HomeMy WebLinkAbout2270 CAMINO VIDA ROBLE; F; CB880562; Permitp~
g [ ~hereby affirm that I am licensed under
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u p elona of Chapter 9 (commencing with
: Seel on 7000) ol Division 3 of the Business
~ and Professions Cod. e, and my license 1s in ~ lull force and effect
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I hereby a1hrm tha1 I am e~empT trorn lhe Contrac
tor's L,cense Law tor the tollow,ng reason 1sec 7031 'l
Business and Pro1ess,ons Code An', c,ty or county wn,u, re ou,res a perm,t ro construe! alter. improve demo·11sh or
repa,r any structu,e prtor to ,ts ,ssuance also requ>res !heap
011cant tor such permit to hie a s1!)ned sta1ement lhal ~e ,s
11censed pursuan1 TO the prov1s,ons ol the Lont•acror s
License Law 'Chapter 9 commencmg w,rh Sert,on 7000 of
Owis,on 3 ol the Busmess and Professions Code, or that ,s e, empt therehom ana the bas,s lo, the allegeo exemot1on Any
viokat1on of Seci.on !031 :, by an appl,can1 for a perm,1 su~ 1ects the aop11cant 10 a c1"1 penally of nol more than 1,ve r,un
dred dollars 1SJ001
as owner ot the properly_ or my employees ,,qh "ages
as lhe1r sole compensation w111 do the work and ihe struc lure ,s nol intended or offered tor sale [Sec 7044 Busmess and Professions Coae Tne Contractor's License Law Coes
nol apply to an owner ol property who builds or ,mproves thereon and who does such work h1mselt or through his own employees prov,ded that such ,mprovemenls are nol 1nlend ed or oHered for sale 11, however. the building or improve ment 15 sold w,th1n one year of comple11on. the owner-bu,lder will have the burden ot proving that he did not build or ,m-
orove lor the purpose 01 sale)
I, as owner ot the oropeny am exclusively con1rarnng
with licensed contractors to construct the pro1ecl (Sec 7044 Business and Professions Code The Contractor's License Law does not apply to an owner 01 property who bu1lds or ,rn proves thereon and Who contracts for each pro1et1s with a contractor(sl 1,cense Pursuant to Ille Contractor's License Law)
As a homeowner I am 1mprov,ng my home and the tallow 1ng cond11,ons ex,sl 1 The won, ,s being perlormed prror to sale 2 I have lived ,n my hOme !or twelve momhs pr1or to completion o1 lh,s work
3 I have not claimed th,s exemption du11ng the last 1hree years
I am exempt under Sec _____ _ B&PC lor lh,s reason, ____________ _
_ I hereby altwn 1ha\ I have a cer1,t,ca1e of consent 10 self insure. or a cer\d1cate ol wo,kers Compensa11on In
su'ance or a ce,t,hed copy I hereof 1Sec '.!800. Laba< Code>
POLICY NO
COMPANY
Copy ,s tiled WLth the city
Cert,t,ed copy 15 nereby fum,shed
CERTIFICATE OF EXEMPTION FROM
WORKERS COMPENSATION INSURANCE
iTh,s section need not be completed ,f the permit
,s lor one hundied dollars t$Hl0\ or IE'SSI
~
cert1ly that ,n the performance of the work. tor ,,n,ch. e,m,t ,s ,ssued. I shall not employ any person ,n any
a er so as !O become sub1ect to the Wor~ers Com pen
sa!ron Laws of Cat,forn,a
NOTICE TO APPLICANT ii alter makmg thLS Cert,l,cate
of Exemp11on. you should become sub1ect to the Workers
Compensa11on pro.is.ans of the Labor Code you must
forthw,th comply with such prov,s,ons '" th,s permit shall
be deemed resoked
I hereby aff"m that there 1s a cons1ruct1on lend,ng
agency for the performance of the work for w~1ch lh,s per
m1t 15 ,ssued (Sec 3097. C1v,1 Code)
Lenders Name
Lender s Address
USE BALL POINT PEN ONLY & PRESS HARO APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT 2075 Las Palmas Dr., Carlsbad, CA 92009-1915 (619) 438-1161
JOB ADDRESS
~4-~v~ " ,e;:os; D7,~'T1 BUSINESS LICENY., VAL;;? PERMIT NUMBER
"') "".) 7r? #' ~tyoCb2 LOT BLOCK l ....,8DI VISION I "f tt:t , 7' , -cYob CONTRACTOR --· f.,,,R CONTRACTORS PHONE # ZONE ' /4/ ~//' <;'a<,r_/ ... /£ O~AME OWNER·s PHONE
~,, -, d,., ~~ -/R CONTRACTOR•s ADDRESS . STATE LICENSE NO . BUILDING sa. F1-GE
/~ e,--<....£. /4/d-s/1 ~..;Ja::7 ~ ~;;_;L~G~,,,,./Rn 1/4,,n ~"B,1.E DESIGNER DESIGNER•s PHONE (..
