HomeMy WebLinkAbout2284 JULIE PL; ; 83-M295; Permit~ 0 : :5 ~
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O 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
lull force and effect.
L,c No __ Cla,s
I hereby affirm that I am exempt from the Contrac-
tor's License Law 1or the follow,ng reason (Sec 7031.5
Business and Professions Code Any city or county which re·
quires a perm,t to construct, alter, improve. demol1sh, or rnpa1r any structure, pnor to ,ts issuance also requires the ap·
plicant for such permit to file a signed statement that he is licensed pursuant to the prov1s1ons of the Contractor's
License Law (Chapter g commencing with Section 7000 of 01v1s1on 3 of the Business and Professions Gode) or that Is ex-
emD! therefrom and the basis for the alleged eMmplion. Any violation of Sect,on 7031.5 by an applicant for a permit sub-
Iec\s the applicant to a c1v1I penalty □t not more than five hun-
dred dollars (S500)
:::J I, as owner of the property, or my employees with wages
as their sole compensation, will do \he work, and the struc-ture Is not intended or offered !or sale {Sec. 7044. Business
and Professions Gode: The Contractor's License Law does
not apply to an owner ol property who builds or improves thereon and who does such work hImseI1 or through his own
employees, provided that such improvements am not intend-ed or ottered lor sale If, however, the building or improve-
ment is sold within one year of completion. the owner-builder will have the burden ol proving tt\at he did not build or im-
prove !or the purpose ol sale)
[J I, as owner of the property, am exclusively contracting
with licensed contractors 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 protects with a contractor(s) license pursuant to the Contractor's License Law)
D As a Mmeowner I am improving my home. and the follow-ing cond1t1ons exist:
1 The work is l)eing per1ormed prior to sale
2 I have lived in my h_ome for twelve months prior to completion ol this work.
I have not claimed this exemption during the last three years
□ lame~emptunderSec ______ ,B&P.G
for this reason
□ I hereby affirm that I ha~ea cert1l1ca!e of consen1
to self-msure, or a cen,t1ca1e of Wonlers Compensa!1on Insurance, o, a cen,f,ed copy thereo1
(Sec 3800, Labor Code)
:~:::~,~-:;~· -
D Copy t~w1t v
1
0 Cert1l~opy ,s by furnished
CERTIFICATE:. OF EXEMPTION FROM
WORKERS· COMPENSATION INSURANCE
(This section need not be comple1ed d the perm,t ,s for one hundred dollars !SH))) or lesSI
0 I cen,ty that ,n the performance of the won:. for which lh1s perrmt ,s ,ssued. I shall not employ any
person many manner so as 10 become subIect to !he Worl<ers· Compensat,on Laws oi Cal1fom1a
NOTICE TO APPLICANT 11, a!!er makm;i this Cert, 11cate o! Exemption. you should t>ecome subIect 10
the Wonlers· Compensation prov,s,ons ot the Labor Code. you must forthw,th comply w,th such
provisions or th,s perm,1 shall be deemed revol<ed
0 I hereby offirm that the•e ,s a conslruchon 1endmg agency tor Hw perlormance of the worl< to,
which th•S permit ,s ,ssued ISec 3097 C,v,I Code,
Lenders Name ___________ _
Lende• s Address __________ _
USE BALL POINT PEN ONLY & PRE~S HARO APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT
1200 Elm, Carlsbad, California 92008-1989 (619) 438-5525
