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Home My WebLink About2112 ESCENICO TER; ; 81-131; PermitLICENSED 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 ef- fect. 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). [ I, as owner of the property, or my employees with wages as ttieir 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 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 doe not ap- ply to an owner of property •ho buil proves thereon, and who contracts lo jects with a contractor(s) license purs contractor's License Law). I am exempt under Sec._. ___ _,1 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 certilied copy thereof (Sec. 38001 La~..13 Co~b 1 . ,,- POLICY NO,.~ , > (}' J Z 2 t~'~-'~-- COMPANY ck-!l-1-L·tJ A"'.1Copy 1s filed with the city )cteertified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE ~ (This section need not be completed if the per- 11it is for one hundred dollars ($100) or less). I certify that in the performance of the work for v.!iich this permit is issued, I shall not employ any person in any manner so as to become subject to the .Worlmrs' Compensation laws of California. NOTICE ~o APPLICANT: If, after making this Cer- tificatr ~·Exemption, you should become subject ·,<;!rs' Compensation provisions of the must forthwith comply with such -permit shall be deemed revoked. ,TION LENDING AGENCY ,, that there is a construction len- . the performance of the work for CITY OF CARLSBAD-BUILDING DEPARTMENT USE BALL POINT PEN ONLY APPLICATION & PERMIT 1200 ELM AVENUE (714) 438-5525 , . "': _No. ' ·,. JOB ADDRESS I.ti ,/J,C; Ii, • <.~ I, A /".A1/J I h',c.~ 1, / I I I ·2, .F. C..'C:,[,/1/( ;,C 'C:/ AV.ST. [DATE OF APPLICATION , f-,. ,;'vi 4--.b~-f· I OWNER OWNER'S PHONE PRIME CONTRACTOR 1--;.L, /.: L,'2,-_.; , £.,r OWNER<I.S MAILING ADDRESS CONTRACTOR'S ADDRESS //.-f •. 0 ,C,, C ... <2'.J? 9 7'71 1 f',u .. ",<. ;, 1 SUBDIVISION i~A,SIEGOR'~ :.;~RfiLJ;· I Ii 7. I DESIGNER DESCRIPTION OF WORK APPLICANT TO FILL IN INFOR - MATION WITHIN RED LINES. ~us. L lCENSE ;z 3 S f-t' PERMlT NUMBER y/-/3/ STATE LICENSE 5y//J.{,1 CONTRACTOR'S i,".;:77/ -0 9, Vi STATE LICENSE . s·:.-z., -/ U-b~ I' ,;:;,:::'~' ~-. ;u /,~-~;;;j S"'?o ti, ' CENSl.l-s' TRACT GP ~USE I ZONING I UNITS PARKING1SPAC'E \.V NUMBER o-I '"· Not Vafid Unless Machin• CMtififld BLOG SQ. FT. BLOG USE occ. GP I STANDARD PLAN ti !TYPE CONST I acc. LOAD I UTY. PLUMBING PERMIT AMT. UTY. MECHANICAL PERMIT AMT. EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100,000 BTU EACH BUILDING SEWER OVER 100,000 BTU I EACH WATER HEATER ANO/OR VENT BOILER/COMPRESSOR UP TO 3 HP I EACH GAS SYSTEM 1 TO 4 OUTLETS ... _/.TV BOILER/COMPRESSOR 3-15 HP EACH GAS SYSTEM 5 0 R MORE BOILER/COMPRESSOR 16-30 HP / EACH INSTAL., ALTER, REPAIR WATER PIPE EACH LAWN SPRINKLER SYSTEM WATER SOFTNER VENT FAN SINGLE DUCT MECH EXHAUST -HODO/DUCTS RELOCATION OF EA FURNACE/HEATER c,,d lf,v'I, l1AT1a0\) 6/,i~~- TOTAL PLUMBING CONTRACTOR UTY. ELECTRICAL PERMIT / NEW CONST EA AMP/SWT/BKR ' 1 PH .25 3 PH EXIST BLOG EA AMP/SWT/BKR 1 PH .25 3 PH REMODEL/ALTER PER CIRCUIT TEMP POLE 200 AMPS OVER 200 AMPS TEMP OCCUPANCY (30 DAYS) TOTAL ELECTRICAL CONTRACTOR _,,,,._ ,_ ~-TOTAL MECHANICAL 7 CONTRACTOR AMT. UTY. MOBILE HOME PERMIT AMT. A AWNING PORCH SET-UP RAMADA, CABANA FENCE OVER 6' .-.lOTAL MOBILE HOME / 2.ao I \ - I HAVE CAREFULLY EXAMINED THE COMPLETED "'APPLICATION AND PERMIT. AND DO HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED;TO COMPLY WITH ALL CITY. COUNTY ANO STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER SPECIFIED HEREIN OR NOT. l.