HomeMy WebLinkAbout2320 HOSP WAY; ; 83-348; Permit"' z 0 " = :'l u w 0
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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
full force and effect.
L,c No _____ Class
I hereby affirm that I am exempt from the Contrac-
tor's License Law for the tallowing reason (Sec. 7031 :, Business and Protess,ons Code· Any city or county wh_ich re-quires a perm,t to construct, alter. improve, demolish or
repair any structure, prior to its issuance also requires the ap-
plicant for such permit to file a signed statement that he is
licensed pursuant to the provisions of the Contractor's License Law /Chapter 9 commencing with Section 7000 of D1v1s1on 3 al the Business and Professions Code) or that 1s ex-empt tnerefrom and the basis 1or the alleged exemption Any vrolation ol Section 7031.5 !Jy an aDpl1cant for a perm;t sub-jects the applicant to a civil penalty of not more than five hun· dred dollars 1:$5001
::-: I. as owner of the property, or my employees with wages
as their sole compensat;on, will do the work. and the struc-
ture is not intended or offered for sale (Sec. 7044. Business and Professions Code. The Contrac1or's License Law does not apply to an owner o! property who builds or improves
thereon and who does such work himself or through his own employees, provided that such improvemen1s are 001 intend-ed or offered !or sale If. however, the bu1ldmg or improve-ment rs sold within one year of completion, the owner-builder will have the burden ot pr011ing that he did not build or 1m· prove for the purpose of sale)
□ I, as owner ol the property, am exclusively contracting with licensed contractors to r;onstruct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds Of im-proves thereon, and who contracts for each pro1ects with a contractor(s) license pursuant to the Contractor's License Law)
C As a homeowner I am improving my home, and ttle 1ollow-rng cond1t1ons exist·
1. The work 1s being performed prior to sale
2 I have lived i~ my home for twelve months prror to completion of this work
I have not claimed this exemption during the las\ three years
n lamexemptunderSec ______ ,B&P.C
!or this reason
0 I hereby atf,rm Iha\ I ha~e ~c !, e of consen1 to sell-,nsure. or a cerl c of Workers Compensation Insurance. or 1f1ed copy !hereof
:,c':':""°~'ylt9 o>JS!J
COMPANY
D Copy 1s e(I w,111 tile c~
D Cet1,T1ed copy 1s..hT"Turn1sh
CERTIFICA~F EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This sect,on need not be completed d !he permr1
,s tor one hundred dollars 1S1001 or less)
D I cert,ty tha1 rn the performance of the work tor wh,ch th,s perrrn1 1s ,ssued. I shall no1 employ any person m any manner so as to t>ecome sub1ec! 10
1he Wori<ers· Compensation Laws of Cah!om1a
NOTICE TO APPLICANT If. after mak1n;i th,s Cet1•
!oca!e of Exempt,on. you should become su01ec1 t? the Workers· Compensation prov1s1ons of the Labor
Code you mus1 fot1'1w1!h comply wnh sucn prov,s,ons or th,s perm,t stiall t:,e deemed re,oked
0 I hereby afl1rm that ttie,e •s a cons1ruc1,on
1ena,ng agency to, th!" perlormance of the work lor which th,s perm,! 1s ,ssued 1Sec YJ9? C,vil COClel
lenders N.ame ___________ _
Lender 5 Address __________ _
USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT
1200 Elm, Carlsbad, California 92008-1989 (619) 438-5525
... ;ADDRESS , :::,':lf\" :AV:'.ST. DATE OF APPLICATION BUStNl:.SS LICENSE # VALUATION PERMIT NUMBER
;1 :;;LZI J 'µ l"I<". D \ 1. J b..._,/
. . Ab. /';./j /Jl.n I~ 11,~ '33-' ' , ,' '"_, ,:
::~NAME~• -r,,_/ )'J, r1. , ~_i{'.;:qz;i, , ~~ftActQff ' CONTRACTORS PHONE # ZONE I ?!J,,r: ~~ , .... ,,. ,. ,,.,.
