HomeMy WebLinkAbout2694 Medford Ct; ; 87-398; Permit., z 0
" .. a: ~ u ~
IC i[
u
a: ~ ~ 5 ~ "' z
!
z 0 s z "' .. ,.
0 u .,
"' "' "' a: 0 lt
r,;f' I hereby affirm that I am licensed under
PFOvlalona of Chapter 9 1commencing w1tt1
Section 7000) of Division 3 ol ttie Business
and Profesaions Code, and my license is in
full force and effect
I hereby at1,rm thal I am exempt from the Contrac
tors L,cense Law lor the 10IIowrng reason 1sec 7031 ~
Business and Protess,ons Code Any c,1y or county wh,cr, re
qu,res a permit 10 construct. al1er. improve demol,sh or
epa,r any struclure. pr,or to ,Is issuance also requires !heap
l!icant 1or such perm,1 to Ille a s,aned statement that he ,s
11c!(lsec pursuant 10 the prov,s,ons ol the t..ontractor "
Llc;/ll_se Law !Chapter 9 commencing with Serhon 7000 of
o,v,s1ll{, 3 o1 lhe Business and Protess1ons Code; or that Is ex
empt ll~relrom and the basrs tor the allegeo e,empt,on Any
,oolalion 11,t Secloon 7031 5 by an .ippl1cant lor a perm1I sub ~e,~~ ~h0~1:~:'i;~b\o a cw,I penalty o! not more than 1,ve ~un
I .is owner ,;it 1he properly, or my employees w,th wages
as lhe,r sole compensatmn will do the work and lhe struc
lure .s no1 ,ntende~ o, o!lered 1or sale (Sec 7044, Busmess
and Profess,ons ctxle The Conlraclor's License Law does
nol apply to an ownili; o( properly who builds or ,rnproves
thereon and wno does :ch work himself or through his own
:~~1r0~i1~~€f1~~I~:1e th~t ?~i;;~~r~~~mbe;]~.~~e o~0,~;;~~~:
:~1n~~~!0ii/~~hr'~e~n~fy~~;~t;~~fie~~~-1~h~o~;~;lr~ bour,,~,
prove to, lhe purpose 01 saleJ
1. as owner of lhe property. am exclusively contracting
with ltcensed contractors 10 conslruQI the pr0Jett 1sec 7044
Business and Professions Code Tfie Contractor's License
Law does no1 apply to an owner o1 prope_rty who builds or ,m
proves thereon. and who contrac1s lor ~ach pro1ects with a
contractor(sl license pursuant 10 the Cantrac1or's License Law)
As a homeowner I am ,mprov,ng my home, and the lollow
Ing cond11lons ex,s1 1 The work ,s being performed prior IQ sale
2 I have lived In my home 1or lwi!Jve months
prior to complehon ot this work \
I have not claimed th,s exernpt,on d\i_r,ng the
lasl three years \
lamexemp!underSec ______ s\oc
for this reason ~ ---------'cs
·; I hereby aff,rm thal I ha\/e a cert,hcate o! consent to
selt-.nsure. or a cert1hcate of Workers Compensa1Ion In
surance or a cert1tred copy thereof 1sec 3800 Labor Code)
POLICY NO -s i ?'') j .~,
~-OMPANY j+,.:_~
ir;'. Copy ,shied w1lh the c,ty r.:..".._} ...
Cert1f1ed copy ,s hereby furnished
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
1Th1s section need not be compleled 1! the perm,t
Is for one hundred dollars 1$100) o, less\
_ I cerMy that ,n the performance of tne work for which
1hIs permit ,s issued. I shall not emplo1· an, person In any
manner so as to become subJeCI to the Workers Compen
sar,on Laws of Cal1forn1a
NOTICE TO APPLICANT If. after making th,s Cert1f1cate
of E~empt,on you should become sub1ect to the Workers
Compensat,on pro-,s,ons of the Labor Code. you must
forthwith comply with such prov,sIons o, this permit shall
be deemed revoked
[
::.J I hereby aff,rm that there Is a construction lenc1ng ffi · agency for the pet!ormanceof lhe work lor which this per
O mIt Is issued (Sec 3097 c,,,I Code! z '
W Lenders Name
~
Lender s Address
USE BALL POINT PEN ONLY & PAE~S HARD At't'Ll(.;AN I JU t-lLL IN 1Nt-Ut1MAI IVN WI I MIN .)MAUCU AnC.1-\ 1-\rllU UC\,,u,\nl"l.11v1-. ...
