HomeMy WebLinkAbout2624 El Camino Real; C; 85-292; PermitCl) z 0 ~ a: <( ..J
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O I hereby 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 alhrm lhat I am exempt lrom the Contrac·
tor·s License Law tor the following reason (Sec 7031.5 Business and Professions Code Any city or county wh1ctt re· quires a perm,! to construct, alter improve, demohsh. or
repair any structure. prior to its issuance also requires :heap·, p1,can1 tor such perm,t 10 fife a s1qned statement that he 1s
licensed pursuant to lhe provisions ol me con1rac1o(s License Law (Chapter 9 commencing w1lh Section 7000 ol
01v1s1on 3 of the Busmess and Professions CodeJ or that 1s ex· empt therelrom and the basis tor the at:egea exemption Any
v1olat1on o1 SecMn 7031.5 by an app11can1 for a perm,1 sub-
Jecls the apphcant to a CMl penalty of no! mOfe lhan live hun-dred dollars 1$500)
1. as owner ol the property, or my employees w1lh wages
as 1he1r sole compensat1on, will do lhe work. and the struc·
ture 1s no11ntended or ollered for sale (Sec 7044. Business
and Proless1ons Code The Conlraclor"s Ucense Law does not apply to an owner of property who builds or improves thereon and who does such work himself or through hrs own
employees. provided that such 1mprovemen1s are not intend-
ed or offered for sale. If. however. the building or improve-ment 1s sold w1thm one year of complehon, the owner·bu1lder
will have the burden of prDYtnQ thal he did no! bwld or im-
prove 10< lhe purpose ol sale).. ·
J I, as owner ol the property. am exclusively contracting with licensed conlractors to construct the pro1ec1 {Sec 7044,
Business and Prnfess1ons Code The Contractor's Ucense Law does not apply 10 an owner ol property who builds or im-
proves thereon. and who con1racts tor each prote<::ls with a contraclor{s) license pursuant to the Contractor· s license Law)
i, As a homeowner 1 am improving my home. and the follow
mg cond1hons exist
1 The work 1s being performed prior to sa1e
2 I have 11ved m my home !or twetve months pnor 10 completlOn of this work
3 I have not claimed this exemption during the
last lhree years.
D I am exempt under Sec B & PC tor 1h1s reason ____________ _
D I hereby alf1rm I hat I na-.,e a cert,hcale ol consent
to seH insure, or a cert1f1ca1e ol Workers
Compensation Insurance or a cen,l1ed copy ir.ereol
iSec 3800. Labor Co<lel
POLICY NO
COMPANY
0 Copy 1s hied with lhe city
0 Cer11t1ed copy 1s hereby furnished
CERTIFICATl OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE
(This section need not be completed 11 the permit
1s !Of one hundre<J dollars ($1001 or less)
D I cer1:lly thal 10 1he pertormance ot nie work tor
which th,s perm,t 1s issued I shall nol employ any person m any manner so as to beeome sub1ec1 tt.:
the Workers Compensation Laws ot Cahtorn1a
NOTICE TO APPLICANT II after mak,n~ this CerH
t,caie ol Exempt,on you should become sub1ec1 I')
1he Wol'1ilers Compensation provisions of !he Labor
Cooe you must lortn~,tn compl'( w11tl such
p,ov1s,ons or 1h15 permit shall be oeemed ,e..,okecJ
0 I hereby att1rm 1hal there 1s cl cons1,uc11on
1en01nQ aoency tor the performance ot 1he wor1< tor
which lht.S permit ,s issued 1Sec 3097 C,v,1 COdel
Lenoers Name __________ ~~
Lenders Aoaress ------------
USE BALL 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 (61~) 438-5525
;OB AD~SS /"j i tcl'c:i AV ST AD lEAREST CROSS Sf l DA TE OF APPLICATION! BUSINESS LICENSE # VALUATION PERMIT NUMBER
/'1b /'. (/J-_1"1 ~~ l<~/1 fr! 4 /~((. (j ;J Jon£J <;;~~ z,q~ LOT BLOCK I SUBD~ISION I ASSESSOR PARCEL NO
r;.:NT~~:A fc{(iPPel2: 'cJW~Tyffl. ZONE
OWNC:~Art\\J ~+.)6 -, OWNf R'S PHONf
'llJf/-f ;f{ c{/(({if).(s(~~1Jvo ,&,/RJJ~ LICENSE NO ~NI.D.# BLOG USE CODE
OWNE ·s c/lL1NG ADDRESS kal s!e
'b ....