-JI,,, ID
OW1 ER'S MAILINU ADDRESS CONTRACTOR'S ADDRESS LICENSE NO. PLAN 1.0. # BLDG USE CODE
C.:t{•L:A ... C:::..-r. g,n. Q12.,110 l I .., Ac::::.,., ~ .rrr'l \ r ,... ~ ,/~ -~-~-.,.,
-~<tl": BLOCK I SUBDIVISION I ASSESSOR PARCEL NO. DE$lGNER fZo LICENSE# STANDARD PLAN# BUILDING SO. FOOTAGE
~JllPTJON OF WORK OESIGNQl.'S ADDRESS DESIGNER'S PHONE
I '
:'-~-1s11t1, re -, ~ Hor .. •· . ,1, FLA ELEV. NO OCC GP EDU
k I< STORIES ·:..s..i }<!:' -i ·<: vO NO
CENSUS TRACT I GP ll'AND USE PARKING SPACE I RES UNITS GRADING ~ERMIT ISSUED I REOEVELOPMENT TYPE OCC LOAD FIRE SPA
AREA CONST
YO "D vO NO vO NO Noffl11fl .U/llt-CJ ~bine Certified ' ~) .,
·7s:!'--SUMMARY/Acc0o0u\Ji~gr-llBEA/ I '1 , 2 I [1 I OTY. PLUMBING PERMIT· ISSUE QTY. MECHANICAL PERMIT· ISSUE ~
~ '~,, -
EACH FIXTURE TRAP ~ INSTALL FURN. DUCTS iJP TO 100,000 BTU / BUILDING PERMIT ---01-00-00-8220
----. ·-
EACH BUILDING SEWER OVER 100 000 ~r _;~ SIGNPElitiif 'tl,,.Qo-00·8221
·-
EACH WATER HEATER AN0/0 ~~0-----=-: .1 ----~--Bo1LER/COMPRESS □R uP TO 3 HP /
--
PLAN CHECK 01·00·0~6
~~
EACH GAS SYSTEM 1 TO 4 OUTLfTS j BOILER/COMPRESSOR 3-15 HP / , TOTAL PLUMBING 01'00·00·8222'\
---------------/ .
EACH GAS SYSTEM 5 OR MORE i METAL FIREPLACE ELECTRICAL 01-00-00-8223
' . ' ---------· ---j-----' ' ·----------· --"
01'00·00·822' EACH INSTA~ .. ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT / MECHANICAL -
EACH VACUUM BREAKER MECH EXHAUST HOOD!□IJtTS I .I MOBILEHOME 01'00·00·~5
~ .. --------------~ 1-------·-
Ot-48226--
L_____j__WATE R SO FTNER RELOCATION OF EA FUR~ACEIHEATER ,.. IJ M ILEHOME PARK INSP
-.. . ------------I n-, 'I. I I ~ ---1£1 .c:. ,• -_ -~ ROOF DRAIN (INSIDE) ___ ,-----·-I ~
'
TOTli.L MECHANIJ;AL I) JJl h bNG MOTION --
_l -92-33-0519
----' ' -I , I ---··
TOTAL PLUMBING I FIRE SPRINKLERS 01 ·00·00-8227
' / PUBLIC FACILITIES FEE / 32·00-00-8923
QTY. ELECTRICAL PERMIT· ISSUE ~ OTY. SOLAR· IS ,UE BRIDGE FEE / ------------------· 'l;K.-NEW CONST EA AMP.:SWT BKR --+ COLLECTORS ~ SCHOOL FEE -/4TRICT I---·--
1 PH 3 PH STORAGE TANKS ';>\ ; ,,U Car1"J 80·92-21-0519
-------_______ _:_ ----
EXIST BLOG EA AMP/SWT:BKR ROCK STORAGE ~ r ..J ;_. .Ancinitas 80-92-22-0519
. -------------' -PUMP . / '-._
---· ---·
1 PH 3 PH . ./ San Dieguito 80-92-23-0519 --·---· ----
REMODELAL TEA PER CIRCUIT PLAN CHECK FEE San Marcos 80-92-24-0519 -·------·-----------------------
. TEMP PO LE 200 AMPS ---I-·----------------------~ ---·
=t-OVE R 200 AMPS
L-~ TE_MP·-~·c-cq~~N_cY no __ □AYS)-----_ _:_ ___ --~ --· ------
·-------------· --
_l --l --' ---------
TOTAL ELECTRICAL TOTAL SOLAR !,><-TOTAL FEES PAYABLE I In<,-. .
