HomeMy WebLinkAbout2538 JEFFERSON ST; MULTI-PERMIT FILE; CB971655; Permit~ . ..
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S~{, 1lGN 106.4.4
DATE SIGNATURE.....,.....,. __ __,
.L.Vt::, LaS PaLmas Ur u:F CARLSBAD
., lsbad, CA 92009 (619) 438-1161
FOR OFFICE USE ONL V
PERMl1 APPLICATION PLAN CHECK NO. 9 71@5'°5
CITY OF CARLSBAD BUILDING DEPARTMENT
2075 Las Palmas Dr., Carlsbad CA 92009
(760) 438-1161
1. PRO.iECT INFORMATION
Business Name (et this 1ddressl
Legal Description Unit No. Phase No. Total I of units
Assessor's Parcel I
Description of Work SO. FT. lot Stories 7 I of Bedrooms I of Bathrooms
'2. CONTACT PERSON ht dlff.,..,t from appllcllrlt) , ... I r I
Name
5. -APPLICANT . 0 comri"otor
Address City
Agent tot Conti'ictor )i{ownir'"O Agentfor 'owner'" ' -v=
Stete/Zip
1-....
Telephone I Fax I
Name Address State/Zip Telephone I
'4. .... ,. ... ~
Telephone I
(Sec. 7031.5 Business end Professions Code: Any City or County which requires e permit to construct, alter, Improve, demolish or repair any structure, prior to Its
is1uence, 1110 requires the 1pplic1nt for such permit to file I signed statement thlt he is licensed pursuant to the provisions of the Contractor's License Law
(Chapter 9, commending with Section 7000 of Division 3 of the Busine11 end Prof111ions Code) or that he is exempt therefrom, end the b11i1 for the elleged
exemption. y violation of Section 7031 .6 by any applicant for• permit subjects the epplicent to I civil penelty of not more then five hundred dollars 1•600)1.
Name Address City State/Zip Telephone I
State License I ----------License Cless ----------City Business License I--------
Designer Name Address City State/Zip Telephone
State License I----------
6. WORKERS' COMPENSATION ---.... ''"t l
Workers' Compen11tion Oecleretion: I hereby affirm under penalty of perjury one of the following decl1rations:
0 I have end will maintain I certificate of consent to self-insure for workers' compensation IS provided by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
0 I have end will maintain workers' compensation, es required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued. My worker's compensetion insurance carrier end policy number ere:
Insurance Company Policy No. ___________ _ Expiration Date _______ _
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS)
0 CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shell not employ any person in any manner so H
to become subject to the Workers' Compensation Laws of C1liforni1.
WARNING: Failure to Hcur1 workera' compen .. tlon cover,ge la unlewful, end lhlll 1ubject 111 employer to crlmlnel penettle1 end civil fine• up to one hundred
thousand doller• ($100,0001, In llddltlon to the cost of compen111tlon, dernege1 u provided for In Section 3706 of the Labor code, Interest end ettomey·, fH1.
SIGNATURE DATE----------
7. OWNER-BUILDER DECLARATION •· •
I hereby affirm that I am exempt from the Contractor's License Law for the following reeson:
, .. .,.
O I, as owner of the property or my employees with w1ges IS their sole compensation, will do the work end the structure is not intended or offered for sale
(Sec. 7044, Business ind Professions Code: The Contractor's License Lew does not 1pply to ,n owner of property who builds or Improves thereon, ind who does
such work himself or through his own employees, provided th1t such improvements ,re not intended or offered for sale. If, however, the building or improvement is
sold within one year of completion, the owner-builder will hive the burden of proving th1t he did not build or improve for the purpose of 11le).
~ I, es owner of the property, em exclusively contracting with licensed contrectors to construct the project !Sec. 7044, Business end Professions Code: The
Contractor's License Law does not 1pply to 1n owner of property who builds or improves thereon, end contracts for such projects with contractor(sl licensed
pursuant to the Contractor's License L1wl.
O I em exempt under Section ------Business ind Professions Code for this r.ieson:
1.
2.
3.
I ~ly pl1n to provide the m1jor l1bor end materiels for construction of the proposed property lmprovement)i:t'YES ONO
I ~ave notl signed en 1pplic1tion for • building permit for the proposed work.