.
DESCRIPTION OF WORK -· ..
OESIGNER·s ADDRESS STATE LICENSE NO. u &£#.Jlt':F /'),,e" ,,II!-,r.., ~ / -,, ,v 6, ~ s. . ' ' F LR ELEV NO ace GP EDU
L,, ,,v F ~-='"-/,...,,_)~ ,,,.,? STORIES ,.-u -· • v □ "'□ I CENSUS TR,¥:T I PAF'K IN(_, SPACE RES UN1TS GRADING PERMIT ISSUED I AEDEVELOPMEr-.T TYPE ace LOAD Fl RE SPF! AREA CONST
,□ 'D '~ .... o vO "'D Not Valid Unless Machine Certified
OTY PLUMBING PERMIT· ISSUE 7$. QTY MECHANICAL PERMIT -ISSUE J:f!P-SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP . INSTALL FURN DUCTS iJP TO 100.000 BTU uu,u,I"" f-tRMI JU1-01U UU·UU-82:!0
EACH BUILlJING SE.WEA OVER 100.000 STU SIGNPE~,_-,... & ..P/l,',i,l,1='8221
EACH WATER HEATER ANO OR VE.NT BOILER,-COMPRESSOR UP 10 3 HP PLAN ~ i.:./ ,C'l.. •• ,_ _rfi_~-8891
EACH GAS SYSTEM l lU4UUlLETS I #IC 801LER:COMPRESSOR 3 15 HP TOTAL PLUMBi"JG 00 ;-81 :J-00-00-8222 /(\ .----
EACH GAS SYST FM'-, OR 'viOH[ r ME~AL FIREPLACE ELECTRICIM I\ V 'l 1 1111(1111)-00 00 8223
EACH INST AL ALTER. REPAIR WATER PIPE VENT FAN SINGLE DUCT MECi,ANICAL 001-810-00-00-8224
EACH VACUUM BREAKER MECH EXHAUST HOOU DUCTS M -25 •
WAHR SOFTNER RELOCATION OF EA FURNACE·HEATER ..., .... o,nnn.~,:Ji,,.
~A[I-' RUCf IIRA'r-..j ,''JS1D~1 DRYER VENT STRO~G MOTIUN
... .,.~-880-519-92·33 .,. ___ ...,,,,,,,.. TOTJ'..L MECHANICAL FIRE SPRl~Ji<LERS DO 1-810-00·00-8227
!lJlAI PlUMHINl, I /V PUBLIC FACILITIES FEE 320-8 1 0. 00-00-8 7 .'.,J
5c.fl. ,,,..,, . .,~ vs ~ BRIDGE FEE 360-810-00-00·8740
QTY. ELECTRICAL PERMIT -ISSUE QTY MOBILE H0,7 _._ 1 UP PARK-IN-LIEU 1AREA '
NEW CONST E:.AAMPSWl l:lKR CAR PORT ,. ,· IIC • l Tl F 312·81 0-00-00-8835
I PH I PH AWNING ¢_':"" LA COSTA TIF 3 ·11·810-00-00-8835
EXISf HtOG E:.A AMP SWT 8KR GARAGE ' FMF
I PH :l PH :-~~ ~ LICENSE TAX co' -3 1 0-•=0-00-8' 62
REMODEL AL TtR PER C,\1CUIT \Ct. t_;,._:.j ()'\ i9-~~· MFF 880-519-92-57
TEMP Pfllf !OU A..,,,PS \~ " :
OVE:R !Oi.l AMPS ,c-~ •'l
TtMP OCCUPANCY 130 DAYSI ~ f:Z'z;:l,'tu:; .
