HomeMy WebLinkAbout2556 NAVARRA DR; BLDG 1; 81-430; PermitCl) z 0 ~ a: ~ ~ Q
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.-f] I 11er..,_, affirm that I am llcensad under
pro¥1slons of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and ProfHslons Code, and my license Is In
full fon:e and effect. lie No _______ Class
I hereby affirm that I am exempt lrom the Con-
~~<>{Bu~f:':: ~-~.~':1:~~ ~i~
county which requires a permit to construct
alter, improye, demolish. or repair any structure,
prior to its issuance also requires the applicant for
such pemut to me a signed staten,e,nl that he is licensed pursuant to the pr0Yis1ons of the Con·
tr1etor's License Law (Chapter 9 commencing with Section 7000 of D1v1sk>o 3 of the Business and Pro--
fessions Code) or that is exempt therefrom and the
basis for the alleged examphon. Any vK>la1ion of Section 7031.5 by an applicant tor a permil subjects
tne applicant to a civil penalty of not more than five hundred dollars ($500).
a I, as owner of the property, or my employees
,.,th wages as their sole compensation. will do the wonc. and the structure is not intended or offered fo, SMe (Sec. 7044, Business and Professions Code:
The Contractor's License Uw does not apply to an
owner of property who builds or 1mpr0Yes thereon
and who does such wonc. himseft °' through his own
empk,yees. provided that such improvements are not mtende1 °' offered for saJe If, however, the
building °' improvement is sold w1thm one year of
completion. the owner-builder will have the burden or proving that he did not buHd or improve fOf the
pul'J>O$e of salef.
□ I, as owner ol the property, am exclusively
contracting with licensed contr~tOfs to construct the p,o,ect (Sec. 7°"4, Business and Pl'oless,ons Code: The ContractOf's License Law does not apply
to an owner of property who builds or improYeS
thereon, and who contracts for each proteets with a
contract0f1s) license pu,suant to the Conlractor's
LK:ense Law).
0 I am exempt under Sec. ______ 8. & P.C
forth,s reason ___________ _
□ I he,eby affirm that I have a certificate of consent
to self-insure. or a certificate of Workers·
Compensation Insurance, or a certified copy thereof
(Sec 3800. Labo< Code!.
POLICY NO _________ _
;:yN1:I
□ Cert,hed copy Is hereby furn,
CERTtFICAU OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE
(This section need not be completed ,t the permit
Is tor ooe hundred dollars ($100) or less)
D I certify that 1n the performance of the work to,
which this permit 1s issued. I shall not employ any
person in any manner so as to become subJect to
the Workers· Compensation Laws of Gallfornia
NOTICE TO APPLICANT It. alter nwun1 this Cen1-
hcate of Exemphon, you shoukt become sut)Ject t'J
the Workers· Compensation prov,sIons of the Labo(
Code. you must forthwith comply with such
prov1s1ons or this permit shall be deemed rev6ked
D I hereby afhrm that there Is a construc11on tending agency tor the per1ormance of the work lor
wl"uch ttus permit ,s ,ssued (Sec 3097. C1v1I Code)
Lenoer's Name ___________ _
Lender's Address __________ _
USE BALL POINT PEN ONLY & PRESS HARD
! CARLSBA{ ~UILDING DEPARTMENT AP, J cATION & PERMIT / 1200 Elm, Carlsbad, Callfomla 92008 (714) 438-5525
" APPLICANT T~LL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
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J;::?s-t ·A/~,,. o o -A--•· Dr A~T-1 ~TE Ta APl'LICATIONI 8USINESS LICENSE # VALUATION PERMIT NUMBER
· ,l V'-/fl'-' '1J,r\ (A 71718'tJ
</1-l}-~ OWNER"S NAME ~ I OW"4Efl"S l'ttCMft l'RIME CONTRACTOR CONTRACTORS PH<1NE # ZONE
L1.. Cos " Gt 'C' /l_Q.. I'\ -' 94 \.~\ Oe .i"'° Kl\ I ()-e," vt.,",_ ... J (.. Yp ,1-l-I ,," J--
OWNER"S MAILING ADDRESS 1--J..-.s:-t .... r(.. CONTRACTOR'S ADORESS UCEN8E NO.
