HomeMy WebLinkAbout2563 NAVARRA DR; A-E; 80-953-F; PermitWORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of con-
sent to self-insure, or a certificate of Workers'
Compensation Insurance, or a certified copy
thereof (Sec. 3800, Labor Code).
POLICY NO.
COMPANY -
OCopy is flied with the city.
OCertifted 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 ($100) or less).
I certify that in the performance of the work for
which this permit is Issued, I shall not employ any_
person In any manner so as to become subject to
the Workers' Compensation Laws of California.
NOTICE TO APPLICANT: If, after making this Cer-
t if
icate 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 - 1 hereby affirm that there is a construction len:
dma aaencv for the nerformance of the work for
Dl, as owner of the property, am exclusively con-
tracting with licensed contractV truct the project (Sec. 7044, Business lons Code: The Contractor's License t ap- ply to an owner of property t.r lJ proves thereon, and who contrç jects with a contractor(s) llcen
Contractor's Llcensó Law): tl I am exempt under Se.f'M , B. & .C.
for this reason -
Date ______________ Owner
OWNER-BUILDER DECLARATION
Dl hereby affirm that I am exempt from the Con-
tractor's License LaW for the following reason
(Sec. 7031 .5Bustness and Professions Code), Any
city or countywhlch 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 for the alleged ex-
emption. Any violation of Section 7031.5 by an ap-
plicant for a permit subjects the applicant to a
civil penalty of not more than five hundred dollars
($500).
Dl, 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 will have the burden of proving that
he did not build or improve for the purpose of ,
sale).
Pie
CITY OF CARLSBAD-BUILDING. DEPARTMENT
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under prov
7000) of Division 3 of the Business and Profesif"
RAI I POINT nwi APPLLCATION&PERMIT
slons of Chapter 9 (commencing with Section
stons Code, and my license Is In full force and ef-
fect.
' ILUU LM AVENUE (714)438-5 L ,T77j
NO. -
I i/VAt)
oe ADDRESS - AV. ST. DATE OF APPLiCATION Bus. LICENSE PERMIT NUMBER
O
OWNER OWNER'S PHONE P E CONTRACTOR ' . STATE LICENSE # f
. ai i2L - .9'c4'- ( - (. 2 L7.2.2
OWNER'S MAILING ADDRESS . . CONTRACTOR'S ADDRESS ' CONTRACTOR'S
4/Q9/ 15 IZ2
'''
LOT BLOCK SUBDIVISION. ASSESSOR'S PARCEL NO. - DESIGNER
liii III 1111
STATE LICENSE
DESCRIPTION wqlix
DESIGNER'S PHONE , ,A,./,7 ( .,,..jJ - .,, DESIGNER'S ADDRESS . -- - --
NUMBER OF STORI CENSUS TRACT GP LAND USE ZONING - - -- RES. UNITS , - - PARKING SPACE
- Not Valid Unless Machine Certiflod
BLDG SQ.F'T. BLDG USE
- •
AMT. QTY - MECHANICAL PERMIT
.r'- OVER 100,000 BTU
/ BOILER/COMPRESSOR UPTO3HP
,' - BOILER/COMPRESSOR 3-15 HP
-
-
VENT FAN SINGLE DUCT
MECH EXHAUST - HOOD/DUCTS .
DCC. GP STANDARD PLAN # PLAN IDE TYPE CONST 0CC, LOAD
INSTALL FURN. DUCTS UP TO 100,000 BTU
- AMT.
-
- - -
- 2q4'7 7
,_ '5'° c.r_7,;:1I,:__:.
' .' b' ,
- -'
406 __
Q'7. PLUMBING PERMIT -
EACH FIXTURE TRAP
EACH BUILDING SEWER
_( EACH WATER HEATER AND/OR VENT
EACH GAS SYSTEM I TO 4 OUTLETS./. EACH GAS SYSTEM 5 OR MORE
-
EACH INSTAL., ALTER, REPAIR WATER PIPE .
EACH LAWN SPRINKLER SYSTEM
WATER SOFTNER - RELOCATION OF EA FURNACE/HEATER - 8UILOING PERMIT - - - %J1'/.