JOB ADDRESS . r) AV. ST-I DATE OF APPLICATION BUSINESS LICENSE# VALUATION J.-, PERMIT NUMBER
"'v'-v'U:4-::r-v'-1£.. ,-~. ·~·•1 . ;,'1/$$'2----~I?, -
l~ER"e~LLteA.-.t..<:lCU,E/2--I OWNER"5"HONE • ~,e;:~:r::~~~· _ , ;;:;;;:~i;,NE• ZONE 1 , prs
o;:•;;~DD(i ,
11
l-,f £ 9 I-CO~T;;Ou::: ,I... VffT"i LICENSE NO. >LAN LO.# BLOG USE CODE
LOT BLOCK , 1 SUBDIVISION I ASSE.SSOR PARCEL NO. DESIGNER t LICENSE# STANDARD PLAN# BUILDING SQ. FOOTAGE
OESCRIPTIT~'I~--.• ...., tt.-d'-/ Wik, -.,.. > ~ --□-E~S",.;Gc.N,:Ec,R.::"S_A.D __ O_R_E_s,;~'-•. --.--------+.-.,-.. -,-G-N_E_R_"S~P-H_O_N_E _____________ _.._ ________ _,
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. ·. F/P FLA ELEV. NO OGG GP EDU
STORIES
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CENSUS TRACT I GP LAND USE I PARKING SPACE RES UNITS I GRADING PERMIT ISSUED I REDEVELOPMENT TYPE OGG LOAD FIRE SPA . AREA CONST
y D N O v D ND v □ N □ Nor Valid Unless lbchine Certified
QTY. PLUMBING PERMIT· ISSUE 7 ~ QTY. MECHANICAL PERMIT-ISSUE :3 -SUMMARY/ACCO!Jjf!;~-~~ I;, Ii ;[,
EACHFIXTURETRAP / INSTALLFURN.OUCTSUPT0100,000BTU BUILOINGPERMIT , ijt,. 6/:_,6/;·2 ~--ri f,, _ _ --+----~-~---+=_c__.c.c__c_ccc.c.c....c_c__cc_==-"--"---+----~--t-~-== 4 -.·
EACH BUILDING SEWER --+--+-OVER 100,000 BTU SIGN PERMIT 01-00-00-8221
EACH WATER HEATER AND/OR VENT --1-----BOILER/COMPRESSOR UP TO 3 HP -----PLAN CHECK 01-00·00-8806 ---. -----------,f--------1
EACH GAS SYSTEM 1 TO 4 OUTLETS ----i--BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING 01-00-00~·8 .. 2=22'-1---------1
f---+-~~CH_G_A_S_SY_S_T_E_M_5_0_R_M_O RE ___ :.,____ M_ET_A_L_F_l~~~ACE ELECTRICAL --'0"'1_-·0 .. 0_-·0 .. 0_-·8,-,2-c23,_f-----------j
EACH INST Al .. ALTER. REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01-00-00-8224
EACH VACUUM BREAKER ------+----+--_MECH EXHAUST -HOOD/DUCTS MOBILEHOME 01-00-00_-·8,.,2""25,_f------;,!!~----c=I.-
WATER SOFTNER --RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP ---1---/..:_-·/'\ ~ --
: EACH ROOF DRAIN (INSIDE) ---+----SOLAR 01-00-00-8226 u.,,-_. _j ___ __ _ -·--T __ L. __ TOT.li.L MECHANICAL STRONG MOTION 80-92-33-0519 ----
TOTAL PLUMBING I • FIRE SPRINKLERS 01-00-00-8227
QTY. ELECTRICAL PERM!~ _:.is_S:'_E _ _ s-QTY. SOLAR . l~~-u_E ---l:~ _ ~ :~~t:~ ::~ILITIES FEE
32
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00
·
008923 ➔/ s-o ~ O
NEW CONST EA AMP-'SWT:BKR COLLECTORS J-----,J•~ SCHOOL FEE -DISTRICT ___ ,__ ---
1 PH 3 PH STORAGE TANKS Carlsbad 80-92-21-0519
EXIST BLDG EA AMP/SWT-'BKR ROCK STORAGE Encinitas 80-92-22-0519
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1 PH 3 PH _ PUMP -----.--cc~=-----+----'--j!f---San Dieguito 80-92-23-0519
REMODEL.1ALTER PER CIRCU-IT___ --PLAN CHECK ~EE 1 J rl) .,.. San-M~rcos 80-92-24-0519 '
-----------· --------------·----.JI----~ -~-~r,'--l'.-+n-,,~-----+-....-~---11 ·· ' <=
.._ __ TEMPPOLE 200~-~PS _______ 1 ______ f-. At.:L£. IIA.,v'-1' 41 .,.....('/J --------+---✓/ __ • ___ _,
OVER 200 AMPS ----, .. 1.11' ---. ..--,~ (-'A"' =, TEMl'OCCLJP~NCYIJD_IJAYSI -----~ ----=~~-=---=--nll,11/V"' ,+-4-1-111,_!--.----l,f-------------/' ,;2:/o ,,-,..J
TOTALELECTRICAL : TOTAL SOLAR _1........-1"-() TOTALFEESPAYABLE I '.( .., -~. r ,,,, "f • ---•
.. . • • , ... • . ,• , . ... . •, l . • '. ,. '. ,. -, • .
