HomeMy WebLinkAbout2021 LADERA CT; ; 81-355; Permit"' z
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D 1 hereby affirm that I am licensed under
provisions of Chapter 9 (commencinQ with
Section 7000) of Division 3 of the Business
and Professions Code, and my license is in
full force and effect.
L•c No ~-,--:;_ _ _) Class --~ -----,C-
I hereby affirm that I am exempt from the Con
~~c~r~~~~:;:: ~; ~~~l~~,~~~~e•e:~;~i~r
county which requires a penrnt to construct
aller, ,mpro'il!, demolish. a, repair any structure
pnor to its issuance also requ,res the appl1can1 for
such penmt to hie a s,gned statement that he ,s
licensed pursuant to the prov1s10ns of 1he Con
tractor's License law /Chapter 9 commencmg w,u, Sec11on 7(X)() o! o,v,s,on 3 of the Busoness and Pro
!ess1ons Code) or that ,s exempt therefrom and the b.ls•~ for the alleged exemp!1on Any v1olat1on of
Section 7031 5 by an applicant tor a perm,t sub1ects
tne il1Jpl1cant 10 a c1v1I penally o! no1 more than five
hundred dollars (SS(XI)
□ I, as owner ot the property, or my employaes
••th wages as their sole compensation. will do the work, and !he structure 1s not intended or offered for
sale (Sec 7044. Business and Pro!ess1olls Code The Contrac1or's License Law does not apply to an
owne, of property who builds or improves thereon and who does such wol1<. h•msel! or throug~ his own
employees. prov1oed that such 1mprovemeco1s are not 1ntende'.l or offered for sale I!, however, the
building or ,mprovement ,s sold w1!h1n one year ol
completion. the owner builder w,11 have the burclen of prnv,ng that he did not build or ,mprove lor the
purpose of sale!
O I. as owner ot 1he property, am exclusi.el)
contrac11ng with licensed contractors to construct the pro1ec1 (Sec 7044. Business and Proless1ons
Code The Contractor s Ltcense Law does not apply to an owner of property who bu,lds or improves
!hereon, and who contracts tor each proiects with a
contractor(s) 1,cense pursuant to !he Con1rac1or's License Law!
O I am exempt under Sec
tor this ,ea son
8 & PC
o•i-he~eby a!ttrm tha1 I ha~e a cert,t1cate of consen1
10 self-insure, or a cert1!1cate ot Workers
Compensation Insurance. or a cert1!ted copy thereol
(Sec 3800. Labor Code)
POLICY NO / -/ ;
COM~,ANY • f <._ ,-"/
□--·Copy ,s 1ded w,th the city
0 Cert,!,ed copy ,s hereby furnished
CERTIFICAH. OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE (Th,s sect.on need not be completed i1 the penrit
1s !or one hundred clollars ISHX)) or less)
D I certify that 1n the perlormance of the wor1< to,
which th,s perm,! 1s ,ssued, 1 shall not employ any person ,n any manner so as 10 become sub1ect to
the Worl\ers' Compensat,on Laws ot Cal1tom1a
NOTICE TO APPLICANT I!. after makin~ th,s Cert,
locate of E~emp11on. you should become sub1ect M the Wol1<.ers· Compensat,on prov,s,ons ot the L.at>or Code. you must forthwith comply with such
prov1s1oros or this perm,1 shall be deemed re,oked
D I hereb~ aflirm thal there ,s a ~ons1ruct10~
1end1ng a,;iency to, !he performance (Jf '.he wor1< lo, wh,ch 1h•s perm,t 15 ,ssued 15ec 3097 C,v,: Code,
Lenders Name ___________ _
Lenders Address __________ _
USE BALL POINT PEN ONLY & PRESS HARD APPLICANT Tr ~ILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS
CARLSBA .. JUILDING DEPARTMENT Af>r-LICATION & PERMIT
1200 Elm, Carlsbad, California 92008 (714) 438-5525
JOB ADDRESS
,L 14..I~ K' ,,q..
