HomeMy WebLinkAbout2275 LISA ST; ; 83-255; Permit.. z 0 : :5 u w 0
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0 I hereby affirm that I am licensed under
provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Professions Code, and my license Is in
full force and effect.
lie No _ Class
I hereby affirm that I am exempt lrom the Contrac·
tor's License Law for the following reason (Sec. 7031 5
Business and Professions Code· Any city or county which re-quires a perrn,t to construct, alter. improve. demolish, or
repa,r any structure. or1or to_ ,ts 1ssuarn;e also requires the ap·
pl,cant for such permit to hie a signed statement that he 1s 1iCBnsed pursuant to the prov1s1ons of the Contractor's License Law (Chapter 9 commencing with Section 7000 of
D1vIsIon 3 of the Business and Professions Code) or that Is ex-
empt therefrom and the bas,s lor the alleged exemption. Any
v1olat1on 01 Section 7031_.5 by an applicant for a permit sub· 1ects the applicant to a cIvII penalty of not more than hve hun-
dred dollars ($500)
;:J I, as owner of the property, or my employees with wages
as their sole compensat.on, will do the work, and !he struc-
ture 1s not intended or ottered !or sale (Sec. 7044. Business
and Professions Gode. 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 tha1 such improvements are not intend·
ed or _ottered for sale. If, however, ttie building or impr_ove-ment ,s sold wIthm one year of completion, the owner-builder
will have the burden of proving IMI he did not build or im· prove for the purpose of sale)
:J I, as owner of the property, am exclusively contracting
with_ licensed contr~ctors to construct the project (Sec. _7G44,
Business and Pro1ess1ons Gode. The Contractor's License
Law does not apply to an owner of property who builds or im· proves thereon, and who contracts for each proIects with a
contractor(s) license pursuant to the Contractor's License Law).
□ As a homeowner I am improving my home, and the follow•
ing cond1tIons exist·
1 The work is being performed prior to sale 2 I have lived In my home for twelve months
prior to completion of this work
I have not claimed this exemption during the
last three years.
D I am exempt under Sec ______ , B & P C for this reason ____________ _
to sell•msure, or cert,! e of Workers D I hereby af!,rm th:J'" ~• ~te o! consen1
Compensa.t1on~~a c or a c 11 ccir>y thereof
(Sec 3800. La~c )
POLICY NO
COMPANY
□ Copy IS hied w,th the c1ty
D eer1,!1ed copy Is hereby furnished
CERTIFICATE:. OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE (Th,s sec!Ion need not be completed ,f the perm,1
,s for one hundred dOllars ($1001 or less)
0 I certify that In the performance ot the worl< for
which this pemi,t ,s ,ssu-ed. I shall no1 employ any
person ,n any manner so as to become subIect 10
the Wor1<ers· Compensation Laws of CaI,torma
NOTICE TO APPLICANT 11, after mak1n;i lh1s Cert,
1,cate o! Exemption. you should become subIect t0
the Worl<ers· Compensa11on prov,sIons of the Labor
Code, you must forthw11h comply w,th such
prov,s,ons or th,s perm,t shall be deemed re,01<ed
0 I hereby aft,rm that There ,s a consIructIon
Iend,ng agency for tt,e perlormance ol lhe worl( lor
wruch th,s perm,1 ,s ,ssued ISec YFJ7. c,,,r Code)
Lender's Name, ___________ _
Lende• s Address __________ _
USE BALL POINT PEN ONLY & PRE~S HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS
CARLSBAD BUILDING DEPARTMENT
1200 Elm, Carlsbad, California 92008-1989 (619) 438-5525 APPLICATION & PERMIT
JOB ADDRESS
!-fSA
~ AV. ST:-OATE OF APPLICATION BUSINESS LICENSE# VALUATION PEAMIT NUMBER
'"Yv7f' ~r
OWNER'S NAM!: T OWNER'S PHONE
RO, ,S'-(/,r'3 / _ tP .,..-¥3-
1 -..___.,, ZONE o<_ ~ j A . €i_.,u Gt.J,S~
OWNER'S MA1L1GA00AESS
CS'f~us.
