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Home My WebLink About270 PACIFIC AVE; ; 80-679; PermitLICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provl• 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 0 1 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 state- ment that he Is licensed 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). DI, 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 J Date ______ Owner -----<~~.,_ ~-WORKERS' COMPENSATION DECLARAT I hereby affirm that I have a certi~cate o n- sent to self-insure, or a certlficatr f ~qrkers' Compensation Insurance, or a ,!'.* IJJe!I( copy thereof (Sec. 3800, Labor Code). POLICY NO II . I \r COMPANY \) ~ □Copy is filed with the city. □Certified copy is hereby furnished. OfiRTIFICATE OF EXEMPTION FROM WOfKERS' COMPENSATION INSURANCE (This ~ectlon need not be completed If the per- mit is fo~one hundred dollars (SHl0) or less). I cert,~thac In the performance of the work for which th,! 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 Lal::tlr Code, you must forthwith comply with such pro~ns or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction len- dlng~ency for the performance of the work for '6#hlr-h thlfll n,armlt le leto11Art /~or 'UI07 l"":lull ("'.nrt1111\ CITY OF CARLSBAD-BUILDING DEPARTMENT USE BALL POINT PEN ONLY APPLICATION & PERMIT 1200 ELM AVENUE (714} 438-5525 NO. JOB ADDRESS tRr 10;;;: i;~TIDN 1.2 ,1, 0, · 11P1 fO-! I 1.f I I Ip .J, I A f 11 I it, I I I I 1'11i.1q, ,3, 81 /J1~1 I OWNER OWNER'S PHONE PRIME CONTRACTOR I , k /t-l-,4. /L G.-. mo I 12-,o cJ o-8 ll.f. l>.,o ,Jr.. "'I I' .n CONTRACTOR'S ADDRESS -;fl;/,,,.. )U{_ .... APPLICANT TO FILL IN INFOR- MATION WITHIN RED LINES. eus. LICENSE PERMIT NUMBER ,. 0? q.:i. tfd~11 STATE LICENSE"' i,- 311f7'1-3- ~ ORS._ -Sl. \ \ ;w7;•s ~~NtG;;ozsstJv< i\ 50'1 ~ . C,,t: .J)/J) ~ ---f.L . 7/Jl/801804 L~7 BLOCK l~UBOIYISION :6 p,J !i~S.EER'~L N~:2.~ DESIGNER • s--,.,.._. I ,,. 000}f8Qb 7/~1180 J8~:2 1 .... • \l} / l.. l,; ' ,II, ►.., I I DESCRIPTION OF WORK rti. f<l'1 .t:J. I .I. ,,,.. A A"., -ci---~04' J'r" J; E,A )s / .. 1'J ... /!) . 41-,, 1 ~ 'JESIGNER' S ADDRESS DESIGNER'S PHONE ,,u ii~., r-~-~,,_"!11.l,ll IA 1?11ti u?!,! CENsus TRACT 11/ GP l.lilNo usE / ZONING.,-/ I;[. UNITS I PA;KING SPACE sf I NUMBER OF STORIES Not VahiJ Unlllss lbchinl Clrtifilld BLOG SQ. FT. BLOG USE occ. GP I STANDARD PLAN II 1~41, I TYPE CONST I occ. LOAD I QTY. PLUMBING PERMIT AMT. QTY. MECHANICAL PERMIT AMT. / • --:r EACH FIXTURE TRAP /,,, . ., .., INSTALL FURN. 0OCTS UP TO 100,000 BTU I EACH BUILDING SEWER c:.-. (J £ I OVER 100,000 BTU , EACH WATER HEATER ANO/OR VENT B0ILER/C0MPRESSO'l!-Ye.I.0 3 HP EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP'\ EACH GAS SYSTEM 5 OR MORE BOILER/COMPRESSOR 16-30 HF 7 EACH INSTAL., ALTER, REPAIR WATER PIPE cJ-.U V VENT FAN SINGLE DUCT L #:13✓3~6!!.-, EACH LAWN SPRINKLER SYSTEM C MECH EXHAUST -HOOD/DUCTS VALUATION: . WATER S0FTNER RELOCATION OF EA FURNACE/HEATER BUILDING PERMl•T I . I 1/,ok.',--. TSSIIF 3.00 ISSUE 3 .-00 SIGN PERMIT ..;1)_ f J I , I I I ._ TOTAL PLUMBING I~ TOTAL MECHANICAL PLAN CHECK~d-~'fl'/) tt11fdS-I I vi o,u . CONTRACTOR CONTRACTOR ALL INCLUSIVE PERMIT I I'_. TOTAL PLUMBING i/LY.