PL,~-:;.~
BLDG USE CODE
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LDT I BLOCK I SUBDIVISIC)N I ASSESSOR PARC£L NO. DESIGNER o....J.c_ A1A STATE LICENSE It STANOARD PLAN # eu17i,~ro~E All-(. .9, 7 J DESCRIPTION OF WORK 0.11 .u t"\ D 1C" ,. I
~ DESIGNER'S ADDRESS ~ L,,,. 'Tc..$..., DESIGNER'S PHONE l/27/627457 3 1723 ,21.J -"=t51 "'-.J:1--I
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F/P FLA ELEV. NO
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EDU " ~ vO NO --I -CENSUS TRACT I GP LAND USE I PARKING SPACE I RES UNITS I GRADING ~ERMIT ISSUED I REDEVELOPMENT l'1J. occ LOAO FIRE SPR -AREA lldl YON~ YO ND vO Ni)( Not Valid Unlffs Machine Certifi,d ,
QTY. PLUMBING PERMIT -ISSUE QTY. MECHANICAL PERMIT -ISSUE SUMMARY/ACCOUNT NUMBER _,
EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100,000 BTU BUILDING PERMIT 01-000-4220 /"f7X _ ..
EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT --01-000-4221 • I
.
PLANCHECK /~I f1' EACH WATER HEATER ANO/OR VENT BOILER/COMPRESSOR UP TO 3 HP 01-000-4806 -EACH GAS SYSTEM I TO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING 01-000·4222
EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE ELECTRICAL 01-000-4223
EACH INSTAI, .. ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01-000-4224
EACH VACUUM BREAKER MECH EXHAUST -HOOD/DUCTS MOBILEHOME 01-000-4225
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP
EACH ROOF DRAIN (INSIDE) SOLAR 01-000-4226 -TOTI.L MECHANICAL ::;TRONG MOTION 65-640·0519 ••...\ 0 I"),,()
TOTAL PLUMBING I FIRE SPRINKLERS 01-000-4227 . -,/
PUBLIC FACILITIES FEE 25·000-4933 I ~-rJ -QTY. ELECTRICAL PERMIT -ISSUE QTY. SOLAR -ISSUE BRIDGE FEE .
NEW CONST EA AMP/SWT/BKR COLLECTORS SCHOOL FEE -DISTRICT
1 PH 3 PH STORAGE TANKS / Carlsbad 65-623-0519 --
EXIST BLOG EA AMP/SWT/BKR ROCK STORAGE / \. .l Encinitas 65-624-0519 )5_ ~-"),..() --
1 PH 3 PH PUMP / v' '\ San Dieguito 65-625-0519 b'h"1.J'l-
REMODE L/ALTER PER CIRCUIT PLAN CHECK FE( ,J ~I I I San Marcos 65-626-0519
TEMP POLE 200 AMPS \ti/ V I /
OVER 200 AMPS .. 1-'d' I
TEMP OCCUPANCY (30 DAYS) " ' I I_ --
I I -,~ I./ "':JI -r-z-:>,-:,,, , ~
TOTAL ELECTRICAL I \TOTAL SOLAR I TOTAL FEES PAYABLE ,..,~,n-.. • ,,~n, ., I
I HAVE CAREFULLY EXAMINED TH&~ MAIIPUC,AllON ANO PERMIT" ANO DO HEMBY ~-'~ -/ __,llrlliellulldillgOllicltlluncllrlMpnMlloneot'lhia * AN OSHA P£AMIT IS~ FOR EXCAVATIONS OVER
CERTIFY UNDER PENALTY OF PER.IURY '$AT AU. INFORJMTION HEAEON INCUIOING lME Code 111111 expire 11r llfflilallan .... ~null Md VOlcL If Ille~ o, work 5' o·· DEEP ANO OEM0UTION OR CONSTRUCTION Of' aithorlnd llylUCII penllitlanal__,_.~ 1•deretrOM.. OflUCII DECLARATIONS ARE TRUE AND ~AND I FURTHERCER1'1P'f ANO AGREE'IF A PEIIMIT IS permit, 01 II Ille ,~..,:ar" ......_, 11r tuc:11 permit la or STRUCl\lAES OY£R 3 STONES .. HEIGHT
ISSUED, TO COMPLY WITH ALL CITY, COUNTY ANO STATE LAWS GOVERNING 8UllOIN8 CON-ablndolied .. ---·--.. , _ .......... ,,, ·~ ~-STfflJCTION, WHETMER Sf'ECIFIED HEREIN ~ NOT. I ALSO MiRl:E TO SAYE INDEMNIFY ANO ~~v qwtaO CONTRACTOR (Y' ~ 1%/t-i--KEEP HARMLESS THE CITY OF CMIMQ~T ALL l,IA8IUTJEI.JUOGMEN1S. COSl8 AND
EXPENSES WHICH ~VIN~ WAY-~ . .-c:,rl. IN CONSEQUENCE 0,-THE BYPHONE 0 GRANTING OF THIS PEAMIT. ._, ..
