HomeMy WebLinkAbout2610 LA DUELA LN; ; CB880880; Permit., z 0
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O 1 hereby affirm ttiat I am licensed under
provision, of Chapter 9 (commencing with
S.Ctlon 7000) of Division 3 ot the Business
and Professions Code, and my license 1s in
full force and effect
I he•eby alhrm lhal I am exempt 'com the C:;orrac
tors License Law to· ine fol1ow,ng •easor ISec 103' ~
Business ano Professions COde Any c,ly or county whrc-·e
quores a permit 1~ cJnstrucr alter 1'TlprJve Ce"1ol,sh o·
repoir any struclu1e prior lo .ts 1ssua~ce also requ,res 'he ao
p11can1 10, sucn pe"'lrf to file a s,oned stare'"'enl Iha: he s 1censeo p,;rsJant :o the nroy1s1ons o• the l,c11racw s
l1cerse Law ,Chaple' 9 commencing with Sed,or ?00C ol
J,.,151on 3 ~f 1ne Business and Profess,ons Code, or I hat sex
ernot lhe'efrorn and the basis lor lhe alleged e,ernpl,on An·1 ,·,oat,on 01 Seer-on 7031 5 by an app'rcart la· d perrn,t s,b ects the applrca~: 10 a c,vrl peoallj o1 not rno'e t~an tr;e e.,n
drec collars ,ss001
I as owner ol the prope-ty or my ernplo1~es w1:h waqes
a1 the,r sole cornpensa1,on w,,1 do The wor< and lhe struc
•ure 1s not rnlended o' oflered 'a, sale 1Sef ma4 Bi..s,ness
and Professrona Code The Contractors I 1cense I aw does
0ot ap~ly lo a~ owner o• property '"ho builds or ,mQ'o,es
:~ereon and who does such wor< h1rnsell or throuqh hrs ow1
employees oro,,oed 1na1 sucn ,rnproyernenls ore r,ol 1nlend
ed or ol'e,ec lor sa·e II however the bu11dmg or ,rnprove 'Tle"t s sole w1th10 Dne year ol compleT,or The owne· bu rider
will naye The bu-den o' prov,rg that he drd no• burld or 1rn Jro,e for lhe pu·pose ol sale1
I as owner or lhe pro;ierly am exclusively rnntract,nq
with lice~sed corlracto"s to co~st"uc• lhe pro1ec1 !Sec ?:},4
Business and Pro•essrons Code The Conlractor s L•cer,se
. aw does ~ot aoo,y to an owner of property w~o builds o, ,rn proves inereon and who contracts lor ea:h pro1ects with a
nntractor(s:, rcense purs,,anl to 'he r:o~·,acto, s I cerse
"aw:
As a holl'eowner I am ,mprov,ng my home ~nd t~e fol c-w
,n9 ~ond11,ons exist
l I !he wo•K •s being pe-formed priO' to sale
2 "a·,e lwed ,n my h0"1e for !Weise mon'h'
pri8r 10 (Or"pletron u' )'·rs wwk
3 ".ave not cla,med t"rs ewmpl18n dur ng 'he
last three years
I am exemp· unoer Sec ______ B & PC to, this reason ____________ _
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I nernb, att ''T !Mt I have a cef11'1cate o' consent lo
se' ,rsure ~racer: frcate of WJ"e·s Compen5a1,on Is
surance o, a cert f1~f1 cop\' the,eof ,Sec 3800. LaborCode1
"OLICY l'.0
COMPANY
Ccp, ,sf, ed . ..,,1, tne c,ty
Ce,i,f ed co~.,. 1s he,eb) 'urn1shed
CERTIFICATE OF EXEMPTION FROM
WORKEPS COMPENSATION l"J5URANCE
,Th•s sec11on need 001 be compleled rf the permit
1s for one hund,ed do a's ,$1001 o, l!"S51
I :e,t1fv lhat 1n the performance ot tne wc,rK fo, ,,h,cn
This permit s issued I shall oc,t emplo1 an; person," aa·,
""Tiarner so as to become subiect w the Workers Com pen
sat c,n Laws 01 Cal1forn1a
i',QTICE TO APPLICAN: II alter ma,.~g lh,s Ce': f1ca\e
ol Exemption you should oecorne sub1ect to the Wcrkers
Ccr"1pensat1on pro,is,ons ol 1he Lato, Code. )'CU ~.~s,
lor:nw1th comp Iv with such prc,is1o~s or i~,s oerf'1•' shal
be deemed 'evo,ed
~Prer,,· atf ,,., •'1a' rre'e s a, •,ns1,_,:1,or P1'r~ ~9
,eq,,~cy 'or ·re ~e"~w•aoc~ .,, t~P ;,-,, '~•r ., 0 ct"· '"1s ~e·
-· s ssu"'J s,,,, ;:,97 C1·.1 CoJe,
Lerce, s r-.a1,e
L~· ,"~' S A "C")''
USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT 2075 Las Palmas Dr .• Carlsbad, CA 92009-1915 (619) 438-1161
~Z~t'c Lp;... ~~TRD L~ASBROSN~s: Io~/~\ ~,oNI BUSINESS LICENSE # VALUATION PERMIT NUMBER
{s?.... ~c;f ;:, £-' 8'd 8'80 COT BLOCK I SUBDIVISION I ASSE~SA~L NO CONT,:::SOl ~ CONTRACTORS PHONE -ZONE C. -(:11.-:7../ "?'
