HomeMy WebLinkAbout2105 LINDA LN; ; 80-147; 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 ef-
fect.
OWNER-BUILDER DECLARATION
0 1 hereby affirm that I am exempt from the Con-
tractor's License Law for the following reason
(Sec. 7031.5,Buslness 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 Ille 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).
□ 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 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 bulld or improve for the purpose of
sale).
'.JI, 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) licens rsuant to the
contractor's License Law). '-"'?
I am exempt under Sec ____ ~'s""'-& P.C.
for this reaSO"---------~~-t--
Date Owner .1'. -i ) --... ~ WORKERS' COMPENSATION DE ATION
I hereby affirm that I have a cert e of c · .
sent to self-Insure, or a certificate of Worke~
Compensation Insurance, or a certified copy
thereof (Sec. 3800, Labor Code).
POLICY NO. C.:: I'/,~~~
COMPANY :x;:~J.J A-
D C2')Y Is flied with the city.
i:3'Ciirtlfled 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 ($100) or less).
I certify that In the performance of the work for
which this permit Is Issued, I shall not employ any
person in any manner so as to become subject to
the Workers' Compensation Laws of California.
NOTICE TO APPLICANT: If, after making this Cer-
tificate of Exemption, you should become subject
to the Workers' Compensation provisions of the
Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there Is a construction len-
CITY OF CARLSBAD-BUILDING DEPARTMENT
APPLICATION & PE RMIT
USE BALL POINT PEN ONLY 1200 ELM AVENUE (714) 438-5525
NO, JOB ADDRESS
~l~#1DA;~7t ;:7;;TION Z/,C\$1 I 1L-1 / 1 µ, 1>1 ~I I I I I I I I I I I I I I I I I I I
OWNER OWNER'S PHONE PRIME CONTRACTOR
FJd-eq,111 I? re, +klA .. ,oJ..?-7S ZCJ Ccas:kf 'Sdar H~{/.-::.
OWNER'S MAILING ADDRESS CONTRACTOR'S ADDRESS < /)..
-z.,../0$ L,',.,.do LIA . ~r-/s; ful cA,-erd-oog 9~W cl..ecooedr~1Jr., ~(Jtj.
LOT BLOCK I SUBDIVISION
I
ASSESSOR'S PARCEL NO. DESIGNER l
I I I I I I I I I I I
DES'!.,!P1tl.i.N Of WOR>j-.. w ~ t, ,r Lo £..IQ, DESIGNER'S ADDRESS
CENSUS TRACT GP LAND USE ZONING
APPLICANT TO FILL IN INFOR -
MATION WITHIN RED LINES.
BUS. LICENSE PER~ NUMBER
-z.. (I '•{2. C/P f, STATE LICENSE I, -:2 'if '-1-60 r
CONTRACTOR'S I p;f 6L)-l6 '"Z.L>
ST ATE LICENSE ' .. : ~
,I_ l /,l~/buB:340
DESIGNER'S PHONE
I '11 L I .
I RES. UNITS I PARK ING SPACE I NUMBER OF STORIES
Not V•lid Unlffl Mlchine c.rtifi«J
BLDG SQ. fT. BLDG USE occ. GP l STANDARD PLAN II I PLAN I D II 1 TYPE CONST I occ. LOAD I
llTY. PLUMBING PERMIT AMT. QTY. MECHANICAL PERMIT AMT.
EACH FIXTURE TRAP --.17 ... e;vlt{ ~ .rib INSTALL FURN. DUCTS UP TO 100,000 BTU
EACH BUILDING SEWER OVER 100,000 BTU -EACH WATER HEATER AND/OR VENT '") .l<b 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 v~~ ,•·),, )?J-cJ EACH INSTAL, ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT
EACH LAWN SPRINKLER SYSTEM MECH EXHAUST -HODO/DUCTS
WA,TER iefflfl!II ~n-" .2 -~ RELOCATION OF EA FURNACE/HEATER -. BUILDING PERMIT I I I I
,/_.A -i, ~ .J ,-$If,' ~ J --i~ ~ '~ .tJcl SIGN PERMIT I , I I I
TOTAL PLUMBING A v TOTAL MECHANICAL PLAN CHECK I I l-i".570 .
CONTRACTOR CONTRACTOR ALL INCLUSIVE PERMIT I I I
ELECTRICAL PERMIT AMT.
TOTAL PLUMBING 1/ID-110
QTY. AMT. QTY. MOBILE HOME PERMIT ELECTRICAL I I • I
NEW CONST EA AMP/SWT/BKR AWNING MECHANICAL I I • I
I PH .25 3 PH PORCH MOBILE HOME I I I
EXIST BLDG EA AMP/SWT/BKR SET-UP SOLAR .... -I I . I I I
I PH .25 3 PH RAMADA, CABANA -A 7----i.._ -I ,.__ ) I . I I I
REMODEL/ALTER PER CIRCUIT FENCE OVER 6' /T I . I I I
TEMP POLE 200 AMPS TOTAL MOBILE HOME MICO·FI LM I I I I
OVER 200 AMPS I I I ; I
TEMP OCCUPANCY (30 DAYSI I . I I I
,, .,, --.,,,, .,,,, -J
., _,,.__. ~·-~ I . I I I . I TOTAL ELECTRICAL TOTAL FEES PAYABLE
CONTRACTOR ,. . I I . II IZ.€0
I HAVE CAREFULLY EXAMINED THE COMPLETED "'APPLICATION AND PERMIT, AND DO •AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER 6,,-t:~ ~
HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I 5•.o·· DEEP AND DEMOLITION OR CONSTRUCTION OF
FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED; TO COMPLY WITH ALL CITY, STRUCTURES OVER 3 STORIES IN HEIGHT ~ COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER
SPECIFIED HEREIN OR NOT. 1,ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM-
LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE
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APPWN71W7r _ ~ OF THE GRANTING OF THIS PERMIT. OWNERQ CONTRACTOR~APPROVED BY DATE
AGENT D BY PHONE O -? .., /.1, &j./' 'l/./.1 ~/ ~
I
SITE
I ADDRESS· -OWNER· PERMIT NO: 80-1~7
FIELD INSPECTION RECORD
INSPECTION DATE INSPECTOR INSP ECTOR'$ NOTES
WOOD FLOOR
FOUNDATION• FORMS• SET BACK• TOILET
UNDER FLOOR PLUMBING
UNDER FLOOR HEATING
OK TO INSTALL SUB FLOOR
SLAB FLOOR
UNDER SLAB PLUMBING
FOOT! NG • 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 (POLEl
SEWER
GAS TEST
SWIM POOL• STEEL BONDING
• PRE DECK
• FENCE PREP LASTER
SHOWN • FRAME .. \ '\ . I '
• PAN \ W·\\~ \ II. IIV"'/
FiNAL INSP BY BLDG DEPT I' \" lu/
I OTHER QEPT'S REQ COMPLETED
'ELEC r.iETER-PERM-TEMP
GAS METER-PERM-TEMP
~
~-
CERT OF OCCUPANCY ISSUED -