7 {j 1. (S ( ( .Li-t':-] I hio (09--J.fd DES1GNEA ( _,,a/l.lS ~t (,4-: (j~c.,C·.)". LICENSE " STANDARD PLAN # BUILDING SO. FOOTAGE
DESCRIPTION OF WOR~4. ,•l-;r17~ . , 5-~n.. ~-
/.: A ,if'J ·' • DESlGNEA'S AODRESS
vVZ/~r;'Sr,E I -r ' -: =1 •-~,-M.L-1A-G.--r1 -rrotJ6 I A} £,<./~Tl ,~ ~/ ,J/t:j~22 ! I F/P FLA ELEV NO OCC GP EDU rr .11
'. ::;-m~£_. n£ -.~ \j \1, J~ ~ A,,l.Dt.J STORIES u;.,~·i1 i:: \. i bli.lt r-l .()1,
vO NO --
I CENSUS TRACT I GP LAND USE PAA KING SPACE AES UNlTS I GRADING PERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD Fl RE SPA
I
AREA CONST
I YO N 0 vO "D vO NO Not Valtd Unlt!fr Machine Certified
I 7s-o 3-SUMMARY/ACCOUNT NUMBER
1
QTY. PLUMBING PERMIT -ISSUE QTY. MECHANICAL PERMIT· ISSUE
EACH FIXTURE TRAP INSTALL FURN DUCTS UP TO 100 .000 BTU -0:::. . ,,.-BUILDING PERMIT 01 ·00·00-8220 I I. r-.X.,o
I EACH BUILDING SEWER OVER 100.000 BTU , SIGN PERMIT 01-00·00-8221
I -'• ---_.___ //, -d.D ~
I EACH WATER HEATER ANO OR VENT ~ BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01 ·00·00-8806
I EACH GAS SYSTEM l TO 4 OUTLETS __ ~ t-BOILER COM PR ESSO R 3 15 HP TOTAL PLUMBING 01 ·00·00·8222 1JJ ---~------.,--I EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE ELECTRICAL 01 -00·00·8223 i ---__ ,_ ---_._ -~,
EACH INSTA~ ALTER. REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHAN'CAL 01-00-00·8224 -----
EACH VACUUM BREAKER MECH EXHAUST HOOD OUCTS MOBILEHOME 01-00·00·8225
WATER SOFTNER RELOCATION OF EA FURNACE1HEATER MOBILEHOME PARK INSP
EACH ROOF DRAIN I NSIDEl SOLAR 01-00·00:.6226 _
TOTt;L MECHANICAL STRONG MOT ION 80·92-33·0519 ~-7 ~-·--
TOfAL PLUMBING I -FIRE SPRINKLERS 01-00·00-8227
QTY. ELECTRICAL PERMIT -ISSUE 5-QTY. SOLAR -ISSUE PUBLIC FACIL:TIES FEE 32·00·0_Q·89l)
BRIDGE FEE
NEW CONST EA AMP SWT BKR COLLECTORS SCHOOL FEE · DISTRICT ·-
1 PH 3 PH STORAGE TAIIJKS Carlsbad 80·92·21-0519
EXIST BLOG EA AMP SWT BKR ROCK STORAGE Encinitas 80·92·22·0519 --
1 PH 3 PH PUMP San D1egu1to 80·92·23·0519
REMODEL ALltR PER CIRCUIT -r ..-PLAN CHECK FEE San Marcos 80·92-24·0519 -
TEMP PO LE 200 AMPS ...... , . /1'] ~
OVER ZOO AMPS -"("" -LICENSE TAX 01-00·00·B162 ...... ~
TEMP OCCUPANCY 130 DAYS! MFF 80-92-57-0519 { ,,/ _,,_. -
.~ CREDIT DEPOSIT /, ~\] I JIJ
TOTAL EL!:CTRICAL I ~ TOTAL SOLAR TOTAL FEES PAYABLE l~~~~r;t:f
I HAVE CAREFULLY EXAMINEO THE COMPLETEO 'APPLICATION AND PERMIT' AND DO HEREBY Exptrat1on Every permit issued by the 8U1ld1ng Qft,c1a1 under the provisions of this * AN OSHA PERM:T IS REQUIRED FOR EXCAVATIONS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall exp1re by hm1tat1on and become null and void If the building or work 5· O" DEEP AND DEMOLITION <>fl CONSTRUCTION OF author1zed by such permit 1s not commenced w1th1n 180 days from the date of such I DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT 15 permit. or if the bulldtnff or work authorized by such per~~s suspended or STRUCTVR£S ov~'1 STC>fllES IN HEIGHT
I ISSUED TO COMPLY WITH ALL CITY COUNlY AND STATE LAWS GOVERNING BUILDING CON abandoned at anv hme a ter th• ..... rk 1s commenced tor'..; """ ol 180 davs ~ /'\ I
I STRUCTION WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND APPLICANTS SIGNATU~/7"' OWN~ CONTRACTOR O' APPRO"ED BY f I u • .1,o//~ 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 ci..,,r ~ .... • ,, ,
I GRANTING OF THIS PERMIT
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TYPE I
BUILDING I
FOUNDATION I
REINFORCED STEEL I
MASONRY i
GUNITE OR GROUT I
FLOOR & CEILING SUB FRAME I
I
SHEATHING D ROOF 0 SHE!AR
FRAME I
EXTERIOR LATH i
INSULATION I
INTERIOR LATH & DRYWALL I
!
