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HomeMy WebLinkAbout2019 MAR AZUL WAY; MULTI-PERMIT FILE; 86-506; Permit"' z 0 ~ "' <( .., " "' 0 "' IL l "' "' 0 .., 3 !! "' "' z ~ O I hereby affirm that I am licensed under provisions of Chapter 9 1commenc1ng w1tt, Section 7000) of □1~is1on 3 of !he Business and Professions Code, and my license 1s •'l full force and ettect Lie Ne -,,,,, JC ~,i1cr :c ",e r.r~8"''1' 8' m·1 e~:;1:,)'ee'., ;her sc'e co~Jerca·,0° r,,·1 do :~e \Jee,, -,~t 1°,teaced o: Jf•e·ec ·0· sale dnd Pr0leos :,,o CJde -he Conrra:,tor s L rot aopl) to ar, owner ol oropert)' ,,he L<J lh~rec-n end ,,ro Goes <;1.rn WJrk •,,,r\e·t or en-,plcyees. pro·,1ded :na1 suc.n :rnoro,e-~e,,:, ae r:l' ntenr. ed or ctfered 'c• sa,e 1f, howe,·er :ne tc1lc,~g o' rne,~-·,e- rnent ,s so,a w,rr,n one year 01 co"'1pler,or the Jwner-Ou, de' w, I ,ave The burde0 u' pro·1Ino thai he d1C not ~u,·.d or ,~. ~co-,e for the e,urpose o' sale)· as •Jwne' of 1ne 8rr.;ie·ty, am e,:IusI·,eI·1 :r,ntr'1c1,rg with l•censed cc•1''actors 1c canstru:t The proIect : Sec 7G4~ Business ond P'ofess1ons C~de The C8nfrc.Cf0· s '"Icense Law does no: ,1poly :o a ·1 ~r1er ot p ·oper!y who t·u .'r.s ar ,m oro,·es :nereo·, and who co1trac!s •or each VJ,tcts wit~ a conrrartorls; license ot:rsuant lo the Cco:";ie'or : License law) As a hcnieowner I J""• ,morav,ng my home a~d :ne 18 lcw ,ng cono,t,ons ex,s: 1 lhe work ,s being perlormed orsor to sa1e 2 I ha"e ,iveO 1n my home lor f,ielve months l p"or 10 comple:Ion of th,s worr 3 ~a,·e nol cla,meo :n,s exem~!·o·, duc•n,;j t~e 'ast three 1ea·s I am e,ernpt under Sec _____ _ lor th,s reason B & PC z 0 s z "' ~ .. 0 " "' "' "' "' "' 0 3 i[ I hereby afh•rn thal I ~aye a ce•t1'1cate of car.sent 10 se'f-,~sure or a certificate of Workers Compersat,on In surance. or a cert, ',ed copy !hereof I Sec 31::lOO Labor Coae1 POLICY NO COMPANY Cop·1 ,s tiled ;,·1th \he c,t,· Cert1f1ed copy ·s hereby fum,shed CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE iTh,s sect,on need not be CO'Tlp!eted ,f the per'TI,t ,s for one hundred dollars 1$100) or less) J<' I certify trial In the performance of the work tor which l~erm,t ,s ,ssued I shall not employ any person ,n any maMer so as to become subJeCt to the Worke,s· Com pen sat,on Laws of Cal,!orn,a NOTICE TO APPLICANT· If alter making th,s Cert1licate of Exempt,on. you should become subject to the Workers Compensation provIsIons of the Labor Code. you must forthwith comply w,th such pro,.sions or th,s permII shall be deemed re,oked ~ ::J I hereby affirm that there ,s a construct,on 'ending agency for the performance of the worl< for wh,cr th,s pe• rn,t ,s issued (Sec 3097 C1v1I Coae1 Lender's •fame Lender s Address , USE BALL POINT PEN ONLY & PRESS HAKU CARLSBAD BUILDING DEPARTMENT Carlsbad, California 92008-1989 (619) 438-5525 APPLICATION & PERMIT JOB ADDRESS )...