HomeMy WebLinkAbout2507 NAVARRA DR; ; 81-135; PermitLICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provi-
sions of Chapter 9 (commencing wilh Section
7000) of Division 3 of the Business and Profes•
slons Code, and my license is in full force and ef·
feet.
OWNER-BUILDER DECLARATION
DI hereby allirm 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 county which reQuires a permit to con•
struct, alter, improve, demolish, or repair any
structure, prior to its issuance also reQui the
applicant for such permit to file a si d state•
ment that he is licensed pursuant the provi-
sions of the Contracto~ Licens aw (Chapter 9
commencing with ffi!iqliO(l 7 of Division 3 of
the Business andf'rolessi Code) or that is ex-
empt therefrom a' t' ·s for the alleged ex·
emption. Any viola t Sec ·on 7031.5 by an ap·
plicant for a permi su jects he applicant to a
civil pe~.•.Y ~not re han live hundred dollars
($500). \'-. ~
L' I, as o~' tlf o the roperty, or my employees
with wage\~· t~eir s le comp.ensation, will do
the work, a e·structure is not intended or of•
fered for sa c. 7044, Business and Profes-
sions Code: e Contractor's License Law does
not apply to a 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 will have the~urdef\oi_p'):>Vif!.9 tpat
he did not build or impro~ tor .. ~~ur~\f pf sale). •·
=i, as owner of the property, a e
tracting with licensed contrac s to !
the project {Sec. 7044, Business Pro ions
Code: The Contractor's Lrcens~ L: es t ap-
ply to an owner of property: :\ho builds or rm•
proves thereon, and who ~ts for such pro-
jects with a contractor(s) se pursuant to the
contractor's License Law). '
I am exempt under Sec _____ , B. & P.C.
for this reason, ____________ _
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of con·
sent to self-insure, or a certificate of Workers'
Compensa ion Insurance, or a certified copy
thereof c. 3800, Labor Code) 6gu A~Yo .. _ ------------
opy is filed with the city.
C Certified copy is hereby furnished
(This section need not ~e pie! he per·
mit is for one h_u re~ dol~.r's ( or less).
I certify that int e P8rlo of the work for
which this per,nit I iss; , shall t employ an. y
person in any r:i;i•~nn rs as o become subJect to
the Workers' ~".IP s ion Laws of California
NOTICE TO AP L~NT: If, after mak.ing this Ger·
!llicate of Exem 110n, you should become subject
to the Work.e~s· Compensation provisions of the
Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revok.ed.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction len•
ding agency for the performance of the work for
which this permit is issued (Sec. 3097, Civil Code).
CITY OF CARLSBAD-BUILDING DEPARTMENT
APPLICATION & PERMIT
USE BALL POINT PEN ONLY 1200 ELM AVENUE (714) 438-5525
"'· JOB ADDRESS AV, ST • .!DATE OF APPLICATION
l ,-S-,c-,7, ,h{,A:,\f,A, Pie ,A-, eo 4 .
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I I I I I ID,K.. -/C:,-'\'..o/
OWNER OWNER'S PHONE PRIME CONTRACTOR
/.Jl(.'o.x (k. (~ 1 de\·,, /l.-,,,.,,,, '\\ , IV' 1 '.., A-,, n 1.5~ -c..1,1t A.,, 7 /i::f,1 UI\ r,'17,/<-,
OWNER'S MAILING ADDRESS CONTRACTOR'S ADDRESS ( J-.'-i,'7 /Jc.wa.tr CJ._,, I\ r. #=-/o-5 Ctv h, ... k, ti '7:x,;1..,J 6,,t1,tft1, --· f~-~(.
COT BLOCK I suB·D1v1s10N I ASSE}S08'S PARCEL NO. t,,-=<., "'t,'f;' ~
."l, ,(,,,, -, 1,7,0 ,-, ·' )'-\ ""'-~
DESCRIPTION OF WORK 1--.. ,/61\ W.J~
DESIGNER'S ADDRESS
~C1J~"i1 ( 1 '"1''fl'"f\t.r:· ,.,, l '--,1 · \,,___:.,'l, \ , ·, -1 \..l..., ~-' L -~-::,)() 17'1 1 1 ( 'k,, 1 !1/· ',j',)1',() ,, C, .. :L ~
CENSUS TRACT GP LAND USE ' ZONING
APPLICANT TO FILL IN INFOR -
MATION WITHIN RED LINES.
BUS. L lCENSE PERMIT NUMBER
.:)" ry • "<
STATE LICENSE f/✓!.3~,/ I :z..,1_ ,, i~ --
CONTRACTOR'S ) llfZfJ.:)&or
STATE LICENSE
·-'£!1.7(J' ,.,1,../81~~(:i
DESIGNER'S PHONE
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" .
I RES, UNITS ·1 P;RKING SPACE sf I NUMBER OF STORIES
Nat Va.id Unless Machine Cartifi«t
BLDG SQ. FT. BLOG USE occ. GP I STANDARD PLAN -1t ['?;;'~~33-I TYPE CONST l occ. LOAD
I
QTY. PLUMBING PERMIT AMT. QTY. MECHANICAL PERMIT AMT.
EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100.000 BTU
EACH BUILDING SEWER ~.,f/V . OVER 100,000 BTU
I EACH WATER HEATER AND/DR VENT P,,OL / BOILER/COMPRESSOR UP TO 3 HP
J EACH GAS SYSTEM 1 TO 4 OUTLETS --7/.1'' BOILER/COMPRESSOR 3-15 HP = EACH GAS SYSTEM 5 OR MORE . BOILER/COMPRESSOR 16-30 HP
/ EACH INSTAL., ALTER. REPAIR WATER PIPE -Z..'1 VENT FAN SINGLE DUCT
EACH LAWN SPRINKLER SYSTEM MECH EXHAUST -HOOD/DUCTS u o, n A " rrn,T . / 1./ 0 0 · -, . .,
WATER SOFTNER RELOCATION Of EA FURNACE/HEATER BUILDING PERMIT -----I I AP_;,..-
ISSUE .'t.UI 1::,::,ui:: 7, AA SIGN PERMIT/.4 ' "\J f I' .
