HomeMy WebLinkAbout2277 LISA ST; ; 83-195; Permit.,
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D I hereby affirm that I am licensed under
J)(Ovislons of Chapter 9 (commencing with
S.Ctlon 7000) of Division 3 of the Business
and Professions Code, and my license is in
full force and effect.
Lie No Cla1s
I Mreby atfirm that I am exempt from the Contrac-
tor's License Law for the following reason {Sec 7031 5 Business and Professions COOe: Any city or county which re-
quires a permit to construct, alter, improve. demolish. or
repair any structure. p_rior to_ its issuance also requires the ap-ol1cant for such permit to hie a signed statement that he 1s
licensed pursuant to the provisions o1 the Contractor's License Law /Chapter 9 commencing with Section 7000 of
o,vIs,on 3 o1 the Business and Profess,ons Code) or that 1s ex·
empt therefrom and the basis for the alleged exemption Any
v1olat1on o1 Section 7031.5 by an applicant for a permit sub-jects the applicant to a civ,I penalty ol not more than five hun-
dred dollars {$5001
-I. as owner of !he property, or my employees w,th wages
as the,r sole compensation, will do the work. and the slruc·
ture is not intended or offered for sale (Sec. 7044. Business
and Professions 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 imprO'/ements are not intend·
ed or offered for sale. 11, however. the building or Improve-
mem Is sold within one year of completion. the owner-builder
will have the burden ol proving that he did not build or Im· prove for the purpose of sale)
0 I, as owner of the property, am exclusively contracting
with licensed contr2ctors to construct the project (Sec 7044,
Business and Professions Code. The Contractor's License
Law does not apply to an owner of property who builds or im-proves thereon. and who contracts for each pro1ec!s with a
contractor(s) license pursuant to the Contractor's License
Law).
D As a homeowner I am improving my home. and thetollow-
Ing cond1t1ons exist
1 The work_ is being performed prior to sale 2 I _have lived in my home for twelve months
prior to completion of thts work. I have not claimed th,s exemption during the
last three years
[J lamaxernptunderSec ______ ,B&P.C
for this reason
D ! hereby af!,rm that I ha~e a cert1t,cate of consent
10 selt-,nsure. or a cert,l1cate ot Workers
Compensation Insurance, or a cenr!,ed copy thereof
(Sec 3800. Labor Code)
POUCYNO ~ f\f\:..;.,'
COMPANY I~
D Copy ,stiled w>lh 1he c I
0 Cen,!,ed copy ,s hereb furnished
CERTIFICATE:. OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(Th,s section need not be completed 11 the pe,m,t
<s tor one hundred OOllars [$100) or less)
D I certify Iha! ,n the pertormance of !he wort< to,
which 1h1s perm,! ,s ,ssued. I shall no1 employ any
person ,n any manner so as to t>ecome sub1ect 10
the Won<ers· Compensation Laws of Cat,torn,a
NOTICE TO APPLICANT It. alter ma1<1n~ 1h1S Cert,
locate ol Exemption, tou should t>ecome sub1ec1 I') the Won<ers· Compensation pro-,s,ons o! !he Labor
Cocle you must forthw,th comply with such
prov1s,ons or this permit shall oe deemed re,ol<ed
0 I hereby 3l!lfm that there ,s a construct,on lending a,;,ency Tor the perlorrnance o! tne worl< tor
which tr.,s perm,t ,s ,ssued 1Sec 3097. C1v1I Code!