() \ "\ \J\ C>.D AV. ST.RD NEAREST CROSS ST. 1).f (" -I ,?"4 DAT~F,;~1;2TION / AssessoR PARCEL ~o coNTRAcTOR OWNER"S PHONE k_ J\RJ2 .. " tJ ~u..... l OT [ BLOCK I SUBOiVLSION / I 7 A~ I ,"sM,T NUMBER :rs~":;~~~-ZONE -t 5 c.,1 & BUSINESS LICENSE t: VALUATION ,JW"-.JE R'S NAME: LICENSE NO CONTRACTOR"S ADDRESS , d-,()).,,~ OW""" MA C>NG ADORSSS \ 7"?,t ~A~ lcv<..C\b L\ o $\_ 1-01 ~ Iv\ It,.~ ~1 vl- DfSCR1P1:6N OF WORK I--c.., \\ 11.1\J_~ M.. €..,E. l=l-.._ & ~\\\,) e:_ '-' CL'\JSUS TRAC l I UIC'c>FC..,'~t:H · -· --·-·· ----··-· • OESIGNE R:, t-'HUNt: DESIGNER'S ADDRESS ' e ~ LR ELEV ,[J GRADING PERMIT ISSUE"C NO STOH-ES TYPE CONST LICENSE NO OCC GP ace LOAD EDU Fl RE SPf' PLANIQ.1'1' ' L ·,j i, I i BU!LDING SQ FOOT-'GE I '" CANO use I >AR'"'" SeACC ReS u,,,, I ,□ f, □ I RE:DE:VELOP.,,,ENT AREA ,::::::; -...o vO ND Not Valid Unless Machine Cert1/1ed QTY PLUMBING PERMIT -ISSUE I ' 1 ~ j QTY.I MECHANICAL PERMIT -ISSUE _7___!::'~1: EACH flXTURE TRAP ]; I INSTALL FURN DUCTS UP TO 100 000 BTU :1" OVER 100.000 BTU ---~-➔r~O~LOMPRESSOR UP TO 3 HP + BOILER C~MPRESSOR J_~S HP 1,\c AL flfl!:.P i\C[ + ------ --4 VENT FAN SIN Gt E □_!!CT FACH flUILlJING SEV,'ER EACH WAHR HEATER ANLJ OR VENT t---------- EACHGASSYSlEMl IU40UTL[TS --------------- EACH GAS SYSH.M J UR MOR[ f----EACH INSTA~ ALHR. HEPAIR WATER PIPE --+ -i ~,. SUMMARY/ACCOUNT NUMBER -BLJII_Dlr-.;G PERMIT SIG'.ll PERMIT f--------- PLAN CHECK ----- 1-----_____:__ __ _ TOTAL PUJMB,NG -f---~ECT R i CA~ ·~-+-MECHANICAL_ MOBILEHOME "oo1 ·810-00-60-8220 001-81 0-00·00-8221 001-81 0-00-00-8806 001-810-00-00-8222 001-810-00·00-8223 -------~- ~18•7'J___ J,J ~ 001-810-00-00-8224 -----t-----------1 001-810-00-00-82 25 :tXCH VACUUM BREAKER MECH EXHAUST HOOD DUCTS '1\/AH:R SO~Tr,,iER trC~~N 1 '1S~ ___ --+-------+---+~LOCATIO~ -~ FURNACE:HEATER ___ +-----11 MOBILEHOME PARK l);SP QTY -------+---ji_ __ L_---,,T"O"Tce,,•M"E~C~H~A~N"l'CAITL-----,--'--------r -"I SQ1.AR __ STRONG MOT ION FIRE SPRINi<:LERS 001-810-00-00-8226 -----+-- 880-519-92-33 fOTAl PlU\1BING ' -'-, 001·810-00-00-8227 ELECTRICAL PERMIT -ISSUE /,/F,. ,C:::-J!_!i(p11 QTY. SOLAR -ISSUE I-_ ___PUBLIC E~CI L ITIES FE~ -~2-8.J._Q_J0-00-8930 +---- -----------·------- NEWCONSTEAAMPSWl BKR . ---. -~.· -UJLLeC'llRS I Jt SCHODLFEE_QISTRICT__ --- 1 PH :l PH ___ _1_ ~ SfDRAGE' 'A"l-;S __ ~s~ ___________ ---1----------1 EXISTEilllGEAAMP·SWTBKR -----__;---_ ___J__ 8GC~STURA!:;E_____ --------+---__ __Enc~ ____ _ 1 PH II ;:iL:M') I PH REMODEL ALHR PE'R CIRCUIT P,A'J C'--IF(;K rE: +-------It---+------------------I---- --------+------'---_JJ---~ Q!egu1to __ San Marcos - TEMPPULF lUUel.MPS -------·-----_ ____j_ __ LICENSE TAX 001-81 0-00-00-8162 -----OVER 200 AMPS P O CC ----,--, UPANCY '30 DAYS, . ~ ~:-+-_ MFF 880-519·92-57 cu}d 16 A1Y\'2s -,---~ · '.. --+--· 'OTA! so"R llllAL El!:.LlHICAL • ' ' : 11 i --1f CREOITDEPOSIT ---~/4~3 ~A¥ TOTAL FEES PAYABLE I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMlr" AND DO HEREBY Expiration. Every per_mit issued byttie BuildingO!flc1el under the prov1s1onsofthis CERTiFY UNDER PENAL TY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall expire by