uctive solar).
G. Directiona l water inlets i n pool for good mixing .
Print Owners Name:
Owners Signature :
Print Contractors Numc:
Contractors Signature : Date :
Address : __ '--7_2 __ 7._o------,-_O_~Ff-~-~~--RJ~_____.:;.---
.S, D. ?~JI/