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Home My WebLink About2642 MADISON ST; ; 81-450; Permit., z 0 ~ "' .. ~ u .. 0 l!l ·1[ u .. .. 0 ~ 3 I .. z ~ z 0 ~ z .. .. "' 8 ., "' .. " "' 0 3 ![ O I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in lull force and eflect. Lie No _ C'ass I hereby att1rm that I am exempt from the Con ~,,~r~~~~~;ss: ~: ~~1::,~~~c:Je'°:~~~,\~r cmJnty which requires a permit to construct alter. improve, demolish, or repa1r any struc1ure, pno, to rts issuance also requires the apphcant ror such permit to hie a s,gned statement that he ,s licensed pursuant to the prov,sions of the Con- tractor's License Law (Chapter 9 commenc,ng wrth Section 7000 o! O,v,s,on 3 of the Business and Pro• fess,ons Code) or that ,s exempt therefrom and the bas•'i> for the alleged exemp11on Any v1olat,on of sect,on 7031 5 by an ~pl,canl for a permit sub1ects tne applicant lo a c1v11 penalty of not more than ftve hundred dolla~ ($.5(X)l D 1. as owner of the property. or my employees ,.,,ih wages as their sole compensat,on. w,11 do the wor1<., and tile structure 1s not intended or offered lor sale (Sec 7044, Business and Pro1ess,ol'ls CO<le The Con!rac!o!'s L,cense Law does not apply to an owne, of property wno builds or 1mpro1>es thereon and who does such wor1<. himself or throug~. h,s own employees, pr0v1ded that such 1mproveme:its are not 1ntende-J or offered for sale If. however. the bulldmg or improvement 1s sold w1th,n one year of complet,on_ the owner-builder will have the burden of provmi. that he did not build or ,mprove tor the purpose of salel O I, as owner of the property am exclusively contracting with licensed contrac10rs to construct the proJect (Sec 7044. Business and Professions Code The Contractor's L,cense Law does not apply to an owner of property who builds or improves there0<1, and who contracts tor each proiec1s with a cont,actor1s1 1,cense pursuant to the Contractor's License Law) D I am eu,mp! under Sec for this reason . B "'PC D I he•eby affirm that I ha•e a cert,t1cate of cor,sent to sei!-msure. or a cert1f1cate of WorKers Compe'1sa1,on Insurance, or a cert1!1ed copy the,eol (Sec 380'.I. Latxlr Code) POLICY NO COMPANY □ Copy IS tiled with the Ct!y O Cert1!,ed copy 1s hereby tum<shed CERTIFICATE. OF EXEMPTION FROM WORt<;ERS' COMPENSATION INSURANCE (Th,s se.:t1on need not be completed 1f the permit ,s for one hundred dollars 1$100) o, less) D I certify that m the performance of the won< lo, which 1h1s perm1t 1s issued. I shall no! employ any person 1n any manne, so as 10 become sub1ec1 10 the Worl<ers· Compensation Laws of Cal11orn1a NOTICE TO APPLICANT If, after mak1n:;i lh1s Cert, f1ca!e of Exemp1,on vou should become sub1ec1 t~ the Worl<ers · Compensation p,ov1s,ons of the Labor Code. you must lorthw1th comply ,..,th suO prov1s1ons or this perm11 shall be dee,.,ed revoked D I hereby affirm lhat !here 1s a construct,on ,end,ng a,;iency for the per1ormance of the worl<. lor wh,ch this permit ,s issued 1Sec 3097 c,,11 Code1 lenders Name ___________ _ lenders Address __________ _ USE BALL POINT PEN ONLY & PRESS HARD APPLICANT T~ FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS CARLSBA-BUILDING DEPARTMENT 1200 Elm, Carlsbad, California 92008 (714) 438-5525 Al-t'LICATION & PERMIT JOB A0DRESS ,fj'jM c.. Mr-.tLJ,,,..' A~·iT· 1 KJ~z7:Le,TION BUSINESS LICENSE# OWNER'S NAME ~ l~\lA'ruY -Sif201HER I-.AJ2 =~~;;+ PRIME CONTRACTOR l'J w /V (' /2 , CONTRACTORS PHONE # OWNE.R'S MAILING AODRESS CONTRACTOR'S ADDRESS LICENSE NO. LOT 1 BLOCK l SUBDIVISION ]~l,S~P.:r,o-.