l1m_1tat1on and become null and void If the bu1ld1ng or work DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS au;horized by such permit ,snot commenced within 180 days from the date of such ISSUED: TO COMPLY WITH ALL C!TY. COUNlY AND STATE LAWS GOVERNING BUILDING CON pe mit. or 11 the building or work authorized by such perm,t ,s suspended or STRUCT!ON, WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AN~ abandoned at an time after the work. is commenced for a nod of 180 de s KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABIUTIES. JUDGMENTS. COSTS AND APPLICANT'S SIGNATURE ,,_ OWNER □ CONTRACTOR\(!' EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE \?-" '\~l ~ '1k n\ GRANTING OF THIS PERMIT ._p BY PHONE [7 _\,.~ "' \.r,\...._ .. f • I * AN OSHA PERM:T IS REQUIRED FOR EXCAVATKJNS OVER 5" o·· DEEP ANO OEMOI..ITKJN OR COHSTRUCTK>N OF STRUCTURES OVE 3 STORIES IN HEIGHT DATE ;,2_1_,,,.,<k_~· I s-~·/,, 1.,,?' m lL 2:-ro c o_ E ~ -c C l'.) C " " o_ o_ 0: I ~ C Q_ 0 ~ ~ m ~ ~ 0: I ~ 0 m >- ~ ~ w u 0 ,t ro " 0 Q w u C ro C U: ,::_ C w :,' l'.) 0 u w o_ ~ C ."! _c ,: TYPE I DATE INSPECTOR BUILDING I FOUNDATION I REINFORCED STEEL I MASONRY ' I GUNITE OR GROUT I SUB FRAME C FLOOR C CEil.JiNG SHEATHING □ ROOF □ SH~AR FRAME I EXTERIOR LATH I INSULATION I INTERIOR LATH & DRYWALL I I PLUMBING I ~ SEWER AND BUCO _ Pl/CO UNDERGROUND □ WASTE □ WATER TOP OUT □ WASTE [7 vi/ATER TUB AND SHOWER PAN I GAS TEST I □ WATER HEATER □ SOLAR W/1.TER ' ELECTRICAL I □ ELECTRIC UNDERGROUND □; UFFER ROUGH ELECTRIC I □ ELECTRIC SERVICE □ TEMP(i)RARY □ BONDING □ POOL ' I I MECHANICAL I □ DUCT & PLEM., □ REF. PIPING HEAT -AIR COND. SYSTEMS I VENTILATING SYSTEMS I I CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE ITE_MS ABO'/E /jA VE_ BEEN APPROVED FINAL . ' PLUMBING I ' /J ELECTRICAL I .5/1...vr. ,- MECHANICAL - I GAS I ' BUILDING I SPECIAL CONDITIONS ' I I FIELD INSPECTION RECORD REQUIRED SPECIAL INSPECTIONS INSPECTION REQ IF I INSPECTOfi s I DA~E CHECKED APPROVAL 1 SOIL_S CC)MP_ ,C,'\J'."E PR 'OR -,':} f-0,JND,\-IU"' ,".S;.c -~ --,~----- 1 I I SFSLJCT!..1F;A.1 C('\Jl PE"f:: 0'/f:Fl 2or~,1 L''.:_" --i--·-r i PRESTRESSEC CONCRETE Pos-TEN5 ur-...E'.' CONCRETE ;::,E:LO 1/vE! Dlr-..'G =+=_j -~ I ._.;;HS"lit,.,.----~-~---I . oU, ,s "'·" I ----+ -I f--------t --~· ----.;pE(:IAL 1,1,\~:, 1~JPV --♦------ 1 7 f-' ,_cs c,~1:::.sc_:"< f---------------+--t f --1-----+--·---- --l-,------+---- --f------------+----·---+------- '-·----------+ ----+---------+ ---- ----+------+ ---+----- r----------------+------+---------+------ 1---~~~+---+----+--- '--------+-----+------+----, t-~~---< I I E -I -- ~'o°Ll0 INSPECTOR'S NOTES __ . ____ :~ -----i ==-=-===~=-=-=--::_ _:_ -==-~-=:j ' ' ' I -- "' z 0 :; .. "' ~ u "' 0 "' ![ 81 I J "' 0 ~ 5 .. a: "' z ~ z 0 :; "' z "' .. '" 0 u "' "' "' " .. 0 3' il 0 I heraby afllrm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is 1ri lull forg"iJPft. 