OWM N(Sf?..e_-\-\-1 c... A'\?.w~¾% CONTRACTOR'S ADDRESS STATE LICENSE NO. BUILDING SQ FOOTAGE
~iloA1:~ ~ l.~ DESIGNER DESIGNER'S PHONE
DESCR;~1073-~/RK _ 1. ,_ IJ /_I •. II /. ; STATE LICENSE NO. DESIGNER'S ADDRESS ., ,, ' . ,P. $0/#i ~/£/I# /7\ r, l71
/("'( V ' ' F LR ELEV NO ace GP EDU
-/}. _-_ -· STORIES
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/ CENSUS TRACT ,,., PAPK1"-C, SPACE: Rf-SUNITS GRADING PERMIT ISSUED I REDEVELOPMENT TYPE DCC LOAD FIRESPP
AREA CONST
,□ ' D ,C -...c v □ r--D Not Vil/id Unless Machine Certified
QTY PLUMBING PERMIT -ISSUE ?-8. QTY MECHANICAL PERMIT· ISSUE IS~ SUMMARY/ACCOUNT NUMBER
EArH flXTURf TRAP INSTALL FURN OUCTS iJP TO 100 000 BTU trnll_ulNL, f'tHr.ol, )IJ · -i:\ 1 IJ-UU-!J~-oc, C . ...,,,.,
E.ACH BUll.lliNG SEWER OVER 100.000 BTU SIGN PERMIT oo· e10 oo o~•-0221
EACH WATER Hf ATER ANLJ OR VENT BOILER COMPRESSOR UP TO 3 HP PLAN CHECK 001-81 0-00-00-8891 ;i~
EACH (.;AS SYSTEM I I U 4 OUl LETS BOILER [OMPRESSOR 3 1'.l HP TOTAL ~l'NG~ A m-:r:,t,:l'r'l\-sn;:
EACH GAS SYS! E.M 'i OR MORF ''1~'A1 ~IRFPIAU: E LE C f!!'C' -'., .., "tc.,.-H-~-8223 , <:
EACH INST AL ALTER. REPAIR \",'ATER PIPE VENT ~AN SINGlE OUCT MECHANICAL 001-81 G-OD-00-8224
EACH VACUUM BREAKER . MECH HHAUST HOOD DUCTS MOBIL EHOW J L l ~ cm-mm1J::i-oo-s22s
,\'ATER so~ TNER RELOCATION OF EA FURNACE HEATER SOLAR :,01-8 O-GO-G::l-8226
I ,:iJ '7 ;;(/; >.l,li\ , ";'-f; DRYER VENT -fii.it,MYoi-1'f 33 /
TOH<L MECHANICAL ,<HU<
TU I Al Pi UMP.l!\li, I . PUBLIC FACILITIES FEE 32D-81 0-0'.1-00-2 >~
. '\t!f!. BRIDGE FEE 360-810-00-00-87 JO
QTY ELECTRICAL PERMIT· ISSUE QTY. MOBILE HOME SETUP PARK \-LIEU !AREA
~~W CONST E.A elMP SI\'! lJKH CAR PORT ., F 312-810-00-00-8835
I PH ; PH AWNING LA COSTA TIF 311-810-00-00-8835
F _\ IS T 6 l [] c; ~ A AMP SW T HK R GARAGE FSF
I PH 1 PH . LICENSE TAX oo 1-2 · 2•-c,~-:-,:1-s, ;:i
I R[MODFl Al ltR PfW r:1RCLtll /0 -fHF SB0-5"9-92-5,·
TF\'P P-:Jl f JUli el \IP',
U1,t:.R llJL, AMPS .