+o -00 DES!GNER STATE LICENSE# DESCRIPTION OF WORK ~ ~ l?oot-4-.8DC2i--OOl••t CENSUS 'RAC' l Ge CANO USE j 'AR<,NG SeACC RES UN'Vi l DESIGNER'S ADDRESS DESIGNER'S f>HONE ---_J FIP FLA ELEV.I I .,,,., I I ' ST~~IES ! ~-G~ I EDU GRADING ".ERMIT ISSUED Y □ ND <J '-0 l REOEVEL0PMENT AREA vO "□ I ~~:N 1: 1°0° I F:~E :;. I , ef~T0N ZONE PERMIT NUMBER B\-,150 PLAN 1.0. # BLDG USE CODE Rts.ADP, STANDARD PLAN# BUILDING SQ. FOOTAGE 1'.L?_~f/l NJr ·v:a,,u Unks1 Machirie Certified QTY. PLUMBING PERMIT -ISSUE QTY. MECHANICAL PERMIT -ISSUE SUMMARY/ACCOUNT NUMBER EACH FIXTURE TRAP EACH BUILDING SEWER 1--EACH WATER HEATER ANO ·OR VENT 1------+-Ecc.A_C_H_G_AS_S Y_S_T~ M_l_T 0 4 0 UTL E TS EACH GAS SYSTEM 5 OR MORE -feAcHINSTA~ALTER~-REPA1R wAiER P1PE -------- +---__ • s---+-•• OVER 1[)0,000 BTU _.L._____ SIGN PERMIT --~!IJS_TALL ~U~D~:::C.:.TcS_Uc_P_T_cD ,10.00:..co:co:::o..:B.:.T-=U ___ , ___ ~---'-'B'-'U"ILOING PERM~ _ _ . -t 7-~5'2 t· -- L - i- ----- _. +- sO~~E_R_1C0MPRESSORUPT03HP_=-~=--=-PLANCHEC-~M~a~ -=-=-=-- ~QI LER /C_~~sso R 3:_1 5 HP TOTAL PLUMBING METAL FIREPLACE ELECTRICAL -------...4oc5 -1--MECH EXHAUST--H□□-~uCTS M0BILEH0ME EACH VACUUM BREAKER ------r.~ ------- -~ATE_R SOFTNER E=f EACH ':'DRAIN(INSIDEi __ --l ~ ~ -vENT-,A-N s!N·G-LE DUCT-------. _M_E_CHA_N_1_cAL _-----------=R~TtON0-F_wu-RNAcE/HEATER --~ . ~:,~~EHOMEPARKINSP--=-----+-------· - ----------- ---TOT.li.LMECHANICAL 1 ~:R0NGM0TI0N _ -_-_------r _ .. ~r=~ l -------~~ -Fl~~INKLERS -b----PUBLIC FACILITIES FEE QTY. ELECTRICAL PERMl.1:..:_18SUE ----t.o O Q:r..~~-___ SOLAR -ISSUE ·-----BRIDGE FEE--= TOTAL PLUMBING ------+----- NEW CONST EA_A_M_P_S_W_l_BK ~-__ __ _ _ --1\-COLLECTORS _ SCH0_D_L _FEE -_D_I_STRICT 1 PH 3 PH STORAGE TANKS Carlsbad ---+-----------------f----------· --- ----+-----------1 ----- ------------- EXIST BLDG EA AMP SWT BKR -----ll-ROCK STORAGE Eric1nitas ~·. iti;~;f--,~:-\-~~,-s~-3u-~~--~ i -if--_---~-;._:_;_C_HE_C_K_FE_E_-_--_--.-_-_ _ _ -:---_ --_ ~::-. ~-,:-::: --• . . .--_-.---- 1 j I I --- TOTAL ELECTRICAL , .oo TOT Al SOL AR TOTAL FEES PAYABLE I 7s:_1I l HAVE CAREF~lLY EXAMINED THE COMPLETED "APPLICATION AND PERMff" AND DO HEREBY Expiration. Every permitinued bytheSuildingOflicial under the provisionsohhis CERTIFY UNOER PENAL TY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Coda shall expire by limitation and become null and void. II the building or work DECLARATIONS ARE TRUE AND CORRECT AND f FURTHER CERTIFY AND AGREE IF A PERMIT IS aulh~rtzad by such ~f'!Jil IS not commence_d within 180days fro~ Iha date of such * AN OSHA PERMIT IS REQUIA£0 FOR EXCAVATIONS OVER 5' 0 .. DEEP AND DEMOLITION 0A CONSTRUCTION OF STRUCTURES OYER 3 STOAtES fN HEK3HT ISSUED: TO COMPLY WITH ALL CITY, COUNT"' AND STATE LAWS GOVERNING BUILDING CON· :~~11. or if the ~1ldmg or work auth011zed by StiCh ~11 IS suspended or STRUCTION, WHETHER SPECIFIED HEREIN OR NOT. t ALSO AGREE TO SAVE INDEMNIFY AND l-:':=~donc:"~°"!!,'1~ta;n~l~•m~•!_!•ll~l9~•2l~he~w~o~ri<~•!!.,C20=!!!!!~enc!!£,8"!2_:f~o~ll~nod2!!.QOIL!!l80!2.Jd~a!l(!a_-=➔~~~~~-----..---,------------ KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO A~PPUCANT'S SIGNATkR ,,. OWNER CONTRACTOR D AlOVED BY &r ,k\ l I Dbl DATE EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE rf' _/ ~ _ /'IA/J.ifllj 'l"t \ ·1 // ,.,. a. ( GRANTING OF THIS PERMIT. :.,. • ' ~ BY PHONE O L-\'~ •V\,\, ( , . J -Z, C,~ ~ ii: " <ii 0 0. E " f- l :s2 0 "' c rn u a. 0. <( I i ~ a:: 0 ., 00 " 00 00 <( I § .; >- "' . ., " u 0 a: "' ei 0 ~ " u C "' C ii: ,c. C " " i!, 0 u " 0. 