77',!!ff!'l,!..I c-=---:,. • l1(. Ne ~~ a·· -~ ·,Jn cs :,"ce· -• t"e proi:eri,, ~rm, er11111r;,·ct\ ;,1:t· ;,·aG•' as ·n•ir SJ,!: cornoe0sa:,c-;111 do ·ie ctru; nter.Ced Jr o'1e·ec 10· sa1e CJde ~"-t Contractur o •:e1se j.'.' ~oes ar owner ol P'Cperty ;,he DJl'U\ or ,m~rrJ•1~S wro cots s1"ch work ~,--se·t or in·o•Jgh 11,1 O,in e~eloyfes provided Char sucn 1m~ro•,~-e-,·, o·e not •n:e1d ed or 01:e·ed 'G' sale If, however l~e o .. ,ld,ng or ,:r,p-c·,e- -,enl ,s soio w1th1n one year of l,Onp:e11on. tr-e owner-ou1lde• ,111•1 od,e ·c,e bu,oer of prov-ng tho! he did nQt build 0' 1,,., Dro,e tor :nr. ~urpose ot sa'e1 as owne· of lhe p·werty, am ex;1usi.·eIy :cnlrdclIng with licensed canl'ac!ors tn rnnstrurr The 8ro·eL1 (Sec /044 8us,ness ana P·ofe,s,ons Coce The Cc-nrractcr·s License Law does no: apply :can owrtr of r:r:ioer!y wM bu11ds or Im-woves t~ereon and whc con1rac\s :or eacn P'~iFTS with a contractoris1 I,cense pu,suant to tr,e Contrac:ur 5 license I.aw) As a homeowner I am ImprovI~g my home. d",d '",etc-law 1ng cond1t1ons ern: 1 The wor•. ,s being pe•formed orio· To sa.e 2 I ha,e lived ,n my Mme 1G' twelve m~nths prior to compleTIor of this wor, I nave not claimed th•s exemot,on du,,ng the last 1hree y·ears !Or ih~: ,~~~~~t under Sec _____ _ S & PC I hereby afl11m that I h~,e a cert,•,cale of consee.t 1o se.f-,~sure_ er a cert,lrcate ot Workers Compensation In su·ance er a ceri,tied coo; thereof 1Sec 3800. Labor Code! POLICY NO CO..,,PANY Copy IS filed Wl\h the c,ty Cert,tied copy Is hereby furnished CERTIFICATE OF EXEMPTION FRQM WORKERS COMPENSATION INSURANCE iTh,s sec\Ion need not be completed ii the permit ,s for one hundred dollars (S1001 or lessl V certdy I hat In the performance of the work for wh,ch ~rm,t ,s issued. I shall not employ any person ,n any manner so as to become Sub1ect to the Workers Com pen satIon Laws ot Callforn,a NOTICE TO APPLICANT If after making this Ce,tlf1ca\e ol Exempt,on. you should become subJeCl to the Workers Compensat,o~ prov,s,ons of the Labor Code. you Must fortnw,th comply w1\h su~h ,s,ons or this perrn:t s~all be deemed resoked '"-· :__ I ~ereby afform that there ,s d ~cnslruc:,on er,C,n£ c1<,enc, 'or :h~ pw'o•c:rance of the ·;,orK 'O' "" er. 'h s ~e· ,-,,,1 ,s issued ,,Sec 3097. c,·,rl Ccde- L0rdec's '-.J~rne cenjer o Adoress USE BALL POINT PEN ONLY & PRESS HARD CARLSBAD BUILDING DEPARTMENT Carlsbad, California 92008-1989 (619) 438·5525 APPLICATION & PERMIT JOB ADDRESS '2..0 I q l'(\A-Q AV. ST.AD. P.,.-Z..V(... NEAREST CROSS ST. BUSINESS LICENSE:"' o;,_:; J'~oNI {/7'2_ 5 LOT BLOCK I SUBDIVISION 1 ~SSESSOR PARCEL NO ~~;~TON~ I ;~T;; ;a? ----n"-~Rct:5 ~ OWNER'S PHONE: OWNER'S IIJ'AILING ADDRESS CONTRACTOR"S ADDRESS _'Zo_ic:1. I\ l7'38 (a -(YI.Aft_ ~"2,_V l,.. DC5'GNeR era ( 5 i.. DESIGNER'S PHONE DESCRIPT•ON OF WORK DESIGNER'S ADDRESS ~-----------------------------1 C~c..e. m~ ... ~ ~ ~ 1\1 c, C!fl<+Nv=-11\J .. S1U2-v1 cr_ Cf.NSi.,':, TRACl I Ge' AND use I >AR"SG S'An RCS UN<TS I GRADING PERMIT ISSUED 1 □ 'j D e e Fl.R~LEV ,c ND I REDEVELOP~fNT AREA ··C -..C NO STORiES TYPE CONST LICENSE