HomeMy WebLinkAbout2072 Mar Azul Way; ; 81-89; 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 lull force and el·
feet
OWNER·BUILDER DECLARATION
C.11 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-
Si(UCI, alter, improve, demolish, or repair any
structure, prior to its issuance also requires the
applicant for such permit to file a signed state·
m11nt 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•
phcant tor a permit subjects the applicant to a
civil penalty of not more lhan five hundred dollars
($500).
l.· 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 Proles•
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. 11, 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).
= I, 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 DECLARATl~-
I hereby af_firm that I have a certifica. le of on
sent to self-insure, or a certificate of Work
Compensation Insurance, or a certified r-9 y
thereof (Sec. 3800, Labor Code). (~t;\
POLICY NO. f 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-
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 Workers· Compensation Laws of California
NOTICE TO APPLICANT: If. alter 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
,o. JOB ADDRESS
tR~T. l°ATE1o; 7;~c/;l~N , , n, ., , , Mia!! 1 Ai2ulway , ' ' ' ' ' ' ' ' ' ' ' I I I I I
OWNER OWNER'S PHONE PRIME CONTRACTOR
Mr. Jack Jardine (H)438-1688 (w) 297-17 o4 SOUTHERN CALIF. SOL
OWNER'S MAILING ADDRESS CONTRACTOR'S AODRESS
or,ryo Me~ ~•nl,,,ov rorlchcrl r• Q?(\(\Q 11211 Sorrento Vy.Rd. c ......... n.;,... rt\ n...,,...,,
COT BLOCK I SUBDIVISION I ASSESSOR'S PARCEL NO, u1:.:;1bNEFf "' ,
' ' ' ' ' ' . ' ' ' '
DESC~oz;; ~RK LIT --NIA ~.-LA.J r, "" DESIGNER'S ADDRESS
-t · /n ~ I I 1 -· •
APPLICANT TO FILL IN INFOR -
Ml>,TION WITHIN RED LINES.
,
BUS. LICENSt' PERMIT NUMBER
·ze,ns gJ-11 STATE LICENSE
R 359062
CONTRACTOR'S
IP,dNE ~..; I ; ::} I;,;"-;._ " ~,.,, ., r., A
SIAIE LJ"?:EN::.t. 0 •~-' ! ~ ~ : a . , I ; ,,. . , --~
DESIGNER'S PHONE
CENSUS TRACT GP LANO USE ZONING RES. UNITS ! PARKING SPACE I NUMBER OF STORIES
Not Vah'd Unless Machine Cartifi«J
BLDG SQ. FT. BLDG USE acc. GP l sT ANDARD PLAN 11 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 UPTO 3 HP
EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP
EACH GAS SYSTEM 5 0 R MO RE .. BOILER/COMPRESSOR 16-30 HP
r. l /) ~,,J Jr ,01> I ""7 -EACH INSTAL., ALTER, REPAIR WATER PIPE II~_.,. VENT FAN Sl~!GLE DUCT
EACH LAWN SPRINKLER SYSTEM MECH EXHAUST HOOD/DUCTS
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER BUILDING PERMIT ' I
;' -• < "O , . -e::1 . ,ro SIGN PERMIT I
• TOTAL PLUMBING /.~ TOTAL MECHANICAL PLAN CHECK I
CONTRACTOR CONTRACTOR All INCLUSIVE PERMIT
. ..• .
I I I
I I , I
I I . I
I "" I
TOTAL PLUMBING • ·,4 --~
QTY. ELECTRICAL PERMIT AMT. QTY. MOBILE HOME PERMIT AMT. ELECTRICAL , I I
NEW CONST EA AMP/SWT/BKR AWNING MECHANICAL I I I
1 PH .25 3 PH PORCH MOBILE HOME I I
EXIST BLOG EA AMP/SWT/BKR SET-UP SOLAR 3+3 I I I .. .
1 PH .25 3~ ' RAMAOA, CABANA A/ ,-,(~-r-v. -1 / 11 . ..dJ.., __ J I I I I
REMODEL/AL TEA PER CIRCUIT ,C:." 1°7n FENCE OVER 6' ff I I I I
TEMP POLE 200 AMPS JOT AL MOBILE HOME J>ICO·FI LM I I J I
OVER 200 AMPS I I -..,.. ~e..., ,'1,..-~ ,.__... I 1 /fh.:r, r
TEMP OCCUPANCY (30 DAYS) -..~' I"--"2---I I I•. I
, -. . ..J oo· ( u /'"l ID -:;i...-I I I I
TOTAL ELECTRICAL -' ~"' TOTAL FEES PAYABLE I ii~ CONTRACTOR . . -"" -I I
'AN OSHA PERMIT IS REQUIRED FOR EXC!~l~VER /4" ~' ~~ -i--o--
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT, AND DO
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 tS ISSUED;TO COMPLY WITH ALL CITY, STRUCTURES OVER 3STORIES IN HEIGHT
COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION. WHETHER
SPECIFIED HEREIN OR NOT. 1,ALSD AGREE TO SAVE INDEMNIFY ANO 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
APPL,~~~T·~ SIG\,ATURE•/ ~ i; CONTRACTOR£',. IAPPr OF THE GRANTING OF THIS PERMIT. OWNER □ VED BY
I 'f-7/~, ! ' I A '" ~ ' " . ' ) . . •. AGENT D BY PHONE O ..,_ . . . ' -I
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SITE
ADDRESS: OWNER: PERMIT NO: ~1--,t~
FiELD INSPECTION RECORD
INSPECTION DATE INSPECTOR INSPECTOR'S NOTES
WOOD FLOOR
FOUNDAT!ON • 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 8: STEEL
PLATE TIES/HEIGHT OF CHIMNEY
OTHER
TEMP POWER (POLE)
SEWER
GAS TEST
SWIM POOL • STEEL BONDING
• PRE DECK
• FENCE PREP LASTER
I SHOWN • FRAME
• PAN
F!NAL lNSP BY BLDG DEPT
OTHER DEPT'S REQ COMPLETED
i E::LEC METER-PERM-TEMP ,
iGASMETER-PERM-TEMP I
C--'-i I I I " ' I tr,i
i \g 1, \ / /J -I CERT OF OCCUPANCY ISSUED