PLUMBING I
SEWER AND BUCO DIP UCO
UNDERGROUND D WASTE D WATER
TOP OUT D WASTE D WATER
TUB AND SHOWER PAN 1
GAS TEST
DATE INSPECTOR
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS
INSPECTION
I I L, so,cs COMPC 'ANCE 1 PRIOR TO ftJ/~1/ft. ~ ... ._~ __JJ;.11.u~DATION INSP
~ I I I I I STRUCTURAL CONCRETE I -· OVER 2000•PS1
PRESTRESSED--
CONCRETE
POST TENSIONED
CONCRETE
FIELD WELDING
HIGH_ ST8ENG,,H
AOL TS "-·
1,PECIAL MASONRY
PILES CAIS$01\,S
REO IF I INSPECTORS
CHECKED APPROVAL DATE
D WATER HEATER D SOLAR WATER ---------~ ---+---·-----+----~
ELECTRICAL I
D ELECTRIC UNDERGROUND D t;JFFER I 1 ,
ROUGH ELECTRIC ~ I I I I
D ELECTRIC SERVICE D TEMPOlilARY
D BONDING D POOL
MECHANICAL
D DUCT & PLEM ., D REF. PIPINµ
VENTILATING SYSTEMS
· T~ ~;,: I ' ~
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HEAT -AIR COND. SYSTEMS •
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE. BEEN APPROVED.
FINAL I
PLUMBING T
ELECTRICAL I
MECHANICAL I
GAS I
BUILDING I
SPECIAL CONDITIONS I
!
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INSPECTOR'S NOTES
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City of Carlsbad
1200 ELM, CARLS8AD, CAl92008 • TEL. (619) 438-5525
r Job
Address ... J,
~ L --A, r "t ·~ L
Owner I ( I
Mailing r / ,:/. Address I • I I 'I. .
City I I Zip Tel. '/ !t ,fr
Contractor ( fr .,1A II .,v
Address ' /J ,., ) (/' ,,_ ...
City I Zip Tel. / ?:/Lr;, 9/r/ '· I,
Stale Lie. <-/-/ 1?L <; City S Class,f Uc. No.
COMPLETE FOR PLAN CHECK ONLY
LEGAL DESCRIPTION
ASSESSORS PARCEL NO
DESCRIPTION OF WORK
.,£. o~AI du IT £.. A -vt:, 7,A.L cl) w,
-.(_;~ C. fe f ') OU f:_. w1..
'P t -n..,..) f: y ~ r6C --ri: ,._ ) "-' ' IJ /' .E J <t ..r J-?-LI, '+-PLAN ID NO.
DESIGNER ADDRESS
PHONE I.,.<, -, I ()I -c.. A1JVA4
1YV-1~ c ,
CONT ACT PERSON r /(
(c I, ~
Signalure of Applicanl Date
"--
MISCELLANEOUS
RECEIPT
MISCELLANEOUS FEE RECEIPT
D • PLAN CHECK FEE 01-00-00-8806
(,uc.J .o VALUATION y
D DEMOLITION
D HOUSE MOVING
D PARKS AND RECREATION FEE
D PUBLIC FACILITIES FEE
D SCHOOL FEE · DISTRICT
D Carlsbad
D Encinitas
D San Diego
D San Marcos
D CERTIFICATE OF OCCUPANCY
n
n
D I
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D Pi U?'" r,: ~ l AJu A R r.u , r-r h
D (.J A.) ~~-~q-z..__
D
D
D
D
D
TOTAL FEE
7"t 'l
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·WARNING: PLAN CHECK FEES. WHERE NO ACTION IS TAKEN BY THE
APPLICANT IN 180 DAYS AND NO BUILDING PERMIT IS ISSUED. ARE
FORFEITED TO THE CITY.