NO. OCC GP EDU OCC LOAD / FIRE SPp vO NO VALUATION PERMIT NUMBER ZONE 5c;;L PLAN I.Cl. n BUILDING SQ FOOT AGE Not Valid Unless Machine Cert1/1ed ~ QTY 1~ ::QTY. ,..:3,...... SUMMARYIACCOU!1f ~b(iii~R ii L~ •' >- PLUMBING PERMIT. ISSUE EACH FIXIURI:. TRAP EACH BUILDING SE.WER +---·-EACH WATER HEATER ANIJ OR VENl --- EACH GAS SYSTEM l TU 1 l.ltJTLElS f----+----·----·-·- EACH GAS SYSTfM :I OR MORE MECHANICAL PERMIT. ISSUE n ; ,_, J:", ..;, ; i ~ ~ INSTALi FURN.UUCTSiJPTOlOOOOOBTU BUILDlr...G PE.RMIT -□01-810-00-00-8220 _, C:-1 t.: ,-----OVER 100 000 BTU SIGN PERMIT ----□□~-00-00-822', -- -+-----¼--+ BDILER·COMPRESSOR UP TO 3 HP, ---PLAN CHECK 001-810·00-00-8805 -- , METAl F'REP'~ACE ELECTRICAL 001-810-00-00-8223 "tJ - I-----l----------- -----1-18 □1LER COMP~[SS□R. 1. 1~ ~p----_ --__ . TOTAL PLUMBING O01-81 □-0G-00-82-22-f-----.--.,.,,,.. --t----·----,,______ --· ------f---~---------, f-----EACH INSTA~ A.LIER Rf.PAIR '1\'ATER PIPE I------+ VENT FAN SINGLE DUCT MECHANICAL 001-810-00-00-8224 EACH VACUUM BREAKER II + MECH EXHAUST HOOD DUCTS MOBILEHOME 001·810-00-00·8225 RELOCATION OF EA FURNACE:HEATER WATER SOFTNER MOBILEHOME PARK INSP ----·--· --·---.---- :_t.:;f-1 Ri.''.)f [:R/;l'j ,_l'FI.~·~ · __ -----=+·-----+--L---T-□-,-,-,-M-E C_H_A_N_I_C_A_L-------~------',__ :~~-~:G MOTION _Q9 1-B:~~~~~:~~~~~:-+--- _J_ __ T lJfALP\ LJ'v\Bir...\J ------, --11 _ ____ FIRE SPRiN!\LERS ---'□"'0"1·-"8"10c_·-,_00c_·-,_00c_·'"82"2"-7-l-________ --" QTY ELECTRICAL PERMIT· ISSUE F ~ '/ PL.IBLIC FACILITIES FEE 332-810-00-00-8930 .;;J ..,.-i QTY. SOLAR· ISSUE ---· --_ f-- NEW CONST E.A AMP SW! l:JKR Cf)! I '.:CTORS __________ 7 ____ ~ SCHOOL FEE· DISTRI~ _ s-□Rt..G'.: TA\~S f---,f------------------~---I PH I PH :l PH FXIST l:HLJG EA AMP·S\r'.'T l:JKR -+--.--ROI~ '.-iT'.JR.t.!;F ___ _ 3 PH . !I P'JMP -,,, ----It------ Carlsbad Encinitas R l ~-~AL Tt R TEMP POLE -~~-CIRCUIT /DO AMPS ~ I OVc_R_?OU AMPS . -·--. I TEMP uC[uPA -. . i ~ Al,C .f-lLC" FF:: I/ NCY '_~YSI . --r----~-~ ~ :£:H-. . -_:_-~9y-r--f /O ~ ----j~ -__f;":c.,,cv1• I l '''""'" -/-+-----+-------{I---~D1egu1to_ _ ___ ---+-------- San Marcos MFF ----+-----------, ------+--- 001-810-00-00·8162 -. ·----+---------880-519-92-57 ~•----- CREDIT DEPOSIT O __.. --j /, TOTAL FEES PAYABLE - - I HAVE CAREFULLY EXAMINED THE COMPLETED ··APPUCATION AND PERMIT 1\1\D DO ClE9EBY E;,;p,ration Every perm11 issued by the Bu,ld1r>g Oft1cIal under the prov,s,ons otth<s * AN OSHA PERM:T lS REQUIRED FOR EXCAVATIONS Q'w'ER CERTIFY UNDER PENAL TY OF PERJURY THAT ALL INFORMATION HEREON iNCLUDiNG THE Code shall exp,re by ilm,tation and become null and void If !he bui!d,rg or wo<k 5· o·· DEEP AND DEMOUTION OR CONSTRUCTION Of .,. , .,. _ , . autt-or•ied by such perm,t 1s no! commenced w1thm 180 days !r0rn the date ,~f SL;Ch '. DECLARATION:3 ARE TRUE A-"-,/0 CORREC, AND I FURTHER CEH.' l.>-Y AND AGREE ,FA PEPM,T 1$ permit. or ,f the bu,ldmq or work authOrLZed by su~n perm,t ,s s spen •ed 0 , STRUCTURES O'w'ER 3 STORIES 1N HEIGHT ISSUED. TO COMPLY W!TH A LL CITY COUN-1 Y A ND ST A TE L.t.. V/S GOVERN I NG BU I LD:NG CON L..'