SIGN PERMIT - ' i i I - I
TOTAL PLUMBING TOTAL MECHANICAL - PLAN CHECK 3.Q,5" I i7I7hi.J
CONTRACTOR Js. CONTRACTOR I'b- ALL'INCLUSIVE PERMIT
- TOTAL PLUMBING
ELECTRICAL QTY. - ELECTRICAL PERMIT
-
AMT. QTY. . MOBILE HOME PERMIT , AMT.
NEW CONST EA AMP6WT/BKR /co - AWNING - MECHANICAL
1
ItI 4 "
- I PH .25 3 PH - PORCH - MOBILE HOME'
EXIST BLDG EA AMP/SWT/BKR . . SET-UP - . SOLAR I I I - . I
1 PH .25 - 3 PH . RAMADA, CABANA . ________________________________ I2AP.7 I ô
-
REMODEL/ALTER PER CIRCUIT - FENCE OVER 6' - _____________________________________ I I I ' I
-- TEMPPOLE 200AMPS . - TOTAL MOBILE HOME . MIC0411M ' I I I - I
- OVER 200AMPS . .it
TEMP OCCUPANCY (30 DAYS) - L h JI i (4rznLr )
- - - 02.. -• ________ _______________________ I ' I I -. I
TOTAL ELECTRICAL ______________________________ __________ TOTAL FEES PAYABLE
CONTRACTOR
- 17 "I i '
- I - ,
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT, AND 00 'AN OSHA PERMIT ISflEOUIREO FOR EXCAVATIONS OVER -
HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I 5'-0" DEEP AND %TIOtCONSTRUATION OF '
STRUCTURES DER 3 S7OfiIqS IN HEp(IT/ FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUEOTO COMPLY WITH ALL CITY,
COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER
SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM. '
LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS. COSTS AND -
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST
OF THE GRANTING OF THIS PERMIT.
SAID CITY IN CONSEQUENCE
APPLICANT'S SIGNATURE' - - OWNER[] CONTRACTORD APPR ED BY Il
AGENTO BY PHONE D
- APPLICANT TO FILL IN INFOR -
MATIflN WITHIN PFfl LINES
a-4n z
op
/
SITE o' t
ADDRESS: OWNER: i PERMIT-NO:
-
FIELD INSPECTION RECORD
INSPECTION DATE INSPECTOR INSPECTOR'S NOTES
WOOD FLOOR
FOUNDATION. FORMS .SETBACK sTOILET
UNDER FLOOR PLUMBING
UNDER FLOOR HEATING
OK TO INSTALL SUB FLOOR
I
SLAB FLOOR
' UNDER SLAB PLUMBING
FOOTING . FORMS . SETBACK .TOILET
OK TO POUR CONCRETE --
FRAME -
ROUGH ELECTRICAL
t ROUGH PLUMBING
4
- ROUGH HEATING/VENTILATING
FRAME OK.PLACE INSULATION
- INSULATION OK • PLACEWALI.BOARD -
WALLBOARD OK. PLACE TAPE *
EXTERIOR LATH OK. PLACE STUCCO -
FIREPLACE - -
DAMPER. 8ST.EEL
PLATE TIES/HEIGHT OF CHIMNEY
OTHER
TEMPPOWER(POLE)
SEWER
GAS TEST
SWIM POOL . STEEL BONDING
PRE DECK
FENCE PREPLASTER
SHOWN •: FRAME -
- ' we PAN
FINAL INSP BY BLDG DEPT
OTHER DEPT'S AtQ COMPLETED
ELECMETER—PERM—TEMP
GAS METER—PERM—TEMP
- CERT,OFOCCUPANCY ISSUED .
