HomeMy WebLinkAbout2415 La Costa Ave; D; 83-314; Permit"' z 0 : .. ... !rl 0
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V I hereby affirm that I am licensed under
/~visions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Professions Code, and my license is in
foll fo,<;1. •".q' ~ i -·,.-3t· Lie No'....(!,,,.,. f Cla;I f , ·'} JI. 1...-'-
I hereby affirm that I am exemot lrom the Contrac-
tor's license Law for the following reason {Sec 7031 5
Business and p,ofess1ons Code. Any c,ty or county which re-
Quires a permit to construct. alter, improve. demoI1sh. 01 repa,r any structure, pnor to I1s issuance also requires the ap-
p,,canl fo, such perm,t to hie a signed slilte,r.enl !ha! he ;5
licensee pursuart 10 the provis,ons of t~e Co~t-actar's
License Law 1Chapter 9 comme~c,ng with Sect,or 7000 of o,v,s,an 3 81 the Business and Professions Codei or that •sex·
empt therefrom and the bas,s 1or the alleged exemot,on Any
v,o,at,on of Sect,on 7031 .5 by an apol,cant for a perm,t sub·
·ects the apolIcan! to a civil penalty of not more than five hun-
d,ed dollars !$5001
_ I. as owner of the prnoerty or my employees with wages
as lhe1r sole compensation. will do the work. ano the struc-
ture ,snot intended or ottered for sale [Sec 7044, Business
and Professions Code The Contractor's License Law does
not apply to an owner of prooerty who builds or improves
thereon and who_ does such work h1mself or through his own
employees. provided that such improvements are not rntend-eo or ottered for sale If. however. the building or improve·
ment Is sold w1th1n one year o! completion,. the owner-builder
will have the burden of proving that he did not build or im-
prove for the purpose of sale)
C.... I. as owner of the property. am exclusively contracting
with licensed contrcctors to construct the pro1ect (Sec ?!J44,
Business and Professions Code. The Contractor's License
Law does not apply to an owner o! property who builds or Im-
prO'les thereon. and who contracts for each pro1ecis with a
con1ractor{s) license pursuant to the Contractor"s License
Law)
I As a homeowner I am imprO'ling my home, and the lallow-
Ing cond1t1ons exist 1 The work 1s being performed prior to sale 2 I have lived In my home for twelve months
prior to completion of this work
I have not claimed this exemption during the
last three years
CJ I am exempt under Sec ______ , B & P C
for this reason ____________ _
~ I hereby af!,rm tha1 I ha•e a cerM,cate ol consen1_ ~ selt-msure, or a cert,f,cate of Workers
~~':"."o::'J€""c~e o, ·.;'"''o ;: '"'""'
POLICY NO_~-' ..-. / _ / ~-~-
COMPANY 5, . , I,.,\_ Y\{__j,
\ I -, ·, \CJ Copy 15 foled wtlh the city
/ CJ Cert,t,ed copy ,s hereby turn,shed
CERTIF\CAH. OF EXEMPTION FROM
WORKERS-COMPENSATION INSURANCE
(This section need not be completed ,1 !he permII
,s tor one hundred dollars (SH))) or less)
O I cert,fy 1hat ,n the per1ormance of the worl< to,
which th•s perm•1 ,s ,ssued. I shalt not emplo:, any
pe,son ,n any manner so as IO become sub1ecl to
the Worl<ers Compensat,on Laws ot Cal,lorn,a
NOTICE TO APPLICANT 11, a!le, mak,n~ rn,s Cert,
hcate of Exempt,on. you should become sub1ect I?
\he Workers Compensa1,on prov,s,ons ol the Labor
Code. you must forthw11h comply w1\h such
prov,s,ons or 11'1<S perm,! shall be df'emed •evoked
0 I hereby a!lirm \hat there ,s a construcl·on
;enct,ng agency tor ihe performance ol tti(' -,.on, to,
,..h,ch !h,s perm,1 ,5 ,ssued 1Sec 3097 Ci,il Co<l!.'1
Lenders Name ___________ _
Lenders Address __________ _
USE BALL POINT PEN ONLY & PRE~S HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT
1200 Elm, Carlsbad, California 92008-1989 (6_19) 438-5525
JOB ADDRESS 2tr/s 7) la Z?osftl-, .i/ AV. ST,lDATE"O~PPLlt._TION
,.-:, , RO . h/.;;ZI / Y3
OWNEA"S NA)Ph \
( V'1J,, f\... 1 OWNE A'S PHONE r:,., CON~ACTOR L ,
-=~~!tla) I'\."\ {) ) \ l .rv-. h:u;
OWNER"S MAILING ADDRESS CONTRACTOR'S ADDRESS ___.}
31-< 6' Dg'.2L_~ ~-
LOT l BLOCK TSUBOI VISION I ASSE~or C'';w~ !,-.> 3 D DESIGNER ~
!""""""°" ., -·· ~ p,;, R, I""'""'"'""""'"
<J
>IS F LR ELEV NO
STORIES
vO r-..0 ---
GRADING f'.ERMIT ISSUED TYPE
AREA CONST
BUSINESS LICENSE #
A~ '"J/ L., L
7 .,,.
CONTRACTORS PHONE #
ftpt)3;J-2..
LICENSE NO.