AV. ST. I DATE OF APPLICATION BUSINESS LICENSE # 7<too PERMIT NUMBER
:lDt:J. I C-1--RO. ,,;; -111!-Z i .-y,-7,-,cj ?f \; .µ,( __ , • 1-'
OWNER'S NAME I OWNER'S PHONE PRIME CONTRAC~OR CONTRACTORS PHONE# ZONE ?.s:r Ct1c1,t II 14-5 />] #Vl 3/3 G, -f,?,1, <j D :>l,t,1 Ir+>!. r,,) ,-L;'c Iii/ ,;7,_-:;? '2i./ '"'i ; -..\5\,\JQ:_,_j I ,., I . I
OWNER'S MAILING ADDRESS CONTRACTOR'S ADDRESS LICENSE NO. PLAN 1.0. ;. BLOG USE CODE
;:;:; D _;;,, I L ,,.,_,j <? ,c ,4 cf-. 1 , /I , -r,:_-, /~ ,_~ T,,. •J r.:c 5 Ii" e. I/co i-'s "7 _/ •: :> V
L/1?1 BLOCK 1 SUBDIVISION I ASSES}~R PARCEL NO. _ t.-( DESIGNER STATE LICENSE# STANDARD PLAN# BUILDING SO. FOOTAGE
,,..,. 7,-1 ;;}./ _,.,g-z_ -2.
DESCRIPTION OF WORK ,
It1/5i'"A// ;..-_b., . .---.,,. I~<' <..CA. DESIGNER'S ADDRESS DESIGNER'S PHONE
7 i;/, ..
' -' /' ---------------------· -----F/P FLA ELEV. NO OCC GP EDU -' STORIES
ye N □
CENSUS TRACT ! GP LANO USE l PARKING SPACE l RES UN1TS I GRADING ~ERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD Fl RE SPA
AREA CONST
,□ N D ,□ NO vO NO Not Valid Unless Machine Certified
QTY PLUMBING PERMIT -ISSUE 7. so QTY. MECHANICAL PERMIT· ISSUE 3.00 SUMMARY/ACCOUNT NUMBER
.
EACH FIXTURE TRAP INSTALL FURN DUCTS i.JP TO 100,000 BTU BUILDING PERMIT z.....,, ~o
---------n ;,, --~
EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT -I ---t-----~-----------PLAN CHECK J..,._( LI ;'l.Kf-KJ ---
EACH WATER HEATER ANO·OR VENT l__ -1--..r; BOtLER/CUMPRESSOR UP TO 3 HP ,-
~~A_!'.~_GAS SYSTEM 1 -T □ 4 ouTLETf~ -~------------------
-~-BOILER:'COMPRESSOR 3-15 HP TOTAL PLUMBING
-_ --~ ----
EACH GAS SYSTEM 5 OR MORE I METAL FIREPLACE ELECTRICAL
---+ ------
w~~CH INSTAI,,, ALTER, REPAIR WAT~~~~PE VENT FAN SINGLE DUCT MECHANICAL
tEACH VACUU_M BREAKE~ ____ ' MECH EXHAUST -HOO □:oucrs MOBILEHOME
--t---.. --------
RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP WATER SOFTNER -------L___ -------. ---------
: EACH ROOF DR~-1~ ~,~SIDE\ _______ SOLAR
----------t---------
~. I TOT!.L MECHANICAL STRONG MOTION
.,~
I-------------
TOTAL PLUMBING FIRE SPRINKLERS
---~ . ------
PUBLIC FACILITIES FEE -------QTY. ELECTRICAL PERMIT· ISSUE 2.00 QTY. SOLAR · ISSUE ~.
BRIDGE FEE
--~ ---·-~·---------------· -----
NEW CONST EA AMP'SWT BKR COLLECTORS SCHOOL FEE -DISTRICT ---------
I PH J PH STORAGE TA'l!KS Carlsbad
~ --------· -
EXIST BLDG EA AMP.'SWLBKR ROCK STORAGE Enc1n11as ----------
I PH J PH
... ~ PUMP Sa_:7 _~1egu1to ------~ --------------
REMO □ E L.'AL TE R PER CIRCUIT ....) ·-PLAN CHECK FEE San Marcos
--------------· --------I-----~. -----·-------------
' TEMP POLE 200 AMPS ---+ --------------~--··-------
±OVER 200 AMPS ~~ TE-_M~ oc:_c~-~~~cy·1_~0 __ □AYSI ~ -------~---------
--------~ -----~ --· -
__l -l ------. ~. --
TOTAL ELECTRICAL 7 -TOTAL SOl AR TOTAL FEES PAYABLE I <Jo _ fri '
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPUCATION AND PERMIT" AND 00 HEREBY Expiration. Every pamrit is&Jed by the Bllllding Official under the provisionsofthis * AN OSHA PERMIT IS REQUIRED FOA EXCAVATIONS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall expire by limitation and become null and void. If the building or work 5· O" DEEP ANO OEMQI.Jl10N OR CONSTRUCTION Of
