HomeMy WebLinkAbout2386 FARADAY AVE; MULTI-PERMIT FILE; CB142007; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Plumbing/Mechanical/Electrical (PME) Permit
11-20-2014 Permit No: CB.142007
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Reference #:
PC#:
2386 FARADAY AV CBAD
PME
2120621800 Lot#: 0
Status:
Applied:
Entered By:
Plan Approved:
Issued: ·
Inspect Area:
Project Title: ELECTRIC SERVICE SWITCHBOARD
REPLACEMENT-REPLACE EXISTING SDG&E SWITCHBOARD TO
ACCOMODATE INCREASED ELECTRIC LOAD FOR ENTIRE BUILDING
Applicant:
LES HAJNAL
375 SURFVIEW DR
LOS ANGELES CA 90272
310 752-6500
Plumbing Fees
Electrical Fees
Mechanical Fees
Other PME Fees
TOTAL PERMIT FEES
Owner:
KW FUND I CARLSBAD I LP
9701 WILSHIRE BLVD #700
BEVERLY HILLS CA 90212
ISSUED
08/13/2014
RMA
11/20/2014
11/20/2014
$0.00
$158.00
$0.00
$430.00
$588.00
Total Fees: $588.00 Total Payments To Date: $588.00 Balance Due:
Inspector:
FINAL!APPROV~L
Date: 'J---~· IS Clearance: ------
$0.00
NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively
referred to as "fees/exactions." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must
follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for
processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack,
review, set aside, void, or annul their imposition.
You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity
changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any
fees/exactions of which ou have reviousl been iven a NOTICE similar to this or as to which the statute of limitations has reviousl otherwise ex ired.
THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: 0PLANNING 0ENGINEERING DBUILDING DFIRE DHEALTH OHAZMAT/APCD
Plan Check No.
Est. Value {"Cityof
Carlsbad
Building Permit Application
1635 Faraday Ave., Carlsbad, CA 92008
Ph: 760-602-2719 Fax: 760-602-8558 ,
email: building@carlsbadca.gov
www.carlsbadca.gov SWPPP
SUITE#/SPACE#/UNIT
CT/PROJECT# LOT# PHASE# # OF UNITS # BEDROOMS # BATHROOMS CONSTR. TYPE OCC. GROUP
DESCRIPTION OF WORK: Include Square Feet of Affected Area(s)
~l:PG~ t:8t,\~\IN~ st'Gt e <2:J816\HCe 9~ rreH'EMRf) m .pc,C() 1\M/\ObATE: /~~
~teer-e,tcAL ~ ~T-St9\LDl~G
EXISTING USE
APPLICANT NAME
Primary Contact
ADDRESS
CITY
PHONE
EMAIL
PROPOSED USE GARAGE (SF)
STATE CA ZIB 0·?..,'1~
FAX
,com
STATE ZIP
FAX
STATE LIC. #
PATIOS (SF) DECKS (SF)
PROPERTY OWNER
ADDRESS
CITY
PHONE
EMAIL
CONTRACTOR BUS. NAME
STATELIC.#
FIREPLACE
YEsO.
AIR CONDITIONING
NoO YEsONoD
STATE ZIP
FAX
FIRE SPRINKLERS
YESONoO
C>&Z,
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or re air any structure, prior to its issuan e, also requires the applicant for such permit to file a signed statement tl\at he is licensed pursuant to the provisions of the Contractor's License Law [C apter 9, commending with Section 7000 of Division 3 of the Business and Professions Code} or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars {$500)).
Workers' Compensation Declaration: I hereby affinn under penalty of pe{jury one of the following declarations: .
D I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
lk:J I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permi is issued. My workers' compensation insurance carr,' er and policy r numberare:lnsuranceCo. h~R-IPS:Z: /V lr7iM,J/-l t---PolicyNo . ...f<"-f:Q~¼~~il~~---ExpirationDate__,r;,,""""_,-~~_._.e.,e--cec_
This section need not be completed if the permit is for .one hundred dollars ($100) or less. 0 Certificate of Exemption: I certify thatin the performance of the work for which is permitis issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of
California. WARNING: Failure to secure orkers' compensation coverage is lawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), in
addition to the cost of compensation, m es as r ided for in Section 6 of the Labor code, interest and attorney's fees.
Ji:5 CONTRACTOR SIGNATURE
I hereby affinn that I am exempt from Contractor's Ucense Law for the following reason:
0
D
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 offered for sale (Sec. 7044, Business and Professions Code: The Contractors
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 offered for
sale. If, however, the building or improvement 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).
I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractors License Law does not apply to an owner of
property who builds or improves thereon, and contracts for such projecls with contractor(s) licensed pursuant to the Contractors License Law).
I am exempt under Section ____ Business and Professions Code for this reason:
1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. QYes 0No
2. I (have I have not) signed an application for a building permit for the proposed work.
3. I have contracted with !he following person (firm) to provide the proposed construction (include name address/ phone/ contractors' license number):
4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name/ address I phone/ contractors' license number):
5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name I address I phone/ type of work):
Ji:5 PROPERTY OWNER SIGNATURE 0AGENT DATE
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the
Presley-Tanner Hazardous Substance Account Act? Yes No
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Yes No
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Yes No
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF
EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code).
Lender's Name Lender's Address
I certify that! have read the application and state that the above information Is conectand that the information on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction.
I hereby authorize representative of the City of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD
AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
OSHA: An OSHA permit is required for excavations over 5'0' deep and demolition or construction of structures over 3 stories in height.
EXPIRATION: Every permit issued by the Building Official under the provisions of this Code shall expire by limitation and become null and void ~ the building or work authorized by such permit is not commenced within
180 days from the date of such permit or if building or work au 'zed by such permit is suspended or abandoned at any time after the \\Qrk is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). ~ APPLICANT'S SIGNATURE ~ DATE -h , ~ 0 f 9.JJ \ 4
STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE.
Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection.
CERTIFICATE OF OCCUPANCY /Commercial Projects O nlyj
Fax (760) 602-8560, Email building@carlsbadca.gov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008.
CO#: (Office Use Only)
CONTACT NAME OCCUPANT NAME
ADDRESS BUILDING ADDRESS
CITY STATE ZIP CITY STATE ZIP
Carlsbad CA
PHONE I FAX
EMAIL OCCUPANT'S BUS. LIC. No.
DELIVERY OPTIONS
PICKUP: CONTACT (Listed above) OCCUPANT (Listed above)
CONTRACTOR (On Pg. 1)
ASSOCIATED CB#
MAIL TO: CONTACT (Listed above) OCCUPANT (Listed above)
CONTRACTOR (On Pg. 1) NO CHANGE IN USE/ NO CONSTRUCTION
MAIL/ FAX TO OTHER: CHANGE OF USE/ NO CONSTRUCTION
,HS APPLICANT'S SIGNATURE DATE
Inspection List
Permit#: CB142007 Type: PME
_[?~~ ·-· .. Inspection Item ____ _
01/20/2015 39 Final Electrical
12/31/2014 33 Service Change/Upgrade
11/21/2014 31 Underground/Conduit-Wirin
11/21/2014 31 Underground/Conduit-Wirin
11/21/2014 31 Underground/Conduit-Wirin
Tuesday, June 02, 2015
Inspector
PD
PD
PD
PD
PD
Act
AP
AP
AP
NR
NR
ELECTRIC SERVICE SWITCHBOARD
REPLACEMENT-REPLACE EXISTING SDG
Comments
Page 1 of 1
DATE: Octob~r 1, 2014
JURISDICTION: Carlsbad
PLAN CHECK NO.: 14-2007
EsGil Corporation
In (J!artnersliip witli (]overnment for (]3ui(aing Safety
SET: III
PROJECT ADDR!=SS: 2386 Faraday Avenue
D APPLICANT
D JURIS.
D PLAN REVIEWER
D FILE
PROJECT NAME: Commercial Electrical Service Modification and Location Change
[ZI The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's codes.
D The plans transmitted herewith will substantially comply with the jurisdiction's
codes when minor deficiencies identified below are resolved and checked by building
department staff.
D The plans transmitted herewith have significant deficiencies identified on the enclosed check list
and should be corrected and resubmitted for a complete recheck.
D The check list transmitted herewith is for your information. The plans are being held at Esgil
Corporation until corrected plans are submitted for recheck.
D The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant
contact person.
D The applicant's copy of the check list has been sent to:
1:8'.] EsGil Corporation staff did not advise the applicant that the plan check has been completed.
D EsGil Corporation staff did advise the applicant that the plan check has been completed.
Person contacted: Les Hajnal Telephone#: 310 752-6500
Date contacted: (by: ) Email: info@hajnaleng.com Fax #:
Mail Telephone Fax In Person
D REMARKS:
By: Eric Jensen Enclosures:
EsGil Corporation
0 GA 0 EJ O MB 0 PC 10/01
9320 Chesapeake Drive, Suite 208 + San Diego, California 92123 + (858) 560-1468 + Fax (858) 560-1576
EsGil Corporation
In (J?artners/i.ip wit/i. government for f.Bui(aing Safety
DATE: September 23, 2014
JURISDICTION: Carlsbad
PLAN CHECK NO.: 14-2007
PROJECT ADDRESS: 2386 Faraday Avenue
SET: II
g_.,_faPPLICANT
~JURIS.
CJ PLAN REVIEWER
CJ FILE
PROJECT NAME: Commercial Electrical Service Modification and Location Change
D The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's codes.
D The plans transmitted herewith will substantially comply with the jurisdiction's
codes when minor deficiencies identified below are resolved and checked by building
department staff.
D The plans transmitted herewith have significant deficiencies identified on the enclosed check list
and should be corrected and resubmitted for a complete recheck.
~ The check list transmitted herewith is for your information. The plans are being held at Esgil
Corporation until corrected plans are submitted for recheck.
D The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant
contact person.
D The applicant's copy of the check list has been sent to:
D EsGil Corporation staff did not advise the applicant that the plan check has been completed.
~ EsGil Corporation staff did advise the applicant that the plan check has been completed.
Person contacted: Les Hajnal Telephone#: 310 752-6500
£ate contacted: q /~by: ~Email: info@hajnaleng.com Fax #:
t:,Mail Telephone Fax In Person
D REMARKS:
By: Eric Jensen
EsGil Corporation
D GA D EJ D MB D PC
Enclosures:
09/17
9320 Chesapeake Drive, Suite 208 + San Diego, California 92123 + (858) 560-1468 + Fax (858) 560-1576
Carlsbad ·14-2007
September 23, 2014
GENERAL PLAN CORRECTION LIST
JURISDICTION: Carlsbad
PROJECT ADDRESS: 2386 Faraday Avenue
DATE PLAN RECEIVED BY
ESGIL CORPORATION: 09/17
REVIEWED BY: Eric Jensen
FOREWORD (PLEASE READ):
PLAN CHECK NO.: 14-2007
DATE REVIEW COMPLETED:
September 23, 2014
This plan review is limited to the technical requirements contained in the International Building
Code, Uniform Plumbing Code, Uniform Mechanical Code, National Electrical Code and state
laws regulating energy conservation, noise attenuation and disabled access. This plan review
is based on regulations enforced by the Building Department. You may have other corrections
based on laws and ordinances enforced by the Planning Department, Engineering Department
or other departments.
