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Home My WebLink About2628 La Costa Ave; ; 80-6; PermitLICENSED CONTRACTOR'S DECLARATION I .hereby affirm that I am licensed under provi- sions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profes- sions Code, and my license is in full force and ef- fect OWNER-BUILDER DECLARATION :::: I hereby affirm that I am exempt from the Con- tractor's License Law for the following reason (Sec. 7031.5.Business and Professions Code), Any city or county which reQuires a permit to con- struct, alter, improve, demolish, or repair any structure, prior to its issuance also reQuires the applicant for such permit to file a signed s1ate- ment that he is Ucensed pursuant to the provi- sions of the Contractor's 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 ex- emption. Any violation of Section 7031.5 by an ap- plicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). C1 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 of- fered for sale (Sec. 7044, Business and Profes- sions 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 of- fered 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 improve for the purpose of sale). :JI, as owner of the property, am exclusively con- tracting with licensed contractors to construct the project {Sec. 7044. Business and Professions Code: The Contractor's License Law does not ap- ply to an owner of property ·.•ho builds or im- proves thereon, and who contracts for such pro- jects with a contractor(s) license pursuant to the contractor's License Law). I am exempt under Sec-----B. & P.C for this reason Date Owner WORKERS' COMPENSATION DECL I hereby affirm that I have a certific sent to self-insure, or a certificate Compensation Insurance, or a c thereof (Sec. 3800. Labor Code). POLICY NO. ____ _ COMPANY ____ _ LJCopy is filed with the city. r"JCertified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed 11 the per- mit is for one hundred dollars ($100) or less). 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. NOTICE TO APPLICANT: If, after making this Cer- tificate 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. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction len- ~ i~.~~a~~,~c_:_ !~}~_e ,~!_rf_o~~a_n_c!~' .. !~~--~°,!~,.'~/ CITY OF CARLSBAD-BUILDING DEPARTMENT APPLICATION & PERMIT USE BALL POINT PEN ONLY 1200 ELM AVENUE (714) 438-5525 "· JOB AOORESS tRr· 10~~/~1~wlON I":>,(,,,~~ I I I I I I ,L,.,__, 'C. ~ ,r:;;., -t, c-...i 1\\ }ii\ 1-J I I I I I I I OWNER OWNER'S PHONE PRIME CONTRACTOR ~\~_\._: ~~,....:,o,'c\ ·•-f'i, \-I ;:l.\,\'6 ~~o.~ OWNER'S MAILING ADDRESS CONTRACTOR'S A~ORESS ' ~ C. .;l._"f., \-c--r;;::s:,'=> ~ \\\)Q_ I~~-~\\ G-~ ¼\\J'-t. co, BLOCK l SUBOIVISION I ASSESSOR'S PARCEL NO. OE SIGNER ' I I I ' ' ' ' ' ' ' OC)CRIPTION OF WORK n ·---•-·-· ---\ -_ --'C OESIGNER'S AODRESS " (2:, CENSUS TRACT GP LAND USE ZONING sf APPLICANT TO FILL IN INFOR- MATION WITHIN RED LINES. BUS. L lCENSE PERMIT NUMBER ,:Q_ O.;)S (., io r STATE LICENSE t f--r~ q '6 <., ":::> CONTRACTOR'S ',o~\\_-C\?, .'.).:l. STATE LICENSE DESIGNER'S PHONE I RES. UNITS I P;RKING SPACE l NUMBER OF STORIES Not Vafid Unless Machine C.rtifild BLOG SQ. FT. BLDG USE acc. GP I STAN OARD PLAN 11 IPLANID# I TYPE CONST I occ. LOAD I QTY. PLUMBING PERMIT AMT. QTY. MECHANICAL PERMIT AMT. EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100,000 BTU EACH BUILDING SEWER OVER 100,000 BTU EACH WATER HEATER ANO/OR VENT BOILER/COMPRESSOR UPTO 3 HP EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP / EACH GAS SYSTEM 5 OR MORE v'.CV BOILER/COMPRESSOR 16-30 HP . EACH INSTAL., ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT EACH LAWN SPRINKLER SYSTEM MECH EXHAUST -HOOD/DUCTS VALUATION: WATER SOFTNER RELOCATION OF EA FURNACE/HEATER BUILDING PERMIT I I I I T--·--,_ or T ~ ~·~-<-00 SIGN PERMIT I I I I TOTAL PLUMBING ~ i..---TOTAL MECHANICAL PLAN CHECK I I I I CONTRACTOR CONTRACTOR ALL INCLUSIVE PERMIT I I I ELECTRICAL PERMIT AMT. TOTAL PLUMBING I " llTY. AMT. QTY. MOBILE HOME PERMIT ELECTRICAL I j . I NEW CONST EA AMP/SWT/BKR AWNING MECHANICAL I I . I 1 PH .25 3 PH PORCH MOBILE HOME I I . I EXIST BLOG EA AMP/SWT/BKR SET-UP SOLAR I I I . I 1 PH .25 3 PH RAMADA, CABANA I I I I REMODEL/ALTER PER CIRCUIT FENCE OVER 6' I I I . I TEMP POLE 200 AMPS TOTAL MOBILE HOME MICO·FILM I I I -I OVER 200 AMPS I I I . I TEMP OCCUPANCY (30 DAYS) STDr>Nf: M{VI' rm,,: I I I I T,... ,...,,..,, 2 .. -00 I I I I TOTAL ELECTRICAL TOTAL FEES PAYABLE I ~ CONTRACTOR I I I I ~f!i!., SCHOOL FEES: I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT, AND DO •AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE ANO CORRECT AND I 5'-0" DEEP AND DEMOLITION OR CONSTRUCTION OF FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED; TO COMPLY WITH ALL CITY, STRUCTURES OVER 3 STORIES IN HEIGHT COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION. WHETHER &~M.n-r-..-SPECIFIED HEREIN OR NOT I.ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM c=: LESS THE CITY OF CAR LS BAO AGAINST ALL LIABILITIES, JUDGMENTS. COSTS AND , EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT APPLICANT'S SIGNATURE" OWNER □ CONTRACTOR□ I APPROVED i vfy 71:;!HJ AGENTc:e.-----sy PHONE 0 , ' I • I ~ 5 ;:: u w a. V, ~ SITE ADDRESS: OWNER: PERMIT NO: <to--1:? ! - FIELD INSPECTION RECORD INSPECTION DATE INSPECTOR i NSPECTOR'S NOTES - WOOD FLOOR FOUNDATION• FORMS• SET BACK• TOILET UNDER FLOOR PLUMBING UNDER FLOOR HEATING OK TO INSTALL SUB FLOOR SLAB FLOOR LINDER SLAB PLUMBING FOOTING• FORMS• SETBACK• TOILET OK TO POUR CONCRETE FRAME ROUGH ELECTRICAL ROUGH PLUMBING ROUGH HEATING/VENTILATING FRAME OK• PLACE INSULATION INSULATION OK • PLACE WALLBOARD WALLBOARD OK• PLACE TAPE EXTERIOR LATH OK• PLACE STUCCO FIREPLACE DAMPER 8: STEEL PLATE TIES/HEIGHT OF CHIMNEY OTHER TEMP POWER (POLE) SEWER GAS TEST SWIM POOL • STEEL BONDING • PRE DECK • FENCE PREPLASTER SHOWN • FRAME • PAN F!N.4.L tNSP BY BLDG DEPT OTHER DEPT'S REQ COMPLETED ELEC METER-PERM-TEMP , -GAS METER-PERM-TEMP '7,4 ,,,. 'l.~ / I f- ~-, OF OCCUPANCY ISSUC:D --