VALIDATION
City of Carlsbad
APPLICATION FR CERTIFICATE OF OCCUPANCY
BUILDING DEPARTMENT
1200 ELM 438-5525
Address where Business
will be conducted 2563 A B C D E Navarra Buildin
Permito. 80953F
Name of Occupant Business
Phone 729-4992
Address of Home Office.of 2850 Plo Pico, Suite I, Carlsbad, CA 92008 Occupant if different from above Home Office 7294992 Phone
Owner of Building FAIRWAY SOUTH, A Limited PartnetJaps 2850 Pio Pico, Suite IPhone729-4992
Type of Business 5 unit condo
Describe exact use of all portions of each building and lot residential condominium
Previous use of Building none .
Type of flammable or explosive liquids to be used, if any none
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
Signature ot_#."i I7R±A1
in the City of Carlsbad, State of California
4 ENTRJ?RISES, IN ináif P
Applican y' GEORGE KRIKORIANI Presis Official Xlffk)-4~ JL'~
-
Use Zone
FOR DEPARTMENTAL USE ONLY
Occupancy Group R-i Type of Construction N
Planning
Department Date Approved Disapproved By
Engineering
Department D at,.5') X2_Approved isapproved By
Fire
Prevention Date Approved Disapproved By
Health
Department Date g-7..8L d By
Building
Department Date /fr/yhI1_
APProv:t04 Disapproved By _7 _
I,
White - Building Dept. Yellow - Applicant Pink - Finance Gold - Fire Dept.
Cttp at CarIbab
REQUEST FOR INSPECTION RECORD
INSPECTORi>_I..\L ,
OWNER
ADDRESS
REQUESTED BY
TIME:
I •
BUILDING
2 FOUNDATION
O REINFORCING STEEL
O MASONRY'
GROUT- GUNITE
O FLOOR AND CEILING SUB FRAME
O SHEATHING 0 ROOF 0 SHEAR
O FRAME )
0 EXTERIOR LATH
INSULATION
O INTERIOR LATH OR DRYWALL
FINAL
PLUMBING \
0 UNDERGROUND PLUMBING
O SEWER AND PL/CO
O TOP OUT PLUMBING
TUB OR SHOWER PAN
O GAS TEST
O WATER HEATER
O SOLAR WATER
AL
SPECIAL INSTRUCTIONS
mi
PERSON TAKING REPORT_____________
ELECTRICAL
TEMPORARY SERVICE
UFFER GROUND
O ELECTRIC UNDERGROUND
O ROUGH ELECTRIC
O POOL BONDING
O ELECTRIC SERVICE
AL
MISCELLANEOUS
O CONDITIONED AIR SYSTEMS
SOLAR HEAT
PATIO
DPOOL OSPA
OSIGN
O GRADING
0. DRIVEWAY
FINAL
Ready For Inspection: 0 Monday 0 Tuesday 0 Wednesday 0 Thursday 'Friday
0 A.M. 0 P.M.
City at Car1bab
REQUEST POA INSPECTION RECORD
TIME:
INSPECTOR PEBMITNO. ___________________DATE:
OWNER K
ADDRESS ' 3 '€ •flt:1/t2A
REQUESTED BY PHONE NO.
BUILDING
O FOUNDATION
O REINFORCING STEEL
O MASONRY
.0 GROUT - GUNITE
O FLOOR AND CEILING SUB FRAME
0 SHEATHING 0 ROOF 0 SHEAR
0 FRAME
O EXTERIOR LATH
O INSULATION
INT15EBUNI.LATH OR DRYWALL
INAL
PLUMBING .
UNDERGROUND PLUMBING
SEWER AND PUCO
0 TOP OUT PLUMBING
TUB OR SHOWER PAN
GAS TEST
WATER HEATER
o
~FINAL O
- -
PERSON TAKING REPORT.......
ELECTRICAL
O TEMPORARY SERVICE
UFFER GROUND
ELECTRIC UNDERGROUND
O ROUGH ELECTRIC
0 POOL BONDING.
0 E ERVICE
FINAL
00, MISCELLANEOUS
CONDITIONED AIR SYSTEMS
SOLAR-HEAT
O PATIO
O POOL 0 SPA
OSIGN
GRADING
IVEWA -
0 FINAL
SPECIAL INSTRUCTIONS
Rejdy For Inspection: 0 Monday 0 Tuesday 0 Wednesday IjThursday 0 Friday
M. 0 P.M.
REQUEST FOR NSPEQTION .
