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Home My WebLink About2393 PALMER WAY; ; 82-350; Permit1/1 z 0 ~ . llC j t.> "' C C I[ 0 t.> O I hereb) m that I am licensed under provisions ot Ulapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is In full force and effect. Loe No ___ Class I hereby attmn that I lffl exempt from the Con- ~~·'.(~~~~.:'::~ ~,~':.~I~~'":~.~ county wtuch requires a permit to construct alter. improve, demohsh, or repair any structure, pnor to ,ts issuance also requires the apphcant for such pemut to hie a signed statement that he 1s lteensed pursuant to the prov,s1ons of the Con· tractor's License Ulw (Chapter 9 commencing with Sectt0n 700:> of 01v1s1on 3 of the Bus,nes.s and Pro. tesst0ns Code) °' that •• exempt tlle<efrom and the basis tor the alleged exempttof'I Any vt0latlon of Section 7031 5 by an apphcant 10< a permit subtects tne apphcant to a c1v1I penalty of not more than five hundred dollars ($5()()) D I. as owner of the property, or my employees ""ilh waoes as their sole compensatton, will do the wM, and the structure 1s not intended or offered for sale (Sec 7°"4, Business and Profess,olls Code The Cont<actor"s license Law does not apply to an owner of property who builds or tmprOYeS thereon and who does such w0f1{ himself or through his own employees. provided thal such ,mprovemeillS are not 1ntende1 Of offered for sale If. however, the building o, 1mproyement 1s sold within one y~ of comp~t1on, the owner builder w,11 have the burden of provmg thait he did not build or improve for the purpose of sale) 0 I, as owner of the property, am exclusively contrachn9 with licensed conlractors to construct the pro1ect (Sec 7W, Business and Protess,ons Code The cbntractor's License Law does not ~ly to an owner of property who builds Of improves ~':~t~ 7.~nc;i~~!~~~ ~~rh~,~~~;;:.: License Law). c:J I am exempt undef Sec fo, lh1s reason ,B &PC D I hereby affirm that I ha"e a cert1hute ot consent to self-insure, or a cert,t,cate ot Workers' Compensation Insurance. or a certified copy thereof (Sec 3800. Labor Code) POLICY NO z 0 ~ C0_7'( ~ ~ .,.,,,,t:f" Copy 1s hied with the c,ty z f D Certified copy 1s hereby furnished :IE 0 t.> 1/1 a: "' :w:: llC 0 3 CERTIFICATl OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section ~eed not be completed 1f the permit 15 tor one hundred dollars (S 11)0) or less) D I certify that 1n the per1ormance of the work for which this penn1t 1s ,ssued. I shall not employ any person in any manner so as to become sub1ect to the Workers· Compensation Laws of Cahforn1a NOTICE TO APPLICANT If. afler mak1n1 this Cert, t1cate of Exemption, you should become subJect t'J the Work.ers· Compen~hon pro111s1ons of the LabOr Code. you must forthwith comply with such provisions or this permit shall be oeemed revoked 0 I hereby affirm that there 1s a construc11on lending agency lor the performance ot the worlt for which this permit ,s issued (Sec 3097. Civil Code) Lenders Name __________ _ Lenders Address---------- USE BALL POINT PEN ON LY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA ANf ~CLARATIONS. CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT 1200 Elm, Carlsbad, California 92008 (714) 438-5525 JOB ADDRESS A~~-T-1 D~;; j;~TIONI .!!? BUSINESS LIC:----VALUATION PERMIT NUMBER u: Uf3 n. .. ---Ate-116# ~"' >, , -· . -................. ---... <ti OWNER'S NAME I OWNER'S PHONE PRIME CONTRACTOR , , CONTRACTORS PHONE • ZONE 1i 71; ~-3~ 0 {Jw.64-b ~ ch<.i~ ~(_ u a. z<j). ~ 77/e; 21.L~ E Q) OWNER'S MAILING ADDRESS CONTRACTOR'S ADDRESS LICENSENO. PLAN 1.0. # BLOG USE CODE f- 1-530 ~.-t.A4,~ Ld· $'..!) 