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Home My WebLink About2603 EL RASTRO LN; MULIT-PERMIT FILE; CB031016; PermitCity of Carlsbad 1635 FaradayAv Carlsbad, CA 92008 04-09-2003 Electrical Permit Permit No: CB031016 Building Inspection Request Line (760) 602-2725 Job Address: 2603 EL RASTRO LN CBAD Permit Type: ELEC Status: ISSUED Parcel No: 2551130900 Lot #: 0 Applied: 04/09/2003 Entered By: SB Reference #: Plan Approved: 04/09/2003 Issued: 04/09/2003 Project Title: BENSON RES MISC ELEC KIT Inspect Area: LIGHTS AND OUTLETS Applicant: Owner: NEW LIFE CONSTRUCTION BENSON FAMILY TRUST 03-2922R7 04/09/03 0002 01 02 8340 VICKERS ST 2603 EL RASTRO LN COP 20-00 SAN DIEGO CA 92111 CARLSBAD CA 92009 858-277-8075 Electric Issue Fee $10.00 Single Phase per AMP 0 $0.00 Three Phase per AMP 0 " $0.00 Three Phase 480 Per AMP 0 $0.00 Remodel/Alteration per AMP 0 $0.00 Remodel Fee $10.00 Temporary Service Fee $0.00 Test Meter Fee $0.00 Other Electrical Fees $0.00 Additional Fees $0.00 TOTAL PERMIT FEES , $20.00 Total Fees: $20.00 Total Payments To Date: $0.00 Balance Due: $20.00 FINAL APPROVAL I nspecto(') Clearance: 01 NOTICE: Please take)l)'CE that a val of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/peons." You e 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protestedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any fees/exdions of which vnii have nreviouslv been aiven a NOTICE similar to this or as to which the statute of limitations has nreviouslv otherwise exnired. PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 1; PROJECT INFORMATION i - "—' j.. FOR OFFICE USE ONLY PLAN CHECK NO.0 a340 l EST. VAL. Plan Ck. Deposit Validated By ' Date Address (include Bldg/Suite #) Business Name (at this address) Legal Description Lot No. ,_Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's l#4 Existing Use L 4A Sic. Proposed Use • Description of Work SQ. FT. #of Stories # of Bedrooms # of Bathroomt_.e.,Iy Jf Name - ' Address City State/Zip Telephone # Fax # 3 APPLICANT 'Contractor 0 Agent for Contractor 0 Owner 0 Agent for Owner L t'$c ~ 0 Ct /24i7oe. '- tcL2' ( '2c (7o7 -7c3—Orrr Name Address City State/Zip Telephone # I \4 PROPERTY OWNE Liite-i /4oa4-) 27 Z i tIi hiid ?2 (?) 7s'J—S 4'J Name Address City State/Zip Telephone # (V 5 CONTRACTOW.7 COMPANY NAME (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law [Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom, and the basis for the alleged exemption. Any iola n of Section 7031.5 by any applicant for a permit s bects the applicant t a civil penalty of not more than five hundred dollars [$5001). )c Ca'7, /G I//X?Ar ( CFs) 2'7-7f Name Address r City State/Zip Telephone # State License # 77 7 License Class / City Business License # Designer Name Address City State/Zip Telephone tate License # - WORKERS' COMPENSATION .. orkers Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is ssued. My worker's compensation insurance carrier and policy number are: Insurance Company c7.Y?"g' _"-"9 Policy No. yO ? Expiration Date THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS) CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand d=($addition to the cost o ensation. damages as provided for in Section 3706 of the Labor code, interest and attorney's fees, 4/lGNATUR -s----....- - DATE 777 7 OWNER DER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: 0 I, 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 offered for sale (Sec. 7044, Business and Professions 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 offered for sale. If, however, the building or improvement 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). o I, as owner of the property, am exclusively 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 improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). 