~VE CAREFULLY EXAMINED THE COMPLETED "APPLICATION ANO PEAMJT .. ANO DO HEREBY Ex~. E~ei,rm~ i~edbyttteBuildingOfficialooderthe_ptovi~ionsofthis * AN OSHA PE~IT,IS REQUIRED FOR EXCAVATIONSOYEA
, TIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON lNCLUOING THE Code~ expere by lim.,t~ion and become n~I and void. If the bu1tchn9 or work 5' o·· DEEP AND 0EMOUTION OR CONSTRUCTION OF
,,;_Dl!ClARATIONS ARE TRUE AND CORRECT ANO 1 FUAlHER CERTIFY ANO AGREE 1F A PERMIT IS 81.!ttl~nzed ~ suctt :! 15 not commenced w,thm 180 days trc_,fl! the date of such STRUCTURES OVER 3 STORIES tN HEIGHf petmd, or If the ~ or work authorized by, such permit ,s suspended or
ISSUED: TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING BUILOING CON-&ban.wt.-at r the wort is cornmettcaA tor a """tiod of 180-...;:.:.'..
'STRUCTfON WHETHER $PECIFtED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY ANO , O,ER□ CONTRACTOR 0 APPROVED BY DATE
KEEP HARMLESS THE-cnY OF CARLSBAD AGAINST All UABIUTIES, JUDGMENTS, COSTS AND 7!1-~7 ~ ··~ _j
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE BVPttONE 0 I 7/J ?':P-. GRANTING OF THIS PERMIT. r •
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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
PLUMBING -
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
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
SPECIAL CONDITIONS
CERT OF OCCUPANCY ISSUED
. .
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
REQ IF INSPECTORS ,. INSPECTION CHECKED APPROVAL DATE
----
I SOILS COMPLIANCE 1 PRIOR TO
F-OL!NOATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI -•--
PRESTRESSED
CONCRETE
POST TENSIONED
CONCRETE
FIELD WELDING
HIGH STRENGTH
BOLTS
. SPECIAL MASONRY
.
..
PILES CAISSONS
--~-... -,
,,
.
---------
.
------
..
--<11:itp of QL:arl.sbab
REQUEST FOR INSPECTION RECORD BUILDitlG DEP/\RTl·IF.NT
TIME: ____ _
INSPECTOR _________ PERMIT NO. _________ QATE: ____ _
OWNER ~ ~
ADDRESS ?';,.J,),o ~ -
, PHONE NO. ___________ _
PERSON TAKING REPORT ____ _
ELECTRICAL
rto work for six months. Permit expired-'-----• ____ _
date initial
l·!ork continues slow1y-_. ____ , ____ _
. .., date initial
I.Jerk not started, permit expired 5.i7.t31-' ~-
·outc ~
The inspector will return the permit to the permit clerk 1•1ho l'ti11
either repluce the permit in the file as active or send the m·mcr/
contructor 1~ritten notice that the permit has expired.
PLUMBING MISCELLANEOUS
D UNDERGROUND PLUMBING □ CONDITIONED AIR SYSTEMS
D SEWER ANO PLJCO D SOLAR HEAT
U TOP OUT PLUMBING 0 PATIO
[) TUB OR SHOWER PAN D POOL D SPA
D GASTEST D SIGN
0 WATER HEATER D GRADING
D SOLAR WATER D DRIVEWAY
0 FINAL 0 FINAL
SPECIAL INSTRUCTIONS-------------------------
------------------------------·-··---·
A,.-.,"'lrjV For 'n'>or>r:I ion• . .cn.,__,,M:wo:lllnd.,.•i-v--.....,n:...:,:Ty .. eii,isd;llia"'Y ----" k □ . Wcdncsda V D Thursday D Frid