The following items listed need clarification, modification or change. All items must be satisfied
before the plans will be in conformance with the cited codes and regulations. The approval of
the plans does not permit the violation of any state, county or city law.
• Please make all corrections and submit four new complete sets of prints to:
ESGIL CORPORATION.
• To facilitate rechecking, please identify, next to each item, the sheet of the plans upon
which each correction on this sheet has been made and return this sheet with the
revised plans.
• Please indicate here if any changes have been made to the plans that are not a result of
corrections from this list. If there are other changes, please briefly describe them and where
they are located on the plans. Have changes been made not resulting from this list?
D Yes D No
'fi , I ,t
Carlsbad '14-2007
September 23, 2014
ELECTRICAL and ENERGY COMMENTS
PLAN REVIEWER: Eric Jensen
ELECTRICAL (2013 CALIFORNIA ELECTRICAL CODE)
• I'm a little in the dark as the site plan has one building with a future building whereas
Google Earth has two buildings. I'm not sure how the "future" building is being fed
presently by the electrical company: If it is a separate building wl a separate setvice or if
it included with this permit? For example: I don't know if this new setvice includes just
the one building shown on the site plan or both buildings or parts of one or both
buildings?
1. Single line diagram:
+ The building has three grounding systems:
+ The new service (remote from the building)
+ The existing setvice
+ DP1 & DP2.
+ (DP1 & DP2) require a building grounding electrode system. All electrodes setving a
common building are required to be bonded together (Existing setvice and DP1/DP2
electrode systems). Please show the electrode system for DP1 & DP2 as well as the
bonding design of the two electrode systems.
2. Equipment grounding conductors must be upsized as in ratio with the ungrounded
conductors for voltage drop.
3. Include the following descriptions: (First review the lead-in comment for design
applicability): At the new main setvice the sign should describe what it's disconnecting.
At DP1 & DP2 the sign should describe the loads (areas(?) setved by each as well as
the other building disconnect locations in the building, At the existing setvice a sign
should describe the new main service location as well as the electrical disconnecting
means throughout the building.
+ The jurisdiction has contracted with Esgil Corporation located at 9320 Chesapeake Drive,
Suite 208, San Diego, California 92123; telephone number of 858/560-1468, to perform the
plan review for your project. If you have any questions regarding these plan review items,
please contact Eric Jensen at Esgil Corporation. Thank you.
j
DATE: August 21, 2014
JURISDICTION: Carlsbad
PLAN CHECK NO.: 14-2007
EsGil Corporation
In (J?artnersli.ip witfi. government for (}Jui{aing Safety
SET: I
PROJECT ADDRESS: 2386 Faraday Avenue
OftPLICANT
/2 JURIS.
D PLAN REVIEWER
Cl FILE
PROJECT NAME: Commercial Electrical Service Modification and Location Change
D The plans transmitted herewith have been corrected where necessary and substantially comply
with the jurisdiction's codes.
D The plans transmitted herewith will substantially comply with the jurisdiction's
codes when minor deficiencies identified below are resolved and checked by building
department staff.
D The plans transmitted herewith have significant deficiencies identified on the enclosed check list
and should be corrected and resubmitted for a complete recheck.
IZI The check list transmitted herewith is for your information. The plans are being held at Esgil
Corporation until corrected plans are submitted for recheck.
D The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant
contact person.
D The applicant's copy of the check list has been sent to:
D EsGil Corporation staff did not advise the applicant that the plan check has been completed.
IZI EsGil Corporation staff did advise the applicant that the plan check has been completed.
Person contacted: Les Hajnal Telephone#: 310 752-6500
pate contacted:~\ (by:~Email: info@hajnaleng.com Fax#:
vf7Mail \,)f"elephone Fax In Person
D REMARKS:
By: Eric Jensen
EsGil Corporation
D GA D EJ D MB D PC
Enclosures:
08/14
9320 Chesapeake Drive, Suite 208 + San Diego, California 92123 + (858) 560-1468 + Fax (858) 560-1576
· ~arlsbad 14-2007
August 21, 2014
GENERAL PLAN CORRECTION LIST
JURISDICTION: Carlsbad
PROJECT ADDRESS: 2386 Faraday Avenue
DATE PLAN RECEIVED BY
ESGIL CORPORATION: 08/14
REVIEWED BY: Eric Jensen
FOREWORD (PLEASE READ):
PLAN CHECK NO.: 14-2007
DATE REVIEW COMPLETED:
August 21, 2014
This plan review is limited to the technical requirements contained in the International Building
Code, Uniform Plumbing Code, Uniform Mechanical Code, National Electrical Code and state
laws regulating energy conservation, noise attenuation and disabled access. This plan review
is based on regulations enforced by the Building Department. You may have other corrections
based on laws and ordinances enforced by the Planning Department, Engineering Department
or other departments.
The following items listed need clarification, modification or change. All items must be satisfied
before the plans will be in conformance with the cited codes and regulations. The approval of
the plans does not permit the violation of any state, county or city law.
• Please make all corrections and submit four new complete sets of prints to:
ESGIL CORPORATION.
• To facilitate rechecking, please identify, next to each item, the sheet of the plans upon
which each correction on this sheet has been made and return this sheet with the
revised plans.
• Please indicate here if any changes have been made to the plans that are not a result of
corrections from this list. If there are other changes, please briefly describe them and where
they are located on the plans. Have changes been made not resulting from this list?
0 Yes D No
' I
• -~adsbad 14-2007
August 21, 2014
ELECTRICAL and ENERGY COMMENTS
PLAN REVIEWER: Eric Jensen
ELECTRICAL (2013 CALIFORNIA ELECTRICAL CODE)
1. Not really sure the significance of sheet E-2: Please explain, are any of the
improvements (phone conduit, site lighting, pool electric, etc.) part of this permit?
2. Single line diagram:
3. Provide a complete detail of the grounding electrode system for the new service
disconnecting enclosure: Electrode design and conductor sizing.
4. Provide a complete detail of the grounding electrode system for the new Havas
distribution panelboards. This electrode system must be bonded to the (existing/prior
service) building distribution equipment grounding system.
5. What is an unknown is the water supply piping modifications: If a new system is being
installed to the building, it will be required to be bonded to the electrical system.
6. Complete feeder sizing descriptions where missing on the single line diagram.
7. I'm not sure what the conduit/feeder description means that is being installed from the
new service to the Havas panels. Please clarify.
8. Clarify if the existing 1200 ampere service will become a giant junction box with no
operable circuit breakers installed therein or if it will have operable circuit breakers?
9. Detail the signage necessary throughout the system: Existing Service, new Havas
distribution boards, and the new service all need signage describing the number of and
location of the electrical sources and their function throughout the building.
• The jurisdiction has contracted with Esgil Corporation located at 9320 Chesapeake Drive,
Suite 208, San Diego, California 92123; telephone number of 858/560-1468, to perform the
plan review for your project. If you have any questions regarding these plan review items,
please contact Eric Jensen at Esgil Corporation. Thank you.
' Cadsbad •14-2007 ' August 21, 2014
[DO NOT PAY -THIS IS NOT AN INVOICE]
VALUATION AND PLAN CHECK FEE
JURISDICTION: Carlsbad
PREPARED BY: Eric Jensen
PLAN CHECK NO.: 14-2007
DATE: August 21, 2014
BUILDING ADDRESS: 2386 Faraday Avenue
BUILDING OCCUPANCY:
BUILDING
PORTION
Air Conditioning
Fire Sprinklers
TOTAL VALUE
Jurisdiction Code cb
Bldg. Permit Fee by Ordinance
Plan Check Fee by Ordinance
Type of Review:
D Repetitive Fee 3 Repeats
• Based on hourly rate
D
AREA Valuation
( Sq. Ft.) Multiplier
By Ordinance
Complete Review
D Other
Hourly 0
EsGil Fee
Comments: 4 hours plan review.
Reg. VALUE
Mod.
D Structural Only
1------4-11 Hrs. @ •
$86.00_
($)
$430.001
$344.001
Sheet 1 of 1
macvalue.doc +
CB142007 2386 FARADAY AV
ELECTRIC SERVICE SWITCHBOARD
REPLACEMENT-REPLACE EXISTING SDG&E
cf/ !J/1 1 Cdr al pc_
-S--/ ?;I(,{, i.(,
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! 1+-l'(J .Jr (O{J 100 f4'lcf:-..fLfma, Inspection required by:
D Plan D CM&I D Fire 0
SW 01SSUED I Dev.
Approved D-,te By ..
BUILDING 10/1 !,</ >.7 ·
PLANNING Ju f..4-I A~-.
ENGINEERING Nik-/i}A-
FIRE Expedite? y N ))fA-YHl'IAA-. DIGITAL FILES Reauired7 y N
HazMat
APCD
Health
Forms/Fees Sent Rec'd Due? By
Encina y N
Fire y N
HazHealthAPCD y N
PE&M y N_,,
School y N
Sewer y N
Stormwater y N
Special Inspection y N
CFO: y N .
LandUse: Density: lmpArea: FY: Annex: Factor:
PFF: y N
Comments Date Date Date Date
Building J /&--1 f 1 '-{, q ;;is},~
Planning
Engineering
Fire
llk!ed? ,,
( /.tNJ A • _ ,J!r A ... //,,•;u. ~one
fll. _; )~rc-,L -..rr1 ( r,,FA ___ y -rfl Ii JJJ h )q>one
~ ~ L. .
llnA•·' CJ Done
~ CJ Done
09/09/98 13:52
Page 1 of 1
B U I L D I N G
Job Address: 2386 FARADAY AV
Permit Type: ELECTRICAL
Parcel No: 212-062-18-00
Valuation: O
P E R M I T
Suite:
Lot#:
Permit No: CB983035
Project No: A9803950
Development No:
Occupancy Group: Reference#:
NEW
ISSUED
09/09/98
09/09/98
JM
Description: INSTALL NEW SUB PANEL
;-·F,NAL AF·: ()\!Al--\
i
I
1
\ F'1$P. /~~ • ~ .
\GLEA:ANCE-_..:--=------w~· . .,.._..,._ -----·
. 3 -9---~ \ -~ ~
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
PERMIT APPLICATION
FOR OFFICE USE ONLY '7.
PLAN CHECK NO. tf3n35
CITY OF CARLSBAD BUILDING DEPARTMENT
2075 Las Palmas Dr., Carlsbad CA 92009
(760) 438-1161
EST. VAL. _________ _
Plan Ck. Deposit =,--,,.,--,,.....,=-----;r-4-~,.,.