0 I am exempt under Section Business and Professions Code for this reason: I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES DNO I (have / have not) signed an application for a building permit for the proposed work. I have contracted with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors license number): I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name I address /phone number / contractors license number): I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number /type of work): PROPERTY OWNER SIGNATURE DATE COMPLETE THIS SECTION FOR NON RESIDENTIAL BUILDING PERMITS ONLY Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? 0 YES 0 NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 YES 0 NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES 0 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 AND THE AIR POLLUTION CONTROL DISTRICT. 8 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 30976) Civil Code). LENDER'S NAME LENDER'S ADDRESS_____________________________________________________________ 9 APPLICANT CERTIFICATION I certify that I have read the application and state that the above information is correct and that the information on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the Cit, of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND 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 excavations over 5'0 deep and demolition or Construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the building Official under the provisions of this Code shall expire by limitation and become null and void if the building or work authorized by such permit is not commenced within 180 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is co or nod of 180 days ection 106.4.4 Unifo Building Code). ?PLICANT'S SIGNATURE -. - DATE 'OVC,Y L/j WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 06/05/2003 Permit# CB031016 Inspector Assignment: JE Title: BENSON RES MISC ELEC KIT Description: LIGHTS AND OUTLETS Type: ELEC Sub Type: Phone: 8582778075 Job Address: 2603 EL RASTRO LN Suite: Lot 0 Location: Inspector: APPLICANT NEW LIFE CONSTRUCTION Owner: BENSON FAMILY TRUST 03-29-00 Remarks: Total Time: Requested By: ALANA Entered By: ROBIN CD Description Act Comment 39 Final Electrical n Associated PCRs/CVs Inspection History Date Description Act Insp Comments 04/14/2003 34 Rough Electric AP JE CEILINGS & WALLS - CIRCUIT CARD ATTACHED Nrl hereby affirm thjt I am licensed under pr visions of Chapter 9 (commencing with I- I Section 7000) of Division 3 of the Business I and Professions Code, and my license is In full force and eftect Z I Lic. No 315'4-Jjj, Class Ui— I hereby affirm that I am exempt from the Con tractors License Law for the following reason (Sec. 70315 Business and Professions Code: Any city or county which requires a permit to Construct alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to tile a signed statement that he is licensed pursuant to the provisions of the Con- tractors License Law (Chapter 9 commencing with Section 7000 of Division 3 of the Business and Pro- fessions Code) or that is exempt therefrom and the basis for the alleged exemption. Any violation of Section 7031.5 by an applicant .1 or a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). I, as owner of the properly or my employees with wages as their sole compensation, will do the work, and the structure is not intended or offered for sale (Sec. 7044, Business and Protessiohs Code: The Contractors 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 offered for sale. It, however, the building or improvement 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). t, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec 704.4, Business and Professions Code: The Contractors License Law does not apply I to an owner of property who builds or improves thereon, and who contracts for each projects with a contractor(s) license pursuant to the Contractors License Law), lam exempt under Sec. - _______-. B. & P.C. for this reason . . Xo I hereby affirm that I have a certificate of consent selt-insure, or a certificate of Workers' Compensation Insurance, or certified copy thereof (Sec. 3800, Labor Cod POLICY NO. WL7±2i57L. COMPANY FIR A(NS £L IL) Copy is filed with the City. Certified copy is hereby furnished CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the permit I is for one hundred dollars ($100) or less) i certify that in the performance of the work for p which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. NOTICE TO APPLICANT: It, after making this Cern- I ficate of Exemption, you should become subject to the Workers' Compensation provisions of the Labor - Code, you must forthwith comply with such provisions or this permit shall be deemed revoked 0 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097. Civil Code) Lenders Name Lender's Address S w z 0 ilier DAlI DAIIIT Dfli ABlY i PDr I1ADfl APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. CARLSBAD BUILDING DEPARTMENT - APPLICATION & PERMIT 1200 Elm, Carlsbad, California 92008 (714) 438-5525 JOB ADDRESS AV, ST. I DATE OF APPLICATION 1 4's LICENSE # RD. I I O3 EL S4.TRb . I5 i OWNER'S NAME J OWNER'S PHONE PRIME CONTRACTOR CONTRACTORS PHONE k /' 7$ —051-5- KEfr7i's 15tALA-TIO/ sPEC 7W-" // VALUATION PERMIT NUMBER ZONE OWNER'S MAILING ADDRESS 24V3 LRA-STiO &H CONTRACTOR'S ADDRESS 1 !2A~5'aASTAfaJV-7- PL. LICENSE NO. PLAN I.D. # BLDG USE CODE LOT I BLOCK SUBDIVISION ASSESSOR PARCEL NO. 6ESI.GNER DESCRIPTION OF WORK STATE LICENSE # STANDARD PLAN # BUILDING SO. FOOTAGE DESIGNER'S ADDRESS DESIGNER'S PHONE Not V dUnIsMach,neCirt,f,ed X-4 1(/ C/ F/P F LR ELEV. yD ND NO STORIES OCCGP j EDU I 'CENSUS TRACT Gl LAND USE PARKING SPACE RES UNITS GRADING PERMIT ISSUED YOND I REDEVELOPMENT AREA YO ND I I I TYPE I CONST 0CC LOAD FIRE SPA Y[-] NO QTY. PLUMBING PERMIT - ISSUE 7.50 QTY. MECHANICAL PERMIT- ISSUE 3 .00 , SUM MA NT EACH FIXTURE TRAP . INSTALL FURN. DUCTS UP TO 100,000 BTU , U N UM BER BUILDING PER EACH BUILDING SEWER ' OVER 100,000 BTU , SIGN PERMIT EACH WATER HEATER AND/OR VENT ' BOILER/COMPRESSOR UP TO 3 HP , PLAN CHECK EACH GAS SYSTEM 1 TO 4 OUTLETS . BOILER/COMPRESSOR 315 HP , TOTAL PLUMBING EACH GAS SYSTEMS OR MORE , ' METAL FIREPLACE At ELECTRIC EACH INSTAL.. ALTER, REPAIR WATER PIPE . VENT FAN SINGLE DUCT MEG(CAL EACH VACUUM BREAKER , MECH EXHAUST - HOOD/DUCTS BILEHOME [SOLAR WATER SOFTNER - RELOCATION OF EA FURNACE/HEATER -- ILEHOME PARK INSP EACH ROOF DRAIN (INSIDE) . , . TOTAL MECHANICAL I I ' , STRONG MOTION TOTAL PLUMBING I . FIRE SPRINKLERS - CITY. Q ELECTRICAL PERMIT - ISSUE 2.00 00 QTY. SOLAR - ISSUE PUBLIC FACILITIES FEE BRIDGE FEE NEW CONST EA AMP/SWT/BKR COLLECTORS SCHOOL FEE - DISTRICT 1 PH ' 3 PH STORAGE TANKS Carlsbad EXIST BLDG EA AMP/SWT/BKR 'ROCK STORAGE Encinitas 1PH 3 P . PUMP San Diegaifo REMODEL/ALTER PER CIRCUIT ,ç' O't(i . LAN CHECK FEE San Marcos TEMP POLE 200 AMPS OVER 200 AMPS __________ TEMP OCCUPANCY (30 DAYS) . TOTAL ELECTRICAL J" - 700 - ' TOTAL SOLAR ' - TOTAL FEES PAYABLE I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION 'AND PERMIT" AND DO HEREBY I Expiration. Every permit issued bythe Building Official under the provisions o(tftis * AN OSHA PERMIT Is REQUIRED FOR EXCAVATIONS OVER Code shaft expire by limitation and become null and void. If the building or work 5'0" DEEP AND DEMOLITION OR CONSTRUCTION OF CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE authorized by such permit is not commenced within l8o days from the date ofsuch DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS permit, or if the building or work authorized by such permit is suspended or STRUCTURES OVER 3 STORIES IN HEIGHT ISSUED: TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING BUILDING CON- I abandoned at any time after the work is commenced for a period 01180 days. STRUCTION, WHETHER SPECIFIED HEREIN OR NOT, I ALSO AGREE TO SAVE INDEMNIFY AND APPLICANT'S SIGNATURE ' OWNER 0 CONTRACTORAPPROVED BY - DAT KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE _, BY PHONE 0' 4jL. GRANTING OF THIS PERMIT. / IdPr.TInNTVPF DATE INSPECTOR BUILDING FOUNDATION REINFORCED STEEL MASONRY GUNITE OR GROUT FLOOR & CEILING SUB FRAME SHEATHING FRAME EXTERIOR LATH INSULATION INTERIOR LATH & DRYWALL - PLUMBING SEWER AND BL/CO PLUMBING UNDERGROUND I PLUMBING TOP OUT TUB AND SHOWER PAN GAS TEST ELECTRICAL TEMPORARY POWER ELECTRIC UNDERGROUND ROUGH ELECTRIC ELECTRIC SERVICE BONDING G. F. I. - SMOKE DETECTOR. MECHANICAL DUCT & PLEM., REF. PIPING HEAT - AIR CON D. - SOLAR SYSTEIAS VENTILATING SYSTEMS I CALL FOR FINAL INSPECT/ON WHEN ALL APPROPRIATE ITEMS ABOVE HAVE BEEN APPROVED. JOB SITE FINAL PLUMBING ELECTRICAL MECHANICAL GAS BUILDING SPECIAL CONDITIONS CERT OF OCCUPANCY ISSUED 7) FIELD INSPECTION RECORD REQUIRED SPECIAL INSPECTIONS INSPECTORS NOTES INSPECTION REQ. IF CHECKED INSPECTORS APPROVAL D ATE - SOILS COMPLIANCE FOUNDATION INSP PRIOR TO STRUCTURAL CONCRETE OVER 2000 PSI - - - - CONCRETE PRESTRESSED POST TENSIONED CONCRETE FIELD WELDING HIGH STRENGTH BOLTS SPECIAL MASONRY PILESCAI55ONS - €'Z. -: - - USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. r 0 I hereby affirm that there is a construction lending IX agency for the performance of the work for which this per. CI roil is issued (Sec. 3097. Civil Code) ZI WI Lender's Name ione -'I L Lender's Address_________________________________ CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT 2075 Las Palmas Dr., Carlsbad, CA 92009-1915 (619) 438-1161 - JOE ADDRESS AV, ST. RD. - THOMAS BROS NO. , DATE OF APPLICATION I BUSINESS LICENSE # VALUATION PERMIT NUMBER 2603 El Rastro Ln. El Camino Real - 3-23-89 J -- . 23805 LOT BLOCK SUBDIVISION . , J ASSESSOR PARCEL NO. CONTRACTOR CONTRACTORS PHONE k ZONE Arlen Foster Plumbing 697-4151 OWNER'S NAME . OWNERS PHONE BUILDING SO. FOOTAGE CONTRACTORS ADDRESS STATE LICENSE NO. Richard H. Benson I 753-0545 2819 Central Ave. '' 443348 OWNERS MAILING ADDRESS DESIGNER DESIGNER'S PHONE 2603 El Rastro,Ln. Carlsbad 92009 - DESCRIPTION OF WORK Wahr flt-r Repl'eIniri - DESIGNER'S ADDRESS STATE LICENSE NO. 5752 03/29/89 0001 01 02 , . BldPmt 10.0 F,'P FLR ELEV. j I NO DCCGP I EDU STORIES I YDND I I I CENSUS TRACT PARKING SPACE RES UNITS GRADING PERMIT ISSUED I REDEVELOPMENT I TYPE DCC LOAD FIRE SPR I AREA I CONST 0 N 0 0 ND j . j vD NO Not Valid Unless Machine Certified — QTY. PLUMBING PERMIT - ISSUE CITY. MECHANICAL PERMIT- ISSUE SUMMARY/ACCOUNT NUMBER EACH FIXTURE TRAP . - INSTALL FURN DUCTS UP TO 100,000 BTU - BUILDING PERMIT 001-8100-8220 EACH BUILDING SEWER . OVER 100,000 BTU . SIGN PERMIT EACH WATER HEATER AND/OR VENT $7 çfi — BOILER/COMPRESSOR UP TO 3 HP ..' PLAN CHECK EACH GAS SYSTEM 1 TO 4 OUTLETS . - BOILER/COMPRESSOR 3-15 HP ." TOTAL PLUMBING sin_pp EACH GAS SYSTEM 5 OR MORE . METAL FIREPLACE ,a' . ELECTR ' 0O.-8o-0o-82p3 - EACH INSTAL., ALTER, REPAIR WATER PIPE . VENT FAN SINGLE DUCJ/ . EACH VACUUM BREAKER' . MECH EXHAUST )Ixd'ODIDUCTS . 0 HO 001-810-00 WATER SOFTNER . RELOCATIONQ(EA FURNACE/HEATER EACH ROOF DRAIN (INSIDE) . DRYER VN'( R 9Q' — OTAL MECHANICAL - NKLERS ç 10'00'OO'8227 TOTAL. PLUMBING sin - BLIC FACILITIES 320-810-00-00-8740 ELECTRICAL PERMIT- ISSUE MOBILE HOME SETUP %lDGE FEE 360-810-00-00-8740 RI-191-1,50 (AREA QTY. NEW CONST EA AMP'SWT BKR CAR PORT _ , 312-810-00-00-8835 1 PH 3 PH ,/ . AWNING ,a" COSTA TIF 311-810-00-00-8835 EXIST BLDG EA AMP/SWTBKR - GARAGE ,.-' FMF 1 PH 3 PH . - LICENSE TAX 001-81000-00-8162 REMOOEL'ALTER PER CIRCUIT ' — .' . . MFF 880-519-92-57 TEMPPOLE 200 AMPS - OVER 200 AMPS — TEMP OCCUPANCY (39,2(YS( CREDIT DEPOSIT — J'ELECTRICAL I . TOTAl , TOTAL FEES PAYABLE 1-~in nn I HAVE CAREFULLY EXAMINED THE COMPLETED , APPLICATION AND PERMIT" AND DO HEREBY Expiration Every permit issued bytheBuilding Offi6al under the provision's of1his * AN OSHA PERM:T IS REQUIRED FOR EXCAVATIONS OVER CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE I Code shall expire by limitation and become null and void It the building or work SO' Authorized by such permit is not commenced within 180 days from the dale DI such DEEP AND DEMOLITION OR CONSTRUCTION OF DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS permit, or it the budding or work authorized by such permit' is suspended or " STRUCTURES OVER 3 STORIES IN HEIGHT 'CON- ISSUED: TO COMPLY WITH ALL CITY. COUNTY AND STATE' LAWS GOVERNING 'BUILDING abandoned ci any time efter the jork is commenced for. period of ISO 'diye -STRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMN AP T'S SIGNATURE * 0 COACTDR Q APPR yE DATE KEEP HARMLESS THE CITY OF- CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, CO AN OWNER EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEOUENCE (J'(-- PLICAN N 'r GRANTING OF THIS PERMIT Y-Sle—z"I'llon hereby affirm that I am licensed under Ui aione of Chapter 9 (commencIng with I 7000) of Division 3 of the Business I and Professions Code, and my license is in L full force and effect. U'- I hereby affirm that I am exempt from the Contrac-tor's License Law for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county whicr, re- quires a permit to construct, alter, improve, demolish, or repair any structure, prior to its issuance also requires the ap- plicant for such permit to file a signed statement that he is licensed pursuant to the provisions Of the Contractors 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 exemption. Any violation of Section 7031.5 by an applicant for a permit sub- lects the applicant to civil penalty 01 not more than five hun- dred dollars $500) I I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the struc- ture is not intended or offered for sale (Sec 7044, Business and Professions 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 intend- ed or offered 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 im- prove for the purpose of safe), I I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec 7044, Business and Protessions Code: The Contractor's License Law does not apply to an owner 01 property who builds-or im- proves thereon, and who contracts for each projects With 0 contractor(s) license pursuant to the Contractor's License Law(, Ii As a homeowner I am improving my home, and the follow- ing conditions exist: t. The work is being performed prior to solo I have lived in my home for twelve months prior to completion of this work. I have not claimed this exemption during the iasi three years. o lam exempt under Sec. - - B & P.C.' for this reason EK thereby affirm that I have a certificate of consent to I seIl.insvre, or a certificate of Workers Compensation In- surance. or a ce1fif+ xl tr83800. Labor Code) POLICY NO, ,LUJ - COMPANY State Fund _! Copy is filed with the city - 0 Certified copy is hereby burnished I CERTIFICATE OF EXEMPTION FROM - WORKERS COMPENSATION INSURANCE - This section need not be completed if the permit I - is for one hundred dollars 111001 or less) O t certify that in the performance of the work to, which I this permit is issued. I shall not employ any person in any manner so as to become subject to the Workers' Compen. sation Laws of California. I NOTICE TO APPLICANT: It. alter making this Certificate J of Exemption, you should become subject to the Workers' I - Compensation provisions of the Labor Code, you mast forthwith comply with such provisions or this permit shall be deemed revoked. I TYPE DATE INSPECTOR BUILDING FOUNDATION REINFORCED STEEL MASONRY GUNITE OR GROUT SUB FRAME 0 FLOOR 0 CEIIJNG SHEATHING 0 ROOF 0 SHEAR FRAME EXTERIOR LATH INSULATION INTERIOR LATH & DRYWALL PLUMBING 0 SEWER AND BL/CO 0 PLICO UNDERGROUND 0 WASTE DWATER TOP OUT 0 WASTE 0 WATER TUB AND SHOWER PAN GAS TEST 0 WATER HEATER 0 SOLAR WATER ELECTRICAL 0 ELECTRIC UNDERGROUND D UFFER ROUGH ELECTRIC 0 ELECTRIC SERVICE 0 TEMPORARY 0 BONDING 0 POOL MECHANICAL 0 DUCT & PLEM., 0 REF. PIPING HEAT - AIR COND. SYSTEMS VENTILATING SYSTEMS CALL WHEN ALL APPROPRIATE FINAL PLUMBING ELECTRICAL MECHANICAL GAS BUILDING SPECiAL CONDITIONS FIELD INSPECTION RECORD REQUIRED SPECIAL INSPECTIONS INSPECTORS NOTES INSPECTION REQ. IF CHECKED INSPECTORS DATE APPROVAL SOILS COMPLIANCE PRIOR TO FOUNDATION INSP OVER 2000 PSI STRUCTURAL CONCRETE PRESTRESSED CONCRETE POST TENSIONED CONCRETE FIELD WELDING 1 Mf HIGH STRENGTH BOLTS - I - •1 SPECIAL MASONRY •/, 46 A, I.., PILES CAISSONS --- -