PLAN LD. # BLDG use CODE .,,_....,__7 ..)--L-1 s A-sr-
LOT BLOCK } SUBDIVISION l ASSE~OR PARCEL NO. O '"' ,.1,07 ~,D C 5' u DESIGNER LICENSE# STANDARD PLAN# BUILDING SQ. FOOTAGE
OESCRlPTlON OF WORK
OESJGNER'S PHONE
L:/ ~ .... I ,;/IJ2t /R ~d £21 loes,GNER'SAODRESS
J,J,r.:) cc+'! !ltit~Vl 7, = ; h,1 -~!
~ v' F/P FLA ELEV.
vO NO
GRADING ~ERMIT ISSUED
NO
STORIES
TYPE
CONST
ace GP
OCC LOAD
EDU
FIRE SPA CENSUS TRACT I c, CANO USE -i eARK>NG SeACE RES UNOTS I
YON 0 rREDEVELOPMENT
AREA
vD NO vO NO Nor V;,/id Unless M.lchine Certifi«J
QTY. PLUMBING PERMIT -ISSUE :7 .:>': QTY. MECHANICAL PERMIT· ISSUE 3-SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP 7 INSTALL FURN DUCTS iJP TO 100.000 BTU BUILDING PERMIT 01·00·00-8220
-------------
_ i-----_ --_ ---------01·00·00-82~ 1 ----->---~LER/COMPRES_~ORUPT~3HP • PLANCHECK 01·00·00-~806
EACH BUILDING SEWER
EACH WATER HEATER ANQ.'QR VENT
OVER 100.000 BTU SIGN PERMIT
------------
EACH GAS SYSTEM 1 TO 4 OUTL~T_S______ +----BOILER/COMPRESSOR 3-15 HP . TOTAL PLUMBING 01·00·00-8222
EACH INSTA~ ALTER, REPAIR WATER P1-P~:~ -----------vENT FAN slNGLE oUC~ . MECHANICA_L __ -----01-00-00-8224
EACH GAS SYSTEM 5 OR MORE --=+ METAL FIREPLACE ELECTRICAL 01-00-00-8223
EACH VACUUM BREAKER ____ M~~XHAUST HOQOiOUCTS . MOBILEHOME 01·00-00-8225 ] ..._\ Q 1 00 1
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER . MOBILEHOME PARK INSP
r--+-EACH ROOF DRAIN (INSIDE) SOLAR 01-00-00 8226 _J ---------' TOT.t..L MECHANICAL I STRONG MOT!ON 80·92-33-0519
~-TOTAL PLUMBING --j ~~ _ ---_ . FIRE SPRINKLERS --q_1-00·00-8227
0 ~~~ PUBLIC FACILITIES FEE 32-00-00·8923 I<// ~-0 OU ELECTRICAL PERMIT· ISSUE ;..--QTY, SOLAR· ISSUE I ,,, "\ J BRIOGE FEE
NEW coNST EA AMPlSwr __ ,_ KR _ ----coLLE_CTORS__ . scHooLFEE. 0IsrnIcr -------~
1 t---+-_l_P_H _______ ~ ____ . __ _:_ STORAGE TANKS ~~ad ___ 80·92·21-05)~ .,
QTY.
EXIST BLDG EA AMP/SWT.:'BKR _-----i-_ ROCK STORAGE
------------#-PUMP _ 1 PH
REMODEL'ALTER
3 PH
PER CIRCUIT
Encinitas 80·92·22-0519
------+----'-~I --San Diegui_to __ _
San Marcos
80-92-23-0519
-------i ~~MP POLE 200 AMPS -------+---
-----------
~
PLAN CHECK f'E_E
~ _-:::___ I _gc,. --------
~------I /o ·3_
_B0_-9_2-24-~5_19 _ _, _______ _,
OVER 200 AMPS
ITEMPoCClJPA-NcY-13□-□A vsi -·r-
---'-----ll--------,·~4-' ,, I iv ._~-
_L
TOTAL fLECTRICAL -1 ----+----
, HAVE CAAeFuLt.VetAM!Nroi'ME COMPLETED "APPLtcATfOR'ANP Pl;FJM1r: .b.~o oo HeRE~v
CE9TIFY UNDER P~NA.LTY ()F Pc.RJURV !HAT ALL !~FORMATION HEREON INCLUDING THE
DECl.ARATIONS AAE TRUE A,ti40 CORRECT ANO I FURTHER' dEATfFY ANO-~REE IF A PERMIT IS
!$SUED: TO COMPC.Y WITH: ALL GITY, COUNTY AND ST'ATE LAWS GOVERN-lNG 8UILDtNG CON·
STAUCTION, WHETHER $PEClFIEO HEAElN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND
KEEP HARMLESS THE Cl'NOF.GARLSBAO AGAINST ALL UABIUTJES, JUDGMENTS. COSTS AND
EXPENSES WHICH MAY lit ANY. WAY ACCAUE AGAIN$T SAIO CITY IN CONSEQUENCE OF THE
GRANTtNG OF THIS PE~MlT.
