HomeMy WebLinkAbout2580 LOKER AVE W; ; 86-1221; Permit4
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,'1 I hereby affirm that I am licensed under
~visions 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. I' Lie No '222~'2.. Class '-L,~o ___ _
I hereby affirm that I am exempt from the Contrac·
tor's Ucense Law lor the following reason (Sec. 7031.5 Business and Professions Code Any c,ty or county which re-
quires a permtl to construct, alter, improve, demoUsh, or repair any structure. prior to its issuance also requires the ap-plicant for such permll to file a signed sla1ement 1ha1 he is
licensed pursuant to the prov1s1ons ot the Contract«'s
License Law (Chapter 9 commencing w,th Section 7000 of o,vis,on 3 of the Business and Professions Code) or that Is ex·
empt therefrom and the basis for the alleged exemption. Any
violallon of Section 7031 .. 5 by an applicant for a perm,1 sut>-1ects the applicant to a c,v,I penalty ot not more than five hun· dred dollars ($500)
D I, as owner ol the property. or my employees with wages
as their ~e compensation, wlll do the work, and the strut· ture IS not intended or ottered for sale (Sec. 7044, Busines•
and Professions Code: The Contractor's License Law does
:r:ttn~0 .:;o d~:rsi~i::k1,=, ~~
1:.:ii~~r;:~ employees. provided that such Improvements are not Intend·
ed or offered for sale. II, 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 Im·
prove for the purpose of sale).
D I, as owner of the property, am excfuslvely contracting with licensed contractors to construct the project (Sec. 7044.
Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or Im-proves thereon, and who contracts for each projects with a contractor(s) license pursuant to the Contractor's License Law).
0 As a homeowner l am Improving my home, and the follow· ing conditions exist 1. The work is being performed prior lo sale.
2. I have lived In my home for twelve months
3. rf.: ::'pci1::l 1
1
~1~ :ption during the
last three years.
D lam exempt under Sec. , B & P.C. for this reason ____________ _
I hereby affirm that I have a certificate of consent to~ sell-insure. or a cer11t,cate of Workers·
Compensation Insurance, or a cert1t1ed copy !hereof
fSec 3800, LabOr Code)
POLICY NO 5&.W~ 1501 _
COMPANY~~
)I(' Copy ,s llled with the city
D Certthed capy ,s hereby furnished
CEATIFICATl OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Th,s section need no! be compleled it the perm11
1s tor one hundred dollars (SH)O) or less)
O I certify that ,n the performance ot the work tor
which this penmt 1s issued, I shall not employ any
person in any manner so as lo become sub1ect to
!he Wor1(ers' Compensation Laws of Cailtorn,a
NOTICE TO APPLICANT It, after mak,n, tn,s een,
ticate ol Exemption. yoo should become sub1ect l'J
the Workers· Compensa11on provisions ot lhe Labor
Code you must forthwith comply with such
provisions or lhtS perm11 shall be deemed revokecJ
D I hereby athrm thal lhere 1s a construction
1end1no agency tor the performance of lhe work lor
which !his permit 1s ,ssue<J (5ec 3097 C,v,I COOel
Lenders Name ___________ _
Lenders Address -----------
USE BAU 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 ADDRESS
A.vE,MUE A':iii'.T.IOATE OF APPLICATION! BUSINESS LICENS~ V VALUATION PERMIT NUMBER
z.stso f,./. J...CK~ ,,-2., 18b I IC\89 ,,
~;22) i(:;;.;~cur~t:wr ' l<~q) ;w;~·u:;r ~: CONTRACTOR CONTRACTORS PHONE • ZONE
C..o. SoJr~ (OM~._.G\ coM~y (6•<i) 744-0lto
OWNER'S MAILING AOORESS CONTRACTOR'S ADDRESS LICENSE NO. PLAN t.O. # BLDG USE CODE
Z\2.\ p~LOMAA ~,A.~1-T ~. ~~,Ur, 91.oc8 55'\ l.l, ~~~<~ \/AUL'( If• z.2.z.-z.s2 SAN ... ,.-,. .... ;. ,
LOT I BLOCK I suB01 v,s,oN I ASSESSOR PARCEL NO. DESIGNER • • LICENSE # STAN OARD PLAN# BUILDING SO. FOOTAGE
DESCRIPTION OF WORK
DESIGNER'S ADDRESS DESIGNER'S PHONE
~CM rtocSfAL ft)~E,Q.,-NO -··--F/P FLA ELEV. OCC GP EDU
l Ob t\Jl\f' SC/l.VlC( STORIES
YO NO --