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 •AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER 5".Q" DEEP ANO DEMOLITION OR CONSTRUCTION OF .::;UCTURES OVER 3 S~~~N H7T (/;-""'.. . /;!,'/~// Bu1LDING PERMIT SIGN PERMIT PLAN CHECK ALL INCLUSIVE PERMIT TOTAL PLUMBING ELECTRICAL MECHANICAL MOBILE HOME SOLAR MICO-FILM TOTAL FEES PAYABLE - I I I c"l I I I I 13~,/ I l ' . I I I I I I I I I I .h'/ I I I I I I I I I I I I I I I I ,I 1'71 , . _,,,,....,_ ,,,_ , "' _, ( !'3~. 1.,~ ldli ilrl ;h .A . OF THE GRANTING OF THIS PERMIT. AP;a-l.(cd'N"f·s SIGNATURE• r / \ / ' OWN ERO AGEN-r)P1 CONTRACTORD IAPPROVE_r; ... rv/ ---/. /_/.._.,._.... BY PHONE O //.,. "' • , /~fl '(DATE ~#·.1 SITE '6' I, /3 l ADDRESS: OWNER: PERMIT NO: - \ FIELD INSPECTION RECORD INSPECTION DATE INSPECTOR INSPECTOR'S NOTES - WOOD FLOOR FOUNDATION• 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 &STEEL PLATE TIES/HEIGHT OF CHIMNEY OTHER TEMP POWER (POLE) SEWER GAS TEST SWIM POOL • STEEL BONDING • PRE DECK . FENCE PREPLASTER SHOWN • FRAME . PAN . i FINAL INSP BY BLDG DEPT I OTHER DEPT'S REQ COMPLETED I ELEC METER..:.PERM-TEMP h;;;1Ae.. 8 M&LtD-0 rn . 01, -r p l,._, A-. GASMETER-PERM~TEMP , "b-, .P... ///(/ /.: -4. . / . , r...,.; ~ • --. / c:,r-d ' -- CERT OF OCCUPANCY ISSUED I L ····--·····-----REQUEST~ INSPECTION .J-o_ ~-~0 INSPECTO~---~~~-~---PERMIT NO. rf tJ -J-/ b TIME: ______ _ DATE: _...if::_-_,,...2'°"-(;J'--:L-_ OWNER _______ ~h~ .... ---~-'-6'.¢?:?~Z"'----------- ADDRESS ___ .2._.::..,/c...,/'-+-/----&z'--"'"""'""/l"""""/,"'-~..=:=~-=:__~~-=c....;:...-=..-"'=.-c::,=<_-.... ,~-- BUILDING 0 FOUNDATION 0 REINFORCING STEEL 0 MASONRY 0 GROUT· GUNITE 0 FLOOR AND CEILING FRAME 0 SHEATHING 0 FRAME 0 EXTERIOR LATH 0 INSULATION 0 INTERIOR LATH OR DRYWALL ELECTRICAL 0 TEMPORARY SERVICE 0 ELECTRIC UNDERGROUND 0 ROUGH ELECTRIC 0 POOL BONDING 0 ELECTRIC SERVICE 0 CEILING HEAT 0 G.F.1. 0 SMOKE DETECTOR D FINAL 't:;J FINAL ~ I ~-( P-~~-. ..---~~~P-LU_M_B_I-NG---~--.04· .17"lr--~~---------, MISCELLANEOUS 0 UNDERGROUND PLUMBING O PLENUM AND DUCTS 0 UNDERGROUND WATER D COMBUSTION AIR 0 ROUGH PLUMBING O PATIO 0 TOP OUT PLUMBING O SIGN 0 SEWER AND PL/CO D GRADING 0 TUB OR SHOWER PAN O DRIVEWAY D GAS TEST O CONDITIONED AIR SYSTEMS 0 WATER HEATER O REFER PIPING D FINAL D FINAL READY FOR INSPECTION: D MONDAY D TUESDAY D WEDNESDAY DA.M. DP.M. THURSDAY D FRIDAY REQUESTED BY_~-----1,r,:1,-.,.J~O _________ PHONE N0, __ 7 _ ./777l,,_ f"l __ , ;;. 7 'f::::::7 fr 1 s'6' PERSON TAKING REPORT ___ • ____ _ INTERDEPARTMENTAL INFORMATION SHEET BUILDING DEPARTMENT DATE~ECEIVED BUILDING ADDRESS: ' A/A.I .2..; G -'I?'/-o? APR O 71981 CITY Qf CARLsSAD PLANNING DEPARTMENT Bulldlng Department 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: ENGINEERING DEPARTMENT u.l,.~ .· . R, 0. W. INDUSTRIAL WASTE IMPROVEMENTS _______ _ SEWER CONNECTION &i)t.J (f' DRIVEWAY LOCATIONS GRAD I NG PERMIT ~ EASEMENTSJ1:C ~----D-R_A_I_N_A_G_E~~~~~~~~~= LEGAL DESCRIPTION~ 'f eJ {!,7 'JS--1 ADDITIONAL COMMENTS ___ -=-----------------------~ 9-~7?jd/ r PWI ____ OK TO FINAL ____ DATE ___ _ FIRE. DEPARTMENT . J SPRINKLING SYSTEM ___________ FIRE PROTECTION EQUIP·-------- FIRE ALARMS EXITS _______________ _ FIRE HYDRANTS LOCATION _________________ _ ADDITIONAL COMMENTS OK TO ISSUE: _____ DATE _______ OK TO FINAL ______ DATE ___ _ WATER DEPARTMENT REQUIREMENTS OF APPROPRIATE DISTRICTS MET ________ DATE ________ _