Lenders Name ___________ _
Lende1·s Address __________ _
USE BALL POINT PEN ONLY & PRE~S HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT
1200 Elm, Carlsbad, California 92008-1989 (619) 438-~25
_· r-_ _ _ _ '> _ /_ ----.'-~:~$".,: _ A:~~.f·DATtf~:~~~•-ON ~ 1,· Lc-1 s .+ ··At.r ,,.,c-to"'-~~~
ow"(E:.R'S NAME ·. OWNER'S PHONE ~ ,-.Lr~". -;::::-L . _ . •vs,, _ ~ ~
____ £~-r _',/._ -
JOB j(OQR£SS' \ BVS!NESS LICENSE #
~-·-
~TRACTORS PHONE#
OWNER'S MAILING ADDRESS· -
.,,_,,-z,,,-J7 L, t A-' .,-co7;:"/47":;yl Sr. 5~~J;c•jom I
LOT 8LOCK I SU8O1VIS!ON
DESCRIPTION OF WORK
ASSES§PR PAf.!£El NO. .,t.O"l --!>,O
& 1 71-£ --IJ-~ e Se..-+
oy,,oD DESIGNER LICENSE#
tl£S1GNE'l'l'S. ADDRESS DESIGNER'S PHONE
-EDU
VALUATION --() --
ZONE
PLAN I.□.#
STANDARD PLAN#
P~MIT NUMBER CZ'? ~ •
11/f'f
BLDG USE CODE
BUILDING SQ_ FOOTAGE
~~
crnsus TRAC; I c• LANO use I >ARK<NG seAn I RES UN<TS I
F/P FLA ELEV
vO NO
l REDEVELOPMENT
AREA
NO
STORIES
OCC GP
,i / Qi/ / t,e t,ii!O
G:lltf'8C ·l/ili,/ 91 1-e 11,0
;;!~ tfj t110
GRADING ~ERMIT ISSUED
¥0 N 0 v □ NO
QTY. PLUMBING PERMIT -ISSUE -J $!:--QTY. MECHANICAL PERMIT -ISSUE
TYPE
CONST
=s'-
DCC LOAD FIRE SPA
vO NO Not Valid Unless Mdchine Certified
SUMMARY/ACCOUNT NUMBER
1 EACH FIXTURE TRAP I / j I INSTALL FURN. DUCTS UP TD 100.000 BTU BUILDING PERMIT 01·00·00-8220
1 EACH BUILDING SEWER I_ II i -----OVER 100,000 BTU SIGN PERMIT-----01·00-00-8221 I
-----1 ___ ,_"___ BOILER/COMPRESSOR UP TD 3 HP PLAN CHECK 01-00-00-8806 +---
---
EACH WATER HEATER ANO:OR VENT
EACH GAS SYSTEM 1 TO 4 OUTLETS
EACH GAS SYSTEM 5 0 R MORE
BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING 01-00-00-8222 1 1
METAL FIREPLACE ELECTRICAL 01-00-00-8223 1
---
EACH !NSTAL. ALTER, REPAIR WATER PIPE
EACH VACUUM BREAKER
__ __,_ __ .,._v_ENT FAN SINGLE DUCT MECHANICAL 01-00-00-8224
WATER SOFTNER
MECH EXHAUST -H0OOIOUCTS
RELOCATION OF EA FURNACE/HEATER
MOBILEHOME
M0BILEHOME PARK INSP t==fEACH ROOF DRAIN {INSIDE! ---
-----+------,!---+--
SOLAR
TDT.C.L MECHANICAL STRONG MOTION
~~~~-~~~~~~~~~~~~~"-~,-.,-----4-_F_IR~E SPRINKLERS
1---TOTAL PLUMBING I ,,,.,. k I -~ I PUBLIC FACILITIES FEE
IQTY. I ELECTR~AL_PERMIT-ISSUE --· ~ -QTY. -__ S9'A:___ISSltE,A'o$/ ~--:>--:V;.-BRIDGE FEE
NEW CONST EA AMP."SWT BKR -----------ll----LCOLLECTORS . I ·--. -~ V\. 1 PH 3PH --1---SI0RAGt IANkSje3/"--..Jf. ~ r---1
ROB HO RAGE_,/ .L)U Al: -~1/~ t;. EXIST BLOG EA AMP/SWT'BKR
1 PH J l'H
REMODEL 'ALTER ----
_ _ -