TOTAL PLUMBING
0~ v TOTAL MECHANICAL PLAN CHE~{' 7,/ 0 //,..L3r 1' • I I I
CONTRACTOR -;. CONTRACTOR ALL INCLUSIVE PERMIT I I
TOTAL PLUMBING I IC;<• '
QTY. ELECTRICAL PERMIT AMT. -; QTY. MOBILE HOME PERMIT AMT. ELECTRICAL I ,...., I; rz
/ NEW CONST EA AMP/SWT/BKR A-• AWNING MECHANICAL I I,, .
' 1 PH .25 3 PH -PORCH MOBILE HOME I I • I
EXIST BLOG EA AMPISWT/BKR 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
TEMP POLE 200 AMPS TOTAL MOBILE HOME MICO-f1LM ! I I
OVER 200 AMPS I I I
TEMP OCCUPANCY (30 DAYS) I I I ' I •
Tc:cUE 2.00 C'T'Df'"T(" MnTTnN. I I I ,'?I l-'
TOTAL ELECTRICAL •73 V TOTAL FEES PAYABLE
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CONTRACTOR I I i31 e ·"' . -r
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT, ANO DO "AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER
HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I 5'-0" DEEP AND DEMOLITION OR CONSTRUCTION OF it{-t)1!t1 FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED;TO COMPLY WITH ALL CITY, STRUCTURES OVER J STORIES IN HEIGHT
COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER
SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM SCHOOL FEE: LESS 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. AhT'SSIGNATURE",d ~ OWNER□ CONTRACTOR □ I.APPR~ DATE
-_,~--, ~ AGEr-N: n SYPHONED ~ ~ 'r"f',/,f.
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SITE
ADDRESS: OWNER: PERMIT NO: I-_L3~
FIEI LD INSPECTION RECORD ---INSPECTION DATE INSPECTOR INSPECTOR'S NOTES ,====
WOOD FLOOR
FOUNDATION• FORMS• SET BACK• TOILET ~
UNDER FLOOR PLUMBING
UNDER FLOOR HEATING ~
OK TO INSTALL SUB FLOOR t--------
SLAB FLOOR ~
UNDER SLAB PLUMBING t--------
FOOTING • FORMS• SETBACK • TOILET
OK TO POUR CONCRETE ~
' ~
FRAME .. ./ /7
ROUGH ELECTRICAL 11 ·, J t--------
ROUGH PLUMBING y ..... , 11 .. .. \
t--------
ROUGH HEATING/VENTILATING
FRAME OK• PLACE INSULATION t--------
INSULATION OK • PLACE WALLBOARD t--------
WALLBOARD OK• PLACE TAPE
EXTEiRIOR LATH OK• PLACE STUCCO t--------
~
Fl REPLACE
DAMPER & STEEL ~
PLATE TIES/HEIGHT OF CHIMNEY t--------
OTHER t--------
TEMP POWER (POLE) t--------
SEWER
GAS TEST t--------
SWIM _POOL • STEEL BONDING t--------
• PRE DECK
• FENCE PREPLASTER t--------
SHOWN • FRAME
~
• PAN .
FINAL INSP BY BLDG DEPT ..,,--,J t--------
OTHER DEPT'? REQ COMPLETED /, I ✓ -t--------
· E.LEC METER-PERM-TEMP ·;, 'f (JJ // ,I
1 ~ A.S METER-PERM-TEMP J I UI y·/'jll.l t--------
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!---~ t--------
L I t-------->---
( CERT 0~ OCCUPANCY ISSUED -
INTERDEPARTMENTAL INFORMATION SHEET
BUILDING DEPARTMENT
BUILDING ADDREss, ,2ScJ 7 4aAt--7-vVk-t?, /
APR lo 1981
CITY OF C.AiRLSBAO
Building Department
PLANNING DEPARTMENT
ZONE _________ LOT S IZE _________ LOT WIDTH. ________ _
UNITS ALLOWED ___________ UNITS PROVIDED ____________ _
PARKING SPACES REQUIRED __________ PROVIDED __________ _
% COVERAGE ALLOWED _____________ PROVIDED __________ _
BUILDING HEIGHT ALLOWED __________ PROVIDED __________ _
FRONT SETBACK: SIDE SETBACK: REAR SETBACK:
ALLOWED ______ _
PROVIDED ______ _
' INTRUSIONS
L4NDSCAPE & IRRIGATION PLAN COMMENTS:
ENVIRONMENTAL PROTECTION REQ:
ENGINEERING DEPARTMENT •(Jri'~'4:
R.o.w. ______ INDUSTRIAL WASTE _______ IMPROVEMENTS _______ _
SEWER CONNECTION /c OU (s DRIVEWAY LOCATIONS ------------
GRADING PERMIT ___ EASEMENTS. _________ DRAINAGE. ____ _
LEGAL DES CRIP T ION ______ ~:c._,_,_/-"'C,'-'-=---'-/ __,7'--=Q--_=5''-""_3=-----------
ADDI TI ON AL COMMEN!S ____________________________ _ . -
FIRE DEPARTMENT
SPRINKLING SYSTEM ___________ FIRE PROTECTION EQUIP. _______ _
FIRE ALARMS EXITS _______________ _
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