TOT AL SOLAR ,:;o, oo ~ I I I I TOTAL FEES PAYABLE /,;;...oo,po
; ~ratiOn. E~ ,"rMff issued b)ltheButldingattiei.t \Xlderiheprovisk>ns~fllis Code'Shatt·•KPM by limitlffOn and become null and YOfd. tf the bu~'Work authoriied by such permit is not comroencecl within m i:tays from the date of such
permit, 01 if the building, or wort authorized by ,och pernut ia suspended or ~ ~ aflef the Worl( is:commtnced for 8 period of 1--., __ ...
l-7
OWNER□ CONTR~C~~
BYPHdNE 0
:,t~-r~~~r·
S~OltEll3STOIIIESINH£1GHT
APPROVED BY ~) DATE
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INSPECTION TYPE
BUILDING
FOUNDATION
REINFORCED STEEL
MASONRY
GUNITE OR GROUT
FL'OOR & CEILING SUB FRAME
SHEATHING
Fl,AME
EXTERIOR LATH INSULATION
INTERIOR LATH & DRYWALL
PLUMBING
SEWER AND B LICO
PLUMBING UNDERGROUND
PLUMBING TOP OUT
-
Tl,JB AND SHOWER PAN
GAS TEST
ELECTRICAL
TEMPORARY POWER
ELECTRIC UNDERGROUND
ROUGH ELECTRIC
ELECTRIC SERVICE
BONDING
G. F. I. -SMOKE DETECTOR
MECHANICAL
DUCT & PLEM., REF. PIPING
HEAT -AIR COND. -SOLAR SYSTEMS
VENTILATING SYSTEMS
CALL FOR FINAL INSPECTION WHEN
ITEMS ABOVE HAVE BEE~
JOB SITE FINAL
PLUMBING
ELECTRICAL
MECHANICAL
GAS
BUILDING
SPECIAL CONDITIONS
CERT OF OCCUPANCY ISSUED
<ll:itp of <ll:arl.sbab
REQUEST FOR INSPECTION RECORD
'-
INSPECTOR µ Q~ PERMIT NO.
OWNER 2_,;;J... 7 ~ ✓
----)_ :'.) ~ Tl ME: -,_~---
_________ DATE: 3 -1 7
ADDRESS c:0
REQUESTED BY ,~~-. I
BUILDING
:J FOUNDATION
□ REINFORCING STEEL
MASONRY
-1 GROUT -GUNITE
, FLOOR AND CEILING SUB FRAME
'7 SHEATHING □ ROOF C SHEAR
C FRAME
J EXTERIOR LATH
IJ INSULATION
□ INTERIOR LATH OR DRYWALL
r] FINAL r-''{ I/
t)
PLUMBING
□ UNDERGROUND PLUMBING
, SEWER AND PL/CO
LJ TOP OUT PLUMBING
□ TUB OR SHOWER PAN
D GAS TEST
C WATER HEATER
□ SOLAR WATER
c FINAL
PHONE NO.
PERSON TAKING REPORT _____ _
ELECTRICAL
'J TEMPORARY SERVICE
C UFFER GROUND
□ ELECTRIC UNDERGROUND
□ ROUGH ELECTRIC
□ POOL BONDING
~Lo/RIC SERVICE
"'~ F'T1Q AL ~
MISCELLANEOUS
CONDITIONED AIR SYSTEMS
C SOLAR HEAT
n PATIO
:J POOL □ SPA
IJ SIGN
[7 GRADING
C DRIVEWAY
D FINAL
-~ hi~ ~
SPECIAL INSTRUCTIONS-------------------------------
R~dJor Inspection: ::J Monday
□h-□ P.M.
