HomeMy WebLinkAbout2585 JEFFERSON ST; ; 81-346; Permitf/J z 0 ;:::
C a:: C .... u "' 0
II:
I[
0 u
a: "' 0 .... 3 ~ "' z ~ 0
z 0 ;:::
C f/J z "' IL
:I 0 u
ti) a: "' "' a:: 0 :i
ll
0 I "'·•bY affirm that I am licensed under
provisions of Chapter 9 (commencing with
S.Ctlon 7000) of Division 3 of the Business
and Professions Code, and my license Is In
lull force and effect.
Lie No __ __ Class
I hereby 1fflrm that I am exempt from the Con ~~~-~~~~~"sS: ~ ~~t~':,~~~~'9:~.(~
county which requires a permit to construct
alter improve, demohsh, or repair NIY structure.
prior to its issuance also requires the appltcant for such permit to hie a signed statement that he 1s hcensed pursuant to the provisions of the Con
tractor's License Law (Chapter 9 commencing with
Section 7(0) of O,v,s1on 3 of the Business and Pro-fessions Code) or th.at 1s exempt therefrom and the
basis for the alleged exemptK>n Any v1olat1on of Section 7031 5 by an Ol>Plicant f0< a perm,t sub1ects
tne apphcant to a c,v,1 penalty ot not more than five
hundred dollars ($500)
0 I. as owner ot the prOl)erty, or my employees ..,,th wages as their sole compensation. will do the
w~. and the structure 1s not intended or offered to, sale (Sec 7044. Business and Professions Code
The Contractors License Law does Mt apply to an
owner of property who builds Of improves thereon and who does such wor1t himself or through his own
employees. provided that such 1mproveme;i1s are
not mtende1 or ottered for sale It. however. the
butldtng or improvement 1s sold w1th1n one year of
completion, the owner-builder will have the burden of proving that he did not build or improve tor the
purpose of sale)
D I. as owner ot the property am exclusively contracting with licensed contractors to construct
the p,oJect (Sec 70.U Business and Professions
Code The Contractors License Law does not apply to an owner of proper,y who builds or improves
~t;:~-~~ 7'~nc;n~~!~~~ ~~~h~,~~~;:~-!
License Law).
0 I am exempt unde, Sec
tor this reason
B &PC
D I hereby afftrm that I ha~e a cer11t1cate of consent
to self-insure, or a cert1f1cate of Workers'
Compensation Insurance. or a cer11hed copy thereof
(Sec 3800. labor Code)
POLICY NO
COMPANY
0 Copy 1s tiled with the city
0 Cert1f1ed copy 1s hereby turn,sheCI
CERTIFICATl OF EXEMPTION FROM
WORKERS COMPENSATION INSURANCE
(This section need not be completed 1f lhe permit 1s tor one hundred dollars ($100) or less)
D t certify that in the performance ot the woo for which this permit 1s issued. I shall not employ any
person 1n ~Y manner so as to beeome sub1ec1 10
the Worli(ers' Compensallon Laws of Caltforn1a
NOTICE TO APPLICANT If. after mak1n~ 1h15 Gen,
hcate ot Exemption you should beeome sub1ect t".>
the Wor1(ers· Compensation provisions ot the Labor
Code, you musl forthwith comply with such
provisions o, this permit shall be deemed revoked
0 I hereby affirm that there 1s a cons1ruc11on
lending agency 10, the pertormance of the work for
wtuch this permit ,s ,ssued tSec J097 C1v11 Code)
Lenders Name ____________ _
Lenders Address ------------
USE BALL POINT PEN ONLY & PRESS HARD ~ APPLICANT -FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
CARLS BA BUILDING DEPARTMENT Ai-.A..ICATION & PERMIT
1200 Elm, Carlsbad, California 92008 (714) 438-5525
JOB ADDRESS
A~i.TrA;;,;;;;;;TION
1
BUSINESS LICENSE ,t VALUATIO~ PERMIT NUMBER ~s-rs-J?F/~~~.s~/t/ ,,:)3'-/ RI /6'6t1 ;;.--
fi-3~ OWNER'S NAME I OWNER'S PHONE
p~i~FRAll,1s -
, ~ , CONTRACTORS PHONE • ZONE
6dl't /\~t...J (? fr>" .. f -f: 7 '/1-1 ~'JS-
OWN[ R'S MAIL• NG AO DRESS CONTRACTOR'S ADDRESS LICENSE NO. PLAN 1.0. # BLDG USE COOE
f',tJ . Rd:.K' 12'1'! ~.?A 4LL/c/tA-/,/5'/~Y
LOT I BLOCK -1 'suB01v•s10N I t,SSESSOR PARC[L NO. DESG~ STA Tl L•Cl NSE # STANDARD PLAN # BUILDING SQ. FOOTAGE
/~-/"74~ -~ n ,,..-"°fC:4P L>/t:/ O
DESCRIPT•ON Of WORK q,' d (""I, OESIGNER S ADDRESS OE SIGNE R'S PHONE
vrff-. I -FIP FLRELEV. NO OCC GP EDU
STORIES
vO NO 6/20/617L!31 ~8,70
CENSUS TRACT I GP LAND USE I PARKING SPACE I RES UNITS I GRADING PERMIT ISSUED REOEVELOPMENT TYPE OCC LOAD FIRE SPR
AREA CONST I , I -......... _, -.