. TIME:_!
IFtISPFTAR - ,&kQ.R.1 PERMIT NO. DATE._I -/3 j'i
OWNER - -
ADDRESS
BUILDING
Cl FOUNDATION
El REINFORCING STEEL
El MASONRY
El GROUT - GUNITE
LOOR, AND CEILING FRAME.
S1EATHING
El FRAME
El EXTERIOR LATH
El INSULATION
El INTERIOR LATH OR DRYWALL
El FINAL
I ELECTRICAL I
, I -
El TEMPORARY SERVICE
El ELECTRIC UNDERGROUND
El ROUGH ELECTRIC
El POOL BONDING
El ELECTRIC SERVICE
El CEILING HEAT
D G.F.I.
D SMOKE DETECTOR
El FINAL
I PLUMBING I
Cl UNDERGROUND PLUMBING
El UNDERGROUND WATER.
El ROUGH PLUMBING
El TOP OUT PLUMBING
El SEWER AND PL/CO
El TUB OR SHOWER PAN
El GAS TEST
El WATER HEATER
El FINAL
I MISCELLANEOUS I
El PLENUM AND DUCTS
El COMBUSTION AIR
El PATIO
El SIGN
El GRADING
El DRIVEWAY
El CONDITIONED AIR SYSTEMS
El REFER PIPING
El FINAL
READY FOR INSPECTION: WEDNESDAY 0 THURSDAY 0 FRIDAY
MD.
DP.M.
SPECIAL INSTRUCTIONS
REQUESTED BY (-o'o 'S1CJç -rY\ PHONE NO.
PERSON TAKING REPORT
REQUEST FOR INSPECTION TIME:_________
INSPECTOR71..t PERMIT NO. - DATE:______________
OWNEA
ADDRESS 2
BUILDING
El FOUNDATION
El REINFORCING STEEL
0 MASONRY
DGROUT - GUNITE
El FLOOR AND CEILING FRAME
SHEATHING -
FRAME
El EXTERIOR LATH
El INSULATION
El INTERIOR LATH OR DRYWALL
0 FINAL
I PLUMBING
El UNDERGROUND PLUMBING
UNDERGROUND WATER
El ROUGH PLUMBING
El TOP OUT PLUMBING
SEWER AND PL/CO
El TUB OR SHOWER PAN
El GAS TEST
El WATER HEATER
El FINAL
READY FOR INSPECTION: 0 MONDAY
DAM. -
P.M.
SPECIAL INSTRUCTIONS
I ELECTRICAL
Cl TEMPORARY SERVICE
El ELECTRIC UNDERGROUND
El ROUGH ELECTRIC
El POOL BONDING
El ELECTRIC SERVICE
El CEILING HEAT
D G.F.I.
El SMOKE DETECTOR
El' FINAL
I MISCELLANEOUS I
El PLENUM AND DUCTS
El COMBUSTION AIR
El PATIO
El SIGN
El GRADING
El DRIVEWAY
El CONDITIONED AIR SYSTEMS
El REFER PIPING
El FINAL
TUESDAY '\II
,
WEDNESDAY DTHURSDAY 0 FRIDAY
REQUESTED BY, PHONE NO.4301:664 '
-
- PERSON TAKING REPORT________________
REQUEST FOR INSPECTION TIME: "-
INSPECTO/22A- PERMIT NO. DATE:
OWN E 2 r? VA 1? (?Js
ADDRE 2 5'6 I 3
BUILDING
EJFOUNDATION
El REINFORCING STEEL
El MASONRY
D GROUT GUNITE
El FLOOR AND CEILING FRAME
El SHEATHING
El FRAME
El EXTERIOR LATH
El INSULATION
El INTERIOR LATH OR DRYWALL
El FINAL
1 ELECTRICAL
Cl TEMPORARY SERVICE
El ELECTRIC UNDERGROUND
El ROUGH ELECTRIC
- El POOL BONDING
El ELECTRIC SERVICE
El CEILING HEAT
El G.F.I.