I have contrac with the following persqn (firm) to provide the proposed construction (include neme I 1ddr111 I phone number I contrectors license number):
4. I plan to provide portions of the work, but I have hired the following person to coordinete, supervise ind provide the mejor work (include neme I 1ddress I phone
number I contractors license numberl=----------------------------------------------
5. I will provide some of the work, but I hive contrected (hired) the f wing persons to provide the work indiceted (include n1me / 1ddress I phone number I type
ofworkl: _________ -+-+-------"1'--,----,,c...--1------------------,::--,'"-:---,--..,...---------~
Is the epplicent or future buil
progrem under Sections 255
required to submit • business plen, ,cutely hezerdous m1teri1ls registration form or risk m1n1gement end prevention
25534 of the Presley-Tenner H1zerdous Substence Account Act7 0 YES O NO
Is the applicant or future building occup1m required to obteln • permit from the air pollution control district or 1ir quality management district? 0 YES O NO
Is the facility to be constructad within 1,000 feet of the outer bound1ry of • school site? 0 YES O NO
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE
REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES ANO THE AIR POLLUTION CONTROL DISTRICT.
•...,...:-"' ·--
I hereby affirm th1t there Is I construction landing 1gency for the performence of the work for which this permit Is issued (Sec. 3097(il Civil Code).
LENDER'S NAME _____________ _ LENDER'S ADDRESS------------------------
I certify thet I hive reed the applicetion end stet• th1t the 1bove lnform1tion is correct end thet the into,m1tion on the plans is eccurate. I egrH to comply with ell
City ordinences end Stete lews releting to building construction. I hereby 1uthorize represent1tiv11 of the Citt of C1rl1b1d to enter upon the ebove mentioned
property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST AU LIABILITIES,
JUDGMENTS, COSTS ANO EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
OSHA: An OSHA permit is required for excevetions over 5'0" deep end demolition or construction of structures over 3 stories in height.
EXPIRATION: Every permit issue by the Bullding Official under the rovlslons of this Code shell expire by limitation and become null and void if the building or
work euthorized by such permit i ot commenced hin 366 d ro the dete of such permit or If the building or work authorized by such permit Is suspended
or abandoned et any time 1fter riod o 80 deys (Section 106.4.4 Unlfor'.'1 Building Code). 0 / . #"'I
APPLICANT'S SIGNATURE DATE ~~y:J:z
PERMIT# CB971655
DESCRIPTION: UPGRADED SERVICE
TYPE: ELEC
CITY OF CARLSBAD
INSPECTION REQUEST
FOR 06/23/97
60 TO 200 AMP
INSPECTOR AREA
PLANCK# CB971655
OCC GRP
JOB ADDRESS: 2538
APPLICANT: LAWRENCE,
CONTRACTOR:
JEFFERSON ST
JERRY
STE:
CONSTR. TYPE NEW
LOT:
PHONE: 760 749-2662
OWNER:
REMARKS: R/STEVE/273-8421
SPECIAL INSTRUCT:
TOTAL TIME:
CD LVL DESCRIPTION
DATE DESCRIPTION
PHONE: t)
PHONE: /
INSPECTOR /-~-----,ir~~~~~~~~~~
***** INSPECTION HISTORY*****
ACT INSP COMMENTS
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O I hereby affirm that I am licensed under
provisions of Chapter 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 alhrm th.al I am exempt from the Contrac·
tor's License Law 10< the followmg reason (Sec 7031.5 Business and Professions Code:. Any city or county w~ich re-quires a permit to construct. alter. improve. demohsh. or repair any structure, p_rior to. its issuance also requires !heap·
plicant lor such permit to Ille a signed statement that he Is licensed pursuant to the prov1s,ons of the Contractof's Ucense Law (Chapter 9 commencing with Sect,on 7000 of
Divos,on 3 ol lhe Busmess and Protess,ons Code) 0< that Is ex· empl therefrom and the basis fo, the alleged exemphon, Any
voolahon ol Sechon 7031.5 by an applicant lor a perm,1 sub·
,ects the applicant to a civ'1l penalty of not more t~n hve hun-dred dollars (S500)
D I, as owner ot the property. or my empl"Y""S wolh wages
as their sole compensation, will do the w0<k, and the Slruc·
lure 1s no11n1ended or offered for sale (Sec. 7044, Business
and Proless,ons Code, The con1racl0<' s Locense Law does not apply lo an owner ot property who builds 0< improves
thereon and wllo does such work homsett Of through his own employees. provided Ill.al such Improvements are nol lnlend·
ed 0< ottered lor sale, 11. however tile building 0< lmpiove-ment is sold w,thm one year ot completion, the owner-builder
will have the burden ot proving lhal he dod not build or im-prove 10< lhe purpose ot sale)
~.~i,t:.:i"~n~:a~~r~rt«::,tr~~t :;'~~~:r 1i:1r~°r:!~~
Business and Prolessions Code: Tile Conlract0<'s License Law does not apply lo an owner ot property who builds or Im· p,oves thereon, and who contracts 10< each projects wolh a
contract0<(s) license pursuant to lhe Contractor's License Law).