~ ,.,_ QTY. ELECTRICAL PERMIT AMT. QTY. MOBILE HOME PERMIT AMT. ELECTRICAL flMU4, NEW CONST EA AMP/SWT/BKR AWNING MECHANICAL (. 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 -1... REMODEL/ALTER PER CIRCUIT /1..v, FENCE OVER 6' I . I I • I TEMP POLE 200 AMPS I -TOTAL MOBILE HOME MICO-FI LM I I I . I OVER 200 AMPS I . I I ; I TEMP OCCUPANCY (30 DAYS) I . I I I ISSIII=' ?-nn STRONG MOTION: I . ,✓.~ TOTAL ELECT RI CAL /7G TOTAL FEES PAYABLE I .~~ CONTRACTOR . I I I HAVE CAREFULLY EXAMINED THE COMPLETED '"APPLICATION AND PERMIT, ANO 00 •AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER . ; t) !· t1tJ HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I 5"-0" OEEP 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 ANO STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY ANO KEEP HARM-SCH80L LESS THE CITV OF CAR LSBA O AGAINST ALL LIABILITIES. JUDGMENTS, COSTS ANO ,, /1 FEE: ., EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. ~~TUR(.,#/4-, • OWNER □ CONTRACT~~ rzo;:;y m DATE AGENT D .• BY PHONE □ • A__, r --. ~-...1. -7-~I) ✓ I • w ~ ~ '.~ ~ ::d 0.. V, ~ ,-ff,) V SITE go-~70, ADDRESS: OWNER: . PERMIT NO: . FIELD IN SPECTION RECORD INSPECTION DATE INSPECTOR INSPECTOR'S NOTES WOOD FLOOR -~ FOUNDATION• FORMS•SET BACK •TOILET -,-~ '1. .. ' UNDER FLOOR PLUMBING . ---~,•= > -- UNDER FLOOR HEATING ------ OK TO INSTALL SUB FLOOR ' f\ E.. . -. t . SLAB FLOOR UNDER 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 I - WALLBOARD OK • PLACE TAPE EXTERIOR LATH O K • PLACE STUCCO FIREPLACE -· DAMPER 8c STEEL ~ ; PLATE TI Es/HEIGHT OF CHIMNEY OTHER TEMP POWER (POLE) SEWER GAS TEST SWIM POOL • STEEL BONDING • PRE DECK . • FENCE PREPLASTER SHOWN • FRAME ' . PAN \ I\ .J FINAL INSP BY BLDG DEPT ~ ..).~ "l ~W1l OTl;IER DEPT'S REQ COMPLETED \\\\'\~ I\~. ' ELEC METER-PERM-TEMP \ \ I GAS METER-PERM-TEMP CERT OF OCCUPANCY ISSUED ~ - LICENSED CONTRACTOR'S DECLARATION I hereby allirm 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- tect. V,_ OWNER-BUILDER DECLARATION D I hereby affirm that I am exempt from the Con- tractor's License Law for the following reason (Sec. 7031.5,Buslness 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 Ille a signed state- ment that he is licensed 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 clvll penalty of not more than five hundred dollars ($500). D 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, Busrness 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 -~ ~wner~ WORKERS' COMPENSATION DECLARATION I hereby allirm that I have a certificate of con- sent to self-Insure, o~ a certificate of Workers' Compensation insurance, or a certified copy thereof (Sec. 3800, Labor Code). POLICY NO. ___________ _ COMPANY ___________ _ □Copy ls filed with the city. □Certified copy Is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed ii the per- mit is for one hundred dollars ($10!)) 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 !his permit shall be deemed revoked. 'a CONSTRUCTION LENDING AGENCY I h'l!reby affirm that there Is a construction len- ding agency for the performance of the work for which tnts permit Is issued (Sec. 3097, Civil Code) . . . ✓ APPLICATION & PERMIT USE BALL POINT PEN ONLY 1200 ELM AVENUE (7l4) 438-5525 NO. FJ. J , JI ~D,:.