lttAVECAREFULLY,EXAMINEOTKE COMPLETED "APPLICATION.AND eERMJT" AND O(}HERE6Y EXJ?ffation,'Every~~PftM-Buif~~~de.-the~1onsof'thi$ * AN,~ "1WiAfJ 1$.ReQUIREO F0A ~CAVATION$.OVER-
CERTIFY UNDER PENALTY OF PERJUflY THAT ALL !NFORMATIQN HEREON INCLUDING THE Code ~Nan ttxpir6 ~ Jhri.~ and ~on\e n~a;nd Yoid'.'H ihe bvifdi~ orwoni. .,-O" OEEP 00.DEMOUTION OR CONSTaucTION 0, -
flEOLARATIONS ARE TRUE AND CORRECT AND l FURTHER CERTIFY AND AGREE IF A PERMIT 1$ •~ed ~ StH;tl ~mit 19:nof COff!mence_d w:itttdri80days fr?m tile date of sucti STflUCl\JR£S OVER 3 STORIES IN HEIGHT , permtt, or If th& building, Of' work authOriZed by auch penmt IS suspended or __
ISSUED: TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING BUlLDING CON· L~•~ban~doned~!!!,!at~an~vtim~•~•~•fte,~J!lhe~WO~ .. L~!LlC!!Offl!!menced!!J!!!i!!!!J!lo<!!..!!•~ --~rlod!l!!_;og!fJ1!§l!...<.\!dW--;::-+':":=0::::~:-:,-"',io--------::-:-::0------1 STRUCTION, WHETHER SPECIFIED HEREIN OR NOT. ! ALSO AGREE TO SAVE INDEMNIFY AND CAN , 0 0 APPROO:½ED 0,
KEEP HARMLESS THE OITY·OF CARLSBAD AGAINST ALL LIABIUT!ES, JUDGMENTS, COSTS ANO ApPLl ~ SfGNAT~ -If, .~ OWNER CONTRACTOR DATE
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE D' /l!..MJ J / J BY PHO E D C-7 I /' / ti3
GRANTING OF THIS PERMIT. f??___ -,-Tz... -N / j' ' t" -#;,.-~
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INSPECTION TYPE DATE INSPECTOR
BUILDING
FOUNDATION
REINFORCED STEEL
MASONRY
GUNITE OR GROUT
FLOOR & CEILING SUB FRAME
SHEATHING
FRAME
EXTERIOR LATH lNSULATION
INTERIOR LATH & DRYWALL
' PLlJMBING .
SEWER AND BL/CO
PLUMBING UNDERGROUND
PLUMBING TOP OUT
TUB 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
HliAT -AIR COND. -SOLAR SYSTEMS
VENTILATING SYSTEMS
,CALL FOR FINAL INSPECTION WHEN.ALL APPROPRIATE
ITEMS ABOVE HA VE BEEN APPROVED.
JOB SITE FINAL
PLUMBING
ELECTRICAL '· ', ( ...
MECHANICAL
GAS
BUILDING
SPECIAL CONDITIONS
CERT OF OCCUPANCY ISSUED
9'3 -m _;2.-<; s-
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR"S NOTES --~-INSPECTION REO. IF INSPECTORS DATE CHECKED APPROVAL '
SOILS COMPLIANCE
PRIOR TO -.
FOUNDATION INSP ~ ·.
STRUCTURAL CONCRETE ,. ___ ,
• • ........ ,, ~ . OVER 2000 PSI
PRESTRESSED
CONCRETE
POST TENSIONED
CONCRETE
FIELD WELDING r
HIGH STRENGTH
BOLTS . ' '
SPECIAL MASONRY
PILES CAISSONS .
. ~--; . .ii
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'
.
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APPLICATION FOR PERMIT TO CONNECT TO CITY SEWER SYSTEM.