00 C -~ .c ;: INSPECTION TYPE DATE INSPECTOR BUILDING FOUNDATION u ·-,.,, .,~ ~ . ' REINFORCED STEEL MA~8PdRY IIJ 51 ,, ;vr, "' l 1/-?7,~ ]QJ.-ft,(\ •• GUNITE OR GROUT FLOOR & CEILING SUB FRAME SHEATHING FRAME i 1-Zo-81 ,:;+ " EXTERIOR LATH lNSULATION INTERIOR LATH & DRYWALL l/.7C:-..-81 r-tJ PLUMBING I/ SEWER AND Bl/CO PLUMBING UNDERGROUND PLUMBING TOP OUT TUB AND SHOWER PAN GAS TEST ELECTRICAL TEMPORARY POWER ELECTRIC UNDERGROUND ROUGH ELECTRIC 1,t-c.o-6'\ a./. ELECTRIC SERVICE \} BONDING ' 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 1.-« 'l ELECTRICAL . ' 1, ·v MECHANICAL • ~ \ V' \.,, GAS "( / \ \'l BUILDING \ l'f',7:7~\ l':tt SPECIAL CONDITIONS •• CERT OF OCCUPANCY ISSUED 81-467) FIELD INSPECTION RECORD REQUIR~D SPECIAL INSPECTIONS INSPECTOR"S NOTES INSPECTION REQ IF INSPECTORS DATE CHECKED APPROVAL ----- SOILS COMPLIANCE PRIOR TO . FOUNDATION INSP STRUCTURAL CONCRETE OVER 2000 PSI PRESTRESSED CONCRETE ----------~ POST TENSIONED CONCRETE FIELD WELDING ·-HIGH STRENGTH ~-~ -------------------------·----- j BOLTS --------· ·-----------··-- SPECIAL MASONRY ! ------- i PILES CAISSONS I ' I -~ . I I - ------ -. -· -----·--- ···------- ------------· -------- -------- . REOUEST~ECTION IN!IPECT0R · • PERMIT NO OWNER z ADDRESS;? & {~ .:&~ D REINFORCING STEEL D MASONRY D GROUT-GUNITE D FLOOR AND CEILING FRAME D SHEATHING D FRAME D EXTERIOR LATH D INSULATION D NTERIOR LATH OR DRYWALL FINAL PLUMBING D UNDERGROUND PLUMBING D UNDERGROUND WATER D ROUGH PLUMBING D TOP OUT PLUMBING 0 SEWER AND PL/CO 0 TUB OR SHOWER PAN D GAS TEST D WATER HEATER D FINAL READY FOR INSPECTION: D MONDAY DA.M. oP.M. ELECTRICAL D TEMPORARY SERVICE D ELECTRIC UNDERGROUND D ROUGH ELECTRIC D POOL BONDING D ELECTRIC SERVICE D CEILING HEAT 0 G.F.1. D SMOKE DETECTOR D FINAL MISCELLANEOUS D PLENUM AND DUCTS D COMBUSTION AIR D PATIO D SIGN D GRADING D DRIVEWAY D CONDITIONED AIR SYSTEMS D REFER PIPING D FINAL TUESDAY □WEDNESDAY D THURSDAY D FRIDAY PERSON TAKING REPORT J;/l{L,: ,. INTERDEPARTMENTAL INFORMATION SHEET BUILDING DEPARTMENT BUILDING ADDRESS: PLANNING DEPARTMENT l \0 !'fAD;sor1 4-D 'E CEIVED DATE: ---=---=-------OCT 27 1981 CITY OF CARLSBAD Bulldlng Department ZONE '2. -P LOT SIZE LOT WIDTH -~~__.______ ------------------- UNITS ALLOWED UNITS PROVIDED ------------------------ PARKING SPACES REQUIRED f\~ PROVIDED------.A-~-------- % COVERAGE ALLOWED I/ PROVIDED Uf:-' ------\--------- BU IL DING HEIGHT ALLOWED PROVIDED FRONT SETBACK: ALLOWED \7 PROVIDED---O~~-=<----- INTRUSIONS SIDE SETBACK: 0~ LANDSCAPE & IRRIGATION PLAN COMMENTS: ----------- REAR SETBACK: ot ENVIRONMENTAL PROTECTION REQ: -8"-'+Ylc~M~l?~f_._ _____________ _ ADDITIONAL COMMENTS: ~N----+'!Ac.....;_ _____________________ _ ENGINEERING DEPARTMENT R.O.W. INDUSTRIAL WASTE ------IMPROVEMENTS --------------- SEWER CONNECTION DRIVEWAY LOCATIONS --------------------- GRADING PERMIT EASEMENTS DRAINAGE --------------------- LEGAL DESCRIPTION -----------------------------ADD IT ION AL COMMENTS __________________________ _ OK TO ISSUkDATE ro..