HomeMy WebLinkAbout2312 MARCA PL; ; 81-27; PermitLICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provi-
sions of Chapter 9 (commencing with Section
7000) pf Division 3 of the Business and Profes-
slonsfode, and my license Is In full force and ef-
fect. •
OWNER-BUILDER DECLARATION
0 1 hel9by 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).
D I, as owner of the property, or my employees
with wages as their 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).
:JI, 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 do~t ap-
ply to an owner of property \•ho i' Im-
proves thereon, and who contracts f ,s pro
jects with a contractor(s) license purs n to th
contractor's License Law).
I am exempt under Sec. ____ ..,..
for this reason , J '\\ \1
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of con-
sent to self-Insure, o• a certificate of Workers'
Compensation Insurance, or a certified copy
thereof (Sec. 3800, Labor Code).
POLICY NO. ____________ _
COMPANY ____________ _
□Copy Is filed with the city.
□Certified copy Is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the per-
mit 16 for one hundred dollars ($10!)) or less).
I certify that In the performance of the work for
which this permit Is issued, I shall not employ any
person In any manner so as to become subject to
the Workers' Compensation Laws of California.
NOl~E.TO APPLICANT: If, after making this Cer-
llflcate of Exemption, you should become subject
•to the Workers' Compensation provisions of the
l~bo• Ct>de, you must forthwith comply with such
'provl!,!lls or this permit shall be deemed revoked.
• • CONSTRUCTION LENDING AGENCY
I ·heretiy affirm that there is a construction len-
ding agency for the performance of the work for
which this permit Is Issued (Sec. 3097, Civil Code).
CITY OF CARLSBAD-BUILDING DEPARTMENT
USE BALL POINT PEN ONLY
CENSUS TRACT GP LANO USE
BLOG SQ, FT, I BLOG USE
QTY.I PLUMBING PERMIT
EACH FIXTURE TRAP
EACH BUILDING SEWER
EACH WATER HEATER ANO/OR VENT
EACH GAS SYSTEM 1 TO 4 OUTLETS
EACH GAS SYSTEM 5 OR MORE
EACH INSTAL., ALTER. REPAIR WATER PIPE
EACH LAWN SPRINKLER SYSTEM
WATER SOFTNER
CONTRACTOR
QTY. 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 PO LE 200 AMPS
OVER 200 AMPS
TEMP OCCUPANCY (30 DAYS)
TOTAL ELECTRICAL
CONTRACTOR
APPLICATION & PERMIT
1200 ELM AVENUE (714) 438-5525
ZONING RES. UNITS PARKING SPACE
OCC. GP STANDARD PLAN# Pl~Dlt
;:, /_ TYPE CONST
AMT. QTY.
INSTALL FURN. DUCTS UP TO 100,000 BTU
OVER 100,000 BTU
BOILER/COMPRESSOR UP TO 3 HP
BOILER/COMPRESSOR 3-15 HP
BO I LE R/COMPRESSO R 16-30 HP
VENT FAN Sl~!GLE DUCT
MECH EXHAUST -HOOD/DUCTS
RELOCATION OF EA FURNACE/HEATER
TOTAL MECHANICAL
CONTRACTOR
:V. MOBILE HOME PERMIT
AWNING
PORCH
SET-UP
RAMADA, CABANA
FENCE OVER 6'
TOTAL MOBILE HOME
,::,2--.uo
3-
APPLICANT TO FILL IN INFOR -
MATION WITHIN RED LINES.
IONI SUS. LICENSE _ I • PERMIT NUMBER
!/-:27
2/17/816169
Not V•lid Unlllss M•chin• CMtifi«J
OCC, LOAD
AMT.
,,,,-
<{7t/-fl)
AMT.
TOTAL FEES PAYABLE
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION ANO PERMIT, AND DO
HEREBY CERTIFY THAT All INFORMATION HEREON IS TRUE AND CORRECT ANO I
FURTHER CERTIFY ANO AGREE IF A PERMIT IS ISSUEO;TO COMPLY WITH A ll CITY,
COUNTY ANO STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER
SPECIFIED HEREIN OA NOT. I.ALSO AGREE TO SAVE INDEMNIFY ANO KEEP HARM-
LESS THE CITY OF CARLSBAD AGAINST All LIABILITIES, JUDGMENTS. COSTS ANO
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE
•AN OSHA PERMIT IS AEQUIAEO FDA EXCAVATIONS OVER
5'-0" DEEP ANO DEMOLITION OA CONSTRUCTION OF {J~~""Z~',:,C....~,....,;;/.~~-:,r;-,,.,,.