COMMENTS:
White -Applicant Yellow -File Pink -(1) Finance (2) Data Process Gold -Assessor
.,
-
~
I
To: ENGINEERING, FIRE, PLANNING, UTILITIES
FINA~ l~SPEC'TION NOTI~~
Date 7
Address cl.b:2f t[,/ ~M Plan # ?5-).,(i'l,,/ e .J-D F~-~tl -Type of Construction __ ...... f;___;:,'--',;;_'--L ________ _
Person to Contact ~ Ph. No. ?'Jf',, '1011>
~ Date Approved cb-:; ______ D_a_te_~=-'-:£:..........,-Y; __ 'S' ___ A_PP_ro_vec1 ___ ,.,..yU{/ _____ _
Department
Utilities
Department
Date
Date
Approved
Approved
Comments: __________________ _
IF A RESPONSE IS NOT RECEIVED WITHIN 24 HOURS, IT WILL IIE ASSUMED IT IS OKAY TO FINAL
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DEVELOPMENTAL
SERVICES
BUILDING DEPARTMENT.
Dear Property Owner:
1200 ELM AVENUE
CARLSBAD, CALIFORNIA 92008-1989
·(S19) 438-5525
An application for a building permit has been submitted in your name listing yourself
as the builder of the property improvements specified. For your protection you should be
aware that as "owner-builder" you are the responsible party of record on such a permit.
Building permits are not required to be signed by the property owners unless they are
personally performing their own work. If your work is bein~ performed by someone other
than yourself, you may protect yourself from possible liability if that person applies for
the proper permit in his or her name.
Contractors are required by law to be licensed and bonded by the State of California ·and
to have a business license from the City of Carlsbad . They are also required by law to
put their license number on all permits for which they apply.
If you plan to do your own work, with the except1on of various trades that you plan to
subcontract, you should be aware of the following infonnation for your benefit and pro-
tection. If you employ or otherwise engage any persons other than your inrnediate family,
and the work (including material and other costs} is $20Q or more for the entire project,
and such persons are not licensed as contractors or subcontractors, then you may be an
employer. If you are an employer, you must register with the state and federal governnent
as an employer and you are subject to several obligations including state and federal
income withholding, federal social security taxes, workers' compensation insurance,
disability insurance costs, and unemployment contributtons. There may be financial risks
for you if you do not carry out these ol)ligaUons and these rfsJcS are especially serious
with respect to workers' compensation fnsurance.
For specific information about your obligations under federal law, contact the Internal
Revenue Service (and, if you wish, the U.S. Small Business Administration). For more
specific information about your obligations under state law, contact the Department of
Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors
are allowed to perform their work personally or through their own em~loyees, without
a licensed contractor or subcontractor, only under limited condftions.
A frequent practice of unlicensed persons professing to be contractors is to secure an
"owner-builder" building permit, erroneously implying that the property owner is providing
hi~ or her own labor and material personally. Buildir.g permits are not required to be
signed by property owners unless they are performing their own work personally. Informa-
tioA about licensed contractors may be obtained by contacting the Contractors State
License Board in your conwnunity or at 1020 N Street, Sacramento, CA 95814.
PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER-BUILDER VERIFICATION FORM SO THAT WE CAN
CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED
UNTIL THE VERIFICATION IS RETURNED .
Very truly yours,
Building Department
City of Carlsbad
ATTENTION PROPERTY OWNER:
• I
An "owner--bu11der" building pal"ullt has been applied for in your name and be:,rfog your
signature~ -
Pleaso cOMplote and return tMs infomation in tht• env~lopc prnvided at your e6'f'l1~st
opportunity to &void unnece$S&ry delay in processing and isst1ing your buildinr r,en,ritc
No building permit will be issued until th'ls verH'iclltion 1s rtceivtd.
1. I personally pl an to provide the~ labor and materials for· construction of
the proposed property improvement (~or no)~ •
2. I (have/h&ve not)-~~ signed the application for a building pennit.
3. I have contracted with the following person (finn) to provide the propos~d construction.
::e-ss ______ A/_4-4-
City __________ ( ........... Z __
Phone ----------------Contractors License No. -----
4. I plan to provide portions of the work, but I have hired the folfowing person to
coordinate, supervise and provide the major work.
Na1iie -----------------------+-~ Phone ------------Address ------------------""M"'l~-r.1 Cont r & ct ors License No. -----
City -------------+-,~
S. I will provid~ some of the work but I have cor.tr&cted (hired) the following pErsons
to provide the work indicated: ~
N&me Address Phone Type of Work
Signed: Property Owner _____ __._ ........ _______ '"""' ________ _
Socia 1 Security Nt111ber _>-_~_~_-_?;_y_-__________ _
Date: h/*' e'f /f§'--,::;;S ________ _
EACH SUBCONTRACTOR WILL BE INSTRUCTED TO OBTAIN A CITY OF CARLSBAD BUSINESS LICENSE
AND FURNISH A CERTIFICATE OF WORl<MAN'S COMPENSATION TG THE CITY OF CARLSBAD. UP Initials