Validated By_-1!!~~~-'r-=-r,1......!'--
Date ______ ___,H..i;.i:~~~~'---
, ~ ·' ~ .. -;-_.., " .,_ .. _ -
E;u t f,Z' · · ~e:>6
Business Name (at this address)
Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units
Assessor's Parcel #
"1'..u.Q.~1:l A.Je..,, )
Existing UAse
i!l ~Cftft·<, '.5,; J~ ¼,ual.,
Proposed Use
Description of Work SQ. FT. #of Stories # of Bedrooms # of Bathrooms
State/Zip Telephone# Fax#
Name Address City State/Zip Telephone#
Name Address Telephone#
(~~ .,:-'()O!',ITRAC:ro,r~-C!)1-'(PA~Y'..!'fAI_V!E7.:'.;··~ ,;:;:::~" :.c= ',:.,:=. :: .· .. . . . ·. ·:. ':~-. , .... , ... "
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its
issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law
[Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom, and the basis for the alleged
exemption. Any violation of Section 7031.5 b,y an~licant for a permit subjects the applicant t~"I. civil penalty of not more t~n five hundred ollar!t ($5001). / I_ A.ud _ ec 1~c_, ri!I. ?-D a · '-4..Jt o t.:2/:J.I( ~l'f l ':l9:)..-/ J..S
Name Address City State/Zip Telephone#
State License # Ga oc:o er License Class----------City Business [icense # ~
Designer Name Address City State/Zip Telephone
State License # _________ _
:J>.: __ , :W.OilKEitS[·'.COMPEfilSATJQN_-:_::~·--.::~.:~:~,;.~~:::_:: .:.:·:,:: · ..:..· _:__ ~~ ... _: ~ '. .. .' ;_ ... :·:0
.:: ·:.: ... __ .:::·~: ..... •
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
0 I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
'N1 I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
~d. My worker's comp~sation insurance carrier and policy number are: . ~ "I f .7 _ Glq . . <3 _ j _ <? ~
Insurance Company ~1"c:_ Pohcy No. f 5 ~ J-'o IO Exp1rat1on Date._--'O'--.....:..---)2-t---
(THIS SECTION NEED NOT BE COMPLETED IF T PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS)
D CERTIFICATE OF EXEMPTION: 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.
WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred
thousand doll s 100,000), in add~ n to the cost of compensation, damages as provided for in Section 3706 of th~a~':7~ '-Jvt and attorney's fees.
SIGNATURE--..!.U.._.L.il.-.l~~=---=i,....t,~~:::µ~~=--.as,,..------------DATE ::/.. L .L.G
:,7; --~bWNER,BUltDER!DE ' RATIOl\i'·;:-'·,i'.· -'"' , .. -. -~,;..,.::' ·'· · .. ;, ., .. ·.; _ ..... ;. . · . :' · -·· .. : ·, .... ' ,,· .· . ., .. -:· ... '. --· --·, .. \7·,
I ·hereby affirm that ·1 am· exempt from the C:ontr~ctor' s icense Law for the following reason:
0 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 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 improvements are not intended or offered for sale. If, however, the building or improvement 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).
D 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 improves thereon, and contracts for such projects with contractor(s) licensed
pursuant to the Contractor's License Law).
D I am exempt under Section ______ Business and Professions Code for this reason:
1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES ONO
2. I (have / have not) signed an application for a building permit for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed con~truction (include name / address / phone number/ contractors license number):
4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone number/ contractors license number): _____________________________________________ _
5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type of work):. _____________________________________________________ ~---
PROPERTY OWNER SIGNATURE _____________________ _ DATE _________ _
fCQMP~IITE.fHIS .SECTiOi'fFO.i:t, NOf:li£1E$iPEN:'tiifL., BUiil)JNG' P~RMiTS'QNl,:,Y:i:';, .. ", ·· ., ; " ,-.
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention
program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? 0 YES O NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 YES O NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site 7 0 · YES O NO
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE
REQUIREMENTS OF Tl-IE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
l°$.; O ',;cO .. ~$TijllC1:t~ffl.~P.ING,;\q~t,,J,C::V.,::.,-:,,,.;:, r .. ·,: , .. · .. ~;,:;:;..-',• ·--... . . , . . . ..
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code).
LENDER'S NAME _____________ _ LENDER'S ADDRESS _______________________ _
;~;;, -:,~l;'~tlCA,NT-:QEflTll;ICAT~Qr,I: ~>,"::.: I;'(·?,,· ;-;'7.,::-;'."'~,·';: · ,,·, .. ,:-..
I certify that I have read the application and state that the above information is correct and that the information on the plans is accurate. I agree to comply with all
City ordinances and State laws relating to building construction. I hereby authorize representatives of the Citt of Carlsbad to enter upon the above mentioned
property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES,
JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
OSHA: An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height.
EXPIRATION: Every permit issued by the Building Official under the provisions of this Code shall expire by limitation and become null and void if the building or
work authorized by such permit is not commenced within 365 days from the date of such permit or if the building or work authorized by such permit is suspended
or abandoned at any time after the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code).
APPLICANT'S SIGNATURE ________________________ _ DATE ____________ _
WHITE: File YELLOW: Applicant PINK: Finance
CITY OF CARLSBAD
INSPECTION REQUEST
PERMIT# CB983035 FOR 09/10/98 INSPECTOR AREA
PLANCK# CB983035
OCC GRP
DESCRIPTION: INSTALL NEW SUB PANEL
TYPE: ELEC
JOB ADDRESS: 2386 FARADAY AV
APPLICANT: ISLAND ELECTRIC
CONTRACTOR:
OWNER:
REMARKS: C/KAREN/
SPECIAL INSTRUCT:
TOTAL TIME:
CD LVL DESCRIPTION
33 EL Service Change/Upgrade
------------------
-------------------
-------------------
_ J:!Q.NSTR. TYPE NEW
STE:·~ LOT:
PHONE: 619 292-1251
PHONE:
PHONE:
INSPECTOR ~_D --------='------
ACT COMMENTS
/1 !0 /11~.r -OeJ ... :$' o~pq44/d:l:: /9''
***** INSPECTION HISTORY*****
DATE DESCRIPTION ACT INSP COMMENTS
? ~ :2--CJ) rr /
j//(; fr~ prrvSfT?"-'
B U I L D I N G P E R M I T Permit
Pro:'Ject
Development
250
No: CB98326::S
No: A9804256
No:
09/28/98 09:51
1
Page 1 of 1
Job Address: 2386 FARADAY AV
Permit Type: ELECTRICAL
Parcel No: 212-062-18-00
Valuation: O
Suite:
Lot#:
Occupancy Group: Reference#:
Const:ry&.j: W,,lRS,l'98PtJ)b1 l'ffl_W 02
Statu&-f'RITT3SUED 20.00
Applied: 09/28/98
Apr/Issue: 09/28/98
Entered By: JM
Description: DEMO EXIST INTERIOR WALLS
: ADD ELECTRICAL OUTLETS
Appl/Ownr : WHITE CONSTRUCTION
6351 CORTE NOGAL
CARLSBD CA 92009
*** Fees Required ***
Fees:
Adjustments:
Total Fees:
760 931-1130
.oo
,00
20.00
***
Fee description
Enter "Y" for Electr·
Enter "Y" for Remade
Ext fee Data
10.00 Y
10.00 Y
~--Fl-"NA._(_A_P--:-P-'-9R_O_VAL~-·
INSP. DATE#L-
CLEARANCE----:..-_-_-_-_-_..._..._~~=-·
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
P.ERMIT APPLICATION
FOR OFFICE USE 0~ ~ /J /3
PLAN CHECK No.__.]IJ_'-.=--Jt,0 __
CITY OF CARLSBAD BUILDING DEPARTMENT
2075 Las Palm as Dr., Carlsbad CA 92009
(760) 438-1161
EST. VAL. -------,....-.,,.-a----,-,,;--
Plan Ck. Deposit=-,-,----::;.,=:,=--'---""'¼,,<---
Validated By_,__ _ _,_.'--"""""'-:-:l'-:c--,....,~,...
Date _________ '-4-_:;;'-"'+-~,.z..
Business Name (at this address)
Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units
Assessor's Parcel #
°heuU.c i A,y\gJlc'\f Wo.,\\» Existing Use .:1.&&. v,.._'<u,s 0Q..C.:\;-\/:}(:c,._{
Proposed Use
&_~H1C"€'.J
Description of Work SO. FT. #of Stories # of Bedrooms # of Bathrooms
State/Zip Telephone # Fax #
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its
issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law
[Chapter. 9, commending with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom, and the basis for the alleged
exempti,;m. ny via tion of action 7.031.5 by any applicant for per it su jects the f'.\l~a~ to a civil penalty of ot or than five hundred dollars [$500)).
~ ,JJ.l \U) V llO -JD
License Class ___ __.£>...,_ ____ _
City State/Zip (t Telephone #
City Business License # ) 9S) 0\ 3 (a Q
Designer Name Address City State/Zip Telephone
State License# _________ _
:s~-~ -WQ8~E~s~ -coMP,EJ''l$.A:tlQN'~ _ + , • ,, • , _ __ _:_,Vs-:~~,_~ · ,,_~ ----, ~. V -· • • • • , _ •
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
0 I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
J!Q' I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued. My worker's compensation insuranc carrier and policy number are:
Insurance Company_....,._;~~-;;,~-:;'-'-'__..."'-'-',.._,~----------Policy No. 22-9-9 8
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS)
Expiration Date_~\~-~\~-_Oj __ Oj~-
0 CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as
to become subject to the Workers' Compensation Laws of California.
WARNING: Failure secure worker ' ompensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred
thousand dollars($ 0 , , interest and attorney's fees .
. SIGNATURE. __ -1=~~~=-..!1;;::;.~'li'!J."i'~:::~-:::___________________ DATE _-+-1-.1o=:...,.._....::..... __ _
: 7:,: . : 9Wi(J;fH~l/JLDg13 DECY.\f!PiriQN " .. _ . . . . .. . _ _ __ _ _ . _ . . ..
I hereby affirm that I am exempt from the Contractor's License Law for the following reason:
0 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 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 improvements are not intended or offered for sale. If, however, the building or improvement 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).
0 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 improves thereon, and contracts for such projects with contractor(s) licensed
pursuant to the Contractor's License Law).
D I am exempt under Section ______ Business and Professions Code for this reason:
1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES ONO
2. I (have / have not) signed an application for a building permit for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors license number):
4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone
number/ contractors license number):. _____________________________________________ _
5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type of work):. ________________________________________________________ _
DATE PROPERTY OWNER SIGNATURE _____________________ _ -----------;CQMPLl;,l;.!rTHIS Sl;:9TION FOB:NON•R~SipfNT/i{i, a·\illl.OING •f'EIJM[TS 01\ltY '',;,_w _,',,
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention
program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? D YES O NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? D YES D NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES D NO
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE
REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES ANO THE AIR POLLUTION CONTROL DISTRICT.
l{IL,1~,~q_qN~$,tft~~1:I_Q.~2~~NPJN~}\Gl:N~Y N , , .-' ,,~A : , -~ ~~A,~~-~A~ ""_":VA ,, , , " , "', U ', ;',,' ,~ V ~ n ~,,_,,. ""'
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code).
LENDER'S ADDRESS LENDER'S NAME _____________ _ ----------------------------~ :~it{?~~~~~:~~!~~~:::~1::;;~'n -~~d st~te t~~~ t~~ :ab~ve,in~~r~at;o~ ;~--~~rr~ct and ~hat ~~: ;~fo;~atio~ ~ o~ -~~~~~s·' is -~ccur:: .. I ag·r:; t~ -c~~'.pl~ ·:~~ ~;;
City ordinances and State laws relating to building construction. I hereby authorize representatives of the Citt of Ca lsbad to enter upon the above mentioned
property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF" ARLSBAD AGAINST ALL LIABILIT
JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OFT GR NG OF THIS PER
OSHA: An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories ir\height.