•~b~•~o~do~o~-,~~"''-"~":'L~t,~~~•C'i"~'C.:-•So~,k~,scc"ocmcm~. S•~"'S'Od2..!;l;C'C'C£:'~'O'OS01-£0I<_~'. 6~0LO£•t"cs',--,;;;:y1""~~,:::~~~------------~------~ STRUCTION. WHETHER SPE.CIFIEO HERE!N OR NOT I ALSO AGHEE TO SAVl INDEMNIFY ANO . ,If n A<'PROVfC BY ,,,~- KEEP HARMLESS Tf--/f CITY 0,"-CARt.SBAD AGAINST ALL Li ABILITIES. JUDGMENTS COSTS AND APPLICANTS SI OWNfR -. • /4~ D ' ~ EXPENSES WHICH MAY lN ANY 'NAY ACCRUE AGAINST SAlD CITY It. CONSEQUENCE OF THE ~ ........., -._, _ ,---, ,,..-.. , f ·~- GRANTING OF THIS PERMIT , V BY PHONt: . J l ...::,-: ) , ..... "") ).._A.P.~'{-I .'E U:: c 0 0 0. E 0 ~ " 6 C ro u 0. 0. <l'. ~ C 0: 0 w w ill w " <l'. ~ 2 © >- w w ill u 0 a: m ,; 0 !3: ill u C m C u. :::. C ill ;" CJ 0 u ill 0. w C X ~ > TYPE ' DATE INSPECTOR . BUILDING I FOUNDATION I REINFORCED STEEL I MASONRY ' GUNITE OR GROUT I SUB FRAME □ FLOOR □ CEl~ING SHEATHING □ ROOF C SHEAR FRAME I EXTERIOR LATH I INSULATION ' INTERIOR LATH & DRYWALL I I PLUMBING I □ SEWER AND BL/CO _ P~/CO UNDERGROUND □ WASTE □ WATER TOP OUT □ WASTE □ WATER TUB AND SHOWER PAN ' I GAS TEST I □ WATER HEATER □ SOLAR WATER I I ELECTRICAL I C ELECTRIC UNDERGROUND □,UFFER RpUGH ELECTRIC I I gJ ELECTRIC SERVICE □ TEMPORARY □ BONDING □ POOL<,; ~. CD.l/"4-<.., MECHANICAL I □ DUCT & PLEM., □ REF. PIPING HEAT -AIR COND. SYSTEMS I • VENTILATING SYSTEMS I I CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE ___ ITEJ,,1S ABOVE HAV,E BEEN APPROVED FINAL I PLUMBING I /) ELECTRICAL ' -r-/-,., I,., I/ . MECHANICAL I , . GAS I BUILDING I ' SPECIAL CONDITIONS ' ' ~-~·~~ FIELD INSPECTION RECORD REQUIRED SPECIAL INSPECTIONS ~-~-~ INSPECTION DATE REO IF J 1NSPECTOn S CHECKED APPROVAL SOILS co __ 1s,p~::."-,·(E --· ------=---------=;cc~I--==-=~_ PR 'OR ~c, ' II . I f-C~,NOA TIC". '\J:,p , ST'<L,Crl:f<A.L Ci''\,'.:;"lfTf:_ t --··t - OVER ?OOC PSI _ ----1--------- PRCS TRESSED ' C'.JNCRETE: j POSTTEl'.Sl'.JNln COl'.CRETE ~'[UJ \IVELD1NC; f-"(_,rl Sl Rel'.·c-,- 30'. TS --+----t' ------ --r--------------------+--~ ~PECIAL ,IJA:::, Y•<Jc1Y _l = -=L ____ -+----- -I C-----------t----;---- P, _.ES CAISS()".' i---~------i-~-t -------:~-- ---+------ f------------ f-- ----+-------- ----l----------+---- ---1----------- ' --r----------i r __: _ --=-~J ___ - I ' -~~ t------- I L----------------~ L ________ -----__j I NSPE_(:TOR S NCJTES ---. ---"..------- l i I l I ' I LICENSED CONTRACTOR'S DECLARATION 1 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 (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 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 live hundred dollars ($500) r:-.