CITY OF CARLSBAD
ENGINEERING DEPARTMENT
438-5541
FOR APPLICANT TO FILL IN
BUILDING
AODRESS
OWNER
MAILING
ADDRESS
CONTRACTOR
CONTRACTOR'S
ADDRESS
NEW BUILDING
LEGAL DESCRIPTION
REMARKS:
EXISTING BUILDING
LATERAL LOCATION
ST.
LATERAL NO. _______ INSTALLATION DATE--------1
SE
ISSUED BY --~~-:::Z:.....:.:..:..C:.:.=~~~'!!!:.~:::....--,.-------
DATE ISSUED-----=---.;,,,,:'-:....!..=..::::........:.;:.~~----.:..._
VALIDATION
LATERAL CHARGE COMPUTATION
STANDARD 4" (Max. H. 30', V. 10'} _________ _
OVER 30' H. ___ @_,,,'--___ FT. _____ ___;; ___ _
OVER 1 0' V. @ FT.-----''-------
STANDAR D 6" (Max. H. 30', V. 10') __ ..,__ ______ _
OVER 30' H. ___ @, ____ FT. _________ _
OVER 10' V. @ FT. _________ _
TOTAL CONSTRUCTION COST----------
SERVICE CHARGE (REPAVING ETC.) _________ _
TOT AL LATERAL CHARGE----------
LINE COST DATA
ASSESSMENT DIST. NO,-------=--------
FRONTAGE ____ COST PER FT. I \
TOTAL __ _
OTHER,-------------'---------
CONNECTION FEE
NO. UNITS_I._ __ COST PER UNIT_, _ _:,__TOTAL----
PUMP STATION FEES
NO. UNITS ___ COST PER UNIT ____ TOTAL---
TOT AL CHARGES ( LA TEA AL ETC.) ---=_f/=-4/'--"Q.,_O()=---.,,____OCJ ____ _
WHITE: Engineering-GREEN: Finance YELLOW: Sanitation PINK: Building GOLDENROD: Permitter
.·'
DEPARTMENT OF BUILDING INSPECTION
CITY OF CARLSBAD
-~
Permit I CITY LIC. f ___ _ 1200 ELM AVE.
CARLSBAD, CAL.
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~ --~ I ~ 15 ,, : ...:,., 1
I ;_j--L.ECTRICAL
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&: □ iil
WATER
DRAIN
INLET
GAS c::J-+.
L ,,
__ _, ____ V ----
,r------i(5t:J----
STREET
l ..
ADDITIONAL DATA TO BE SUBMITTED WITH APP:
1. Two copies of Mobilehome support and Fdn.
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
o_n adjacent lots and within 10' of the
proposed mobilehome.
DISTRIBUTION: Original to Perrnittee
Copy to Customer
Copy to Finance
DATE:
-------
FEE:
5, ARTICLE lA
LOT UTILITY SERVIC~EJ,,:
1. Gas: N~tural ___ LP~L-,,.,,~--
Riser Size ~
2. Drain Inlet:Size 31
3. Electrical:
al Receptacle ___ _
Rating/amps
bl Connection f9t,,,Power Supply
Assembly /Vv
c) Circuit Br-epL;.!s,-,e-r~R-a-t~ing
(amps) _,"-vv ____ _
d) Equipment✓ Rating (amps) /rJt:I
MANAGER APPROVAL:
MOBILEHOME DATA:
1. Size: Length
Width
2.
I· 3.
4.
5.
Electrical Power Co; ____ _
Ampere Rating
Metal Tag Rating amps_(..._{! ___ _
Electrical Power Assembly ldrl
Wire Size & Type l ~,
Flexible Conduit Size 1 --=-----Gas Supply Inlet Size _t..:-~
Gas Con7ect°,:, describe "f L-<11!1.H
Water Connector Size -;.i&•'
Water Conne~or·LDescrib~ ~~.x. 'I ...,, , ~ --, -
7. Manufacturer
Address
Model
Ser .. No. ,
State rns1gn1a
Roof Live Load
Wind Load / ti p.s.f
Year of Manufacture "7 7 _
8. M/B State License Nos.5'".f (,,t'/f
1111 '/r7;-
PARK MGR'S. SIGNATURE:
INSTALLER'S SIGNATURE:
BLDG. DEPT. APPROVAL:
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