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Home My WebLink About2112 ESCENICO TER; ; 80-411; PermitLICENSED CONTRACTOR'S DECLARATION t hereby affirm that I am l'lcensed under provi· sions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Proles· 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 five hundred dollars ($500). V., as owner of the property. or my employees ~h wages as their sole compensation, will do the work, and the structure ·1s not intended or of. ed for sale (Sec. 7044, Business and Profes- ns Code: The Contractor's License Law does apply to an owner of property who builds or roves 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). ·.:.1, 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 at 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 th·1s 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 thereof (Sec. 3800, Labor Code) POLICY NO. _______ . _____ _ COMPANY ~Copy is filed with the city. l! 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 I.his permit is issued, I shall not employ any person 1n any manner so as to become subject to the Workers' Compensation Laws of California. No·tr .fro APPLICANT: If, after making this Cer· tificate of Exemption, you should become subject to ttiq 'flurkers' Compensation provisions of the I ',t,or Code, you must forthwith comply with such i,rovisin,1s or this permit shall be deemed revoked. CONSTRUCtlON LENDING AGENCY I h"ereby affirm that there 1s 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 USE BALL POINT PEN ONLY APPLICATION & PERMIT 1200 ELM AVENUE (714) 438-5525 NO. JOB ADDRESS ;vR~T. !o~~f/~ON L2. 1 I ,j :.J' ,£1<..('__, f,N, I ,('.,O I 7f1/:",P,L' 1a1c,r-:-I I ' ' ' I ' OWNER ~WNER'S PHO~ p"';i,;;:;::; Mh. H1.i.al-i 1 J;../ie .:Si~emore ( 'f '-/;;J. -~ 1-j OW!-QJ'S MAILING ADDRESS - :;i_/Jot t:sc,en i co ~r QJ.y/5bos:l, c_A, CONTRACTOR'S /DRESS 1'16 8 LOCK J su51v~-N'7 ·-_}t:}'Z'''. :t,1?,;; t,J? I DESIGNER ' ~s±,l~ION ~~:ter '°)J,J.l f77 DESIGNER'S ADDRESS I ' / CENSUS TR ACT OP LAND USE ZONING UNITS sf APPLICANT TO FILL IN INFOR - MATION WITHIN RED LINES. BUS, LICENSE PERMIT NUMBER STATE LICENSE 'fo-il/ CONTRACTOR'S PHONE ST ATE LICENSE DESIGNER'S PHONE I '"· ) P;RKING SPACE 1 NUMBER OF STORIES Not Valid Unlets Machine Certified BLOG SQ. FT. BLDG USE OCC. GP ! STANDARD PLAN II l'Rb4ff I""' CONST I occ. LOAD I OTY. PLUMBING PERMIT AMT. OTY. MECHANICAL PERMIT AMT. / EACH FIXTURE tRAP INSTALL FU N. DUCTS UP TO 100,000 BTU EACH BUI LOU SEWER OVER 100,000 BTU EACH WATER EATER ANO/OR VENT BOILER/COM '11.ESSOR UPTO 3 HP EACH GAS SY! ~M 1 TO 4 0 UT LETS BOILER/COMPR~OR J.15 HP EACH GAS SYSTEM srY'R'-M.o RE BOILER/COMPRESS0~30 HP EACH JNSTAL.. ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT ""\. /c~~ EACH LAWN SPRINKLER SYSTE~ MECH EXHAUST -HOOO/OUC1'1; VALUATION: WATER SOFTNER RELOCATION OF EA FURNACE/H'"KATER BUILDING PERMIT I 1/i/.~ T "".Q;1•""" 3 .. nr Ts sue 3.00 SIGN PERMIT I I 1 1 I TOTAL PLUMBING TOTAL MECHANICAL PLAN CHECK I 1 1~:-'L CONTRACTOR .-CONTRACTOR ALL INCLUSIVE PERMIT I I I ELECTRl9'L PERMIT AMT. MOBILE AMT. TOTAL PLUMBING I I I QTY. QTY. OME PERMIT ELECTRICAL I I I NEW CONST EA AMb!