D As a homeowner I am Improving my home. and the follow· Ing cond1hons exist: t l~a~:~rl~ :11r= f~or:~~·months
prior to compttllon ot lh,s work
I have not clalmed lhos exemptoon during the last three years.
D I am exempt under Sec. , 8 & P.C tor this reason ____________ _
D I hereby affirm that 1 ha'te a cert1t,cate of consent
to self.insure, or a certificate of Workers
Compensation Insurance, or a cer11t1ed copy thereat
(Sec 3800. Labo< Code)
POLICY NO
COMPANY
o Copy ,s hted Wllh ·~ rl,
0 Cen,hed copy ,s he\Wfur~shed
CERTIFICATl oJ EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed 1f the permit
1s tor one hundred dollars (S 100) or less)
0 I cen1ty that ,n the performance ot the wont for
which this permit 1s issued, I shall not employ any
person in any manner so a.s 10 become sub1ec1 to
the Wonters· Compensation Laws of Callforn1a
NOTICE TO APPLICANT 11. alter makon~ lhos Gen,
hcate of Exemption. you should become subJect t'l
the Workers· Compensation provisions of the Labor
Code. you musl forthwith comply w1tn such
provisions or this permit shall be deemed revoked
0 I hereby affirm that there 1s a construction
1enoino agency tor the performance of 1he wo°' tor which 1h,s perm11 ,s ,ssued ISec J097 C,v,t Code)
Lenders Name ____________ _
lender s Address A~
USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT 1200 Elm, Carlsbad, California 92008-1989 (714) 438-5525
JOB AOORESS --::se_ f' f' e !2.S 01\J A~i.T-,0;;:7:L~ONI
BUSII lvSE# VALUATION PERMIT NUMBER
2S~X I z:, / ~3 OWNER'S NAME
, 7~W:E;H,? ~l~+-k\Y~ (~ ' CON TR JTORS PHONE • ZONE
( ud royz c-l N..t'"\QQ_\~ l lAVYlbtl'\C. !??..3000
OWNER'S I\IIAJLING AOORESS CONTRACTOR'S ADDRESS I LICENSE NO. PLAN 1.0. # BLOG USE CODE
S)q.me. lxl ~ ~c, ~,\ \ 2'-/ t.,'J i~
LOT BLOCK j sueo1v,s,0N I ASSESSOR PARCEL NO. DESIGNER LICENSE # STANDARD PLAN# BUILDING SO. FOOT AGE
·3~ DESCRIPTION OF WORK
-DESIGNER'S ADDRESS DESIGNER'S PHONE -c~ 1o.±ev-c.. ..W-eAek.-,< ep I AC£ rn~-e..to t-F/P FLRELEV. NO OCC GP EDU .!./ STORIES L,' 'f "'.-'
vO NO ' .1 .' /• + --
CENSUS TRACT I GP LANO USE I PARKING SPACE I RES UNITS I GRADING ~ERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRE SPA AREA CONST
YO N 0 vO NO vO NO Not Valid Unlffr Machine <Artifitd
QTY. PLUMBING PERMIT -ISSUE 7-E:-QTY. MECHANICAL PERMIT· ISSUE ."5'~ SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP
, INSTALL FURN. DUCTS UP TO 100,000 BTU BUILDING PERMIT 01-00-00-8220 -
EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT 01 ·00·00·8221 -I EACH WATER HEATER ANO/OR VENT 7 :5.LJ BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01 ·00·00·8806 ----
EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3·15 HP TOTAL PLUMBING 01 ·00·00-8222 /O~()-G
EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE ELECTRICAL 01 ·00·00·8223 -.. ~ EACH INSTAl . ALTER. REPAIR WATER PIPE VENT FAN SINGLE OUCT MECHANICAL 01 ·00·00-8224
EACH VACUUM BREAKER MECH EXHAUST -Hl)OO!QM(TS__.--MOBILEHOME 01 ·00·00·8225
WATER SOFTNER RELOCATION f<'1>. ~E/HEATER MOBILEHOME PARK INSP