EXPIRATION: Every permit issued by the Building Official under the provisions of this Code shall expire by limitation and become null and void if the building or
work authorized by such permit is not commenced wi in 365 days from the date of such permit or if the building or work authorized by such permit is suspended
or abandoned at any time after the ork ·s com men ed or a period of 180 days (Section 106.4.4 Uniform Building Code). \
APPLICANT'S SIGNATURE --~~~~:::_......:!~~~::::::.____________ DATE _q~-_:2Jf___,._--q_-~:l_.,.__,,\,--_____ _
\:" WHITE: File YELLOW: Applicant PINK: Finance
CITY OF CARLSBAD
INSPECTION REQUEST
PERMIT# CB983263 FOR 10/28/98
DESCRIPTION: DEMO EXIST INTERIOR WALLS
ADD ELECTRICAL OUTLETS
TYPE: ELEC
JOB ADDRESS: 2386 FARADAY AV
APPLICANT: WHITE CONSTRUCTION
CONTRACTOR:
PHONE: 760
PHONE:
INSPECTOR AREA DH
PLANCK# CB983263
OCC GRP
CONSTR. TYPE NEW
STE: 250 LOT:
931-1130
OWNER: PHONE: 4
INSPECTOR __ D_) _____ _ REMARKS: C/DEBBIE/931-1130 EXT 46
SPECIAL INSTRUCT:
TOTAL TIME:
CD LVL DESCRIPTION ACT COMMENTS
19 ST Final Structural
29 PL Final Plumbing
39 EL Final Electrical
49 ME Final Mechanical
------------------
------------------
------------------
***** INSPECTION HISTORY*****
DATE DESCRIPTION
101598 Rough Electric
ACT INSP
AP PD
COMMENTS
CEILING ONLY
t JUN 23 '98 17:25 FR CORPORATE REAL ESTATE 5152216562 TO 917609311171 P.02/04 U. \OATA\CAPS\8AANCH\CALlfOAN\NM!3642.0WG Mon Jun 22 17: 39: 45 1998 MV r Ill==:~-==--=~~~~~=:; I I Ii I Ii ! • ,, I II I II I ___ JI I .---7!
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USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND ~ECLARATlb~~
CIC
. CARLSB·AD BUILDING DEPAR'l"M:ENT .. APPLICATION & PERMIT
..
2075 Las Palmas Dr., Carlsbad, CA 92009-1915 (619) 438-1161 ----
0. .provisions of Chapter 9 (commencing with JOB ADDRESS AV. ST.RD, THOMAS BROS NO. VALUATION PERMIT NUMBER 2 [ 0 ., ,...., ,m~ , ... , '· •• "~··" """"
: Section 7000) of Division 3 of the Business
1-and Professions Code, and my license is in ~ full force and effect.
. . DAT!; OF APPLZ/ONI ' BUSINESS LICENSE#
. ~3t'C:. fA/(_ r+J A-I ~"'2-~ · .. 1/.:2~ . (·/>L ¥='1 /..p ..
c.81/l0i38 r ur I hereby affirm that I am exempt from the Conlrac-I tor's License ·Law tor the following reason (Sec. 7031 .5 I BusmeSs and P'rolessions Code Any city or county which re-quires a perm1l to construct, alter, improve, .demohsh, or I· repair any structure, prior to its issuance also requires !heap-
phcant for such permit to file a signed statement that he rs licensed ,pursuant to the prov1s1ons of the Contractor's L,canse Law (Chapter 9 commencing with Section 7000 ot D1v1~1on 3 of the Business and PrQJessmns Code) or that 1s ex· empt therefrom and the ba51s for-the alleged exemptmn. Any v1olat1on ol Sectmn 7031.5 by an applicant for a perm,! sub· 1ects the applicant to·a civil penalty of not more than five hun· dred dollars ($500) ·
CIC I I I. as orwner of the property, army emplqyees With wage_s
w as their sole compensation •• WJII do the work, and the struc-
0 lure is not.mlended or offered for sale (Sec. 7044. Business i ... and Professions Code: The Contractor's License law does 3. not apply to an owner of property who builds or improves l
Ill thereon and who does such ihork himself or through his own I ii: employees. provided that sue improvements are not intend-w ed or offered 1or sale. 11, however, the bmldmg or improve-I z ment IS sold Within one year Of COffipfet10n, the owner-builder ·r ~ will have the burden of peeving that he did not DUild or im-I 0 prov.e for .the purpose of sale).
I I I, as owner of the property, am exclusively contraclmg with licensed C9J11ractors to construct the project (Sec. 7044, Qusmess and Professions Code: The Contractor's license Law-does not.apply to an owner of property who builds or ,m-proves thereon, and who contracts for each pro1ects with a
-colitractor(s} licensa~pursuant to the· Contractor's license Law).
' I l 1 A.$'.a homeowner 1·a111 1rnprovmg my home. and the follow· _ i .-mg .conditions exist: --.. , 1. The work is being performed prior to sale i
z 0 .::•· -~ z w a. ~ 0 ()
Cl) a: w :..: IC 0 ~
cc:l ~. z. w ..J
2. I have lived in my home for twelve months prior to completmn o( thlS ,:,ork. _ 3. I have n~t claimed ·\his ,exemption durmg the 1-last three years. I
D ·I am exempt under Sec. for this reason • B~P:C. I
. i ·o I hereby affirm that I have-a certificate of consent to i
self-insure. or a certificate of WoTKers· Compensation In-I
~_uranc~. o·r a c~rtified copy thereof (Sec. 3800. Labor Code)
'P0LICY NO. I
C~M'P'ANY I r ~ Qopy 1s~!1led with the city
0 Certified copy is bereby furnished
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE
{This section need not be completed if the permit
, Js for one hundred dollars ($100) or less)
0 I certify that in the performance of the work for which
th1s-perm1t 1S iSsuE!d,:1 shall not employ any person many
manner so as to become subject to the Workers4·compen-
sation Laws of California.
NOTICE TO APPLICANT: If. after making this Certificate
~of Exemption. you should becorTfe subject to the Workers·
I
i
~;~~~hs~~~~;;~r~~:~i~~~h 0;r~~fsl~~~
0
~r ~~~ePe~~~t ~i:i~ I
be deemed revoked. ~ -I
i
D ~, nereby auirm that ttiere is a construction lending I
agency for the performance of the work for which this per-I
m1t is i~sued (Sec 3097, Civil Code) i
Lender"s Name _____________ ·f
Lender"s Address; ____________ _ I
LOT BLOCK I SUBDIVISION I I AS}f'SOR PARCEL NO. i~I/-Y· coNTRAcToR o/ b ·111 ,f' L. -::r oU.A-~H;oNTRAcroRs PHONE# ZONE
. . -.IIA..~-lt::> leo 11 ,. q, 2.. 111:f} 29 2 £s-C7J OWNER'S NAME OWNER'S PHONt trte", t I -~
-d)'l2.s;r~ CONTRACTOR'S ADDFIESSFI -JJ,r,e...a,o .. STATE LICENSE NO. BUILDING SQ. FOOTAGE 3. cc·~ ...
OWNIER'S MAILING ADDRESS /LJ. -~-v~ .D, -e_p'J ~ . 3 0 '---,O,_ -/J O ,. ~ ' . ~-.... DESIGNER V . DESIGNER'S-PHONE ,'%-s;o .Q~ • l'D . .J 0 ... '?_ .I' 1 · I 0/.--eil / DESCRIPTl'ON OF WORK.' V -,...,.,.._ . .. .. .-DESIGNER'S ADDRESS STATE LICENSE NO, " /d4, kt-~~ '""$o5-.. DA10e:-L-·0-019 Oi/28 ·01.01 ·02BldPmt 55u()1) . I "-. F/P FLA ELEV. NO OCC GP EDU .;:o((. STORIES
f...._£).-,....1'\ 0., II \ '\C:-Q._ ' ~t~ ,~ti:\f'Y'lT -. ..
vO NO --
CENSUS TRJ\CT · PA·RK ING SPACE RES UNITS ! GRAOING PERMIT issuEo I REDEVELOPMENT TYPE ace LOAD FIRE SPR AREA · CONST
----YONO . YONO vO NO Not Valid 1/nfess Machine Certified
-.. --
QTY. PLUMBING PERMIT· ISSUE . QTY. MECHANICAL PERMIT· ISSUE SUMMARY/ACCOUNT NUMBER . .. . .
EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100.000 BTU. \lUILUINl, PERMIT UOl ·81 U-00·00·8220
EACH BUILDING SEWER --OVER-100,000 BT-U • -SIGN PERMIT 001·810·00·00·8221
. EACH WATER.HEATER AND10R VENT BO I LER/C9MPR ESSO R UP TO 3 HP PLAN CHECK 001-810·00-00-8891
EACH frAS SYSTEM 1 TO 4--0!JTLET"S
,. -· s·OILER/COMPRESS.OR 3-15 HP. TOTAL PLUMBING 001·810·00-00·8222 -
EACH GAS SYSTEM 5 OR MO,RE METAL FIREPLACE .. ELECTRICAL 001·810·00·00·8223 -..t.....r -EACH JNSTAL.. ALT):R. REPAIR WATER PIPE VENT FAN SINGLE DIJCT MECHANICAL 001-810·00·00·8224
EACH VACUUM BREAKER MECH EXHAUST HOOO!DUCTS MOBILEHOME 001·8·10·00·00·8225
W~TER SOFTNER RELOCATIQN.OF EA FURNACE/HEATER SOLAR oo 1-81 o-oo-oo-8a26
EACH ROOF DRAIN (INSIDE! DRYER VENT STRONG MOTION 880-519-92·33
; . T-O:r.C.L MECHANICAL . FIRE SPRINKLERS 001·810·00·00·822T
TOTAL: PLUMBING I PUBLIC FACILITIES FEE 329·81O·OO·OO·!:l740 .
.. -~12829~ BRIDGE FEE 360-810·00·00-87 40
QTY. ELECTRICAL PERMIT· ISSUE ~ ---iOTY. MOBILE HOME _$ETUP 4 ,~.PARK-IN-LIEU (AREA ) .
. . .
.. NEW_CON_ST EA AMP :sw1 ~K ~ : -CAR PORT ;;,,w,'-' /). '-m 312-810·00·00·8835 .. .. -
((3 PH // fJI) ,,.Jt.J. -AWNING 1.r;,· ...
y~,OSTA TIF 1 _PH "· ,,,,:.,,, 311-810·00·00-8835
EXIST BLDG EAAMPISWT'~ ' --GARAGE ti -· JAN 1:100 F~ ..
1 PH 3 PH ~ f'i',!l.l .-.... , Ll§:1 NSE TAX oo 1-sf 0:00-00-8162
REMODEL 'AL TfR PER CIRCUIT -~ 0. tiUY H';t.A~U\H..,\\ ~rrv nr .-.~,m..,;p,tJ) ~1 880·519-92-57
T·EMP POLE 200 AMPS . \"~ CARL~E!J), cr1. ~O.,f . .. . ..