L Tuesday -..J Wednesday C Thursday ~ Friday
8 3-~~-:-s
TES
---------------------------------1
-:-. .. :~-·,.,,,.-;'i.:' -_, __
--···----------,
.. . ...
APPLICATION FOR PERMIT TO CONNECT TO CITY SEWER SYSTEM.
CITY OF CARLSBAD
ENGINEERING DEPARTMENT
438-5541
FOR APPLICANT TO FILL IN
BUILDING
ADDRESS
OWNER
MAILING
ADDRESS
CONTRACTOR
CONTRACTOR'S
ADDRESS
7
NEW BUILDING EXISTING BUILDING
LEGAL DESCRIPTION
REMARKS:
LATERAL LOCATION
ST.
..,:
(/)
LATERAL NO. _______ INSTALLATION DATE--------
SE 1
ISSUED BY ----=--:-:-.,---:------------
DATE ISSUED------------------
VALIDATION
LATERAL CHARGE COMPUTATION
STANDARD 4" (Max. H. 30', V. 10') _________ _
OVER 30' H. @ FT. _________ _
OVER 10' V. ___ @ ___ FT. _________ _
STANDARD 6" (Max. H. 30', V . 10') _________ _
OVER 30' H. ___ @,__ ___ FT, _________ _
OVER 10' V. @ FT, _________ _
TOTAL CONSTRUCTION COST----------
SERVICE CHARGE (REPAVING ETC.) _________ _
TOTAL LATERAL CHARGE _________ _
LINE COST DATA
ASSESSMENT DIST. NO.--------------
FRONTAGE ____ COST PER FT. ____ TOTAL __ _
OTHER ____________________ _
CONNECTION FEE
NO. UNITS ____ cosT PER UNIT ____ TOTAL----
PUMP STATION FEES
NO. UNITS ___ COST PER UNIT ____ TOTAL---
I tJDO TOTAL CHARGES (LATERAL ETC.) ___ _,_ ______ _
WHITE: Engineering GREEN: Finance YELLOW: Sanitation PINK: Building GOLDENROD: Permitter
/
DEPARTMENT OF BUILDING INSPECTION
CI'l'Y LIC'. I
CITY OF CARLSBAD
1200 ELM AVE.
CARLSBAD, CAL.
Permit f -----'-
FEE:
____________ M_O_B_I_L_E_H_O_/'-_[E __ I_N_S_T_A_L_L_A_T_I_O_N_I_N_F_O_R_MA_'r_I_O_N _______________ ~
MINISTRhTIVE-CODE, 'rl1'LE 25, CHAPTER 5, ARTICLE lA
DRAIN
INLET
GAS
c=i--
~ ~L ___ t..___,_,.......•v' ..i..
,,,J.~-----c::i------
STP.EET
l ..
ADDITIONAL DATA TO BE SUBMITTED WITH /\PP:
1. Two copies of Mcbilehome support. and Fdn4
plans (if mobilehome was manufactured after
10/7/73 two copies of manufacturer's
instructions and plans must be provided).
2. Show size and location of all structures
on lot and distances to lot lines and any
mobilehome or permanent structure located
on adjacent lots and within 10' of the
proposed mobilehome.
DISTRIBUTION: Original to Perrnittee
Copy to Cur;tomer
Copy to Finance
DATE:
I r
!-I
L01' UTILITY SERVw:
1. Gas: Natural ~ Riser Size
2. Drain Inlet :Size --
3. Electrical: /~
a) Receptacl 2,.o 2,1/o
Rating/amps --
M
1.
2.
3.
4.
b) Connection Ue'.~Suppl.y
· Assembly
c) Circuit Brc4 er Rating
(arn,.:,s) c_rv
Rating {amps)/az,
DATA:
Size: Length
Width
Gas
Gas
PARK MGR'S. SIGNATURE:
(