HomeMy WebLinkAbout2415 La Costa Ave; C; 83-313; Permit'" z 0 a: .. a: .. .,
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m: i,;i I hereby affirm that I am licensed under
o .~lslons of Chapter 9 (commencing with
~ and Protessl.ons Code, and my license is ln
,_ [ Section 7000) of Division 3 of the Business
~ full force and~& ::,J [;• .3-(, ~ Lir No 3 / t ~y1m __ l:J
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I hereby affirm that I am exempt from the Cont·ac-tor' s L1ce~se Law for the tolow,ng reason iSec 7031 5
Business and Pro!ess1ons Code· Anv city 0r county which :e-qu1res a oerm1t to cons!'uct alter. ,mo,o,e, aernol,sh or
repair any structure, p·10r to its issuance also requ,,es t~e ap-
p11cant 'O' such oerm,t to Ille a signed statement that he 1s
l,censea pursuant lo the prov1s,un~ 01 the Contractor's LICe~se Law 1,Chaoter g cof'lme~c,~g w,th Sect,on 7000 of
~1·1,s1or 3 of the Business and Professions Code) or that 1s ex-
emat tnerefrom and the basis for tr.e alleged exemption. Any
v,olat,on ot Sec/1on 703; 5 by an appl,can\ for a permit sub·
1ects the applicant to a c1v1I penalty of not more man tive hun-
dred do,lars !$500!
_J I, as ow~er of the property. or my employees with wages
as their sole compensation will do \he work. and the struc-
ture 1s not intended or Offered for sale (Sec 7044, Business
and Protess1ons Code. The Contractor's L;cense Law does not apply !O an owner o! property who builds or improves
thereon and who does such work himself or through his own
employees provided that such improvements are not ,ntend-
ed or offered for sale If, however. the building or improve-
ment 1s sold w1tn1n one year of completron. the owner-builder
will have the burden 01 pr0111ng that he did not build or im-
prove tor the purpose 01 sale)
:J I, as owner ot the property, am exclusively contracting with_ licensed contr~ctors to construct the pro1ect {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 !or each proiects with a
contractor(s) license pursuant to the Contractor's License Law)
:J As a homeowner I am improving my home. and the follow-
mg conditions exist 1 The work is being periormed pr,or lo sale
2 I have lrved in my home for twelve months prior to completion ot this work
I have not claimed this exemption during the
last three years
~r /ht~ r~~~~~t under Sec _____ _ B & P.C
~ I hereby affirm 1ha! I ha•e a cer1,t,cate of consent to self-insure. or a cemt,ca1e of Workers
Compensation Insurance, or a cert,1,ed copy thereo1
(Sec 380'.J. Labor,_Qode) ,..
eoucrno £,,•-9r5. P'i --o.J1,
COMPANY __ '"5"_~ ~J\CJ ~ Copy IS tiled w,th The c,ty 'J
0 Cer11!1ed copy ,s hereby furnished
CERTIFICATE. OF EXEMPTION FROM
WORKERS-COMPENSATION INSURANCE
(Th,s se.::t1on need not be completed ,1 the perm,t 1s for one hundred dollars Is100I or less1
D I certify that in the performance ot the work tor
which this perrn,t 1s ,ssued. I shall not employ any
person in any manner so as lo become sub1ect tu the Workers· Compensa1,on Laws of Cal,1orn,a
NOTICE TO APPLICANT It. alter makrn;i lh,s Cef1• !1cate o1 Exemption. you snould become sub1ec1 T'J
t'1e Workers Compensation pro111s,ons ol the LabO< Code, you must fort'1w1th comply w,th such
prov1s,oros or th,s perm,1 shall be deemed revoked
0 I nerebv atfirm 1ha1 lhere ,s a cons1rurt1or-
·,end111g agency •or 1he performance ol n-.e wor1<. lor ...-n,ch this pe•m,t ,s ,~suecl 1sec. 3097 C,v,1 Cooe,
Lenae, s Na,,..,e ___________ _
Lenaers Ada,ess __________ _
USE BALL POINT PEN ONLY & PRESS HARO APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT
1200 Elm, Carlsbad, California 92008-1989 (619) 43~-5525
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7: /Y_ . J AV. ST. BUSINESS LICENSE# VALUATION PERMIT NUMBER G r-a L,,.(J.51tL e,, AO
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OWNER'S PHONE (' :;,~;;1;1 ZONE
~
3/3
OWNER'S MAILING ADDRESS C~Ti~:zs D~P. ~ p u ~~ [ 3j"~g_3 I PLAN I.□ # BLDG USE CODE
COT BLOCK l SUBOIVISION I ASSESSOR PARCE~ _NR. -81 DESIGNER \' LICENSE# STAN DARO PLAN# BUILDING sa. FOOTAGE
DESCRIPTION OF WORK
.:> LI,, ;;t'l:Y 5~
r, AA j/.,,, _,, 0 ! DESIGNER'S ADDRESS DESIGNER'S PHONE
{l ' I I I NO I ace c, [ EDU ' F/P FLA ELEV. STORIES -----· ------
v □ r..D
GRADING f:ERMIT ISSUED TYPE
CONST
OCC LOAD FIRE SPA
,.