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INSPECTION TYPE DATE INSPECTOR
BUILDING I
'
FOUNDATION I
I
REINFORCED STEEL '
MASONRY I I
GUNITE OR GROUT I
FLOOR & CEILING SUB FRAME I
SHEATHING I
I
FRAME !
EXTERIOR LATH lNSULATION I
INTERIOR LATH & DRYWALL I
I
PLUMBING I .
SEWER AND BL/CO I
PLUMBING UNDERGROUND I
' PLUMBING TOP OUT I .
TUB AND $HOWER PAN i
GAS TEST I i
ELECTRICAL '
TEMPORARY POWER
ELECTRIC UNDERGROUND
ROUGH ELECTRIC
ELECTRIC SERVICE
BONDING A
G. F. I. -SMOKE DETECTOR I I
MECHANICAL I
DUCT & PLEM., REF. PIPING
HEAT -AIR COND. -SOLAR SYSTEMS ~~-➔·• .
VENTILATING SYSTEMS .. •-. I
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HA VE BEEN-APPROVED.
JOB SITE FINAL I • l
PLUMBING I
ELECTRICAL ~
MECHANICAL
-
GAS > , ,, --\ I\ \
BUILDING V \
SPECIAL CONDITIONS \
CERT OF ocr-• 'PANCY ISSUED I --~
'
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS
INSPECTION REO IF INSPECTOR'S DATE CHECKED 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 I ' C .
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O I h8febt affirm that I aln licensed under
pro-,lalona of Chapter 9 (commencing with
Section 7000) of Division 3 of the Buslnesa
and Profeaalona Code, and my license Is In
lull force and effect. Lie No _____ Class _____ _
I hereby affirm that t am exempt from the Con· ~tr~~!~:=~ ~1:::~~i~
county which requires a pe,mit to construct .iter, improve, demofish. or repatr any struclure, pnor to its 1sso.nce also requires the IIPPficant for
such permit to file a s1goed statement that he ,s
licensed pursuant to the pro-,,s,ons of the Con-tractor's License Law (Chapter 9 commencing with
Sectk>n 7{XX) of DivislOI\ 3 of ttle Business and Pro-
fnst0ns Code} or that 1s exempt therefrom and the
basis fOf the aUeged exemption. Any violation of
Section 7031.5 by"" applicant for a permit subjects tne applicant to a civil penalty ot not mo,e than five
hundred dollars ~
□ I, as owner of the property, or my employees
-..,th wages as their sole compensation, will do the wort.;, and the structure is nor intended o, offered for
sale (Sec. ,-, Business anil ProfesslOhs Code: The Contractor's License Law does not apply to an
owner of property who builds or improo,es thereon
and who does such work himself or throogh his own
employees. provtded that such ,mprOYemeiits are
not intende1 or offered fOf sale If, howevef, the
buitding o, improvement Is sok1 w1th1n one year of
completK>n. the owner-buikSer will haYe the burden
of prOYing that he did not build or improve for the
purpose of salef
C I. as owner of the property, am exclusi~y
contr.c:ting with licensed contr~tOfs to construct the p,OfllCt (Sec. 7044, Business and Professions
Code: The Contract0<'s License Law does not apply to an owner of property who builds o, improves
~~~i~ ~~n~~:!~: ~~~\~:::-:
Ucense law).
0 I am exempt under Sec. _____ , 8. & P.C
torth,sreason ___________ _
□ I he<itby affirm that I ha''le a cert1fteaite of consent to self-insure, or a certificate of Wor1(ers·
Compensation Insurance, or a cen1fled copy thereof
(Sec. 3800, Lobo< Code).