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS author12ed by such permit is not commenced w1th1n 180 days lrom the date of such STRUCTUA£S OVER 3 STOAtES IN HEIGHT permit. or if the bUildi::ft or work authorized by such permit is suspended or --
ISSUED: TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING BUILDING CON-abandOned at an" time a er the work is commenced tor a ""'riod of 180 s. •
STRUCTION, WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND 1 , OWNER □ CONTRACTOR !lJ.. ,-P
i:O~Y
rw,, n...l KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS. COSTS ANO AT s SIG~
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE , "' ........ BY PHONE 0 . 1T 1/J'I GRANTING OF THIS PERMIT. ---, • -
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INSPECTION TYPE DATE INSPECTOR
BUILDING
FOUNDATION
REINFORCED STEEL
MASONRY
GUNITE OR GROUT
FLOOR & CEILING SUB FRAME
SHEATHING
FRAME
EXTERIOR LATH lNSULATION
INTERIOR LATH & DRYWALL
PLUMBING --
SEWER AND BL/CO
PLUMBING UNDERGROUND
PLUMBING TOP OUT ---
TUB AND SHOWER PAN ,,
GAS TEST lq_,,,,_. I./
ELECTRICAL
TEMPORARY POWER
ELECTRIC UNDERGROUND -
ROUGH ELECTRIC 9.'li..fl 11.f'
ELECTRIC SERVICE
BONDING 11
G. F. I. -SMOKE DETECTOR
MECHANICAL
DUCT & PLEM., REF. PIPING
HEAT -AIR COND. -SOLAR SYSTEMS
VENTILATING SYSTEMS
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HA VE BEEN APPROVED.
JOB SITE FINAL
PLUMBING " ELECTRICAL ' • MECHANICAL " AA " GAS " 1,//•vr
BUILDING " SPECIAL CONDITIONS
CERT OF occ• 'PANCY ISSUED
¥/,,,.3::)~
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES -
INSPECTION REO IF INSPECTORS DATE CHECKED APPROVAL -----
SOILS COMPLIANCE
PRIOR TO -
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRESTRESSED
CONCRETE
POST TENSIONED
CONCRETE
FIELD WELDING
--HIGH STRENGTH
BOLTS --1-----------------------·---
SPECIAL MASONRY
----
: PILES CAISSONS
I
I
----
.
-----------
--
·, ----c---
BUILDING DEPARTMENT
BUILDING ADDRESS:
••
PARTMENTAL INFORMATION SHEET
0il€ CE IVE D
AUG 181981
1 /r:================================~c~,:rv~O~F~C~A~RL~S~BA~Dt:::::::=. Building Department
PLANNING DEPARTMENT
ZONE _________ LOT S IZE _________ LOT WIDTH ________ _
UNITS ALLOWED UNITS PROVIDED ------------------------
PARKING SPACES REQUIRED PROVIDED -----------% COVERAGE ALLOWED _____________ PROVIDED
BUILDING HEIGHT ALLOWED PROVIDED
FRONT SETBACK: SIDE SETBACK: REAR SETBACK:
ALLOWED ______ _
PROVIDED -------
INTRUSIONS
LANDSCAPE & IRRIGATION PLAN COMMENTS:
ENVIRONMENTAL PROTECTION REQ:
OK TO ISSUE: ____ DATE ____ OK TO FINAL ________ DATE. ____ _
ENGINEERING DEPARTMENT
R.o.w. ______ INDUSTRIAL WASTE _______ IMPROVEMENTS _______ _
SEWER CONNECTION DRIVEWAY LOCATIONS ___________ _
GRADING PERMIT --~~---EASEMENTS _________ DRAINAGE ____ _
LEGAL DESCRIPTION di:-1:122 c... t:z~--:.. 2
ADDITIONAL COMMENTS ____________________________ _
~ TO ISSU~b DAT;g►/'&-#/ PWI ____ OK TO FINAL ____ DATE,_----, __ _
•
FIRE DEPARTMENT
SPRINKLING SYSTEM ___________ FIRE PROTECTION EQUIP. _____ ~
FIRE ALARMS EXITS, ______________ ,F=.._:~
FIRE HYDRANTS LOCATION, _______________ _
ADDITIONAL COMMENTS-----------------------------=-
OK TO ISSUE: _____ DATE _______ OK TO FINAL. ______ DATE_--lt-a~--
WATER.DEPARTMENT
REQUIREMENTS OF APPROPRIATE DISTRICTS MET ________ DATE ________ _
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