71 1s------,1 n4n c Y I sq l ~CKCEE / PER CIRCUIT ----+
c-"H00L FEE -DISTRICT -· -"
-'=' " t Carlsbad
Encinitas ")..--t,--7'~
San Dieg~it~--
C::;rn M~rf'n~
01-00-00-8225
+-
__ 91-0_0-00-8226_ t
80-92-33-0519
01-00-00-8227
32-00-00-8923
------+--
80-92-21-0519
80-92-22-0519
80-92-23-0519
80-92-24-0519
'
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C ID ID P TEMP PO LE 200 AMPS_
OVER 200 AMPS
TEMP OCCUPANCY 130 DAYS) --1---------
1
TOTAL ELECIRICAL
--------
--------11--------+------
------ll---------+---TOTAL SOLAR
-----f t1:r:S-iti:-~L1VCJr£~ -" ------+------lC--~,
(o~ TOTAL FEES PAYABLE I
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I i:t:6YE CPiREFllLLY EXAM1NED THE COMPLETED "APPLICATION AND PERMITI; ANo QC.HEREBY --~--~ •. ~pe,:mt~~uec(byt~Buif~~l.l-~f¥P;~vl~ionsoiihis '4.' P' ()SHA PEFIMfl.lS~ fOfl UCA.VA~ ~;
··4,;:&enFV UN~R. PEN.ti. LTY OF PERJURY THAT ALL INFORMATION HEREQN INCLUOlNG TH€ Code~~•xptrebylimitai10naod,becomemiWi!~~~.· ..,trullOtngOt"WOfk ,5'.0''DEEPANOJ>blOUTloN""'~Of: · . -IIUlhof~by Suet\ permit iS not commenced wi --,•-~..,,1, the date of suet, --oECLARA'tlOH'S·AffE"TRUE AND CORRE.CT AND I FURTHERCERTfFY AND·AGREE1F A PERM.IT IS "'"'it,, or if the bullding,ot ~ authoriZM· * pa{~lt 1$ or ~ lSTORIES IN-HEIGHT -,.
lSSUEO: TO COMPLY WITH 'ALL CITY, COUNTY ANO S'fATE -LAWS GOVERNJNG.-frlJILDING CON-. ~. an um. .nerthe WQfli is-lXSffl ' --·• · ' of 1 -----A
STflUC'ftON, WH£THER~PECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY ANa-·, APF"t,~ TI.JAE" If. , ""~...,_.,_. 0
KE_EP HA'RM'LE,$$ THE Crf'v OF ~LSBAD AGAIN$T ALL LIABILITIES, JU[?GMENl§, COSTS A.ND,_,.; ;". "-" ,., .,:~R CONTRAC-TO
£XPENSES WHICH M_AY IN ANY WAY ACCRUE AGAJNST SAID CITY IN CONSEQUJ:t{CE OF TH£'.,;t '._ ' " ...,__ ,
GRANTING OlhH1s·PERt,,ttT. ' -__ , .--' , ~~-~-· ~ :· '"' -/ I_._;-";_·_.;..;..;_ _________ _..
...-..
_ IDATo/1fy3
~
£ ,:
--c::::7 (_/ , ,
-,. l ~⇒-J9'S-
INSPECTION TYPE DATE INSPECTOR .
BUILDING FIELD INSPECTION RECORD
FOUNDATION
REINFORCED STEEL REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
MASONRY INSPECTION REO lF INSPECTORS
CHECKED APPROVAL DATE
GUNITE OR GROUT SOILS COMPLIANCE
FLOOR & CEILING SUB FRAME PRIOR TO . FOUNDATION INSP
SHEATHING STRUCTURAL CONCRETE
FRAME OVER 2000 PSI
EXTERIOR LATH lNSULATION PRESTRESSED
CONCRETE
INTERIOR LATH & DRYWALL POST TENSIONED
CONCRETE
PLUMBING FIELD WELDING --
SEWER AND BL/CO HIGH STRENGTH
PLUMBING UNDERGROUND BOLTS ..