-al 8\ PWI ____ OK TO FINAL ____ DATE ___ _ FIRE DEPARTMENT SPRI~KLING SYSTEM ___________ FIRE PROTECTION EQUIP. _______ _ FIRE ALARMS EXITS _______________ _ FIRE HYDRANTS LOCATION _________________ _ ADDITIONAL COMMENTS OK TO ISSUE: _____ DATE _______ OK TO FINAL ______ DATE __ _ WATE R DEPARTMENT REQUIREMENTS OF APPROPRIATE DISTRICTS MET ________ DATE ________ _ 1200 ELM AVENUE CARLSBAD, CALIFORNIA 92008 Dear Property Owner: • <ll:itp of <ttarlsbab TELEPHONE: 714-438-5525 An application for a building r:;ermit has been surrnitted in your name listing yourself as the builder of the property folprovements specified. ?or your protection you should be aware that as "owner-builder" you are the responsible parr.1 of record on such a permit. Building permits are not required to be signed by the property owners unless they are personally performi.'lg th.eir own w0rk. If your \..urk is being performed by saneone other than yourself, yoL~ lll2.Y 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 w0rk, with the exception of various trades that you plan to suboontract, 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 irrroediate family, and the w0rk (including rraterial and other costs) is $200 or rrore for the entire project, and such persons are not licensed as contractors or suboontractors, then you rray be an em- ployer. If you are an employer, you must register with the state and federal government as an employer and you are subject to several obligations including state and federal incane withholding, federal social security taxes, w0rkers' COIIIJ?ensation insurance, dis- ability insurance costs, and unemployment contributions. There rray be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to w0rkers' canpensation insurance. For specific infonnation about your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U. s. small Business Administration). For IrOre specific infonnation 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 w0rk personally or through their own employees, without a licensed contractor or subcontractor, only under limited conditions. 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 his or her own labor and rraterial personally. Building permits are not required to be signed by property owners unless they are performing their own w0rk personally. Infonna- tion about licensed contractors may be obtained by contacting the Contractors State License Board in your carrnunity or at 1020 N Street, Sacrarrento, CA. 95814. PLEASE COMPLETE AND REI'URN THE ENCIDSED OWNER-BUTIDER VERIFICATIQ.'l FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATI'ERS. THE BUILDING PERMIT WILL NOI' BE ISSUED UNTIL THE VERIFICATION IS REI'URNED. Very truly yours, Building Department City of Carlsbad ATI'ENTION POOPERI'Y OWNER: An "clwnc,.e-builder" building pennit has been applied for in your name and bearing your· signature. Please canplete and return this information in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building permit. N::l building permit will be issued until this verification is received. 1. I personally plan to provide the major lal:x:>r and materials for construction of . the proposed ~ty improvement (yes or no) ~ 2. I (hav·ee ____ signed the application for a building permit. 3. I have =ntracted with the following person (fil:m) to provide the proposed construction. Name;__ ___________ _ Phone ____________ _ Address Contractors License No. ---------------- City ------------- 4. I plan to provide portions of the w:irk•, but I have hired the following person to coordinate, supervise and provide the major w:irk. Name -------------Phone:.....------~----- Address -----------Contractors License No. ----- City ------------- 5. I will provide scxne of the w:irk but I have contracted (hired) the following persons to provide the work indicated: Name Address Phone Type of 'lbrk Signed: Property Owner ~ 'Jfl_J;c;tt__ g___._ Social Security Number S (; 5 ?, z.__ ZS j' c./ .,. Date: /0 2 Ss -81 •