<!WT/BKR AWNING \ MECHANICAL I I I I PH .15 ' 3 PH PORCH " MOBILE HOME I I I EXIST BLDG EA AMP/SWT~ SET·UP ' SOLAR I I I I I PH .15 311" RAMADA, CABANA ' 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 OVER 200 AMPS I I I I TEMP OCCUPANCY (30 DAYS) ~ -··-MnTION: I I I /....., ..... Issue 2 •. oo ·, I I I I TOTAL ELECTRICAL TOTAL FEES PAYABLE I ilv.T CONTRACTOR I I SCHOOL FEES: I HAVE CAREFULLY EXAMINED THE COMPLETED .. APPLICATION AND PERMIT. AND 00 "AN OSHA PERMIT IS REQUIRED FDA EXCAVATIONS OVER HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I 5'-0" DEEP AND DEMO LIT JO OR CONSTRUCTION OF FURTHER CERTIFY AND AGREE IF A PERM!T IS ISSUED; TO COMPLY WITH ALL CITY, STRUCTURES OVER 3 STOA i:S IN HEIGHT COUNTY ANO STATE LAWS GOVERNING BUILDING CONSTRUCTION. WHETHER ~-1#,: (2~1 r SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM ' .,; ~ /Yfl rH. J. LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS. COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE . - OF THE GRANTING OF THIS PERMIT. r LICANT'S SIGNATURE,' I OWNN~ co::R:~::~R~=P~~ ~ - DATE 1L'"?10 (.., AGENT ' c., SITE ADDRESS: WOOD FLOOR INSPECTION FOUNDATION• FORMS• SET BACK • TOILET UNDER FLOOR PLUMBING UNDER FLOOR HEATING OK TO INST ALL SUB FLOOR SLAB FLOOP UNDER SLAB PLUMBING FOOT! NG • FORMS• SETBACK • TOILET OK TO POUR CONCRETE FRAME ROUGH ELECTRICAL ROUGH PLUMBING ROUGH HEATING/VENT1LAT1NG FRAME OK• PLACE INSULATION INSULATION OK • PLACE WALLBOARD WALLBOARD DK• PLACE TAPE EXTERIOR LATH OK• PLACE STUCCO Fl REPLACE DAMPER 8:STEEL PLATE TIES/HEIGHT OF CHIMNEY OTHER TEMP POWER (POLE) SEWER GAS TEST SWIM POOL • STEEL BONDING --· I . PRE DECK • FENCE PREPLASTER SHOWN • FRAME I . PAN FINAL INSP BY BLDG DEPT l_9THER DEPT'S REQ COMPLETED i ELFC Mt::TER-PERM-TEMP 1 GAS METER-PERM-TEMO t_ I f-I [ CE~1· OF OCCUPA~.Cy ISSUED OWNER: PERMIT NO: FIELD INSPECTION RECORD -- DATE INSPECTOR INSPECTOR'S NOTES .... I j - ' \ ' ' J \\ ,\' IJ \ \ ! I J_ ________ ~ -- ---- [ __ ! j -' tc.,t-, • , .. ~ '/'11,,~ ~3"'1/" •·');~•· . . INTERDEPARTMENTAL INFORMATION SHEET BUILDING DEPARTMENT BUILDING ADDRESS: PLANNING DEPARTMENT Building Department OITY OF. CAM.SW> "7/ 1.,5/ ZONE r c., LOT SIZE LOT WIDTH r ---~~~--------------------- UNITS ALLOWED I UNITS PROVIDED I ------------------------ PARKING SPACES REQUIRED ) PROVIDED ).. --------,----% COVERAGJI ALLOWED _____ _,_5/_t,__.ic...::,.o ___ .PROVIDED lt',;5 /)t:;ltl fO ~tJ .?S" JI IJ :5,...7 BUILDING &EIGHT ALLOWED .1. PROVIDED .J..> FRONT SETBACK: ALLOWED 'J.(} I PROVIDED~-;,,------ INTRUSIONS, _ .. ----- SIDE SETBACK: /I)/ ·,l;ANDSCAPE & IRRIGATION PLAN COMMENTS: ENVIRONMENTAL PROTECTION REQ: ENGINEERING DEPARTMENT aJ~6 ~ ff'~ ~ REAR SETBACK: ')." R. 0. W . _____ INDUSTRIAL WASTE ______ IMPROVEMENTS ______ _ _______ DRIVEWAY LOCATIONS ___________ _ SEWER CONNECTION GRADING PERMIT LEGAL DESCRIPTION _______ EASEMENTS _________ DRAINAGE ____ _ --------------------------- ADD IT ION AL COMMENTS---------------------·----- •••• -•• 1 ,.i.D . A "\YI l.il OK TO ISSUE:..Y,Y"'-" DATE "!:-..,,~lU PWI OK TO FINAL DATE ---------------------- FIRE DEPARTMENT SPRINKLING SYSTEM FIRE PROTECTION EQUIP. -------------------FIRE ALARM$ EXITS ______________ _ FIRE HYDRANTS LOCATION ________________ _ ADDITIONAL COMMENTS----------------------------/ OK TO ISSUE: _____ DATE _______ OK TO FINAL ______ DATE __ _ WATER DEPARTMENT REQUIREMENTS OF APPROPRIATE DISTRICTS MET ________ DATE _______ _ l/1/