OVER 200AMPS \.~ ""/ TEMP OCCUPANCY (30 DAYS) ; ~4 9) ,._ · .. ~-~ -1,: V -~ .. .
.. . . .
......._ -... &:e, Ger.,,. ----CREDIT D,EPOSIT ..
TOTAL E:LECTRICAL I c--TOTAL TOTAL_FEE-S_PAY~ L ..6~6 --~ ( --..
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT'' AND DO HEREBY Expiration: Every permit ,ssued by the B~ilding Offic1~t under the prov1s1ons of this ":" * ~AMIT IS REQUIRED FOR EXCAVATK>NS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall expire by fimitatmn and become null and void If the buddm(f or Wolk 5' O" EP AND DEMOLfTlON OR CONSTRUCTION OF
DECLARATIONS ARE TRUE AND CORRECT AND f FURTHER CERTIFY AN_D AGREE IF A PERMl:r 1& authorized by such permit is not commenced wi1hin 180 days from the date of such S lURES OVER 3 STORIES IN HEIGHT permit, or if Jhe building 01 work autoonzed by such perm11 1s suspended or ISSUED~ TO COMPLY WITH ALL CITY. COUN1Y AND STATE LAWS GOVERNING BUILDING CON· abandoned at anv time a lei the work 1s commenced for a oenod of 180 davs . . ,,
STRUCTION. WHETHER SPECIFIED HEREIN OR NOT l ALSO AGREE TO SAVE INDEMNIFY AND • OWNERD CONTRACTOR 0
~:-:,~~/ KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS, COSTS AND APPLICANTS SIGNAT?/ (J-J.
EXPENSES WHICH MAY IN AN'f WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF TH~~ · .... ~ .• j
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I O I hereby affirm that I am licensed under f
provlsl<:>ns of Chapter 9 (commencing with I
Section 7000)· of Division 3 of the ·Business ·
and Professions Code, and, my license Is In I
full· force and effect. l
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tor·! t;;!~!e a[~':' t~~a:h~ f~o!1~~~~a1:~~ <~~ec. c~~~f~s I Business and Professions Code: Any city or county which re· I quires a permit ti> construct. aller, improve, demolish, or I fepair any structure, prior to its issuance also requires !heap-plicant tor such permit to tile a signed statement that he is I t~i;~;i L~~%tn}p1: J~~o~~:~s~~~; ;,\h 1~~cig;%~~r;i I
Division 3 of the Business and Professions Code) or that is ex· · I
~~Pa\i~h,;'~1~:1fo~d i~;1b.ts~/~~t~;~1i~J,i1°t~~~".'t~)~~t s~~~ I
jects the applicant to~ civil penalty of not more than five hun· I
dred dollars ($500). f
I I I, as owner of the property, or my employees with wages I
as their sole compensat,on, will do·the work. and the struc· I lure is not intended or offered for sale (Sec, 7044, Business and Professions Code: The Contractor's License Law does f not apply to an owner of property who builds or improves I
thereon and who does such work himsell or through his own employees, provided that such improvements are not intend· I
ed or offered for sale. If, hOwever, the bmlding or improve· I ment is sold within one year of completion, the owner-builder •1 w,11 have the burden of proving that he did not build or 1m· prove for the purpose of safe}. · f
0 I, as owner of the property. am exclusively contracting I with licensed contractors to construct the pro1ect (Sec, 7044, j
Business and Professmns Code. The Contractor's License I Law does not apply 10 an owner qi property who builds or im· proves thereon, and who contracts for each projects with a I r~w;~ctor(s) license pursuant to the Contractor's License I
0 As a homeowner I am improving my home, and the follow· mg conditions exist: •
1. The work is being performed prior to sale 2. I have lived in my home (or twelve months prior to completion of this work. 3 f have not claimed this exemption curing the last three years.
D I am exempt under Sec. _______ , B & P.C . · for this reason_· ___________ _
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D I hereby affirm that I have a certificate of consent to I
.self-msure, or a certificate of Workers· Compensation In-l
surance. or a certifled;copy thereof {Sec. 380Q. Labor Code) t
POLICY NO, , J
COM'PANY {
D Copy Is flied with the city
0 Certified copy is hereby furnished
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CERTIFICATE OF EXEMPTION FROM I
WORKERS' COMPENSATION INSURANCE f
(This section need not be completed 1f the permit i
_ is for one hundred dollars ($100) or less) f
0 I Certify, that in the performance of the work for which
this permit is issued, I shall not employ any-person in any f
manner so as to become subject to the Workers· Compen-I
~atlon Laws of California. t
NOTICE TO APPLICANT: If, after making this Certificate I
~~;:~~~i~-:~~o~~~i~~sb~~~~: t~~~~c~:d:\~ir~e~=~ ,l
forthwith comply with such provisions or this permit shall f
be· deemed ,revoked. I
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I D I hereby affirm that there is a construction lending l
agency for the performance of the work for which this per-I
mit is issued (Sec. 3097, Civil Code)
Lender's Name __ ~----------
Lender's Address ___ ~---------
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USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
. CARLSBAD BUILDING DEPARTMENT \·· 2975 Las Pfllmas Dr., C?-rlsbad, CA 92009-4859 (619) 438-1161 -~---~·"· , __ ,,...._ _______ .,_ .
APPLICATION & PERMIT
JOB ADDRESS
!~31(;,
"".-~· ~-,. ••. \ • AV.ST.'Ro. N,EAF,!ES!CRq~~~F'·
'·.F,4 rr Pr d:O. :.1 ·:s-t1,-te t"¥t,. ----, . . -
Loi' ~FaL.9cK ---;--.I suB@1vrsici'N~l';AssEssoRJ>ARCELNo. · ' -...,. --., l ,,J " • ,. -.. ! ' ~ ........ 'J,.
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.,._;:..ONTRACTOR
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BUSINESS LICENSE #
{2&?J7
CONTRACTORS PHONE#
,?.t72s-s-s-0
VALUATION
ZONE
PERMIT NUMBER
011/Lf-1
t~R';;:~·-b;zq;~N:~;s; CONTRACTOR'S ADO RESS STATE LICE:NSE NO. l.l U Ut; U U i [I ; / ':'.il,· -SUILQIN/l.Sd. FOOT~G_!: -••~-atYKMI ~u.Qu~
OWNER'S MAILING ADDRESS
~733 D ~u--"
,. p .£,,,,(,, h:..zfl,
DE;SCRIPTION OF WORK ~
~. -b. 9'oJ.J!I DESIGNER DESIGNER'.$ PHONE
DESIGNER'S ADDRESS STATE LICENSE NO.
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~A-LA-........ -.--.-~ .. ~~ · ,,. ecaem. ,,t~es o,,o, "" .... -·· A--J L LI) LJ', ~ vO NO
TYPE
CONST
OCC LOAD I FIRE SPA I PARKING°''S'll"ACE RES UNITS l GRADING PERMIT ISSUED
YO N 0 I REDEVELOPMENT AREA
vO NO vO NO Not Valid Unless Machine Certified
QTY. PLUMBING PERMIT -ISSUE 1@ QTY. MECHANICAL PERMIT -ISSUE c3. !) If) SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP I II I INSTALL FURN. DUCTS UP TO 100.000 BTU I n BUILDING PERMIT 001·810-oo:oo-8220
EACH BUILDING SEWER I II I OVER 100.000 BTU I D SIGN PERMIT 001-810·00·00·8221
EACH WATER HEATER AND/OR VENT I II I BOILER/COMPRESSOR UP TO 3 HP I n PLAN CHECK 001-810-00-00-8821
EACH GAS SYSTEM 1 TO 4 OUTLETS I II I BOILER/COMPRESSOR 3·15 HP I II TOTAL PLUMBING 001-810-00-00·8222
EACH GAS SYSTEM 5 0 R MO RE I II I METAL FIREPLACE I U ELECTRICAL 001-810·00-00·8223 ~
EACH INSTAI. .. ALTER. REPAIR WATER PIPE _ _j___ VENT FAN SINGLE DUCT MECHANICAL 001-810-00-00-8224
EACH VACUUM BREAKER --r MECH EXHAUST -HOOD/DUCTS MOBILEHOME 001·810·00·0Q·8225
,
WATER SDFTNER I II I RELOCATION OF EA FURNACE/HEATER I II SOLAR 001-810-00·00·8226
EACH ROOF DRAIN (INSIDE) I II I DRYER VENT I II ,STRONG MOTION 880-519-92-33
TOH;L MECHANICAL I I FIR~ SPRINKLERS 001-810·00-00·8227
TOTAL PLUMBING I PUBLIC FACILITIES FEE 320-810-00-00-8740
QTY. ELECTRICAL PERMIT -ISSUE S:o" QTY. I MOBILE HOME SETUP
BRIDGE FEE 360-810-00-00-8740
PARK-IN-LIEU (AREA )
NEW CONST EA AMP/SWT 1BKR CAR PORT TIF 134-810-00-00-8835
1 PH 3 PH AWNING LA COSTA TIF 133-810-00-00-8835
EXIST BLDG EA AMP/SWT/BKR GARAGE FMF
1 PH 3 PH UCENSE TAX 001·810·00-00·8162
REMODEL:AL TER PER CIRCUIT MFF 880-519-92-57
TEMP PO LE 200 AMPS
OVER 200 AM.F'S
-r,1i-1P OCCUPANCY {30 DAYS) r~~...,. -Z.-~--.-It-CREDIT DEPOSIT
' TOTAL ELECTRICAL 1 ~-II---TOTAL TOTAL FEES PAYABLE I ~
-
-1
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION ANEl PERMIT" ANO DO HEREBY Expiration. Every permit issued by the Building Official under the provisions of this * AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER
'cERT1FY UNDER PENALTY OF PERJURY THAT ALL INPORMATION HEREON INCLUDING THE Code ~hall expire by llm,t'7l!on and become n~II anci void If the building or work 5• O" DEEP ANO DEMOLITION OR CONSTRUCTION OF authorized by such permit ,snot commenced w1thm 180 days from the date of such DECLARATIONS ARE TRUE AND CORRECT AN_D I FURTHER CERTIFY AND AGREE IF A PERMIT IS permit, or if the bUildmg or work authorized by such permit ,s suspended or STRUCTURES OVER 3 STORIES IN.HEIGHT
ISSUED: TO COMPLY WITH ALL CITY. COUNlY AND STATE LAWS GOVERNING BUILDING CON· L::.ab:::a:::n:.::d::::o.:,:ne:::d::..,:.atc,:a:::n:z..:t:::1m:!!.e::.!::al~ltec:.r..:.t:!!.he~w.::'.o!.!rk~1~s.::c::::o!!.m!!!m:!!.e!!!n:!::ce~d~fo!!.r~a=e~ri::a:o!!.d.::o~l.!c18~0<.:ds,,a,i,,as~. __ ...,_~ ________________ .,._ ____ ...it
STRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND , 0 ½
KEEP HARMLESS THE CITY OF CARLSBAD AGAJNST ALL LIABILITIES, JUDGM.ENTS ....•.. C.OSTS AND A. PPLICAN .. T .. S.SIGNATU···R·E :If. . .. .. OWN .. E.R CO.NTRACTO. RO / EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY 7cONSEfUE!:!9i OF TH.½__, /J ~ /j"'(l_ .Jl__,,,...,__ I:• BY PHONE [J r ~
GRANTINGOFTHISPERMIT. • . ( /./Li/ ___ ~-~-~--0~"._::_---==----·~-···. 1.·_ • ,,--,~~,t.....-fl..,..-,IL,..,(_,_,E~-~1
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0 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 following reason (Sec. 7031.5
Business and Professmns Code Any city or county which re• quires a permit 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 ,s
licensed pursuant to the provisions of the Contractor's License Law (Chapter 9 commencing with Section 7000 of
Division 3 of the Business and Professmns Code) or that 1s ex-empt therefrom and the basis for the alleged .exemption Any violation of Section 7031.5 by an applicant for a permil sub-
jects the applicant to a c1v1I penalty of not more than five hun-dred dollars ($500).