POLICY NO ___________ _
COMPANY
□ Copy 1S hied wtth the city
□ Cert11ted copy ,s hereby turn1shed
CERTIFICA Tl OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed 1f the permit
,s for one hundred dollars ($100) or iess}
D I certify that in the performance of the wM for
which this penmt 1s issued, I shaU not employ any
person m any manner so as to become subiect to
the Wor1(ers· Compens.1hon Laws of ca11tom1a
NOTICE TO APPLICANT II, after makrn1 thrs Certr-ltcate of Exemption, you should become sub1ect t-:>
the Workers· Compensation prov1st0ns of the Labo(
Code, you must forthwith comply w1lh such
provIs,ons or tt11s permit shall be deemed revoked
0 I hereby affirm that there 1s a const,uchon lendmo agency fQf the pet1ormance of lhe wM for
which this oermIt Is issued (Sec 3097. C1v1I Code)
Lenders Name ___________ _
Lender's Address __________ _
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 (714) 438-5525 -J08ADORESS AV. ST-10ATE °" Al'PLICATIONI BUSINESS LICENSE # VALUATION PERMIT NUMBERf
,;1SS6 u,vHl'li-.. o.
11--L/-~ e OWNER'S NAME
li:,s f .. I
OWNE R"S PHONE
PAIME 'R'~Of £)~. CONTRACTOIIS PHONE t ZONE
L,. Gir~s /Y}
0-ER'S MAILING ADDRESS
c;;:.Aoro1s1A:;ES8 ~ &J~) LICENSE NO. PLAN 1.0. # BLOG USE CODE ,
p.r.,.e. ... J( tl<J.J /l.. .s.f. C,.. -' l-O b-, ru. .
LOT I BLOCK I SUBDIVISION I I o\SSESSOR PARCEL NO. DEllcJNER , STATE LICENSE It STANOARO PLAN # BUILDING SQ. FOOTAGE
fll-1~,C • s,o.o
DESCRIPTION OF WORK
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~ J DESIGNER'S ADDRESS DESIGNER"S PHONE c -tSl-.....~ -#1 /0 (/fJ ·~ J'I
'--' ~~---~---F/P F LR ELEV. NO "O._er:'o/ EDU
1ln c.~~t:--STORIES B..-1 vO NO
Cll .!:2 a. a. <
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CENSUS TRACT I GP LANO USE I PARKING SPACE I RES UNITS GRADING ~ERMtT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRE SPA AREA CONST
YO ND v O NO vO NO Not Valid Unlt1ss Machine ~,tifi,d
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QTY. PLUMBING PERMIT · ISSUE -rs~ QTY. MECHANICAL PERMIT· ISSUE ?2 .,,-SUMMARY/ACCOUNT NUMBER 0 en /1A EACH FIXTURE TRAP .-\J'Jn . .-Ill INSTALL FURN. DUCTS UP TO 100,000 BTU 4--f), .,,-BUILDING PERMIT 01 ·000-4220 --,~ EACH BUILDING SEWER -~f--OVER 100,000 BTU SIGN PERMIT 01 ·000·4221 .
en (I) en en < JIJ, -EACH WATER HEATER ANO /OR VENT .,_..r-BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01-000-4806 --J/J EACH GAS SYSTEM I TO 4 OUTLETS -i,..,_'(. -BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING 01 ·000-4222 ~ '),-~. ~ f,i I
3:
EACH GAS SYSTEM 5 OR MORE /.~ METAL FIREPLACE ~i') /' ELECTRICAL 01 ·000-4223 ·1 JU.... _r/..
EACH INSTA~ .. ALTER, REPAIR WATER PIPE lH VENT FAN SINGLE DUCT ll./\r" MECHANICAL 01 ·000-4224 /.._ra _ .. .Q
Q)
►
EACH VACUUM BREAKER MECH EXHAUST -HOOD/DUCTS V MOBILEHOME 01 ·000-4225 .
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP <h en
EACH ROOF DRAIN (INSIDE) SOLAR 01 ·000-4226
TOTJ.L MECHANICAL 1A STRONG MOTION 65·640-0519 ,.
