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HomeMy WebLinkAbout2504 LA COSTA AVE; ; 80-167; Permit.....d) CONTRACTOR'S DECLARATION --<nereby affirm that I am llcensed under provi- sions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profes- sions Code, and my license is In full force and ef- fect. OWNER-BUILDER DECLARATION DI hereby affirm that I am exempt from the Con• tractor's License Law for the following reason (Sec. 7031.5 Business and Professions Code), Any city or coutlty which requires a permit to con- struct, alter, improve, demolish, or repair any structure, prior to its Issuance also requires the applicant for such permit to file a signed state- ment that he Is licensed pursuant to the provi- sions 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 tor the alleged ex- emption. Any violatlon of Section 7031.5 by an ap- plicant tor a permit subjects the appllcant to a civil penalty of not more than five hundred dollars ($500). DI, 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 of- fered for sale (Sec. 7044, Business and Profes- sions 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 of- fered for sale. If, however, the building or Improve- ment is sold within one year of completion, the owner-builder wm have the burden of proving that he did not build or improve for the purpose of sale). -..L.1, as owner of the property, am exclusively con· ~cling with llcensed contractors to construct the project (Sec. 7044, Business end Professions Code: The Contractor's License law does not ap- ply to an owner of property \•ho builds or im· proves thereon, and who contracts for such pro· jects with a contractor(s) license pursuant to the contractor's license law). I am eXempt under Sec _____ B. & P.C. for this reaso~ Dot• '0 p<,1\§) Owne, e0;),_ v<c; ' ~ ' WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of con- sent to self-insure, o~ a certificate of Workers" Compensation Insurance, or a certified copy thereof (Sec. 3800, labOr Code). POLICY NO. ___________ _ COMPANY ___________ _ □Copy Is filed with the city. □Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed If the per- mit Is for one hundred dollars ($10!)) or less). I certify that in the performance of the work for which this permit is lss_u!.Q,. I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of Callfornia. NOTICE TO APPLICANT: If, alter making this Cer- tificate 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. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction len• dlng agency for the performance of the work for which this permit Is Issued (Sec. 3097, Civil Code). " r CITY OF CARLSBAD-BUILDING DEPARTMENT USE BALL POINT PEN ONLY APPLICATION & PERMIT 1200 ELM AVENUE (714) 438-5525 NO, J08 ADDRESS z... i),t),4, ,L .... c,o,:s;--r,A, ,.«.,IJ", , I I I I I I I I I I I I r ~ APPLICANT TO FILL IN INFOR - MATION WITHIN RED LINES. AV. ST. IOATE OF" APPLICATION BUS. LICENSE PERMIT NUMBER RD f6.l6 1 , 11,80 ftJ--/(, 7 OWNER OWNER'S PHONE PRIME CONTRACTOR / ST ATE LICENSE ,Sw831JS-y ,AwDfU:i.v T q-4'2.. -l.{,co OWNER'S MAILING ADDRESS r CONTRACTOR'S ADDRESS/ CONTRACTOR'S 2-Sc) 4: ~ C:oS'T-f,, Av PHONE 2/~'5/AfJ2S7!.: ~c .. : o: !!2(;7L: ?:l'.1 £il EFJ :j~ II I _. ~ BLOCK ~~·".#-/ I 1'i.':t.••·:r.t:·;,,•· , I, "I, , DESIGNER_/ ST ATE LICENSE OES ~JON OF" WORKP-n ~K- . ~,'A-/,;.i-500 7n'S ADDRESS DESIGNER'S PHONE , CENSUS TRACT GP LANO USE ZONING I RES. UNITS I P;KING SPACE sf I NUMBER OF" STORIES Not V•lid Unlm M«:hiM c.rtifild BLOG i?J d 1!I BLOG USE acc. GP I STANDARD PLAN 11 IPLANI011 I TYPE CONST I occ. LOAD I -QTY. PLU,..INu PERMIT AMT. QTY. ME9""NICAL PERM'IT AMT. EACH FIXTUffE TRAP INSTALL FA.JRN. DUCTS UP TD 100,000 BTU EACH BUILDIN.G SEWER OVER 100,000 BTU EACH WATER HEA""-fill_O/DR VENT BOILER/C OR UPTO 3 HP EACH GAS SYSTEM 1 TO 4 DUl'l,ETS BOILER/COMPRESSOff'l,.15 HP EACH GAS SYSTEM 5 OR MORE '-BOILER/COMPRESSOR 16-1ll HP EACH INSTAL., ALTER, REPAIR WATER PIPe. VENTFAN SlllGLE DUCT \ _:2;;~s-o EACH LAWN SPRINKLER SYSTEM '\. MECH EXHAUST -HODO/DUNS VALUATION: WATER SOFTNER RELOCATION OF EA FURNACE/iffcATER BUILDING PERMIT I . 