PLUMBING TOP OUT SPECIAL MASONRY
TUB AND SHOWER PAN
GAS TEST PILES CAISSONS
ELECTRICAL
TEMPORARY POWER f----------------·~-------
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 ALL APPROPRIATE
ITEMS ABOVE HAVE BEEN APPROVED. .· ------
JOB SITE FINAL ..
.
PLUMBING
ELECTRICAL " . •
MECHANICAL
GAS •
BUILDING • • J ~
. ---. •
SPECIAL CONDITIONS ,c,711,; I.\' ' .,,,....., X/
CERT OF OCCUPANCY ISSUED i -....
. '
71'?1~~ -tHI~ ~ IS ,4-
'lf}O A ~ wl, A-,{!_ 1 ~e,
ilM.d ~ · 6iJ-w/ 1--<. ""-"d
Ff¥0 Wu-~ 'c, * ~ \v~ ~ ~ <....l,)C..,"-~/\IY'\/1-,...Lv--· ~
,,(,1; -:?tl lc,..d. .lo ~ ~ . s:= ~
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T-\-a__ fv'W~ cb-eA ~ ) ~ ~~~\~~ ~
. ~-
•
-----·•······•-·---······
•• ei::ttp of ei::arlsbab
REQUEST FOR INSPECTION RECORD
/NSPECTOR __ J_~~~~-•---PERM/TNO. _/J')_~/~~t~S'~--~~~:: fw_3
OWNER ___ ~~~------L.,..._--~---------------------
ADDRESS --d-:--"-=,)._'-7-+--")c'---'-'~"-"'-=.ec=------~~~~c--c,,_,,,,...-=-----
REQUESTED BY ---~K~-, ... ~,-..e-h-b..c..=~~---PHONE NO. b Y''I-)I f'" r-'
BUILDING
n FOUNDATION
0 REINFORCING STEEL
CJ MASONRY
lJ GROUT -GUN/TE
Cl FLOOR AND CEILING SUB FRAME
0 SHEATHING O ROOF O SHEAR
0 FRAME
0 EXTERIOR LA TH
□ INSULATION
0 INTERIOR LATH OR DRYWALL
o FINAL /l /
u7
PLUMBING V
0 UNDERGROUND PLUMBING
[J SEWER AND PL/CO
0 TOP OUT PLUMBING
0 TUB OR SHOWER PAN
0 GAS TEST
0 WATER HEATER
0 SOLAR WATER
D FINAL " I
PERSON TAKING REPORT ~~ l
ELECTRICAL
0 TEMPORARY SERVICE
0 UFFER GROUND
0 ELECTRIC UNDERGROUND
0 ROUGH ELECTRIC
0 POOL BONDING
0 ELECTRIC SERVICE
D FINAL
MISCELLANEOUS
0 CONDITIONED AIR SYSTEMS
0 SOLAR HEAT
0 PATIO
0 POOL O SPA
0 SIGN
□ GRADING
0 DRIVEWAY
;1/~sd? ,.
SPECIAL INSTRUCTIONS __________________________ • __
~~Y For Inspection: D Monday
AA,M. 0 P.M. ------·--------
D Tuesday D Wednesday D Friday
---------·----·
APPLICATION FOR PERMIT TO CONNECT TO CITY SEWER SYSTEM.
CITY OF CARLSBAD
ENGINEERING DEPARTMENT
438-5541
FOR APPLICANT TO Fl LL IN
BUILDING
ADDRESS
OWNER
MAILING
ADDRESS
CONTRACTOR
CONTRACTOR'S
ADDRESS
NEW BUILDING
LEGAL DESCRIPTION
REMARKS:
EXISTING BUILDING
LATERAL LOCATION
ST.