CREDIT DEPOSIT
lfl[AL El[Clflll.At I TOT Al TOTAL FEES PAYABLE I /0 --
I HAVE CAREFULLY EXAMINED THE COMPLETED ··APPLICATION AND PERMIT'-AND DO HEREBY Expiration. Every permit issued by the Building Otl,c,el under the prov1s,ons olth,s * i\N OSHA PEFN!T IS REOUIREO FOR EXCAVi\TIONS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall expire by hm1tat1on and become null and ~01d lf the bulldmg or work 5' O" DEEP ANO OEWOI.JTION OR CONSTRUCTION OF
DECLARATIONS ARE TRUE ANO CORRECT ANO 1 FURTHER CERTIFY AND AGREE IF A PERMIT I~ authorized by such permit 1s not commenced within 180 ?~~m lhe date of such STRUCTUMS OVER 3 STORIES IN HEIGHT permit, or ii I~" bu1ldi~ or work authonzed by such 11 ,s suspended or 1SSUEO· TO COMPLY WITH ALL CITY. COUNlY AND STATE LAWS GOVERNING BUILDING CON-abandoned at 111ru1 a er the wOfk 1s commenced for nod of 180 d STRUCTtON. WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND APPL1:,· fs;:z:e t!-£Aw ~Al!r APPROVED "j7 1 p/i,/fl KEEP HARMLESS 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 ,· T --, PHONE Q
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TYPE DATE INSPECTOR
BUILDING
FOUNDATION
REINFORCED STEEL
MASONRY
GUNITE OR GROUT
SUB FRAME □ FLOOR D CEILING
SHEATHING □ ROOF □ SHEAR
FRAME
EXTERIOR LATH
INSULATION
INTERIOR LATH & DRYWALL
PLUMBING
□ SEWER AND BUCO D PL/CO
UNDERGROUND □ WASTE □ WATER /"'I
TOP OUT □ WASTE □ WATER I I
,TUB AND SHOWER PAN I/
GAS TEST ,,O::.~-~ //
□ WATER HEATER □ SOLAR WATER I
ELECTRICAL
D ELECTRIC UNDERGROUND □ UFFER
ROUGH ELECTRIC
□ ELECTRIC SERVICE □ TEMPORARY
□ BONDING □ POOL
MECHANICAL
□ DUCT & PLEM., D REF. PIPING
HEAT -AIR COND. SYSTEMS
VENTILATING SYSTEMS
CALL FOR FINAL INSPECTION WHEN ALL APPBOPRIATE ITEMS ABOVE HAVE BEEN APPROVED: ·
FINAL
PLUMBING
ELECTRICAL II
MECHANICAL · I I
GAS <'-rJl-61 /7
BUILDING I
SPECIAL CONDITIONS
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS
INSPECTION REQ IF I INSPECTORS
CHECKED APPROVAL
~ l'.> 'lS OSI,;;2.
INSPECTOR"S NOTES
DATE
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
--·~~-~~ l
i.\
PRESTRESSEO
CONCRETE
POST TENSIONED
CONCRETE
FIELD WELDING
HIGH STRENGTH
BOLTS
SPECIAL MASONRY
PILES CAISSON:::
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