1..21.V.""'t'O Issue 3.00 Issue 3 .• 00 SIGN PERMIT I I I I TOTAL PLUMBING TOTAL MECHANICAL PLAN CHECK I I~.,.,, CONTRACTOR CONTRACTOR ALL INCLUSIVE PERMIT I I I ELECTRICAL PERMIT AMT. TOTAL PLUMBING I I I QTY. AMT. QTY. MOBILE HOME PERMIT ELECTRICAL I I I -. NEW CONST EA AMP/SWT KR AWNING -MECHANICAL I I I 1 PH .25 3 PH PORCH I MOBILE HOME I I I EXIST BLOG EA AMP/SWT/ 111(:R SET-UP \ SOLAR I I I • I 1 PH .25 ''--3 PH RAMADA.CABANA "--I , I I I REMODEL/ALTER PER CIRCUIT ' FENCE OVER 6' ' I I I • I TEMP POLE 200 AMPS '\. TOTAL MOBILE HOME \. MICO-FILM I I I • I OVER 200 AMPS ' '\. I I I • I TEMP OCCUPANCY (30 DAYSI '\ I ' I I I T--.. -?.nn ·-,....,...,._.;,... .... I I I ./17 TOTAL ELECTRICAL TOTAL FEES PAYABLE I . CONTRACTOR I I ,L, ,I r1 • I HAVE CAREFULLY EXAMINED THE COMPLETED "'APPLICATION AND PERMIT, ANO DO •AN OSHA PERMIT 1S REQUIRED FOR EXCAVATIONS OVER HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE ANO CORRECT ANO l 5'-0" DEEP ANO DEMOLITION OR CONSTRUCTION OF FURTHER CERTIFY ANO AGREE IF A PERMIT IS ISSUEO;TO COMPLY WITH ALL CITY. STRUCTURES OVER 3STORIES IN HEIGHT school fees: COUNTY ANO STATE LAWS GOVERNING BUILDING CONSTRUCTION. WHETHER SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY ANO KEEP HARM-I LESS THE CITY OF CAR LS BAD AGAINST ALL LIABILITIES, JUDGMENTS. COSTS ANO -I EXPENSES WHICH MAY JN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. APPLt?Jrut·~RP OWNE:,C:,,-... CONTRACTOR□ AP ~-/3-fllATE AGENT D BY PHONE 0 ! ~ ~ ;:: ~ "-V) ~ ;" INTERDEPARTMENTAL INFORMATION SHEET BUILDING DEPARTMENT BUILDING ADDRESS: PLANNING DEPARTMENT RECEIVED DATE: _.,....FE'"""'B-· -1 -1 ~i --~,:3-" -- CITY OF CARLSBAD Buifding Department ZONE _________ LOT SIZE _________ LOT WIDTH _________ _ UNITS ALLOWED UNITS PROVIDED -------------------------- PARKING SPACES REQUIRED PROVIDED ---------------------- _____________ PROVIDED % COVERAGE ALLOWED BUILDING HEIGHT ALLOWED FRONT SETBACK: ALLOWED PROVIDED -------- INTRUSIONS ___________ PROVIDED SIDE SETBACK: REAR SETBACK: ~LANDSCAPE & IRRIGATION PLAN COMMENTS: ENVIRONMENTAL PROTECTION REQ: ADDITIONAL COMMENTS: OK TO ISSUE, ~~ DATE*~ OK TO FINAL _______ DATE ___ _ ENGINEERING DEPARTMENT R.O.W. INDUSTRIAL WASTE IMPROVEMENTS --------------------- SEWER CONNECTION GRADING PERMIT LEGAL DESCRIPTION_(Z::.2'.J~_!_.L-_.£.~~2t.~.__Jil..!..._ _ __:__+------------- PWI OK TO FINAL DATE _,_...,........,...___ ------------ FIRE DEPARTMENT SPRINKLING SYSTEM ____________ FIRE PROTECTION EQUIP. _______ _ FIRE ALARJl!S EXITS ________________ _ ~. FIRE HYDRANTS LOCATION __________________ _ ~ADDITIONAL COMMENTS OK TO ISSUE: DATE OK TO FINAL DATE ----------------------- WATER DEPARTMENT REQUIREMENTS OF APPROPRIATE DISTRICTS MET ________ DATE ________ _ ---• -90.zr- Plot-P\o."' I ,f-- <]» -Lot-!'l J LA COSTA '.::C)un-\ , )1" I , ~5'9 ➔ B = 3 -/0-, I r ,,, . OE<:.\<--s.1..p,..g I r{\ I ef\ ' . C\( ,so' C\{ C'4 I ('\{ \ /01 - I -/() .i ~70'➔ J ::r H()(.JSE "< ~ ' • t too' i -qo'-------12.503/ L..Pr loS;-A A-uF BUILDING DEPARTMENT ::, ' COMPLAINT AND/OR REQUEST FORM Complaint and/or Request: :J .>dz' ~ ~,c.., ~-- ~~a~{rrhzfp,~JP1·~+/4k Name of Complaintant:7d':~ ~_,..... . _ . Address: £,;lf }J,-a:L . ~ ;e;;..f 5. ~ c.l- Phone: ~::J{-F 9 ti I Date Received: __ ~'/4~:;g~,/4u',l"~~g--By Whom:_~/44.,--'-"~~'-=·-----------, 7 Referred to:_-J.--='""'------------------------- Action Taken: 1 / -~c/J)_ y/;JP. JVJTt/JN Nature and Date of Notification of · Action to complaintant or Petitioner: ------------------ PLEASE RETURN THIS COPY TO THE BUILDING DEPARTME?lT, WITH NOTATION AS TO ACTION TAKEN.