CARLSBAD BUILDING DEPARTMENT
2075 Las Palmas DL, Carlsbad, CA 92009-1915 (619) 438-1161 APPLICATION & PERMIT
JOB ADDRESS PERMIT NUMBER
J {, 4/-f h . .:. J J> _}
AV. ST.RO. t+. THOMAS BROS NO.
I Lf C-:3 ;~;;~·;-1•01 BUSINESS a# 1•,1T•~
LOT j SLOCK 1-S~B~lVISION 1 •sit,Rat~ Nf~ o0 CONTRACTOA""'-
f\, l G,"~J..,,.::_
CONTRACTOR5'°PHONE•
1'7'YIB, '1c'7)
ZONE 01,,-3,f fi'
OWNER'S NAME .., .
(\-\ .,,\~~ l OWN,E R'S PK.ONE
4-3'1-417( BUILDING 50. FOOTAGE
OWNER'S, MAILING A00RES$
I ,J~c
STATE UCENSE NO.
Lf-3,Clk-1 i-1
destl'(tJ.T,o_N 0] WOFfl(~ ~~ ""'~ ~ . • • OEStGNER'S ADORES&-STATE NO.
CONTRACTOR'S ADDRESS
1r-'ff'I· d ~J~~l,f,
DESIGNER
Tc...1t-.
0£.SIGNER'S PHONE
~
U:
>-;;;
0 0,
E ~ t I I" -l, -, • . · . . ->--
I
'Q_· .' · .. · A,cl-· ·--· 'I:: . ,, -:t':1,,'1. --~-,' -~ -.".'\,.:;;!..~<;.. --., T ' e
1:'
F LR ELEV NO
STORIES
OCC GP EDU 0002 07/23 0101 02BldPmt ~1 -ob°' -0
1
CENSUS TRACT rAPK ONG se•ee
QTY I PLUMBING PERMIT -ISSUE
EACH FIXTURE. TRAP
EACH BUILDING SEWER
EACH WATER HEATER ANU OR VE.NT
EACH GAS SYSTEM 1 TO 4 UUTLE rs
EACH GAS SYSTEM~ OR MOR[
EACH INSTAL ALTER REPAIR WATER PIPE
EACH VACUUM BREAKER
WATER SOFTNER
EACH Rnm CR,'.\IIJ 1l'-JS1'.ll:,
TOlAl P! lJMHINL. I
QTY. ELECTRICAL PERMIT -ISSUE
NEW CONST EA AMP SWl t!KR
I PH IPH
EXIST fl LOG EA AMP SWT RKR
IPH 3 PH
REMODEL ALHR PER CIRCUIT
TE MP POLE 200 AMPS
OVER ?OU AMPS
Tf.MP OCCUPANCY 130 UAYSI
lfllAL fLlLTHILAl l
ASS UN' ,s l
7___£5!,.
f-~
y[J NO
GRADING PERMIT ISSUED
I
REDEVELOPMENT
ARE A
~ D ~ 0 ,o "'□
QTY MECHANICAL PERMIT· ISSUE
INSTALL FURN DUCTS UP TO 100 000 BTU
OVER 100.000 BTU
BOILERiCOMPRESSOR UP TO 3 HP
BOILEfCCOMPRESSOR 3 1~ HP
METAL FIREPLACE
VENT FAN SINGLE DUCT
MECH EXHAUST HOOD DUCTS
RELOCATION OF EA FURNACE,HEATER
DRYER VENT
t □Tt:.L MECHANICAL
QTY MOBILE HOME SETUP
CAR PORT
AWNING
GARAGE
iOTAI
TYPE
CONST
LJ_QO
OCCLOAD j FIAESPP
YO "'10 Nat Vaf1d Unless M.chine Certified
SUMMARY/ACCOUNT NUMBER -BUILDING PERMIT UU l -81 Q-QQ-00-8220 ~ _; I
SIGN PERMIT OD 1-810·00·00 ·8221
PLAN CHECK 001-810-00-00-8891 7,,...