CENSUS TRACT I GP LANO USE I PARKING SPACE I AES UNITS I GRADING f'.EAMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRE SPA iiiill iiul lli2liB6PRiiT 3ii. AREA CONST
YO ND vO NO vO NO Nor Valid Unlffs lbchine Certified
QTY. PLUMBING PERMIT -ISSUE /,s-'o QTY. MECHANICAL PERMIT -ISSUE .:?,.ti'# SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP INSTALL FURN. DUCTS i.JP TO 100,000 BTU BUILDING PERMIT 01-00-00-8220
EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT 01-00-00-8221 -
EACH WATER HEATER ANO/OR VENT BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01-00-00-8806
EACH GAS SYSTEM 1 TO 4 OUTLE.TS BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING 01·00-00-8222
EACH GAS SYSTEM 5 0 R MO RE MET AL FIREPLACE ELECTRICAL 01 ·00-00-8223 ' '=l ,.., ,nC)
-------f-
EACH INSTAl .. ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01-00-00-8224
EACH VACUUM BREAKER MECH EXHAUST HOOO/OUCTS MOBILEHOME 01-00-00-8225
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP
EACH ROOF DRAIN (INSIDE) ~nlAD n1.nn.nn.oooc
TOTt.L MECHANICAL STRONG MOTION 80-92-33-0519 ' '-------:" -~, -TOTAL PLUMBING FIRE SPRINKLERS 01-00-00-8227
QTY. ELECTRICAL PERMIT -ISSUE £/H QTY. SOLAR · ISSUE PUBLIC FACILITIES FEE 32-00-00-8923
BRIDGE FEE -
NEW CONST EA AMP/SWT IBK R COLLECTORS SCHOOL FEE -DISTRICT -'"' , '"C' l"l
1 PH 3 PH STORAGE TANKS Carlsbad r.\o-,Q"-'..-~ j ~µ-
EXIST BLOG EA AMP/SWT/BKR ROCK STORAGE Encinilas ._,. 80-92-22-0519 --1 PH 3 PH PUMP San Dieguito f.sk~ \';10/ ------. --
REMODE UAL TER PER CIRCUIT PLAN CHECK FEE I San Marcos 8 -92~24-0519 ---
TEMP PO LE 200 AMPS -ot r_jl RL~--~ .• ----·------,;;"'C\NG ~tK'f;), OVER 200 AMPS \,11.J --n~"E.lOPMt;'.1' '"" TEMP OCCUPANCY (30 DAYS) 1 ee, -t±J --· -_,.. ·-,____. ____
}
({JTAL ELECTRICAL ----r-~=-.._ ,
-3o. TOTAL SOLAR TOTAL FEES PAYABLE l -f ' a?o
l HAVE CAREFULLY EXAMINED THE COMPLETED ·APPLICATION ANO PERMJT" AND DO HEREBY Expiration. Every permit issued by the Bu tiding Off1c1al under the prov,s,ons ol th1s * AN 06HA PEIWIT IS REOUIAED FOA EXCAVATIOHS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall expire by 1,m11ation and beeome null and void ti tile building or work 5· O" DEEP AND D£MOUT10N OR CONSTI'IUCTIOH OF
DECLARATIONS ARE TRUE AND CORRECT ANO l FURTHER CERTIFY AND AGREE IF A PERMIT IS authorized by such permit ,snot commenced w,th,n 180 days from the date of sucti STAUCT\JA£S OVER 3 STCrlES IN HEIGHT permit. or ,f t~~':ff or work 1uthor1zed by such permit ,s suspended or ISSUED TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING BUILDING CON· abandoned 111 e er the work ,s commenced for a oenod of 180 d•v• ~
STAUCTION. WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND OWNEA0 CONTRACTOA'f\ APPAO~M:
DATE
KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS. COSTS AND ~G~ lf--..
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE _ BY PHONE 0 Ii ---~ -£t< GRANTING OF THIS PERMIT , ~ ~. b' / / ,, \ I/
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INSPECTION TYPE DATE INSPECTOR
BUILDING I.
FOUNDATION ;
REINFORCED STEEL -
MASONRY I
I'
GUNITE OR GROUT
FLOOR & CEILING SUB FRAME
SHEATHING
FRAME
EXTERIOR LATH lNSULATION
,.
INTERIOR LATH & DRYWALL
PLUMBING
SEWER AND BL/CO ! ,.
PLUMBING UNDERGROUND I
PLUMBING TOP OUT
TUB AND $HOWER PAN l
GAS TEST I
I.'
ELECTRICAL
TEMPORARY POWER
ELECTRIC UNDERGROUND
ROUGH ELECTRIC
ELECTRIC SERVICE I'
BONDING .
I
G. F. I. -SMOKE DETECTOR
MECHANICAL '
DUCT & PLEM., REF. PIPING '
HEAT -AIR COND. -SOLAR SYSTEMS
VENTILATING SYSTEMS
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE BEEN APPROVED.
JOB SITE FINAL
PLUMBIN'G
ELECTRICAL
MECHANICAL
GAS
BUILDING
SPECIAL CONDITIONS
CERT OF OCCUPANCY ISSUED
.. -
-FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS
-
INSPECTOR'S INSPECTION REO. IF
CHECKED APPROVAL -
-SOILS COMPLIANCE
PRIOR TO -FOUNDATION INSP
-STRUCTURAL CONCRETE
OVER 2000 PSI -PRES TRESSED
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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