D I, as owner of the property, or my employees with wages as their sole compensation, win do the work, and the struc-ture is not intended or offered for sale (Sec. 7044, Business
and Professmns Code: The Contractor's License Law does not apply, to .an owner, oJ property who builds or Improves thereon and who does such work himself or through his own
employees, provided that such improvements are not ,mend-ed or ollerea for sale. II, however, the-bu,ldmg or Improve-
ment ,s sold within one year of completion, the owner-builder
will have the burden of proving that he did not· build or im-prove for the purpose of sale).
D 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 projects with a [~~)~ctor(s) license pursuant lo the Contractor's license
D As a homeowner I am ,mprovmg my home, and the follow-ing cond1llons exist:
1. The work is being performed prior to sale. 2. I have lived in my home for twelve months
3. rr~;v~ ~~~p~r~/~~t /~;1; ;~!~ption during the last three years,
D I am exempt under Sec. _______ , B & P.C.
for this reason_--, __________ _
D I hereby affirm that I have a certificate of cpnsent to
self-insure, or a certificate of Workers· Compensation In·
surance. or a certified copy thereof (Sec. 3800, .Labor Code)
POLICY NO
COMPANY
0 Copy is flied with the city
0 Certified copy is hereby furnished
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed If the permit
Is for one hundred dollars ($100) or less}
D 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· Compen-
sation Laws of California.
NOTICE TO APPLICANT: If, after making this Certificate
of Exemption, you should become subject to the Workers·
Compensation provisions of the Labor Code, you must
forthwith comply with such provisions or this permit shall
be deemed revoked.
D I hereby affirm that there is a construction lending
agency for the performance of the work for which this per-
mit is issued (Sec. 3097, CiVil Code}
Lender's Name ____________ _
Lender's Addres~------------
USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
CARLSBAD BUILDING DEPARTMENT
Carlsbad, California 92008-1989 (619) 438-5525 APPLICATION & PERMIT
JOB ADDRESS
23~6
OWNER'S -NAME OWNER'S PHONE
LOT ,BLOCK
BUSINESS LICEI-/SE #
I SUfJOIVISION,
VA~
CONTRACTORS PHONE ff ZONE
PERMIT NUMBER
721-
/c O (_L -----·'<lr'l"OC.. ___ C_O_N_Tkc_R_A_~_T_Ol_l_A_D_D_c_E_~....;''-------------1...-----------11-----------'----------~
DESIGNER DESIGNER'S PHONE
~~~~'tjL_L~~~~~r___j-~~Ll1 /co{(_ ~;
LICENSE NO. PLAN I.D.-# BUILDING SQ. FOOTAGE
._ __ _!.:....J!::_;;ti __ -!..2.S.:,-:t..:.::,;;,:::C~---------------,----!I DESIGNER'S ADDRESS LICENSE NO.
~
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-0 0 C)
-C co
..._ _____________ -·---------------
CENSUS TRACT I GP LAND USE I PARK ING SPACE RES UNITS 1
F/P FLR ELEV.
vO NO
I REDEVELOPMENT AREA
NO
STORIES occ GP I EDU 7rTEl166::!880
0ElDT382tl -77'iB/ 813
000).°§aaq o:(
30~00 ~r,I
~0~00 ~L;
7:1'1'8/SS
GRADING PERMIT ISSUED TYPE
CONST
OCC LOAD I FIRE SPR
YO ND v-0 NO YO NO Not Valid Unless Machine Certified
QTY. PLUMBING PERMIT -ISSUE 1~7) QTY. MECHANICAL PERMIT -ISSUE 5--SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP II I INSTALL FURN. DUCTS UP TO 100,000 BTU I II BUILDING PERMIT 001-810-00-00·8220
EACH BUILDING SEWER I II I OVER 100,000 BTU I O SIGN PERMIT 001-810-00-00-8221
I EACH WATER HEATER AND/OR VENT . BOILER/COMPRESSOR UP TO 3 HP • PLAN CHECK 001-810-00-00-8806
·: EACH GAS SYSTEM 1 TO 4 0 UTLETS • BO I LEA /COMPRESSOR 3-15 HP . TOTAL PLUMBING 001-810-00-00-8222
i EACH GAS SYSTEM 5 0 R MORE . METAL FIREPLACE • ELECTRICAL 001-810-00-00-8223
: EACH INSTA~, ALTER. REPAIR WATER PIPE --~ • VENT FAN SINGLE DUCT -. MECHANICAL 001-810-00-00-8224
I EACH VACUUM BR~AKER , MECH EXHAUST -HOOD/DUCTS • MOBILEHOME 001·810-00-00-8225
: -WATER SOFTNER . RELOCATION OF EA FURNACE/HEATER • MOBILEHOME PARK INSP . _ _
i EACH ROOF DRAIN (INSIDE) --SOLAR 001-810-00-00·8226
I , TOTJ;L MECHANICAL I STRONG MOTION 880-519-92-33
I TOTAL PLUMBING \ --FIRESPRINKLERS 001-810-00-00-8227
I l
: QTY. ELECTRICAL PERMIT -ISSUE ~ ,-QTY. SOLAR -ISSUE • P~:+M~1,-332-3Jo-oo-oo-393o ~.:?~~~
I NEW CONST EA AMPISWT1BKR COLLECTORS • SCHOOL FEE -DISTRICT
: 1 PH 3 PH . STORAGE TANKS . Carlsbad
I EXIST BLDG EA AMP/SWT /BK R ROCK STORAGE • Encinitas
I 1 PH . 3 PH . PUMP -San Dieguito
: REMODEL:ALTER PER CIRCUIT • PLAN CHECK FEE • San Marcos
'...--+------------------+-------l!--4-----. TEMP PO LE 200 AMPS
I OVER 200 AMPS LICENSE TAX 001-810-00-00-8162 i l--+-"-------,------~--+-----ll----l---------------+---___.:.--11---c-==-------------l--------l I MFF 880-519-92-57
: ~ 00 CREDIT DEPOSIT
I TOTAL ELECTRICAL efe. TOTAL SOLAR TOTAL FEES PAYABLE ..::, oO
I 'O, a:f0-
I I I HAVE CAREFULLY EXAMINED THE COMPLETED "APPUCATION AND PERMIT" AND DO HEREBY Expiration. Every permit issued by the Building Official under the provisions of this
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall expire 'b)I limitation and become n'!II ~nd void. If the building or work
f DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS aulh~r,zed by such p~r':'lt is not commence_d within 180 days from the date of such
* AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER
5' O'' DEEP ANO DEMOLITION OR CONSTRUCTION OF
STRUCTURES OVER 3 STORIES IN HEIGHT f permit, or 11 the building or work authorized by such permit ,s suspended or ISSUE.D: TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING BUILDING CON-L..;;.;ab:;..:a"-'n-=-do::_cn;.;;ed-=--::a.;..;t a::.:.n:,._:.ti::..:m:..:e...::a::..:fl,:.,erc..,l::..:he::..w=or::..:k...::is'--'c"'o::..:m"'m::..:e::..:nc,::e::.::d'--'f::::Orc.:a'-"-'e"-'ri"'ode...,cofc..1e><8,,_0-"'da"-'-"s~. __ .., __ _ l STAUCTION. WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND • I KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS. COSTS AND APPLICANTS SIGNATUR >I' OWNER O CONTRACTOR O DATE
f EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE. OF THE. -.,~-1,':;rb<-r,.l, B PH
: LG.:.R.:A.:N.:T;,;l.:N.:.G.:O.:F_T.:H.:.IS:..P.:ER.:M.:.l.:T.:. -----------------------i"""'tt:_·_·~~=-,~~~-=~::::"".::~'!~:c!:!Z~2k-----Y--O·N-E-jµL.1.!~~~(___J_~.fk.~~-...... -_J4~J;.l-!!___!_J
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PREST<RE"SsEb • ·· • -
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I[ O I hereby affirm that t' am llcensed under I•
provisions of Chapter 9 (commencing with I Section 7000) of Division 3 of the Business i and Professions Code, and my license Is In
O· full· force. ~nd effect.
ur I hereby a!firm that I ani exempt -from the Contrac-tor's. license Law for the following reason (Sec. 7031.5
. Business and Professions-Code· Any city or county which re-q4ires ,a, permit to construct, alter, improve, demolish, or
CIC w 0 ... 3 Ill ii: w z ~ 0
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repalr·any structure, prior to Its Issuance also requires the ap· plicanrfor such permit to 1IIe a signed. statement that he is licensed pursuant to the provis,ons of the contractor's I License Law (Ctiapter 9.commencing-wlth Section 7000 ,of I 01vis1on 3 of the Business and Prolessions Code) or that is ex-empt therefrom and the basis-for the alleged exemption. Any I violat10n of Section 7031.5 by an· applicant for a perm,!' sub-jects the apphcant to a civil penalty of-not more than five hun-.,
dred dollars ($500).
ri I, as owner o_f the property, .or my employees with wages
as their sole compensation, w,11 do the work, and the struc-
ture is not intended or'6ffered for sale [Sec. 7044. Business
and Professions Code: The Contractor's License Law-does n9t apply to an ,owner of property who builds or improves
thereon and who does such work hImsell or through h,s own employees, provided that such improvements are not intend-
ed or ofleied for sale. If., however. the building or improve-ment Is sold within one yeat of complet,on, the owner·bmlder will have the burden of proving.that he d1d,not build or im,
proye for·the purpose of sale).
d · 1. as ·owner ol the property, am exclus,vely coniracting with licensed contractors to construct the project (Sec. 7044,
Business and Professions Code: The Contractor's License Law ilo'es not apply to an owner.of property who bmlds or im-
pr9ves thereon, jnd who contracts. for each projectswith a contractor(s) license pursuant .to the Contractor's License Law). . . .
D As a homeowner I am ,mproying my home, and the follow-ing condltions·exist:
1; The work is being )lertormed prior Jo safe. 2. I have lived in my liome for twelve months
3. P'~!v: ~~rp~r~/~~tt'~,I; ~~!~ption dun~g the last three years.
D I am exempt under Sec. · for this.reason . , B&P.C.