LATERAL NO,-----~-INSTALLATION DATE _______ __.
SE
ISSUED BY ---------4-..::.;~==:..::~==------
DATE ISSUED----------=:,..=--;__;_ _ _:_ _____ _
VALIDATION
I I
LATERAL CHARGE COMPUTATION
STANDARD 4" (Max. H. 30', V. 10'} _________ _
OVER 30' H. ___ @_,,,.__ ___ FT. _________ _
OVER10'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---
TOTAL CHARGES (LATERAL ETC.)_--L../_O::;___D_tJ __ ,_t!!J(!),..,• __ '
WHITE: Engineering GREEN: Finance YELLOW: Sanitation PINK: Building GOLDENROD: Permltter
t.
_,,
DEPARTMENT OF BUILDING JNSPECTION
CITY LIC, I 2g7g-d"o CITY OF CARLSBAD
1200 ELM AVE.
CARLSBAD, CAL,
PJrmit t -------
FEE:
MOBILEHOME INSTALLATION INFORMATION
CALIFORNIA ADMINISTMTIVE CODE, TITLE 25, CHAPTER 5, ARTICLE lA
PARK NAME EL l/4",/,v<)Lk~-s · I.D. NO. 90-SPACE NO.
LNOAMET OCCUP ANTE. LL">.-'<,.. . ;;:z;)? 7 7, r-. c------------,--.,......,..~ __ -________ ADDRESS _________ ->r __ ...,_'' 'l'EL. # ______ _
CONTRACTOR ,,f:°"~;v,ES' //4.f?. ,./4.S,, STATR..,!:ICJ. / CONTRACTOR ~DREJl.li.., '.f:¥,. # NAME _$::JS.],~ ,S:.. 7=> ,e;,-, ~ -~~/,..-;r-t:>
WATER
DRAIN
INLET
GAS
MOB!L F.·
HOME
L ,,
---,;,----v ----
!·
1
i~---iCJr-------.;-,.l
· __________ s_T_P._E_E_T _________ ~
ADDITIONAL DATA TO BE SUBMITTED WITH APP:
1. Two copies of Hobilehome support and Fdn.
plans (if mobilehorne 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 Permittee
Copy to Customer
Copy to Finance
DATE:
~ S1/-.;l /.,J~ ,,
LOT UTILITY SERVICES:
1. Gas: N';'tural_ // Lfl~....,,.;--
Riser Size ~--'-7:::t.~h---
2. Drain Inlet:Size :f'
3. Electrical: ~
a) Receptacle /J"' ;)"/',::,
Rating/amps
.b) Connection '.,lor Power Supply
Assembly ..H#f,!-er-
c) Circuit Brea~r Rating
(amps) /~
d) E • t . ( /4 quipmen Rating amps) __ _
MANAGER APPROVAL:
MOBILEHOME DATA: (;,,?
1, Size: Length Width ---:;;,~,.,..._-__ _
2. Electrical Power
Ampere Rating
Metal Tag Rating
cr,,_d ____ _
amps 7*vo
Ass'2!"1~,,~
Size 7
3. Electrical Power
Wire Size & Type
Flexible Conduit 37~ 4. Gas Supply Inlet Size.~-~'-"7 __
Gas Connecto~, de2ibe ___ _ J/~· :-Uy
5. Water Connector Size 3//'
Water Connec~,;7,..Desc;ibe . '/ P C _, ,C,,,,,,_
6. Drain Connector Size 1 3
Drain Connec~~ ~,F-~e ___ _
7. Manufacturer Ji' /R/.._,,: #~.-.S
Address
Model 7~17t--fiv
Ser. No. ¥01 Z..3
State Insignia No. 9'Jq9J,.3 'r;! Roof Live Load _____ _,,.s.f'
Wind Load-~------p.s.f Year of Manufacture @ 3
B. M/B State License Nos. ____ _
IGNATURE:
BLDG. APPROVAL:
) ·------...... " .