· 1, 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 sate (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) := l, 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 pro- jects with 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 Workers' Compensation Insurance, or a certified copy ;~~~~~l~~.:Sif' 2~6F658-3-82 coMPANY ~v ers Indemnity,. ,, . C..:Copy is filed with the city. r ~ertified copy is hereby furnished ~I CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the per· mil 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 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 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 performance of the work for which this permit is issued (Sec. 3097, Civil Code). CITY OF CARLSBAD-BUILDING DEPARTMENT APPLICATION & PERMIT USE BALL POINT PEN ONLY 1200 ELM AVENUE (714) 438-5525 "· JOB ADDRESS AV.ST. IDATE or APPLICATION 2,0,1 ,9, 'Ha,r' ,A,z "'•I, 1W1n•u I I I I I I I I ' I I I I I ',' OWNER OWNER'S PHONE PRIME CONTRACTOR Alvin L. Bergman 438-0998 Blackhawk Industries Inc, OWNER'S MAILING AOORESS CONTRACTOR'S ADDRESS 7ZUZ/ 2019 MarK Azul Way, Carlsbad 92008 P.O. Box 27763, Escondido "' BLOCK I SUBDIVISION I ASSESSOR'S PARCEL NO. DESIGNER 2 ,1 ,5,-, 1,3,0, -,1,4, ' "tcl:/"o~ °' wo" ~ /), {!, ,,t,,,t;;:;Jvn I) J A / Uri", 1 IA /1 Jr. 5 ,,,. ,.'11----, ·-~ ..::, DESIGNER'S ADDRESS , £I' CENSUS TRACT GP LANO US£ ZONING APPLICANT TO FILL IN INFOR - MATION WITHIN RED LINES. BUS.lfZ/:, PERMIT NUMBER STATE LICENSE 31! 053702 CONTRACTOR'S PHONE'. 741-9946 - STATE LICENSE DESIGNER'S PHONE - I RES. UNITS I P:KING SPACE sf I NUMBER or STORIES Not Valid Unless •chine C.rtifitld BLOG SQ. rT, BLDG USE occ. GP I STANDARD PLAN /I IPLANID# 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 AND/OR VENT BOILER/COMPRESSOR UP TO 3 HP .. EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP ..._,_,.u "AS SYSTEM 5 OR MORE BOILER/COMPRESSOR 16·30 HP EACH INSTAL., A1.1 P£,IR WATER PIPE VENT FAN SINGLE DUCT VALUATION: EACH LAWN SPRINKLER SYSTE"M---MECH EXHAUST HOOD/DUCTS WATER SOFTNER .. RELOCATION OF EA FURN~iucATER BUILDING PERMIT I I I I ·--T,-. ----, .rn,-Tcc110 '"'I. ,,.,.,., SIGN PERMIT I I I TOTAL PLUMBING ~~ICAL '_ _ PLAN CHECK I I I I CONTRAC OR <... Ee::'.--. \ CONTRACTOR ----..7 ALL INCLUSIVE PERMIT I I MOBILE HOM~1™4:t:.._, ~ -TOTAi PLUMBING I I . I QTY ELECTRICAL PERMIT AMT. QTY. ~-A ·_,,,-ELECTRICAL (11• d()O-lf)->-,3 I 1--~- NEW CONST EA AMP/SWT/BKR AWNING t---... / 6,--, 1' MECHANICAL I f. 1 PH .25 3 PH PORCH --....:;.. --MOBILE HOME I I , I EXIST BLOG EA AMP/SWT/BKR SET-UP p:::: -SOLAR I I I . I 1 PH .25 3 PH RAMADA, CABANA ........ I I I • I A. REMODEL/ALTER PER CIRCUIT 0 -- FENCE OVER 6' • I ---..... I I I . I . TEMP POLE 200 AMPS TOTAL MOBILE HOME <.. . _i-. _ M"r-c-0-FILM ............. I I I ' OVER 200 AMPS ...__ -?--7 _)( ......._ I I I TEMP OCCUPANCY (30 DAYS) ,-..._ I ......_ I I I . I 2,00 S~ MfVl'TC\1\T: ---~ I I I . ,s 7~ I ~11.