9iJ..lt I ?3~ GJG ltlCJut:/l Ld. I "O LOT I BLOCK I SUBDIVISION I ASSESSOR PARCEL NO. DESIGNER STATE LICENSE # STAN DARO PLAN# BUILDING SQ. FOOTAGE 0 (!) DESCRIPTION OF WORK .l\~~,,4., L- zu ~ ...,_ ~-·L'AJ... ~ DESIGNER'S ADORES$ DESIGNER'S PHONE c <ti -~ -F/P F LR ELEV. NO OCC GP EDU a. a. STORIES <( vO NO ---I CENSUS TRACT I GP LAND USE I PARKING SPACE I RES UNITS I GRADING 1:ERMIT ISSUED I REOEVELOPMENT TYPE OCC LOAD FIRE SPA ~ AREA CONST C YO N D vO NO vO NO Not Valid Unlt!ss Machin~ C.rtifi,d a: QTY. PLUMBING PERMIT -ISSUE 7,:fo QTY. MECHANICAL PERMIT -ISSUE ~(/(I SUMMARY/ACCOUNT NUMBER 0 <fl EACH FIXTURE TRAP INSTALL FURN. DUCTS i.JP TO 100,000 BTU BUILDING PERMIT 01-000-4220 <fl Q) EACH BUILDING SEWER OVER 100,000 BTU <fl SIGN PERMIT 01-000-4221 <fl -<( EACH WATER HEATER ANO /OR VENT BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01-000-4806 I -------~- EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING 01-000-4222 3 EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE ELECTRICAL 01-000-4223 "')~/. ~ .Q ----r a> EACH INSTAL ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01-000-4224 >- EACH VACUUM BREAKER MECH EXHAUST -HOOD/DUCTS MOBILEHOME 01-000-4225 WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP Iii <fl EACH ROOF DRAIN (INSIDE) SOLAR 01-000-4226 Q) 0 TOTI.L ME CHANICAL STRONG MOTION 65-640-0519 0 a: -l TOTAL PLUMBING FIRE SPRINKLERS 01-000-4227 <ti iii PUBLIC FACILITIES FEE 25-000-4933 0 QTY. ELECTRICAL PERMIT -ISSUE J~(k) QTY. SOLAR -ISSUE BRIDGE FEE §: I NEW CONST EA AMP/SWT BKR /(f!J41,U A~ ,Zi COLLECTORS SCHOOL FEE • DISTRICT Q) 0 C 1 PH 3 PH STORAGE TANKS Carlsbad 65-623-0519 <ti C: EXIST BLOG EA AMP/SWT/BKR ROCK STORAGE Encinitas 65-624-0519 u::: -1 PH 3 PH PUMP San Dieguito 65-625-0519 s RE MODEL/ALTER PER CIRCUIT PLAN CHECK FEE I /7') I /'V"""'" San Marcos 65-626-0519 I --C: TEMP POLE 200 AMPS l /) /}?_,..{ /lb ,vvv--Q) -~ OVER 200 AMPS I JV tr -~-(!) TEMP OCCUPANCY 130 OAYSI I ---n---------- -. ----I V 0 - T TOTAL Sf LAA 0 TOTAL ELECTRICAL 'l.-J _cl) TOTAL FEES PAYABLE I /]_ ,-rv0 Q) a. <fl E '""' c'""""' ""''"" '"' COMecrneo' ...... ,CATION AND .... .., A,D DO"";[ -= ,_, __ ,,, ........ ..,_,,_ .. .,.._.,_ * AN OSHA PENIIT • llfGl...a> FOA EXCAYA TIONS OYER I CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING E Code sh exp,re by llmlta ,0,. and become null •nd void II the building orworll 5' O DEEP AND DEIIOLmON OR CONSTIM:TION OF DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMI IS authorized Y such permit I not commenced within IBOdayslrom thedateofauch STAUCTUMS OVEll 3 SlONES IN HEIGHT ~ permit o, the budd1:.'ff ~ ~hoflzed by such permit 11 ~~ or / SSUED TO COMPLY WITH ALL CITY COUNTY AND STATE LAWS GOVERNING BUILDING CO abllndoned ,L.onv tune a 11 -Or11 commenced for a DArood of 1 ...... .c STRUCT ON. WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND ~ U.' ~l..._ ~ APPROVED BY DATE ~ KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS. COSTS AND IC S IGNC'.I OWNER O CONTRACTOR ~ fd t ( t'{ .to. EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE ~ BY PHONE 0 I V GRANTING OF THIS PERMIT ' ' INSPECTION TYPE DATE INSPECTOR BUILDING FOUNDATION REINFORCED STEEL MASONRY ' GUNITE OR GROUT FLOOR & CEILING SUB FRAME SH~ATHING FRAME EXTERIOR LATH lNSULATION INTERIOR LATH & DRYWALL I PLUMBING ' -- SEWER AND BL/CO .... PLUMBING UNDERGROUND PLUMBING TOP OUT ' TUB AND $HOWER PAN GAS TEST ELECTRICAL TEMPORARY POWER ELECTRIC UNDERGROUND 1, ROUGH ELECTRIC ELECTRIC SERVICE BONDING I G. F. I. -SMOKE DETECTOR MECHANICAL DUCT & PLEM., REF. PIPING HEAT -AIR COND. -SOLAR SYSTEMS VENTILATING SYSTEMS CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE ITEMS ABOVE HAVE BEEN APPROVED. JOB SITE FINAL PLUMBING ELECTRICAL - MECHANICAL - GAS j BUILDING I,• -''~ 'Y•l-\_ 1.") SPECIAL CONDITIONS CERT OF OCCUl""NCY ISSUED ' FIELD INSPECTION RECORD REQUIRED SPECIAL INSPECTIONS REO IF INSPECTORS INSPECTION CHECKED A PPROVAL SOILS COMPLIANCE PRIOR TO FOUNDATION INSP STRUCTURAL CONCRETE OVER 2000 PSI PRES TRESSED CONCRETE -POST TENSIONED CONCRETE -~ ' I FIELD WELDING ~ HIGH STRENGTH . BOLTS ~- SPECIAL MASONRY ' PILES CAISSONS -. ,__ l -. } \ t L - '"'"'. INSPECTOR'S NOTES .:\" . DATE - - ' -~ •" J \ ~ ~ - ·--- ·- --- ------I -----l ---. - -' I . -- ~~1 ~-, -- - ·-· ~ ----------- .. -·---- • -- . .. ; ------I I J .. ---=------- ' " -l --------- ---- 0