HomeMy WebLinkAbout2322 LA COSTA AVE; ; 84-182-B; Permiten z 0 ;::
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I hereby affirm that I am exempt from the Contrac·
tor's License law tor the following reason (Sec 7031 S Business and Profess,ons Code Any c,ty or county which re-• qu,res a permit to construct, aller. improve, demot1sh, or repair any stnJcture, pnor 10 ils issuance also requires !heap--
phcant tor such permit to file a signed stalement that he 1s 'tteensed pursuant 10 the prov1stons of the Contracror's License Law (Chapter 9 commencing w1lh Sec110n 7000 of
Oiv1st0n 3 ol the Business and Professions Code) or that 1s ex-
empt therefrom and the basis IOf' the allegeo exemption Any • violation ol Seclion 7031 .S by an applican1 !or a perm,, sub-
)e(:1s the applicant to a CMI penalty of not more than hve hun-dred dollars ($500).
D I, as owner ol lhe property. or my employees with wages
as their sole compensation, wm do the wOfk, and the strut· ture is not intended or offered for sale (Sec 7044. Business
and Professions Code: The Contractor's ucense Law does
not ap~y to an owner of property who builds or improves thereon and whO does such work himself or through his own
employees. provided Iha! such improvements are not intend-ed or ottered lor sale. 11, however, the building or improve-
menl is sokJ within one year or comp~tion. the owner-builder
will have the burden of proving thal he did not butki or im-
prove tor the purpose Of sale).
O l, as owner ot the property, am excluswely contracting
with lk:ensed contractors to construct the pr(liect (Sec. 70•4. .. Business and Professions Code: The Contractor's license Law does not appty to an owner of property who builds or m-proves thereon. apd who contracts tor each protects with a contractor(s) lk:ense pursuant to the COntractDf's license UW).
D As a homeowner I am improving my home. and the folk7w-ing conditlOfls exist:
1. The work is being pertormed prior to sale. 2. I have lived in my home tor twelve months priof to completion ol this work.
3. t have not claimed this exemption during the last lhree years.
D I am exempt under Sec. ______ . 8 & P.C.
lor this reason
□ I hereby affirm that I ha'lf!! a cert,t,cate of consent
to self.insure. or a cert1t1cate of Workers·
Compensation Insurance. O< a certified CoPy thereof !Sec 3800, Lat>o< Code)
POLICY NO
COMPANY
□ Copy 1S filed with the Ctty
0 Cert1hed copy ,s hereby furnished
CERTIFICATl OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE
(This section need not be completed it the permit
1s fOf one hundred dOtlars (S 1001 Of less)
D I certify that in the performance of lhe worit lo,
which lh1s perm11 1s issued. I shall not employ any
person in any manner so as to become sub1ec1 to
the W~ers· Compensatt0n Laws of Ca.hlorn,a
NOTICE TO APPLICANT If. after makin1 this Cert,
t,cate of Exemption, you sl'\Ould bec:ome sub1ect 1-,
the Wo,11.ers' Compensation prov1s1ons of !he Labor
Code. you musl torthw1lh comply w,lh such
p,o..,1s1ons or this oerm11 shall be deemed revoked
ll
0 I hereby affirm that thete 1s a cons1ruct1on 1end1ng .-oency tor the performance ot the wor1i. lor
which ttus perm11 ,s ,ssue<J tSec 3091 c,..,,1 cooe,
Lenc,e, s Name ___________ _
Lenders A0<11ess __________ _
... CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT 1200 Elm, Carlsbad, California 92008-1989 (619) 438-5525
JOB ADDRESS A . ST.RO. NA?Z:;€ 1;7;~7,71 BUSINESS LICENSE # VALUATION PERMIT NUMBER
'"2-~"2-=2-... .A-L.D~~ ~1, lo. OOfJ ~4-✓1~-v ~~ I~ l A .a.I( .:'\"TSUBOI VISION I ASSESSOR PARCEL NO n~NTRACTOR
, CONTRACTORS PHONE • ZONE f L.:7 n--'1¢,;l -6"97d OWNER'S NAME ~J 9~::;:;.,d t:T',Jf//S .i ~
C. ~ /116!..o!N /:?Av t..<; CONTRACTOR"S ADDRESS LICENSE NO. PLAN 1.0 . # BLDG USE CODE
~~ l.lJ,~~~ 33712.7 OWNER'S MAILING AOORESS ~~ ~CL)S?» AVG DESIGNER LICENSE# STAN DARO PLAN # BUILDING SO. FOOTAGE
O~TION OF WORK ~,-..... l5. --...... t-J\, ) / ---~ _,1--,...l_,, .• NER'S ADDRESS -.. .. · -DESIGNER'S PHONE 4/ I Ol . .J4 c!U lb~ '-~ ~-e~ --~~----1:,:::-; l.H-: _--t F/P FLA ELEV. r NO OCC GP EDU
STORIES
vO NO .. --
CENSUS TRACT I GP LANO USE I PARK ING SPACE AESUNITS I GRADING PERMIT ISSUED I REDEVELOPMENT TYPE DCC LOAD FIRE SPA AREA CONST