7/?i".3/
LICENSE It
DESIGNER'S PHONE
I occ GP I EDU
OCC LOAD FIRE SPA
VALUATION
ZONE
PLAN 1.0. /:J
STANDARD PLAN#
PERMIT NUMBER
S-J -
311/
BLDG USE CODE
BUILDING SO. FOOTAGE
-
crnsus rnACT ruse T >ARK<NG SSA Ce Res UN'TS l
,□ 'D
l REDEVELOPMENT
vO NO vO NO Not Valid Unless ~chine Certified
QTY. PLUMBING PERMIT -ISSUE
BUILDING PERMIT 01-00-00-8220 -----------j
I 7-.sa11 QTY. MECHANICAL PERMIT· ISSUE 3,0<1 SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP INSTALL FURN DUCTS UP TO 100.000 BTU
EACH ~ATER HEATERAN-□.:oR v~~!-L---B0ILER1coMPRES_soR UP TO 3 HP PLAN CHECK Oi-oo-o□-8806 --·---<
EACH BUILDING SEWER I ----OVER 100.000 BTU I I SIGN PERMIT ----01-00-00-8221
~CH GAS SYSTEM_2____!_0 ~ OUTLETS -+--~~_,..._"."If__ SOILER/COMPRESS□RTi5-HP TOTAL PLUMBING____ 01·00·00-82221 tO .!!f'-----.j ./
EACH GAS SYSTEM 5 OR MORE ---4 METAL FIREPLACE ELECTRICAL 01-00·00~~223 -+------
EACH INSTA~ .. ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT C-------+----------------------
EACH VACUUM BREAKER . MECH EXHAUST HOOD/DUCTS ------------------
~.i.-W:~~ER SOF__T_~_ -----1~----'----.J-RELO_CATION o_~ EA FURNACE/HEATER -t-----·-I~ MOBILEHOME ~ARK INSP
EACH ROOF ORAi~ 1 INSIDE)
MECHANICAL ·----
l __ __c _ __Jlf---MDBILEHOME
~ SOLAR
TOT.G.l MECHANICAL STRONG MOTION
01-00-00-8224 --+---
01 -00 -00 -8225
c----
___ Ql:.Q0-00-8226 I
___ 80_·_92_-33-05~1~9-+-. _ c----r-~---
TOT AL PLUMBING
'
J_ /!. ~--,--~-
-OTY. ~oa ,___ SOLAR · ISSUE
! GAE SPRINKLERS _____ 0)·0_0-00-8227 I Pll_BLIC_ FACILITIES FEE 32--0o-oo-~
QTY. ELECTRICAL PERMIT· ISSUE . +--
NEW CONST EA AMP'SWT ·8t<R
I PH 3 PH -------f
EXIST BLOG EA AMPiSWT:Bt<R ---+-
I PH 3 PH
REMODEL ALTER PER CIRCUIT
TEMP POLE 200 AMPS r= -lorn 20.Q_ ~~s---_--
I TEMP OCCUPANCY 130 DAYSI
-----4 COLLECTORS ---jf-8RIOGEFEE__ _ __
t.T~~A~~-T~N~ _-_------------+------'----l--~CHOOL..£~DISTRICT -----
Carlsbad
---ll----ROCK STORAGE -______ -J-___ __: _ _Jle __ Enci~
---ji---'
PUMP
~AN CHECK ~EE ---~ San D~eguito
--+---------,,~--San M~~o_s
. --If---+---
··---➔---+--
+--EZr.
-lC-
80-92-21-0519
80·92·22-0519
e----
80-92· 23-0519 ·------+
80-92-24-0519
-
-
---
---
----
·----
--
-------
TOTAL ELECTRICAL
I
-+-
TOTAL SOI AR
--+-
TOTAL FEES PAYABLE I ., v~ l' .. ..------
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION ANO PERMIT"' ANO 00 HEREBY
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE
DECLARATIONS ARE TRUE AND CORRECT AND l FURTHER CERTIFY AND AGREE IF A PERMIT IS
ISSUED: TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING BUILDING CON-
STRUCTION, WHETHER SPECIFIED HEREIN OR NOT. l 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 TH!S PERMIT
Expiration. Every permit isaued by the BufldJ.ng Official under the prov1s100s oft his
Code shall expire by limitation an ome null and void 1f the building or work
authorized by su"i,ih rmit is not enced within 180days fr.om the date of such
permit. or if the ding or w k uthorized by such permit is suspended or
abandoned at a · ea~ t w k is commenced tor a penod of 180 days.
AP7l NATU~E, --OWNER □ CONTRACTO~
/ BY PHONE 0 -,,__,,,/ ----
* AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER
5' O" DEEP ANO DEMOLITION OR CONSTRUCTION OF
STRUCT\JRES OVER 3 STORtES IN HEIGHT
APPROVED BY ~ lo~e~ -v\i7
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INSPECTION TYPE DATE INSPECTOR
BUILDING
FOUNDATION
REINFORCED STEEL
MASONRY
GUNITE OR GROUT
FLOOR & CEILING SUB FRAME
SHEATHING
FRAME
EXTERIOR LATH lNSULATION
INTERIOR LATH & DRYWALL
PLUMBING
SEWER AND BL/CO
PLUMBING UNDERGROUND
PLUMBING TOP OUT -
TUB AND ~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 IL-76..;J 7
BUILDING
SPECIAL CONDITIONS
CERT OF OCCUPANCY ISSUED
'li"~ · "3 IL!,°
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
PRES TRESSED
CONCRETE
POST TENSIONED
CONCRETE
FIELD WELDING
HIGH STRENGTH
BOLTS
SPECIAL MASONRY
PILES CAISSONS
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