El SMOKE DETECTOR
El FINAL
I PLUMBING I
El UNDERGROUND PLUMBING
4
El UNDEfrGROUND WATER
GH PLUMBING
TOP OUT PLUMBING ..-
El SEWER AND PL/CO
El TUB OR SHOWER PAN •
El GAS TEST
El WATER HEATER
El FINAL
I MISCELLANEOUS I
Cl PLENUM AND DUCTS
El COMBUSTION AIR
El PATIO
El SIGN
El GRADING
El DRIVEWAY
El CONDITIONED AIR SYSTEMS
El REFER PIPING
El FINAL
READY FOR INSPECTION: o M9M5AY 0 TUESDAY I DNESDAY DTHURSDAY 0 FRIDAY
SPECIAL INSTRUCTIONS
REQUESTED B'? PHONE NO.________________
PERSON TAKING REPORT1b
'REQUEST FO
INSPECTOR ) I
OWN ER__________
ADDRESS________
INSPECTION
PERMIT NO. _DATE: _~ P-0 -& -
Li '
TIME: 1
BUILDING
FOUNDATION
El REINFORCING STEEL
MASONRY
El GROUT - GUNITE
El FLOOR AND CEILING FRAME
El SHEATHING (
El FRAME
El EXTERIOR LATH
El INSULATION
El INTERIOR LATH OR D YWALL
FINAL kj
I PLUMBING I
El UNDERGROUND PLUMBING
El UNDERGROUND WATER
El ROUGH PLUMBING
El TOP OUT PLUMBING
El SEWER AND PL/CO
El TUB OR SHOWER PAN
El GAS TEST
El WATER HEATER
El FINAL
I ELECTRICAL
El TEMPORARY SERVICE
D ELECTRIC UNDERGROUND
El ROUGH ELECTRIC
El POOL BONDING
El ELECTRIC SERVICE
El CEILING HEAT
O G.F.I.
El SMOKE DETECTOR
O FINAL
I MISCELLANEOUS \ I
El PLENUM AND DUCTS
El COMBUSTION AIR
El PATIO
SIGN
El GRADING
El DRIVEWAY
El CONDITIONED AIR SYSTEMS
El REFER PIPING
C3 FINAL
READY FOR INSPECTION: ,4MONDAY) 0 TUESDAY 0 WEDNESDAY 0 THURSDAY 0 FRIDAY
SPECIAL INSTRUCTIONS
REQUESTED BY, L4'ONE NO.___________
AKING REPORT_(11
REQUESTED BY
REQUEST FOR INSPECTION 86' 63 D TIME:________
INSPECTOR_____________________ PERMIT NO. DATE/O_-/_ç.f/
OWNER
AflflQ tIAp-/L'tG
BUILDING
El FOUNDATION
El REINFORCING STEEL
El MASONRY
El GROUT .GUNITE.
- El FLOOR AND CEILING FRAME
El SHEATHING
El FRAME
El EXTERIOR LATH
El INSULATION
El INTERIOR LATH OR DRYWALL
El FINAL
I ELECTRICAL
El TEMPORARY SERVICE
El ELECTRIC UNDERGROUND
Cl ROUGH ELECTRIC
El POOL BONDING
El ELECTRIC SERVICE
El CEILING HEAT
El G.F.I.
El SMOKE DETECTOR
El FINAL
PLUMBING
,NDERGROUND PLUMBING
' El UNDERGROUND WATER
El ROUGH PLUMBING
El TOP OUT PLUMBING
El SEWER AND PL/CO
El TUB OR SHOWER PAN
El GAS TEST
El WATER HEATER
El FINAL
MISCELLANEOUS
Cl PLENUM AND DUCTS
El COMBUSTION AIR
9 El PATIO
El SIGN
El GRADING
El DRIVEWAY
El CONDITIONED AIR SYSTEMS
El REFER PIPING
El FINAL
READY FOR INSPECTION: 0 MONDAY 0 TUESDAY 0 WEDNESDAY 0 THURSDAY ( 0 FRIDAY
SPECIAL INSTRUCTIONS