D -I hereby affirm th~t I have a certifipate of consent to
self.lnsu(e. or a certificate of Workers· Compensation 1(1-
suran~e. Or a certified qopy thereof (Sec. 3800, l:,abor Code) .
POLICY.NO.
COM PA.NY
D Copy is filed with the city
D Certified copy·is hereby fi.Jrnished
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
· (This section need not be completed If the permit
is for one hundred dollars {$100) or less)'
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[J ·1 certify, that In th~ performance of the work for which
this permit Is fssued, I stiall not eri1ploy any person in any
manner so as to become subject to the Workers' Compen-
sation law~ of California. I
NOTICE TO APPLICANT: If, after making-this Certificate ."I
of Exemption. you should become Subject to the Workers' '
Compensatloii provlsi~_ms Of the labor·Code, you must 'I
forthw1th-comply with.such provisions or this permit shall J
be deemed revoked. I
D I hereby affirm that there is, a construction lending
agercy for the perf0rmance of the work for which this per·
mit is issued (Sec. 30~7. Clvll-Co~e}
Lender's Name ______ ~------
Lender's Address ____________ _
I
.'";~-!Ir''~·':~-.-,':.
USE BALt POINT PEN ONLY & PRESS .HARO;-,_ .. '. ·-. '· . -[;
--r
APPLICANT TO Fill IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
_. ~CARbS~_Ah~·Q.~JILDING DEPARTMENT ":-?:-. -· ...
APPLICATION & PERMIT .. , , · c·a.tl:>paa, 9,-~l!fornia 92008-4859
JOB ADDRESS ii4;~·dA~ #1111·,s~ .. Ag,
.. J'lEAREST CROSS ST. . I DATE OF APPLICATION:! BUSINESS LICENSE # VALUATION PERMIT NUMBER
£/ cf'!l.wt, 11/~
{ Fn ,,.A-eJ ~ . • ..2.:~ e ~ c lJ/ LO; BLOCK I SUBDIVISION ./ ·,1 · ASS6-¥'PARCEL No/h CONTRACTOR CONTFIACTORS PHONE# ZONE {0~ · _; . +' 't'JOf ~ /fd/1 {1o4,5J. G,. (.
OWNER'S NAME ,· I OWNER'S PHONE tfl1'?-.2..rz -J:>J'tl
f I,.,,, k;;11 CcMihne,,-
CONTRACTOR'S ADDRESS STATE LICENSE NO. BUILDING SQ. FOOTAGE
,/9'-.292.-Sf'So '1 ~'<d C,,.9; 4J'(.;,-%. ~f'/ 75'/ OWNER'S-MAILING ADDRESS ,
ho;~ e -'q,(' 72d. DESIGNER " DESIGNER'.$ PHONE 7:?~c) A;.o,n-. -6d/2 u el< I/lie leo 4.,;,,,,/ 1~1-/&C/() ·bESCRIPTt()N OF WOR¾ 11-2;,/)rdve "1e"'l .J. -/4,/2 ..e . -.. '.(?..,.V~ DESIGNER'S ADDRESS I STATE LICENSE NO.
. A-~~~ '?35 <; lift<1rd"II /J.tJ e. .uh-; . C-·/2-9 .-' 9 . t F/P FLR 0ELEV. NO EDU
I --••
OCC GP
SlORIES
YO NO --
I I· PARKl~G SPACE RES UNITS 1 · GRADING PERMIT ISSUED I REDEVELOPMEN'I: TYPE OCC LOAD FIRE SPA AREA CONST
... ----_YONO . YO NO YO NO -: ~ • • No1 Jla,lid f!'jler_r_Mac~iffe. f.eI.t{ff'J.1, --. -~ ~· 7$12--_. ___ v--v .. ~, r:..-.r wwrs'\i"ll ' '".' QTY. PLUMBING PERMIT -ISSUE QTY'. MECHAN.ICAL PERMIT -ISSUE 0-SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP INSTALL FURN. DUOS UP TD 100,000 BTU BUILDING PERMIT 001-810,00-00-8220
EACH. BUILDING SEWER . OVER 100,000 BTU . SIGN PERMIT 001-810-00-00·8221
tACH WATER HEATER ANQ/OR VENT .. BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 001·810-00-00-8806
EACH GAS SYSTEM 1 TO 4 0 UTLETS BOILER/COMPR'ESSOR 3-15 HP TOTAL PLUMBING OOj-810-00-00-8222
EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE ELECTRiCAL 001 ·8~ 0·00-00-8223 .. "Jo--
EACH INSTA~ .. ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT .( T -.,.,,.MECHANICAL -001-810-00-00-8224
· EA~H VACUUM BREAKER MECH EXHAUST -HOOD/DUCTS
.
"-l!,M4l1u'111iME.... 001-810-00-00-8225
WATER SOFTNER •·• RELOCATION OFEA FURNACE/HEATER SOLAR -4. \ .l!., I ) 001-81 Q-00-00-8226 ---..
~
EACH ROOF .DRAIN (INSIDE) DRYER VENT -0l p .S)fmNG MOTION 88.0-519-92-33 -TQT/;.L MECHANICAL c-~ RRt's~~l.leRS 001-810-00-00-8227
TOTAL PLUMBING I . DE'fl~I ! ., 0 r,P!J,BJ.IC FACILITIES· FEE 320·810-00-00-8740
QTY. . ELECTRICAL PERMIT -ISSUE s~ QTY. MOBILE HOME SETUP -~rnEN1 ..:~5t~trt»----.. ,. ... ·-u fA'ffl!,11/' )
.. NEW CONST E·A·AMP/SWT1BKR CAR PORT C TIF .• " -SEfl11~ 001-81 o-oo,oo-8835 --
1-PH -3 PH AWNING LICENSE TAX -· 001-810-00-00-8162
EXIST BLOG EA AMP/SW.T/BK-R GARAGE MFF 880-519-92-57
1 PH 3 PH -, ·-
REMOOEL!ALTER PER CIRCUIT ..
TEMP POLE 200 AMPS ..
OVER 200 AMPS -. ..
'· TEMP OCCIJPANCY l'.}O DAYS) ., -.. -, ,-= '5 -1--/11 ~. 'fe--r ZS---• CREDIT DEPOSIT ' .
TOTAL E.LEC:rRICAL I 30__... TOTAL TOTAL FEES.PAYAB.LE ,. "30 --..
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT" AND DO HEREBY Expiration. Every,perm,t Issued by the Building Official underthe provIsIons olthis * AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDlNG THE Code shall expire by limitation and become null and void If the building or work 5' O" DEEP AND DEMOLITION OR CONSTilUCTIO"f OF
DECLARATIONS ARE TRUE AND CQRRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT 15 authorized by such permit Is not commenced within 180 days from the date of such STRUCTURES OVER 3 STORIES IN HEIGHT permil, or 11 the buildinft or work authorized by such permit is suspended--or ISSUED: TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING BUILDlNG CON-abandoned at anv time a !er the work is commenced for a period of 180 davs. · STRUCTION, WHETHER SPECIFIED HEREIN _QR NOT. !·ALSO AGREE TO SAVE INDEMNIFY AND
A2CAN,T'S SIGN,;~ OWNERD CONTRACTOR CJ APPRGV~/ilA-
DATE KEEP HARMLESS THE CITY OF CARLSBAD AGAINS:r ALL LIABILITIES, JUDGMENTS, COSTS AND
EXPENSES WHICH MAY IN -ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE BYPHONE 0 lt:f--25 ... -gL GRANTiNG OF THJS PERMIT.
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O l,her,by affirm that I am licensed under
provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of flie Business
and Professions Code, ·11nd my license Is In
fuli force' and.iiifect.
I herebi affirm that I am exem'pt froin the Contrac· tor's License Law for the following reason (Sec. 7031.5 Business and-Professions Code: ·Any city orcounty which re· quires:a permit to construct, alter, improve, demolish, or repair-ariy structure, prior to its issuance also requires !heap-plicant for such permifio file a signed statement that he is licensed pursuant to the pr_ovlsmns ot the Contractor's License Law (Chapter 9-commencing with Sectmn 7000 of
Division 3 ot the Business·and Professions Code) or that 1s ex· empt theretrom and the basis.for the alleged exemption. Any
violation ot Section 7031.5 by an applicant tor a permit sub· jects the·applicant to a civil penalty ot not more than five hun·
dred dollars ($500).
r1 · I, as owner ot the.property, or m9 employees with wages
as'their sole compensation. will ~o the work, and the struc· ·ture is not intended orolfered for sale (Sec. 7044, Business and Professions Code:· The Contractor's Liceos'e taw does not apply to an-owner of property who bu1tds--or improves
thereon and who does such work himself or thtough,his own· 1 employees, provided that·such improvements are not intend' I ed or olfered for sale II, however, the building or improve· I ment is sold within one year of completion, the ownwbuilder · --will have· the burden of proving that· he did not build or-im· prove for the purpose of sale).
0 I, as owner of the property, am ~xclusively 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 ot,grdgerty who builds or im· proves there_o_n, and WM. 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 the lollow· Ing condltmns exist: · · · I
1. The work is being performed prior to sale. 1 2. I have lived ·I~ my hoITTe:for twelve months prior to-complet1011,,of -this-work. • -I
3. latiarhere~oieii;imed this exemption during the I
. ' D Iain ~xenipt under Sec. ~~-----, B & p.C. for this, reason
0 I hereby affirm that I have a certificate of consent to
_ self-insure .• or a certificate of Workers· ComPens8.tion ln-
surance,,or a certified copy thereof {Sec. ~00. Labor Code) .
POLICY NO.
COMPANY
D Copy is filed with the city
D Certified copy Is hereby furnished
CERTIFICATE.OF EXEMPTION FROM WORKERS" COMPENSATION INSURANCE
(This section need not be completed If the permit
-I~ fo( one hundred dollars ($100) or lessf
D I certify, that in the Performance of the work for which
, this permit is issued, I shall n6f employ any person in any·
manner so as to become subject to the Workers' Compen-
satlorr L'aws of California.
NOTICE TO APPLICANT: If, after making this Certificate
" ,of Exemptlo,n, you shquld become s4bJect to the Workers'
Compensation provisions of the Labor Code, you must
forthwith comply with such provisions or this permit shall
be deemed revoked
D I hereby affirm that there is a•construction lendmg
agency for the performance of the work for which this Per-
mit 1s issued (Sec. 3097, Clv11~Code)
Lender's Name ___ ...,... ________ _
Lender's Address, ____________ _
I
I
'
USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
1CARLSBAD BUILDING DEPARTMEN'T
...
APPLICATION & PERMIT -. _~, Carlsbad, California 9200~,4859 .. "'
JOB_ADDRESS,_. ' AV.ST.RO. NEAREST CROSS ST.
IDAr;;;7;o;J
BUSINESS LICENSE # VALUATION PERMIT NUMBER
/4..-/.l-/~
.