YO N □ vO NO v□ NO Not Valid Unkn ~chine Certified
QTY. PLUMBING PERMIT· ISSUE .-:1_£!!-QTY. MECHANICAL PERMIT· ISSUE 3-SUMMARY/ACCOUNT NUMBER ,;" -EACH FIXTURE TRAP . INSTALL FURN. DUCTS UP TD 100.000 BTU BUILDING PERMIT 01-00-00·8220 .lJLl JL:J
EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT 01·00·00·8221 --.-i----EACH WATER HEATE R AND/DR VENT BOILER/COMPRESSOR UP TD 3 HP PLAN CHECK 01-00·00-8806 .J'7-, ~~
EACH GAS SYSTEM 1 TD 4 OUTLETS BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING 01-00-00-8222 17 ....J[)
EACH GAS SYSTEM 5 DR MORE METAL FIREPLACE ELECTRICAL 01-00-00-8223 /.', -EACH INSTAl .. ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01-00·00·8224
EACH VACUUM BREAKER MECH EXHAUST • HOOD/DUCTS MOBILEHOME 01-00-00-8225
WATER SDFTNE R RELOCATION OF EA FURNACE/HEATER MDBILEHOME PARK INSP
EAC~ DRAIN (lits!DE) SOLAR 01-00·00-A??~ -I-,-.. .. ,~,+-_ID_,.,,., TDTI.L MECHANICAL STRONG MOTION 80-92-33-0519
TOTAL PLUMBING I l"1-IO FIRE SPRINKLERS 01-00-00·8227
S!-QTY. SOLAR • ISSUE PUBLIC FACILITIES FEE 32-00-00-8933 QTY. ELECTRICAL PERMIT· ISSUE BRIDGE FEE
NEW CONST EA AMP/SWT •BKR COLLECTORS 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
1 PH 3 PH PUMP San Dieguilo 80-92-23·0519
REMOOEL'ALTER PER CIRCUIT PLAN CHECK FEE San Marcos 80-92-24·0519
TEMP POLE 200 AMPS
OVER 200 AMPS LICENSE TAX 01-00-00-8162
TEMP OCCUPANCY (30 DAYSI #/F'P
.:"r,1' •• J I~ u--/(j r CREDIT DEPOSIT
TOTAL ELECTRICAL I £-~ TOTAL SOLAR TOTAL FEES PAYABLE I /1.,~3.! V
I HAVE CAREFULLY EXAMINED THE COMPLETED 'APPLICATION AND PERMIT" ANO DO HEREBY Explqll,o,i_'t..,...-illuedbyllle8uilcllftg0lllc:talunderlheprov1s,onsolth,s * AN OSHA PEINIT IS REQUIAEO FOR EXCAYATIOHS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code INN_,... by Ii~ ancr·~ 1'11111 and WOid II Ille bu11d,ng or work 5· O" DEEP ANO OEMOUTION Ofl CONSTRUCTION Of
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS ..,~ bysuell,_...4 • not-iced Willllft 1-,dllyalrom llMt data ol such STRUCTURES OYER 3 STORIES IN HEIGHT ,_...it. or If Ille llulldl:x:' -" ~ by 8llc:tl pem111 • suspended or ISSUED. TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING BUILDING CON-at,end1111ed. -111M the wmll ii '..,_ ■ _,_ OI 180 ,. __ STAUCT!ON. WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY ANO
~'j).,,~ OWNER □ CONTRACTOR 0 APPRJ p BY
1 D1-"/4i1_
KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS, COSTS ANO /4 ~ ~ ~ 1., "",--BY PHONE 0
.. ,_
EXPENSES WHICH MAY IN ANY WAY ACCAUE AGAINST SAID CITY IN CONSEQUENCE OF THE ~ Lo .l ~ J GRANTING OF THIS PERMIT. • .. ~ __ _... ____ ,
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' TYPE I DATE INSPECTOR
BUILDING I
... -~ -~----
', '2(4 ... ,~~
FOUNDATION ' I FIELD INSPECTION RECORD
REINFORCED STEEL I
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
MASONRY I
GUNITE OR GROUT ' l
-
INSPECTION REO. IF INSPECTORS DATE CHECKED APPROVAL
FLOOR & CEILING SUB FRAME I i
SOILS COMPLIANCE --SHEATHING □ ROOF □ SHEAR PRIOR TO
FRAME r
I
EXTERIOR LATH I
,ouNDATION INSP
-· STRUCTURAL CONCRETE
OVER 2000 PSI -~
INSULATION I PRESTRESSED
INTERIOR LATH & DRYWALL I
I
CONCRETE
POST TfNSIONED
I CONCRETE
PLUMBING I FIELD WELDING
SEWER AND BUCO DIPUCO I
I
UNDERGROUND D WASTE D WATER
---~ --HIGH STRENGTH
BOLTS '
TOP OUT □ WASTE □ WATER -· .
Sf'ECiAL MASONRY·. .
TUB AND SHOWER PAN I
' GAS TEST I PILES CAISSONS
□ WATER HEATER D SOLARW.t..TER ---~------
I •. _,.
' ELECTRICAL I -..
□ ELECTRIC UNDERGROUND D1UFFER ,· -. ___
ROUGH ELECTRIC I ---· ... ~
□ ELECTRIC SERVICE D TEMPORARY
□-BONDING □ POOL I
I
. MECHANICAL I
D DUCT & PLEM., D REF. PIPING
HEAT -AIR COND. SYSTEMS 1
A•·---.. i VENTILATING SYSTEMS I ; . ~. --
' .. .-, --t--' ·_.-I ,. --•-.
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE ..
ITEMS ABOVE HA VE BEEN APPROVED · ~ -· . -.
FINAL I '
PLUMBING ' .
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ELECTRICAL I -·,
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MECHANICAL I .. •.
GAS I
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BUILDING I
SPECIAL CONDITIONS I
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