TOTAL PLUMBING DO; .310-00-00-8222
ELECTRICAL 001-810-00-00-8223
MECHANICAL 001-810·00-00-8224
MOBILEHOME 001 ·81 0· 00-00-8225
SOLAR 001·810-00-00-8226
STRONG MOTION 880-]19·92-33
FIRE SPRINKLERS OD 1-810-00-00-8227
PUBLIC FACILITIES FEE 320-810-00-00-8 7 40
BRIDGE FEE 360-810-00-00-8740
PARK-IN-LIEU (AREA
Tlf 312-810-00-00-8835
LA COSTA TIF 311-810-00-00-8835
FMF
LICENSE TAX 001 -8 lD-DD ·00 ·8162
MFF 880-519-92-57
CREDIT DEPOSIT _/
TOTAL FEES PAYABLE />J7 J;
~
-
! HAVf CAREFULLY EXAMINED THE COMPLETED ··APPLICATION AND PERM!r .. AND DO HEAEB¥ EJ1Cpirati~:£veryeerm1;1~.u•~tbyltle8.uilQir,gOthc1at1.1nderlheprov19ionsofthia * 1$ REQUIRED FOft EXCAYAllONS OY£fl
CfRllFY UNOER PENALTY OF PERJURY THAT All INFORMATION HEREON INCLUDING THE Code stiall ellpire by fim_it~ion and become null ~nd vc»d If the budding o• work OEMOl..fTK)N OR CONSTRUCTION OJ ,., authorized by such perm111s not commenced w1lh1n 180 days from the date.:>l such DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGt1EE iF A PERMIT!$ permit. or if the buttdir,g or work _authorized by sucti permit 1s_ suspended or OYER l STOfUES IN HEIGHT
ISSUED: TO COMPLY WtTH AU cnv. COUNlY AND STATE LAWS GOVERNING BUILDING CON L,;-~~""'~'!""!.!•!.•!••~~-~ ... !!.!•~rte~,1•~""!!..?W~O~••!!.!!";_oo~m~m~M~C•!d,!_';lo~•c•!J!;'•"S!!!.'"£O!,ICl80!!!LS,'1._-=c-i~~~~~~----"r--------:~rt'---.,----1
STRUCTION. WHETHER SPECIFIED HEREIN QR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND APPLICANT'S SIGNATURE Jf, OWNER[] CONTRACTOR1S-APPROVED Y 0
-KE-EP HARMLESS THE-CITY OF CARLSBAD AGAINST ALL UABILIT1ES. JUDGMENTS. COSTS AND ~ 0-A ( '~-,"0-:,,_;.j----7, _
EXPENSES W~JQH-MAY !N ANY WAY ,«cCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE (\ BY PH [J -~ 0
GRANTING OF TtHS PERMIT ~ ONE I O 7
CJ
c m u
o_
0, 4'.
I
~
C
CL
0 m m ~ m m
4'.
~ 2 ,; >-
w u C m
C
LL
,cc
C ~ ~
CJ
0 u w
0, m
C
~
" ,:
TYPE ' DATE INSPECTOR -72?-3~
BUILDING ' FOUNDATION : FIELD INSPECTION RECORD
REINFORCED STEEL I
MASONRY '
GUNITE OR GROUT I
'
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTION REQ IF INSPECTORS DATE CHECKED APPROVAL
SUB FRAME □ FLOOR □ CEll!.ING SOILS COMPl_!ANCE
SHEATHING □ ROOF □ SHEAR PRIOR TO
FRAME I
'
~OUNDATION INSP
EXTERIOR LATH I STRUCTURAL CONCRETE
OVER 2000 PSI -INSULATION I
INTERIOR LATH & DRYWALL ' '
PRES TRESSED
CONCRETE
POST TENSIONED
I CONCRETE
PLUMBING '
' FIELD WELDING
□ SEWER AND BUCO L P!-/CO
UNDERGROUND □ WASTE □!WATER
,-
HIC._1H STRENGTH
BOl fs
TOP OUT D WASTE □ VVATER SPECIAL MASONRY
--
TUB AND SHOWER PAN '
GAS TEST I PILES CAISSONS
□ WATER HEATER D SOLAR WATER
I
' ,,_
ELECTRICAL '
□ ELECTRIC UNDERGROUND □; UFFER
ROUGH ELECTRIC ' ' □ ELECTRIC SERVICE □ TEMPORARY
□ BONDING □ POOL ' I
' I
MECHANICAL I ----
□ DUCT & PLEM., D REF. PIPING
HEAT -AIR COND. SYSTEMS I -
VENTILATING SYSTEMS '
I
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HA \I.E BEEN APPROVED
FINAL I
PLUMBING ' I'\. ' ELECTRICAL I t_\_ '-
MECHANICAL -' ~. I -
GAS ' 1, " I\..-I
BUILDING I '\j \\"-.'
SPECIAL CONDITIONS I ~ ~-
' -~ '