,,,.2 3 F1' . LO/· BLOCK '.I SUBDIVISION' . I ASSESSOR PARCEL NO. CONTRACTOA CONTRACTORS PHONE# ZONE 1)L
,,, 1 DC(__ , (. \ :· /3!/-r-,o/~,t;,t, ;lrc;LL {:;,15/ ~-, v
OWNER'S NAME I , I ,1f-:;;::;;~d ~If-,,,2. 'i 2..-D""S<1
7/2e ~;/·: .. , .~··· CONTRACTOR'S ADDRESS STATE LICENSE NO. BUILDING SQ, FOOTAGE
' r.;.h,, ./) t,, /JG, 7.330 E '19 ,.d-t'~v-k!al. Lff/75/ 01/'JNER'S MAILING ADDR.ESS 1 . ,,
7,_!?~o , £;,_9" j A./'f:. CR' ?_c1. OESIGNER • ' /. DESIGNER$ PH~NE ,
OESCRIPTfON OF W,K .,LI. · . ./-
thc0/V ~~~/_ k~Mm&JAt1t!.!c /),fetfeC)C/.,;~ . J,:1,/-/~tfCI
Un/A~ . r,,:,.,,lrd~e,, -D'ESlGNER'S ADDRESS . STATE LICENSE NO.
~·
J,355 J111.;,ff1u-t1 A-(I(. Oc.$. · ~-/ill 9.39
F/P FLR ELEV, NO OCC GP EDU
'•· STORIES
vO NO --
l I l PARKING SPAC.E RES UNITS l GRADING.PERMIT ISSUED ·1 REDEVELOPMENT TYPE ·occ LOAD FIRE SPR Oul6 Oul u9i25i86~RHT 3iJ.I AREA CONST
YO N Q vO NO v,D NO Not Valid Unless Machine Certified,
QTY. PLUMBING PERMIT -·ISSUE; .7$ QTY. MECHANICAL PERMIT -LSS~ 3-.SU.MMARY./ACCOUNT NUMBER
EACH FIXTURE TRAf' INSTALL F~flN. DUCTS UP T!) 100,!)01'.JBTU BUILDING PERMIT 001·810-00·00·8220
EA~H BUILDING S~ER ,,.. OVEB)1fo,ooo BTU SIGN PERMIT 001-810-00-00·8221
EACH WATER HEATER AND/OR VENT / . BOILER/COMPRESSOR Y)Yfo 3 HP .. PLAN CHECK· 001·810·00-00-8806 -
EACH GAS SYSTEM 1 TO 4 OUTLETS / 801LEA/COMPRESS_p,R3-15 HP TOTAL PLUMBING 001-810-00·00·8222
EACH GAS SYSTEM 5 OR MORE / METAL FIREPLA!,Y -~3'.n...;.... ELECTRICAL 001-~ 10-00·00-8223
EACH INSTA~. ALTER, REPAl¢'TER PIPE VENT FAN,,S'('NGLE DUCT MECHANICAL 001-8,10·00-00-8224
-EACH VACUUM 8REAKf)(' MECHffeHAUST -HOOD/DUCTS MOBILEHOME 001-810-00-0Q-8225
WJ\rER SOFTNER / R~CATION OF"EA FURNACE/HEATER --SOLAR 001-810-00·00·8226
EACH ROOF DR~INSIDE) : ¢"RYER VENT ,STRONG MOTJON 880-519·92-33
/ TOT/iL MECHANICAL FIRE SPRINKLERS 001-810·00-00-8227
· 1'oTAL PLUMBING I : PUBLIC FACILITIES FEE 320-81'0·00·00-87~0
,,
ELECTRICAL PERMIT· ISSUE 5" BRIDGE FEE' QTY. -QTY. MOBILE HOME SETUP ..
PARK-IN·LIEU (AREA )
NEW CONST EA AMP/SWT1BKR CAR PORT : TIF · . 001-810-00'00·8835.
-1 PH 3 PH AWNING LICENSE TAX 001·810-00·00·8162
EX,IST BLOG EA AMP/SWT/BKR GARAGE MFF 880-519·92-57
1 PH 3 PH
REMODEL:ALTER PER CIRCUIT ..
TEMP POLE 200 AMPS
OVER 200 AMPS :
TEMP OCCUPAN'CY;(30 OAYSJ
f I~ c:;/-·1>1A '1-t::'< . .. ,_c:;-' -CREDIT DEPOSIT .
,_ , TOTAL ELE-CTRICA-L r .3D~ TOTAt TOT.AL-FEES PAYABLE ·I Jo ---·--'
I I HAVE CAREFULLY EXAMINED THE COMPL,ETED "APPLICATION AND PERMlt" AND DO HEREBY· · · Expiration. Every permit issue<tbythe Building Official under the provisions of this * AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER I. CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shatJ, expire by limitation and become null and void If the building or work 5' O" DEEP ANO DEMOLITION OR CONSTRUCTION OF
I .. DECLARATIONS AR,E T-RUE AND CORRECT AND 1 FURTHER CER.TIFY AND AGREE IF A PERMIT 11;. authorized by such permit 1s not commenced within 180 days from the date of such STAUCTIJRES.OVER 3 STORIES IN HEIGHT permit, or if the -buitdin~ or work authorized by such permit ls suspended or I ISSUED; TO COMPLY W!Th1 ALL CITY. COUNTY ANO STATE LAWS GOVERNING BUILDING CON· abandoned at any time a er the work is commenced for a oeriod of 180 davs. _,.,..
I STRUCTION, WHETHER SPECIFIED H!::REIN OR NOT, I ALSO AGREE TOBAVE INDEMNIFY AND APJJ;;IG7d/-OWNERD CONTRACTOR 0 APPROV~ _ A ·• _L_/ ' _-DATE
I KEEP HARMLESl:\.THE CITY OF CARLSBAD AGAINST A\-L LIABILITIES, JUDGMENTS, COSTS AND ~~-EXPENSES WHICH MAY IN.ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE; f. GRANTING OF THIS PERMIT. BYPHONE 0 1/t?-Z..5~ I
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K) I he~/'.ll,m' that.I am licensed under
provisions i>f Chapter 9 (commencing with
Section 7000) of Division 3 of the B1181ness
and Professions Code, and my license Is In
full force'.36"%~19c,1. Lie. No. fdJ_ Class C-2 Q
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I hereby alf~m that I am exempt from the Contrac·
tor's Llcense'Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which re· quires a permit to construct, alter, improve, demoffsh, or repair any structure, prior to its issuance also requires the ap-plicant for such permit to tile a signed statement that he is licensed purauant to the provisions 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 exemption, Any j~~~tl~~ ~~:,rz!~t"t:~
3
c1ivri ~in!~t:~r~~~i~; ;hg~\~~ ~~~: dred dollars ($500).
D I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the struc-ture is not intended or offered for sale (Sec. 7044, Business
and Professions Code: The Contractor's L_icense 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 intend-ed or offered 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 im·
prove for the purpose of sale).
D 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 projects with a contractor(s) license pursuant to the Contractor's License Law).
D As a homeowner I am Improving my home, and the follow-ing conditions exist:
~: rh~a~:r~1i:le/~g ~:"i':m"ed rii0't-1"e1~e months
3, rr~!v: ~~r p~:l~~t tt~i~ :~~~ption during the last three years.
0 I am exempt under Sec. _______ , B & P.C.
for this reason
IQ I hereby affirm that I have a certificate of consent to self-insure. or a certificate of Workers·
Compensation Insurance. or a certified copy thereof (Sec. 3800, Labor Code).
POLICY NO WP _liQ06 7 48~~--~
COMPANY Fireman ' s _.Eund __ .
m Copy is filed with the city
O Certified copy 1s hereby furnished
O~. CERTIFICAT~ OF EXEMPTION FROM U ~ WORKERS' COMPENSATION INSURANCE l'> (This section need not be completed 1f the permit ffi ·, · 1s for one hundred dollars (S100) or less) ~ \~certify that .m the performan(:e of the work tor 0 w this perrmt is issued, I shall not employ any ~ \ person m any manner so as to become sub1ect to
the Workers' Compensation Laws of Cahforn,a
![
-./
NOTICE TO APPLICANT If, after makin~ this Cert1-
t1cate of Exemption, you should become sub1ect t0 the Workers' Compensation prov1s1ons of the Labor
Code, you must forthwith comply with such
prov1s1ons or this perrmt shall be deemed revoked
0 I hereby affirm that there 1s a construction
lending agency tor the performance of the work for which this permit 1s rssued (Sec 3097, C1v11 Code)
Lende(s Name __________ ---'_
Lender's Address ___________ _
1 USE BALL POINT PEN ONLY & PRESS HARD
CARLSBAD BUILDING DEPARTMENT
1200 Elm, Carlsbad, California 9200.8-1989 (619) 438-5525
vO NO
REDEVELOPMENT AREA
YO ND vO NO
QTY.I PLUMBING PERMIT· ISSUE QTY.I MECHANICAL PERMIT· ISSUE
EACH FIXTURE TRAP J JI J INSTALL FURN. DUCTS UP TO 100,000 BTU
EACH BUILDING SEWER I I I OVER 100,000 BTU
EACH WATER HEATER AND/OR VENT I BOILER/COMPRESSOR UPTO 3 HP
EACH GAS SYSTEM 1 TO 4 OUTLETS J j 1 I BOILER/COMPRESSOR 3-15 HP
EACH GAS SYSTEM 5 OR MORE ! lMETAL FIREPLACE
EACH INSTAl., ALTER, REPAIR WATER PIPE TVENT FAN SINGLE DUCT
EACH VACUUM BREAKER I ~ 21 MECH EXHAUST -HOOD/OUCTS
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER
EACH ROOF DRAIN (INSIDE)
TOT.i;L MECHANICAL
TOTAL PLUMBING
QTY. I ELECTRICAL PERMIT -ISSUE .e-_ QTY. I SOLAR -ISSUE
NEW CONST EA AMP/SWT /BK R COLLECTORS
1 PH 3 PH STORAGE TANKS
EXIST BLDG EA AMP/SWT/BKR ROCK STORAGE
1 PH 3 PH PUMP
REMODEL/ALTER PER CIRCUIT PLAN CHECK FEE
TEMP PO LE 200 AMPS
OVER 200 AMPS
TEMP OCCUPANCY (30 DAYS)
TOTAL ELECTRICAL TOTAL SOLAR
APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
TYPE
CONST
OCC LOAD I FIRE SPR
vO NO
VALUATION
ZONE
_tE,~,•UT NUMBER
~-/"c}/J
PLAN 1.0, # BLDG USE CODE
STANDARD PLAN# BUILDING SQ. FOOTAGE
Not Valid Unless Machine Certified
-SUMMARVACCOUNTNUMBER
BUILDING PERMIT 01 ·00-00-8220
SIGN PERMIT 01-00-00·8221
PLAN CHECK 01-00-00-8806
TOTAL PLUMBING 01-00-00-8222
ELECTRICAL 01-00-00-8223
MECHANICAL 01-00-00·8224
MOBILEHOME 01-00-00·8225
MOBILEHOME PARK INSP ---
SOLAR 01-00-00·!!226
STRONG MOTION 80·92-33-0519
19 • . 00 r FIRE SPRINKLERS 01-00-00-8227
PUBLIC FACILITIES FEE 32-00-00-8923
BRIDGE FEE
SCHOOL FEE • DISTRICT
Carlsbad 80·92-21-0519
Encinitas 80-92-22-0519
San Dieguito 80-92-23-0519
San Marcos 80·92-24-0519
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