YO ND v O NO vO NO Not Valid Unlffs Machine Cutified
QTY. PLUMBING PERMIT· ISSUE 7.50 QTY. MECHANICAL PERMIT -ISSUE 3.00 SUMMARY/ACCOUNT NUMBER ~
EACH FIXTURE TRAP INSTALL FURN DUCTS UP TO 100.000 BTU BUILDING PERMIT ~ ,,--.;.::---
EACH BUILDING SEWER ~ OVER 100.000 BTU SIGN PERMIT -
/ EACH WATER HEATER AN0.10R VENT -1----::y ~ .._ --//-:-BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK
~ EACH GAS SYSTEM 1 TO 4 OUTLETS ___ +-1.,-.~ BOILER/COMPRESSOR 3-15 HP ·-TOTAL PLUMBING ·/~
, EACH GAS SYSTEM 5 OR MORE ~ METAL FIREPLACE /. ELECTRICAL 7-~-I-------
/ EACH INSTA~. ALTER, REPAIR WATER PIPE _y__':,.;;-VENT FAN SINGLE DUCT / MECHANICAL
EACH VACUUM BREAKER MECH EXHAUST HOOO/OUCTS / MOBILEHOME
WATER SOFTNER RELOCATION OF EA FURNACE/HEATEfV MOBILEHOME PARK INSP
-/ EACH ROOF DRAIN (INSIDE) SOLAR
/~ i-TOT.t.L MEGHAN/ STRONG MOTION ~ r1"7' ,__ ---r-TOTAL PLUMBING FIRE SPRINKLERS
SO~SSUIJ ff
, PUBLIC FACILITIES FEE
QTY. ELECTRICAL PERMIT· ISSUE 2.00 Qp. V ......
BRIDGE FEE
~
,,,
/ ~ co111.1i( ~ \1 1 / ---
NEW CONST EA AMP'SWT IBKA ... G SCHOOL FEE · DISTRICT -./ ~GI:~ I\ )j / 1 PH 3 PH ) Carlsbad '
EXIST BLOG EA AMP/SWT/BKR \ ~ ROCK STORAGE -
. "1 J ~ Encinitas
1 PH 3 PH J, ~ I I\ I (,, .n -··--PUMP San D1egu1to ---REMOOE UAL TEA PER CIRCUIT /'~ PLAN CHECK FEE I W r San Marcos
TEMP PO LE 200 AMPS ~: / I ------.-...... -· ----OVER 200 AMPS ./ --
TEMP occue.-_c, 130 DAYS~ -----· --------~---
TOTAL ELECTRICAL -I 7er0-~ TOTAL SOLAR TOTAL FEES PAYABLE I thJ>?!!--
I HAVE CAREFULLY EXAMINED THE COMPLETED 'APPLICATION AND PERMIT" AND DO HEREBY Expiration E,ery permit issued by the Building Ofllc,al under the provisions of th,s * AN OSHA PERMIT IS REQUIA£0 FOR EXCAVATIONS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall expire by hm,tation and become null and void If the bu1ld1ng or work \~EP ANO OEMOllTIOH °" CONSTRUCTION Of
DECLARATIONS ARE TRUE AND CORRECT AND l FURTHER CERTIFY AND AGREE IF A PERMIT IS authorized by such permit IS not commenced w1th,n 180 days from the date of such ST T\JA£S OVER 3 ST°"IES IN HEIGHT ~
ISSUED: TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING BUILDING CON· :~~~n~ 1~t ·=~. ~~~~·~ne~~h=~~r:~ti~~~e:le~,~~ ro::.;:,i'~i'r:rd~~~ or
STRUCTION, WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND ~ CONTRACTO
AJE~ofl /)i/ 11k/r1 KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS, COSTS AND APPLICANTS SIGNATU ) OWNER 0
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE~ . "\ BY PHONE
GRANTING OF THIS PERMIT • j
' ·r
/
/.•
INSPECTION TYPE DATE INSPECTOR
BUILDING
FOUNDATION I /) I
REINFORCED STEEL 2-?J..,J,/ rd'
MASONRY I
GUNITE OR GROUT I
l
FLOOR & CEILING SUB FRAME I
SHEATHING
FRAME .