TOTAL PLUMBING I 'fy--Y.,Jr FIRE SPRINKLERS 01 ·000·4227
ELECTRICAL PERMIT· ~SJUE QTY. SOLAR • ISSUE
PUBLIC FACILITIES FEE 25·000-4933 QTY. -i--BRIDGE FEE . I
(I)
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I NEW CONST EA AMP/SWT/BKR 'HJO h'-IIJl'J.,.., COLLECTORS SCHOOL FEE • DISTRICT (I)
0 C I 1 PH l,Pf'f ... rn j g. /y.,_// I STORAGE TANKS Carlsbad 65-623-0519 , EXIST BLOG EA AMP/SWT/BKR ,
ROCK STORAGE Encinitas 65·624-0519
Cll C u::
1 PH 3 PH PUMP San Oieguito 65·625-0519
REMOOE L/AL TER PER CIRCUIT PLAN CHECK FEE San Marcos 65·626-0519
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TEMP POLE 200 AMPS (I)
~
OVER 200 AMPS Cl
TEMP OCCUPANCY (30 DAYSI -0
TOTAL ELECTRICAL I J/U-J~ TOTAL SOLAR TOTAL FEES PAYABLE I lotJo -
I HAVE CAREFULLY EXAMINED THE COMPLETED '"APPLICATION ANO PERMIT' AND DO HEREBY &pindlon. E.-y perlllll ...._l,r11198uildlngOlllc:ial und9rlll9ptO¥islona of tht1 * AN OIIHo\ PENrlfT IS REQUIRED FOR EXCAVATIONS 0Y£II
CEATIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code ahall 8llpire br IIMllallon and becolM null and void. If Iha building or worl< 5· O" DEEP AHO OEltlOUTION 0111 CCINSTRUCT10N CW
DECLARATIONS ARE TRUE AND CORRECT ANO I FURTHER CERTIFY ANO AGREE IF A PERMIT IS aulttonzad by IUClt pem,11 ia not -•-iced ..t1hin 180 days from the oate of such STRUCTURES OVER 3 STONES IN HEIGHT permit. Of if Ille buildt=x.,o' --aullloriad by ~h permit 19 -pended or ISSUED: TO COMPLY WITH ALL CITY, COUNTY ANO STATE LAWS GOVERNING BUILDING CON-abandoned lit -11me the-" ia ~ for a.....,... of 180 "•v• I
STRUCTION, WtiETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND APPLICANp,rT~ OWNER (iilJ""" CONTRACTOR 0 APPRJ BY 1~/2 KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEOUENCE OF THE BYPHONE 0 11'1 ~-~ ~ GRANTING OF THIS PERMIT. -.l -~ $"'v-
ti a: a.
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INSPECTION TYPE DATE INSPECTOR
BUILDING . i
I
FOUNDATION l
REINFORCED STEEL I ' ,.
MASONRY !
j
GUNITE OR GROUT I
FLOOR & CEILING SUB FRAME I . I
SHEATHING ' FRAME I
EXTERIOR LATH lNSULATION I
INTERIOR LATH & DRYWALL I ·~
PLUMBING .
I --I SEWER AND BL/CO I
PLUMBING UNDERGROUND I
PLUMBING TOP OUT I I
TUB AND $HOWER PAN I
I
GAS TEST I
' ELECTRICAL I
TEMPORARY POWER I I
ELECTRIC UNDERGROUND I ' . -~
ROUGH ELECTRIC I ...
ELECTRIC SERVICE I , I
BONDING I~ I I
G. F. I. -SMOKE DETECTOR i
MECHANICAL I I
DUCT & PLEM., REF. PIPING \
; .
• i, (..,.
HEAT -AIR COND. -SOLAR SYSTEMS I. rt-L \ <
VENTILATING SYSTEMS ' \ -~ .... 1
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE BEEN APPROVED.