~ ~--, u lfe\l ELECTRICAL TOTAL FEES PAYABLE CONTRACTOR I I HAVE CAREFULLY EXAMINED THE COMPLETED '"APPLICATION AND PERMIT, AND DO "AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER SCHOOL FEES: I 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, ··n;~R~·7:~;,_. COUNTY AND ST A TE LAWS GOVERNING BUILDING CONSTRUCT ION, WHETHER SPECIFIED HEREIN OR NOT. 1,ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM- LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS. COSTS AND J ' . , E)SPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. APPLICANT"S SIGNATURE• OWNE:~ CONTRACT□~ IAPPROVEO BY !IJll (hEo~ AGENT BY PHONE 0 , ' " SITE I ADDRESS: OWNER, PERMIT NO: ' FJELD INSPECTION RECORD INSPECTION DATE INSPECTOR J NSPECTOR'S NOTES WOOD FLOOR FOUNDATION• FORMS• SET BACK• TO!LET 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 TIES/HEIGHT OF CHIMNEY OTHER TEMP POWER (POLE) SEWER GAS TEST SWIM POOL • STEEL BONDING • PRE DECK I • FENCE PREP LASTER i SHOWN . FRAME • PAN FINAL INSP BY BLDG DEPT OTHER DEPT'S REQ COMPLETED ELEC METER-PERM-TEMP IGA~METER-PERM-TEMP L I 1---~-r- [ CERT OF OCC~PAr-KY ISSUED ; L City of CARLSBAD, CALIFORNIA 92008 A rcant to complete numbered spaces only Phone 7 29 1181 p pp I -erm1t o. ·, - . . -___.. :" / / . N .' ~ " ~ ,.109 ADOIII CS!i t/ I /-if-,) I > AZ.UL LOT NO,· 7 I ILK 1 I T•Ac T . Qstc ATTACHED SHEET> LEGAL I 1 ouc•. \ OWN u, 1:.,.-J • MAIL ADDfllt.55 ZIP PMONE. z ,_A • 1~Gtv ~JE.. uvf-\.J -ul r , ' IAe A'Z.l.l LA<... ) -..,A C..f)j_ <. I .. ' CON TllllAC TO" , MAIL ADD .. ESS PHONlt L IC[N.SC NO, STATE CITY 3 i .... t" i:--t ; ~ ,_ C,.TL.-, \(" ' I l I I~ -~ 'i'.;1) r , ;-o .. L ... AllllCHITCCT Ollll DtSIGNl:111 MAIL ADD"[SS PHON C ' LICENSE NO, 4 I.NC.INtU, : I MAIL ADO .. tSS PHONE LJCI.NSC NO. 5 ·- COMPENSATION INS CARRIER MAIL ADD .. ESS BfllANCH 6 U.St OJ' ■UILDIHG 7 8 Class of work: 0 NEW moomoN 0 ALTERATION 0 REPAIR 9 Describe work: Rf½.1-1 OS'::>E L 1\ In C' ~AL J/'.. J?r .f i J .S.F et11c ,_- _. .• t -_, ,o 1, PERMIT FEES . t -.., .• No. Each Fee SPECIAL CONDITIONS: ISSUANCE OF EACH PERMIT ' It :i. 1 //L,,f -(l) ,Pv~ NEW CONSTRUCTION, FOR EACH APPLICATION ACCEPTED BY PLANS CHECKED BY APPROVED FOR ISSUANCE BY AMPERES OF MAIN SERVICE, SWITCH , FUSE OR BREAKER ,,. (._/..:__,JC-;' • DATE NEW SERVICE ON EXISTING BLDG. FOR EA. AMPERE OF INr.REASE NOTICE IN MAIN SERVICE, SWITCH, FUSE THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-OR BREAKER TION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A REMODEL, ALTERATION, NO CHANGE PERIOD OF 120 DAY~ AT ANY TIME AFTER WORK IS co~: MENCED. IN SERVICE, FOR EA. AMPERE OF I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS INCREASE s.~ 11) APPLICATION ANO KNOW THE SAME TO BE TRUE ANO CORRECT. -ALL PROVISIONS OF LAWS ANO ORDINANCE:!. GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT TEMP. SERVICE UP TO ANO INCLUD· PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING ING 200 AMP. CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. 11 . . /1 ~. TEMP. SERVICE OVER 200 AMP . PER 100 I 1-rf;S ,~ .L." "· /~~..3 / ~ " SICINATUlll:E OP' CONTRACTOIII OR AUTHOIIIIZED AGCNT IOATll PERMIT FEE ,I 11' 1. ~ rt) • ffNA."'11•• OP' "'WN•" IP' OWfrflfl ■UILDE" DA.Tl - WHEN PROPERLY VALIDATED IIN THIS SPACEI THIS IS YOUR PERMIT PLAN CHECK VALIDATION CK. M.o. CASH PERMIT VALIDATION CK. M.O. CASH INSPECTOR