CENSUS TRAC, l ce cAND uSE l eARK>NG seAcE RES UN>TS l
v □ ND l REDEVELOPMENT
AREA
YD ND vO NO Not Valid Unless M•chine Certified
QTY. PLUMBING PERMIT· ISSUE 7
I },60 QTY. MECHANICAL PERMIT· ISSUE 3✓oo SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP
EACH BUILDING SEWER bf-~:~~ W. AT_E_~~i82._ER~-.N~.□R V~~!-
~ GAS SYST~~ 2_!9_ ~ OUTLET] ~~
INSTALLFURN OUCTSiJPT01~0000BTU . BUILDINGPERMIT ___ 01·00-00-8220 __
I OVER 100.000 BTU SIGN PERMIT 01-00-00 82~1 -L -BO~LER1C0MPRESSO~~p~~3H~ ----• PLANCHECK ___ -_-_-01-00-008806_ --~~I
BOILER1COMPRESSOR 3 15 HP TOTAL PLUMBING 010000-8222 'O ' --+ ---" --------------
EACH GAS SYSTEM 5 OR MORE
EACH INSTA~ .. ALTER, REPAIR WATER PIPE 1--+------·---. -------
--'----· -----01-00-00-8223 METAL FIREPLACE __ L l:.Ll:.GlRICAL -
01-00-00-8224 -~A~SINGLEOUCT MECHANICAL ---.·--
EACH VACUUM BREAKER MOBILEHOME ---
~~T_E~ SOFT_N~~-----+-------It--~C_ATION OF ~A FU~ACE1HEATER I __ r--MOBILEHOME PARK INSP
JL__ ~H E~~AUST HOQO:QUCTS ·~----~-+-~--01-00-00-82~ --
+ACH ROOF DRAIN IINSIDE1 ~ L_ SOLAR -I -----------------..f) --. TOT/..L MECHANICAL I -STRONG MOTION
TOTAL PLUMBING ~~-. _ --~ -~-_:_ _ FIRE SPRINKLERS 01-00-00-8227
___ 01-00_-00-8226
80-92-33-0519
,___ QTY.I ELEcrn1cAL PERMIT -1ssuE l s3",00 oTY soLAR-1ssuE ~!~~~::~iumsFE_E__ 3200·00·8923
NEW CONST EA A.MP:sw~ BKR _______ :__ ~----=---tt---couiC10f1S------·--------scHOOL FEE. 01srn_1C_T __ Effifu BLDG EA AMP•SWLBJ~H -_ _j -=~~:A!io:;;~~S =-=~ . .. -~!:Ii~~:: --80·92
·
21
·~
3 PH 80-92-22-0filf-519. . ---'8'0-92-23-051~ I PH ~---+-------. --l-.
~ _0 ~E-~ LT ER PER CIRCUIT
, TEMPPOLE 200AMPS -+--
L ~ O~E_R 200 ~~S
TEMP OCCUPANCY !JO DAYS!
' _ _j_
---------'1--------PUMP
---1 PLAN CHECK i'"EE
~-. -----------~
__ ;._
-
--11-_.l.
-------..+ -
San D~eg_LJ_ilo __
-l---·-· _ ll _ San Ma~c_os 80·?2-24-05) 9
. -'-_73/. T ---------4-------~,L
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TOTAL tLECTRICAL TOTAl SOI.AR TOTAL FEES PAYABLE I /j. }'5!-
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT" AND DO HEREBY
CERTIFY UNDER PENALTY OF PERJURY THAT All INFORMATION HEREON INCLUDING THE
DECLARATIONS ARE TRUE ANO CORRECT AND I FURTHER CERTIFY ANO AGREE 1F A PERMIT lS
ISSUED: TO COMPLY WITH All CITY, COUNTY AND STATE LAWS GOVERNING BUILDING CON·
STRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND
KEEP HARMLESS THE CITY OF CAALSBAD AGAINST ALL LIAB!LIT!ES, JUDGMENTS, COSTS AND
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE
GRANTING OF THIS PERMIT
Code shall expire by hmi !ton and e null and void If the building or work E,p;.ration. Every pe. r_mit issued bylhe B 'Id. ing Official undef" th.,•. rovis;onsofthis
authorized by such per is not com ed within 180 days from the date of such
permit, or if !he bUII or work onzed by such permit 1s suspended or
abandoned at any ti a er the '!10 commenced for a period of 180 d!lv,.
OWNER O CONTRACTO
BY PHONE 0 .,, ...
* AN OSHA PEIWfT IS REQUIRED FOR EXCAVATIONS OVER ·5' O"' DEEP ANO 0£MOUTK>N OR CONSTRUCTION OF
STRUCTUR£S OVER 3 STORIES IN HEIGHT
APPROVED BY J1 I D\:J/.,-. (g )
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INSPECTION TYPE DATE INSPECTOR
BUILDING
FOUNDATION
REINFORCED STEEL
MASONRY
GUNITE OR GROUT
FLOOR & CEILING SUB FRAME
SHEATHING
FRAME
EXTERIOR LATH INSULATION
INTERIOR LATH & DRYWALL
PLUMBING
SEWER AND BL/CO
PLUMBING UNDERGROUND
PLUMBING TOP OUT
TUB AND $HOWER PAN
GAS TEST
ELECTRICAL
TEMPORARY POWER
ELECTRIC UNDERGROUND
ROUGH ELECTRIC
ELECTRIC SERVICE
BONDING
G. F. I. -SMOKE DETECTOR
MECHANICAL
DUCT & PLEM., REF. PIPING
HEAT -AIR COND. -SOLAR SYSTEMS
VENTILATING SYSTEMS
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE BEEN APPROVED.
JOB SITE FINAL
PLUMBING
ELECTRICAL
MECHANICAL " GAS ,,,_'fh-r;J T
BUILDING I
SPECIAL CONDITIONS
CERT OF OCCUPANCY ISSUEO
83-3.i3
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR"S NOTES
INSPECTION REQ IF INSPECTOR"S DATE CHECKED APPROVAL
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PAESTRESSED
CONCRETE
POST TENSIONED
CONCRETE
FIELD WELDING
HIGH STRENGTH
BOLTS
SPECIAL MASONRY
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PILES CAISSONS
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