JOBS
PLUMBING
ELECTRICAL
MECHANICAL
GAS
BUILDING
SPECIAl:''CONDITIONS
CERT OF OCCIJPANCY ISSUED
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS
INSPECTION I REO IF INSPECTOR'S
CHECKED APPROVAL
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRESTRESSED
CONCRETE
2;sr TB'.J§IONED
NCRET'E
,·
Fl-ELD WELDING .... .. ' HIGH STRENGTH
BOLTS A
SPECIAL MASONRY
PILES CAISSONS
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INSPECTOR'S NOTES ,, -
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O I her.._,. ·,tt1nn that I am licensed under
l)l'O'llslons of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Professions Code, and my license Is In
lull force and effect. LK: No _____ Class _____ _
I hereby affirm thal I am exempt from the Con-
~~~-~!f,:':;" ~ ~f=~~ ~i~ county which requires a pennil to constn.ic1
ajter, improye. dttfooish, o, repair any structure,
prior to its issuance also requires the applicant f0t
such permit to file a signed statement that he 1s licensed pursuant to lhe provisions of the Con-
tractor·s License uw (Choj)ter 9 commencing with section 7000 ol DtvlSK>n 3 of the Business and Pro-
fessions Code) or that os exempt the<efrom and the
basis tor the ailleged exemption. Any violation of 5echon 7031.5 by an applicant for a permit subiecis
tne appHcant to a civil penalty of not more than five hundred doll;ws (S500).
Q I, as owner of the p<operty, or my employees
,..ilh wages as their sole compensation, will do the w<>nl, and the structure is not intended or offered for sale (Sec. JOU, Business and Pl'ofess,ons Code:
The Contractor"s Lteense Law does not apply to an owner of property who builds or improves thereon
and who does such wOf1t himself Of through his own
emptoyees, proYided that such 1mprovemeilts are not intende1 or offered for Some. If, however, the
buitding or ,mprovement is sold within one yu,: of
completion, the owner-buitder will haYe the burden of proving lhllt ~ dtd not build or improve for the
purpose ot sale).
C I, as owner of the property, am exclusively contracti'li with licensed contr~tors to construct
the pro,ect (Sec. 7044. Business and Professions Code: The Contractor's license Law does not apply
to an owner of property who builds or improves ~:r~i~ ~~nc:~:!~~ ~:=~t!'~~~.;!:-:
License Law}.
0 I am exempt unde< Sec._----· 8. & P.C.
forth1sreason ___________ _
□ I hereby affirm lhat I have a cert1hcate of consent
to selt-,nsure, or a cer1iricate of Workers·
Compensation Insurance. Of a cef'11hed copy thereof
1sec 3800, ut,_p, Codet.
>Mi)(NY
IS filed with !he City w
0 Certified CoPy 1s hereby furnished
CERTIFICATl OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This sechon need not be completed 1f the permit
1s tor one hundred dOllars ($100) Of ~ss)
D I cert,ly that 1n the performance of the wotk tor
which this pem11t ,s issued. 1 shall not employ any person 1n any ~nner so as to become sub1ect to
lhe Wor1(ers· Compensa.lton Laws of Cahfornia
NOTICE TO APPLICANT II. after makm;i this Cert1-
hcate of Exemption, you shoufd become subject t?
the Workers· Compensation prov1st00s of the Labor
Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked
D I hereby affirm that there 1s a construction
lending ~ency l()f the performance of lhe wot1( for
which tn,s pemut ,s 1ssued (Sec 3097. C1v1I Coc:le)
Lender's Name ___________ _
Lenders Address __________ _
U'"'L un•• 1 v1n1 t Ln vnLJ a l"ftL..J'"' """u , .... ... ,. .. ___ ,, .... --------------·-·· -· ·-. .. --
CARLSBAD-.,U ILDING DEPARTMENT APt J cATION & PERMIT 1200 Elm, Carlsbad, Callfomla 92008 (714) 438-5525
JOB ADDRESS
A) If ,J It t? /j .fl AV. ST.I DAT½ APPLICATIONI BUSINESS LICENSE # VALUATION -~ PERMIT NUMBER ~ss-, RD. l . ~v ~4--t lA ) I 77y:----, , >'J Rt-f3tJR. o~i1 a I OWIIIE A'S PHOIIIE FifP.T~d _, CONTIV,CTORSf>HONE• ZONE
. ~-4 • -.AA -, . ., -
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>,
<O 0 a. E (I) I-
7;;&DR~ 'IP-·-,,{,c _ l '~ 7~. CC!llffR.-CTOR'S ADDRESS LICENSE NO. PLAN 1.0. # BLDG USE CODE
e, ___ ~ ~
LOT BLOCK , I SUBDIVISION I ASSESSOR PARCEL NO. DESIGNER STATE LICENSE# STANDARD PLAN # BUILDING SQ. FOOTAGE
I
-0 0 (!)