TE'.1P 11:.l.lJPANlY 30 LJAYS1 . .1
CREDIT DEPOSIT /j"J-i --"'
: II r A I f I f. i l >-!II r, I I /5-rp:;1 TOTAL FEES PAYABLE I /~
1 HAVE CAREFULLY EXAMINEJ 'HI:: COMPLETED APPLiC,'\TiQN AND PERMIT ANO 00 HE9EBY Exp1r1111on Every perm,t ,ssued by the Bu,lding Ol!<c,sl under !he prov,s,ons o! th,s * AN OSHA PERM:T tS REQUIRED FOR EXCAVATIONS OVER
CERTIFY UNDER PENALTY OF PEPJLrPY THA"'." ALL :NFCRMAT•ON HEREON INCLUDING Tt"'E Code shall expire by 1,m,tat1on and become null and vo,d 11 the bur!d,ng o, work 5· O" DEEP ANO OEMOl.lTION OR CONSTRUCTK>N OF-"
LJFC! ARATIQNS ARE TRUE A"-JD CORRECT AND I F~JPTHE;'.l CERrlFY AND AGREf IF A PERMIT le., authorized by such perm rt ,s not•~t:.Juenced w,thm 180 days from t'>e date o' sue!"' STRUCTURES OVER J STORIES IN H[IG)-H pern:uJ ..... 01 ,! the bu1tdmft or work uthorrzed by such per,n,t ,s svsp1.mded or
'SSl;lCl TO COIV'PLY V/ITH .-,Le c1~y COUN-fY ANJ STllTE LAWS (,Q',,'ERr,i"NG BUILD!NG CQf, ndon at am lime.a ter the rk ,~ commenced for a nenod of 180 davs
STPLJ(~TION WHFTHER SPECIFIED >-<£REIN OR ".CT I llLSO AGRE:': '0 SA'/E !NOEMNIFY ANU 'ff'PLICA ~s1§j1 /1(, J -VWNERn CONTRACTOR [J APPRG 8' , () ,A -• CA/ r<-.EEP >1A8f,!LESS THE c1ry OF CARLSBAD AGAl'\/ST A.-....L LiABILITIFS JUUGVEr--.TS COSTS AND
E~Pff.iSES \Nf-;ICH MA'!' i"-J ll,N'r' 1'Jt,,Y ACCRUE AGAlr-.iST SA!O CITY 1N CC",SE'OLJENCE OF THE . ('
~v ?q ~,-C.0.PA"JTi'\/G Q!C ~HIS PE8MIT / )('\_ BY PHONE [J / V,' ~, , __ , I I ½ I« ·-. '
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TYPE DATE INSPECTOR
BUILDING
FOUNDATION
REINFORCED STEEL
MASONRY
GUNITE OR GROUT
SUB FRAME □ FLOOR D CEILING
SHEATHING □ ROOF □ SHEAR
FRAME
EXTERIOR LATH
INSULATION
INTERIOR LATH & DRYWALL
PLUMBING
□ SEWER AND BL/CO □ PL/CO
UNDERGROUND □ WASTE □ WATER
TOP OUT □ WASTE □ WATER
TUB AND SHOWER PAN
GAS TEST
□ WATER HEATER □ SOLAR WATER
ELECTRICAL
□ ELECTRIC UNDERGROUND □ UFFER
ROUGH ELECTRIC
□ ELECTRIC SERVICE □ TEMPORARY
□ BONDING □ POOL
MECHANICAL
□ DUCT & PLEM., □ REF. PIPING
HEAT -AIR COND. SYSTEMS .
VENTILATING SYSTEMS
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HA VE BEEN APPROVED.
FINAL
PLUMBING
ELECTRICAL
MECHANICAL
GAS
BUILDING
SPECIAL CONDITIONS
CS 8~0 8"~<J
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTION REQ IF INSPECTORS DATE 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 1:,:AHi.'itr;fi/'. t}·:,:r-·.:n·'•j ;·. ·
C!P ~~ r •-~··:_;r ~~t.n·: ._,;
Pl:...ES CAISSON::·
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Architectural Committee or Landscape Committee
Approved/Date: /lu! 2 //lo{ Denied/Date
Recommended or AcµpiA'S17 Changes: -------------------------d/6!5T:S ;;. 0, A, &b ,,PAfp.fTS
By: ~L
Form Revised 1/15/86
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