EXTERIOR LATH lNSULATION
INTERIOR LATH & DRYWALL I
PLUMBING --
SEWER AND BL/CO I I)
PLUMBING UNDERGROUND 3-').J.,YJ J,7
PLUMBING TOP OUT -
TUB AND ~HOWER PAN I
GAS TEST I
ELECTRICAL I
TEMPORARY POWER I
I
ELECTRIC UNDERGROUND I '·
ROUGH ELECTRIC j
I
ELECTRIC SERVICE I /)
BONDING ~ , .. ,., ... 11 1117'
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
PLUMBING
ELECTRICAL
MECHANICAL
GAS I
BUILDING ~
SPECIAL CONDITIONS
CERT OF OC' . 'PANCY ISSUED
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS
INSPECTION REO IF INSPECTORS
CHECKED APPROVAL
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRESTRESSED
CONCRETE
POST TENSIONED
CONCRETE
FIELD WELDING !
HIGH STRENGTH I
BOLTS I
SPECIAL MASONRY "
PILES CAISSONS
'
.
.
' •
'"I.;
~
-,
• ' ' . ,__
r ·,
~
' . '
I· . -.
INSPECTOR'S NOTES
·, l· If;,'• ~I J,I.
-.
DATE
-----
-
--
' .
I
-
' ,. ---·:" ' -( .. . -., ' --
-• -~ .
---.
-
--
•·
~ ·-~ ' I .L '"' ~-• -;..
-
..,;.' ._ -. .
' ,. "' . ' ,·1, "· ... .... -. ' . ' ....
'"l
INTERDEPARTMENTAL INFORMATION SHEET
BUILDING DEPARTMENT DATE~~J::Jf ~D
BUILDING ADDREss: ~~~~~~~~~~~~~~-~~-~~~~~~~~~A~u~G-1-9~~~,~~
/S15-/70 -3D
PLANNING DEPARTMENT
UNITS ALLOWED UNITS PROVIDED
CITY' OFi CARLSf3AD Bulldlng Department
--------------------------
PARKING SPACES REQUIRED ---------~PROVIDED ___________ _
_____________ PROVIDED % COVERAGE ALLOWED
BUILDING HEIGHT ALLOWED
FRONT SETBACK:
ALLOWED
PROVIDED -------
INTRUSIONS
__________ PROVIDED
SIDE SETBACK:
LANDSCAPE & IRRIGATION PLAN COMMENTS:
ENVIRONMENTAL PROTECTION REQ:
OK TO ISSUE:
ENGINEERING DEPARTMENT
REAR SETBACK:
R.O.W. INDUSTRIAL WASTE ------_______ IMPROVEMENTS _______ _
SEWER CONNECTION ________ DRIVEWAY LOCATIONS ___________ _
GRADING PERMIT _______ EASEMENTS _________ DRAINAGE ____ _
LEGAL DESCRIPTION _____________________________ _
ADDITIONAL COMMENTS ____________________________ _
g~/7 ~{ PWI ____ OK TO FINAL ____ DATE ___ _
J __ _
OK TO ISSUE~~ATE
FIRE DEPARTMENT
SP~It~KLING SYSTEM FIRE PROTECTION EQUIP ·--------
FIRE ALARMS EXITS ________________ _
FIRE HYDRANTS __________ LOCATION __________________ _
ADDITIONAL COMMENTS
OK TO ISSUE:
WATER DEPARTMENT
REQUIREMENTS OF APPROPRIATE DISTRICTS MET ________ DATE ________ _