DESCRIPTION OF WORK I} OEStGIIIER'S ADDRESS DESIGNER'S PHONE C:
;Jlp-fJ9 ,' µ i~lft17J~,. I:,._...._ .1.12u~271.i95 S4-.r F/P FLA ELEV. NO OCCGP EDU q□D/7496 1/271 v ~r~o 1 STORIES
vO NO -. ea llilJ,0
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1ft
CENSUS TRACT I GP LAND USE l PARKING SP¥E 1
AES UNITS 1 GAADING f'.ERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRE SPA AREA CONST
YO N □ vO NO vO NO Not Valid UnMs Machine Certifi«I
.:,,:_
C a:
QTY. PLUMBING PERMIT -ISSUE QTY. MECHANICAL PERMIT -ISSUE SUMMARY/ACCOUNT NUMBER 0 "' EACH FIXTURE TRAP INSTALL FURN . DUCTS UP TO 100.000 BTU BUILDING PERMIT 01-000-4220 _.;?_p~
EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT 01-000-4221
EACH WATER HEATER ANO/OR VENT BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01-000-4806 ..:J<";'t>S--
"' (I) "' "' <
I
EACH GAS SYSTEM I TO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING 01-000-4222
EACH GAS SYSTEM 5 OR MORE MET AL FIREPLACE ELECTRICAL 01-000-4223
EACH INSTAl .. ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01-000-4224
,::
.Q
a; >-
EACH VACUUM BREAKER MECH EXHAUST -HOOD/DUCTS MUBILEHOME 01 ·000-4225
WATER S0FTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP en "' EACH ROOF DRAIN (INSIDE) SOLAR 01-000-4226
TOTI.L MECHANICAL STRONG MOTION 65-640-0519 ~ ~--o_
(I)
0 0 a:
TOTAL PLUMBING I FIRE SPRINKLERS -01-000-4227 cu co
QTY.
PUBLIC FACILITIES FEE 25-000-4933 QTY. ELECTRICAL PERMIT -ISSUE SOLAR -ISSUE BRIDGE FEE
0
~
NEW CONST EA AMP/SWT/BKR COLLECTORS SCHOOL FEE • DISTRICT (I)
0 C
1 PH 3 PH STORAGE TANKS Carlsbad 65·623-0519 cu
C
EXIST BLOG EA AMP/SWT/BKR ROCK STORAGE Encinitas 65-624-0519 u:
1 PH 3 PH PUMP San Dieguito 65-625-0519
REM 00E L/AL TER PER CI RCUIT PLAN CHECK FEE San Marcos 65-626-0519
~
I
C
TEMP POLE 200 AMPS (I) ~
OVER 200 AMPS (!)
TEMP OCCUPANCY (30 DAYSI -0
TOTAL ELECTRICAL I TOTAL SOLAR ' ' . ·-1 h¥"r TOTAL FEES PAYABLE ,
0 (I) a. "' -= I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PEAMIT" AND DO HEREBY Expnllon.&.ypermita111C11!¥thellullclflg0fllc:ielundlrltleprovision1ofthit * AN OSHA P£AMIT IS~ FOIi EXCAVATIONS OY£II
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATlON HEREON INCWDING TM£ Qlde lllall ...,.._ 11¥ lllllitatian and becollle null and VOid. ff !tie building or work 5· o·· DEEP AND DEMOLIT10N OR CONSTRUCllON OF
DECLARATIONS ARE TRUE AND CORRECT ANO 1 FURTHER CERTIFY ANO AGREE IF A PERMIT IS aulllorlHd 11¥ IIICh pemilt le nol commeoiced wlttlln tlOdap from !tie date of such STRUCTURES OYER 3 STORIES IN HEIGHT ...-or If h ~or -" authOnZ8d 11V tuCh ri:::!:., is auspendad or ISSUED: TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING BUILDING CON-__,dDMd .. -..... .. work ii I far a · of jail~.... •
STRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND ~~ CONTRA~ APPROVED BY ~ DATE 7j/Y~ KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF lHE A BYPH ,~ GRANTING OF THIS PERMIT.