EACH ROOF DRAIN (INSIDE) /? '-"-:)"'/ C:nl 4R n1 .nn-nn.Roo~
7otYC
~tCHANICAL STRONG MOTION 80·92·33·0519 ----.. --·-r /f' TOTAL PLUMBING FIRE SPRINKLERS 01 ·00·00-8227
o-<L~-I~ / PUBLIC FACILITIES FEE 32·00·00·8923 QTY. ELECTRICAL PERMIT · ISSUE SOLAR · ISSUE
BRIDGE FEE
NEW CONST EA AMP/SWT,BKR A IJ\?-"' COLLECTORS SCHOOL FEE • DISTRICT
~--
-·--· -··
1 PH 3 PH STORAGE TANKS Carlsbad 80·92-21-0519
EXIST BLOG EA AMP/SWT/BKR ROCK STORAGE Encinitas 80·92·22·0519
1 PH 3 PH i PUMP San Dieguito 80·92·23·0519 ~ ·---REMODEL/AL TEA PER CIRCUIT PLAN CHECK FEE ' San Marcos 80·92·24·0519 -------
TEMP POLE 200 AMPS ----------~--
OVER 200 AMPS ----
TEMP OCCUPANCY (30 OAYS) -
' --.--·-------
!~-----. -1 -~ ---. -~------
TOTAL ELECTRICAL TOTAL SOLAR TOTAL FEES PAYABLE I "20.4-0
I HAVE CAREFULLY EXAMINED THE COMPLETED 'APPLICATION AND PERMIT'' AND DO HEREBY Expiration. Every permit inued by the Building Ofllc,al under the provisions ofth11 * AN OSHA PERMIT IS REQUIAEO FOR EXCAVATIONS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall exp,re by 1,m,talion end become null and void II the building or wort< 5' O" DEEP AND OEMOl.lTION 0A CONSTMICTION OF
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS authorized by such permit is not commenced w,thon 180 days from the date ot such STAUCl\JAES OY£A 3 STORIES IN HEIGHT permit. or 1t the buildi~r work autho11Zad by such permit ,s suspended or ISSUED: TO COMPLY WITH ALL CITY. COUNTY AND STATE LAWS GOVERNING BUILDING CON· abandoned at any lime a the work ,s commenced for a oerlod of 180 "•u•
STRUCTION. WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND
APPLICA,NT'S SIG~ATU~ d OWNER0 CONTRACTO~ APPROVED BY a ~3
KEEP HARMLESS THE CITY OF CARLSBAD A<!AINST ALL LIABILITIES, JUDGMENTS, COSTS AND
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE (/_,,p_Jj~ r, . ~/b BY PHONE 0 GRANTING OF THIS PERMIT
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INSPECTION TYPE DATE INSPECTOR
BUILDING
-FOUNDATION
REINFORCED STEEL
MASONRY
GUNITE OR GROUT
FLOOR & CEILING SUB FRAME ;
SHEATHING I
I
FRAME
EXTERIOR LATH lNSULATION I
INTERIOR LATH & DRYWALL '
PLUMBING I --
SEWER AND BL/CO
PLUMBING UNDERGROUND I
PLUMBING TOP OUT I
I
TUB AND $HOWER PAN I
I
GAS TEST I!
ELECTRICAL I
I ,
TEMPORARY POWER I .
ELECTRIC UNDERGROUND 1•
ROUGH ELECTRIC r
I ...
ELECTRIC SERVICE . I
BONDING I
G. F. I. -SMOKE DETECTOR
MECHANICAL
DUCT & PLEM., REF. PIPING
HEAT -AIR CONO. -SOLAR SYSTEMS
VENTILATING SYSTEMS
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE BEEN APPROVED.
JOB SITE FINAL ----PLUMBING 1~·14~ ~
ELECTRICAL .
' MECHANICAL
GAS
BUILDING
SPECIAL CONDITIONS l
CERT OF OCCUPANCY ISSUED . '
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS
INSPEC TION REO. IF INSPECTOR'S
C HECKED APPROVAL
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRESTRESSED
CONCRETE
POST TENSIONED
CONCRETE
FIELD WELDING
HIGH STRENGTH
BOLTS
SPECIAL MASONRY
\ • PILES CAISSONS
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INSPECTOR"S NOTES
DATE
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