STRUCTURES OVER 3 STOA I ES IN HEIGHT
OF THE GRANTING OF THIS PERMIT.
3Lit;,3 BP ·
! < 0 ~ >
~ ~ ~
Q. V)
~
SITE <;s/-oo;;,. 7 ADDRESS: OWNER: PERMIT NO:
FIELD INSPECTION RECORD
JNSPECTION DATE INSPECTOR
t
INSPECTOR'S NOTES
·--.•. "'" WOOD FLOOR
FOUNDATION• FORMS• SET BACK• TOILET
''+lNDER FLOOR PLUMBING
Ut'l-QER 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 ST0UCCO
FIREPLACE ,
DAMPE8 &STEEL . . .
PLATE Tl ES(. HEIGHT OF CHIMNEY
OTHER
TEMP F'OWER (POLE) •·
SEWER
GAS TEST
SWIM POOL• STEEL BONDING ..
• PRE DECK .-
• FENCE PREPLASTER
SHOWN • FRAME ·• . /"'\ . P,AN .. //
FINAL \NSP BY BLDG DEPT ?-/,1..-J'/ fil
OTHER OEPT'S REQ COMPLETED ~
: ELEC METER-PERM-TEMP
iC,AS ~ETER-PERM-TEMP r I .. , ..
f C"_:C:FOCCUPANCYOSSUE;
.
; ,
.. .
.• .. ,,. .
CITY OF CARLSBAD NC!
ENGINEERING DEPARTMENT 2/ 171816 189
03967,
1 □ □a
181 HIF f/_.i'-52,-P/ .. . "
PERMIT FOR WORK ON CITY RIGHT OF WAY
BUILDING
~A~D'..!:::D~R,.!:E=S~S___Jz::=::.:!J.L:::.:::!_...L.:.~~~~~~~~~----1VALIDA TION ST AMP
CITY
Emergency TEL. NO.
STARTING DATE
EST. DATE OF COMPLETION
I hereby acknowledge that I have read this application and state
that the Information given ts correct.
I agree to comply with all applicable City Ordinance$ and State
Laws and with the requirements of this permit.
ADDRESS
AUTHORIZED AGENT
ENDORSEMENT OF COMPLIANCE
I have examined this application and have found that It complies
with all requirements of the Carlsbad environmental protection
ordinance.
DATE Planning Director
PERMITTEE CALL CITY ENGINEERING
DEPARTMENT FOR INSPECTIONS
CHECKED BELOW:
24 Hours Notice Required.
0 EXCAVATION
0 FORMS
0 BACKFILL
0 PAVEMENT
0 PRIOR TO BACKFILL
0 PRIOR TO CURB CUT
DATE
SPECIAL CONDITIONS
INSPECTOR
(A) ALL WORK MUST CONFORM TO REQUIREMENTS OF
CITY OF CARLSBAD STANDARDS, PLANS AND
A.P.W.A. SPECIFICATIONS.
(Bl INTERFERENCE WITH TRAFFIC MtlST BE KEPT TO A
MINIMUM.
(Cl PERMIT EXPIRES SIX (6) MONTHS FROM DATE OF
ISSUANCE UNLESS EXTENDED BY CITY ENGINEER.
(DI OTHER
PERMIT FEE
INSPECTOR'S
SIGNATURE
$
TOTAL $
APPROVAL FOR RELEASE
DATE
COPIES: BLUE-OFFICE YELLOW-INSPECTOR GREEN-FINANCE PINK-PERMITTEE MANILA CARD MUST BE POSTED ON JOB
}
)
•
INTERDEPARTMENTAL INFORMATION SHEET
BUILDING DEPARTMENT
'BUILDING ADDRESS:
•
PLANNING DEPARTMENT
LOT SIZE LOT WIDTH
JAM 211981
ZONE (Z-1 -----------------
UNITS ALLOWED UNITS PROVIDED ----------------------
PARKING SPACES REQUIRED Ai~ PROVIDED ___ -A-~'-/ _____ _
% COVERAGE ALLOWED -----bl-----~~-----PROVIDED ____ () __ .~fC------i ____ _
BUILDING HEIGHT ALLOWED PROVIDED
FRONT SETBACK: SIDE SETBACK: REAR SETBACK:
:~~::::D====c::):~::,:::~
INTRUSIONS
LANDSCAPE & IRRIGATION PLAN
otc arr
COMMENTS: ~N~~F-+------------
ENVIRONMENTAL PROTECTION REQ: ~~~~~=m;..L....~f-~-1---------------
7~
ENGINEERING DEPARTMENT Sf}) --
R.o.w. _____ INDUSTRIAL WASTE ______ IMPROVEMENTS ______ _
SEWER CONNECTION gou'J DRIVEWAY LOCATIONS __________ _
GRADING PERMIT. ~. ~A EMENTS ,
LEGAL DESCRIPTION~ 2 5' _ ~ ti~
ADDITIONAL COMMENTS
.,,,,~ ...... -c..., ra.~~-,.-.J---=--~-:..L<...,,-----~---r,1...,,._ ________ _
DRAINAGE -----.J./' -:3J-(J -J-~
FIRE DEPARTMENT
SPRINKLING SYSTEM FIRE PROTECTION EQUIP. -------------------
FIRE ALARMS EXITS ______________ _
FIRE HYDRANTS LOCATION ________________ _
ADDITIONAL COMMENTS
\OK TO ISSUE: DATE OK TO FINAL DATE ---------------------------..