I
~ ~ ~
,,
INSPECTION TYPE DATE INSPECTOR
BUILDING '
FOUNDATION ' REINFORCED STEEL "-..... '9-~-92 ,f)
I
MASONRY
I 2-~-S?7 ~ GUNITE OR GROUT I
FLOOR & CEILING SUB FRAME I I
I
SHEATHING i
' FRAME I
EXTERIOR LATH lNSULATION I
;
INTERIOR LATH & DRYWALL I
PLUMBING .
I --
SEWER AND BL/CO I
I
PLUMBING UNDERGROUND I . PLUMBING TOP OUT I -
TUB AND $HOWER PAN I
I
GAS TEST I •
ELECTRICAL I
TEMPORARY POWER ' I
ELECTRIC UNDERGROUND I .
ROUGH ELECTRIC I
ELECTRIC SERVICE I
I
BONDING A . I
I
G. F. I. -SMOKE DETECTOR j
MECHANICAL I
I
DUCT & PLEM., REF. PIPING
HEAT -AIR COND. -SOLAR SYSTEMS
VENTILATING SYSTEMS ,,. . ,-~ I f
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HA VE BEEN APPROVED.
JOB SITE FINAL _, '
PLUMBING
ELECTRICAL : -~ -
MECHANICAL I ,, ~
L . GAS . .~ " . -
BUILDING ..,
~
SPECIAL CONDITIONS I
8ERT 'JF OCCUPANCY ISSUED
-11
-. ' ,, \ r ,, ~,✓ t/30 ..,,R._ i \ ~ .
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTION REO IF INSPECTORS DATE ,R~r-_ Tfalf/,) AUIJ /All"P. ~tC'/. tJ/JU.... A:,V#J~. CHECKED APPROVAL 2-2.-92----
SOILS COMPL ,ANCE
PRIOR TO --
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRESTRESSED
CONCRETE --POST TENSIONED
CONCRETE
FIELD WELDING 1 HIGH STRENGTH
BOLTS
SPECIAL MASONRY --. . '
PILES CAISSONS
-
.. -' '--
; ~~ -
·-------
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't' J .. ~ "
----] -~\.~ ·,, ~ ~-'I' ' --1 -,. ..
1 --.c"" (" ~ ~ . ,·. ~ { ~-. r. ~ . . I,· " ,.. .... " -I• ~ _1 --. ~ _,, ' ,, -. r--; , I · •. ., ....... ,. , I I' \ . ' '· \
,F ,'
City of Carlsbad
APPLICATION FOR CERTIFICATE OF OCCUPANCY
BUILDING DEPARTMENT
1200 ELM 438-5525
ttf.t£\1Ei
~\>R 'au\~
u>t -·· 0
VALIDATION
Address where Business 2566 Navarra_ 10 Unit Condo -~~~ Buildini 81-430 will be conducted Permit o.
L, ~ Business Name of Occupant ·( I-c_ G ""u.--r C Phone , -t ) I Ou .1
Address of Home Office of ~-~
Home Office (209) Occupant if different from above American Savings & Loan Assn. 943-3813 . Phone
Owner of Building ,Ameri can Savings .& Loan Assn. Address P.O. Box 667 Phone(2O9) 943-381 -..._J ~ ..
Type of Business SatinQ"s ~ Loah •. French Camp, Ca. 95231
iJ l. .... ).,s Describe exact use of all portions of each building and lot ,, ~ O'.JS\ '-:,,....._
Previous use of Building None1 ~ s. ~
'J.
Type of flammable or explosive liquids to be used, if any
I certify that I have read the statements contained in this application; that they are true and correct, and that I make this statement under penalty of perjury .
Dated this c! day of . 1 ..... 1 '19 9 3 In the City of Carlsbad, State of California -Signature of 111 j~,V ✓b, l ~ I C < Signature of /1 U r 1 'u-t.-. ~ J-Applicant .... ~ Building Official
' I ~
FOR DEPARTMENTAL USE ONLY
Use Zone • f\,1 Occupancy Group I Type of Construction -tr /6, ..
Planning Department Date Approved Disapproved By
Engineering
Department Date Disapproved By
Fire
_,,. Disapprovetr" Prevention Date By
Health Department Date Disapproved By
Building
Department Date By
White -Building Dept. Yellow -Applicant Pink -Finance Gold -Fire Dept.
7
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