WAfER' ::D§P ARTMENT
REbutREMENTS OF APPROPRIATE DISTRICTS MET ________ DATE _______ _
· ....... .....
f/-.27
....
•
4/21/78
LEUCADIA COUNTY WATER DISTRICT
APPUCATION FOR SEWER SERVICE
Owner's Name J9mes §00s31velt
Mailing Address T29 egap~; ia
Phone No. 753-9009
Encinitas, CA 92024 !,[;\'/E:t Frnl,llT ISSUED U?ON
Service Address: Marca Place r:~:F.!:1r o;:: BUILD!NG PEm-Ali.
1ract Description: lot 94, Spanish Village c.:J.L:.:i:::. PERMiT MUST Bi: 83~
A I l ll APPLIED r-or. r.y £., ·-c~lc,;-~. s ses sor s Paree 110. '"2...,l 6u..:-c....3 ... 5.u;Q-=2;...,,,3.___________ ~'
Type of Buildi.ng Spanish Vj]]age No. Units l Connection Fee $ 600.00
Lateral Size: 411 611 811 Saddle Easement Connection (pre-pd 200.00}
Extra Footage:· @ $.---Extra Depth: __ @ $ __ ,,4(X') ·CO
Amount Rec I d $41.CO .rn
Ck. No/Cash ,::u=::L\ 0
Date 9-\0-3
Rec'd By ~so
Lateral Fee
Prorated Sewer
Service Fee
Total $ lc,CQ•Qv
The application must be signed by the owner (or his authorized representative) of
the property to be served. The total charges must be paid to the District at the
time the application is submitted.
If a service lateral is required, it will be installed by the Leucadia County Water
District. The service lateral is that part of the sewer system that extends from
the main collection line in the street (or easement) to the point in the street (at
or near the applicant 1 s property line) where the service lateral is connected to
the applicant's building sewer. The applicant is responsible for the construction,
at the applicant's expense, of the sewer pipeline (building sewer) from the appli-
cant's plumbing to the point in the str·eet (or easement) where a connection is made
to the service lateral.
The connection of the applicant's building sewer to the service lateral shall be
made by the applicant at his expense. The connection must be made in conformity
with the District's specifications, rules and regulations; and IT MUST BE INSPECTED
AND APPROVED BY THE DISTRICT BEFORE THE SEWER SYSTEM MAY BE USED BY THE APPLICANT.
THE APPLICANT, OR HIS AUTHORIZED REPRESENTATIVE, MUST NOTIFY THE DISTRICT AT;THE
TIME INSPECTION IS DESIRED. ANY CONNECTION MADE TO THE SERVICE LATERAL OR COLLEC-
TION LINE WITHOUT PRIOR APPROVA~ AND INSPECTION BY THE DISTRICT WILL BE CONSIDERED
INVALID AND WILL NOT BE ACKNOWLEDGED.
Tne prorated sewer service fee is based upon the date the District estimates that
service will begin and covers the balance of the fiscal year. There will be no
additional fee or refund if service actually conmences on a different date. For
succeeding fiscal years, the sewer service fee will be collected on the tax roll
in the same manner as property taxes. ·
The undersigned hereby agrees toat the above information given
to the conditions as stated.
d!l2. .. ~a...----Owners~1gnature d-/~4 ~
--... ---~ .... .-. ...... ......, ...... , . ...,., .. ,,. .
is correct and agrees
lOQO , Account N
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