-~ .D t~r l°?Jii1i1f i171l'I I •~C.. , ... (<;-I I ti. I . <::1 '• I I I I I l I I I I OWNERt • G~ /) Y1o OWNER'S PHONE PRIME CONTRACTOR I I 7 l '1-311 ~ 1. r,-U.f JAtJ >. OWNER'S {A110 ADD,~ ('_,] J r ( 1 (iv~ CONTRACTOR'S ADDRESS LOT I BLOCK I SUBDIVISION /) I ASSESSOR'S PARCEL NO. DESIGNER I I I I I I I I I I I DESCR7J'1Jf w;:K fYLi, -II Jn i Pu.k V 11An 1-r:£ Lu,nAl.y,, DESIGNER'S AODAESS --; /) A l - CENSUS TRACT GP LANO USE ZONING V APPLICANT TO FILL IN INFOR - MATION WITHIN RED LINES. BUS, LICENSE PERMIT NUMBER STATE LICENSE CONTRACTOR'S PHONE STATE LICENSE 0 1~ 0 1 .:>4 DESIGNER'S PHONE I 0 61 at I RES. UNITS I PARKING SPACE I NUMBER OF STORIES Not Valid Unless M11chin1 Cllrtifi«J BLOG SO. FT. BLOG USE occ. GP I STANDARD PLAN II I PLAN IO 11 I TYPE CONST I occ. LOAD I QTY. PLUMBING PERMIT AMT. QTY. MECHANICAL PERMIT AMT. EACH FIXTURE TRAP INSTALL FURN. OUCTS UP TO 100,000 BTU EACH BUILDING SEWER OVER 100,000 BTU EACH WATER HEATER AND/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 BOILER/COMPRESSOR 16-30 HP EACH INSTAL., ALTER, REPAIR WATER PIPE VENT FAN SINGLE OUCT EACH LAWN SPRINKLER SYSTEM MECH EXHAUST -HOOO/OUCTS WATER SOFTNER RELOCATION OF EA FURNAC.E/HEATER BUILDING PERMIT I . I I P'J,,-e ,I-;,/ r r/f<-e ll/'2u --1 .C,Q SIGN PERMIT I , I TOTAL PLUMBING , . TOTAL MECHANICAL I ..::3. ~ PLAN CHECK I . I l,CONTRACTOR CONTRACTOR --0{) -r... ALL INCLUSIVE PERMIT I I . TOTAL PLUMBING I QTY. ELECTRICAL PERMIT AMT. QTY. MOBILE HOME PERMIT AMT. ELECTRICAL I NEW CONST EA AMP/SWT /BKR AWNING MECHANICAL I 1 PH . 25 3 PH PORCH MOBILE HOME I EXIST BLDG EA AMP/SWT/BKR SET-UP SOLAR I , I 1 PH .25 3 PH RAMADA, CABANA I I REMO OH/ALTER PER CIRCUIT FENCE OVER 6' I . I TEMP POLE 200 AMPS TOTAL MOBILE HOME MICO-FILM ! . I OVER 200 AMPS I . I TEMP OCCUPANCY (30 DAYS) I . I I . I TOTAL ELECTRICAL TOTAL FEES PAYABLE I CONTRACTOR . I I . I - 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 AND 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 SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM-/?.) LESS THE CITY OF CARLSBAD 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" ;/2_ ,77Zt,-OWNEA)l CONTRACTOR□ IAP~.,/. -AGENT D BY PHONED -v- :F • w ~ 0 i > I I I I I I I I I I I I 17ilih 1--. I I I I I I I I I I ; I I I I.J ,( I ~-ere """ I~ ~ 7"' SITE ADDRE SS: OWNER; PERMIT NO: . FIELD INSPECTION RECORD INSPECTION DATE INSPECTOR INSPECTOR'S NOTES WOOD FLOOR FOUNDATION• FORMS • SET BACK• TOILET UNDER FLOOR PLUMBING UNDER FLOOR HEATING OK T O INST ALL SUB FLOOR SLAB FLOOR UNDER SL..AB PLUMBING FOOTING• FORMS• SETBACK• TOILET OK T O 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 &STEEL 't' PLATE TIES/HEIGHT OF CHIMNEY OTHER TEMP POWER (POLE) SEWER GAS TEST SWIM POOL• STEEL BONDING • PRE DECK • FENCE PREP LASTER SHOWN • FRAME • PAN FINAL INSP BY BLDG DEPT \t ~ ,N \ -OTHER DEPT'S REQ COMPLETED .~ \~ t\J'(\J \ ELEC METER-PERM-TEMP \\\\ \ I \\l I GAS METER-PERM-TEMP \ \ CERT OF OCCUPANCY ISSUED - t . INTERDEPARTMENTAL INFORMATION SHEET DEPARTMENT BUILDING ADDRESS: JUL to 1980 CITY OF: CARLSBAD Bulldlng Department PLANNING DEPARTMENT ZONE LOT SIZE LOT WIDTH ---------------------------- U~ITS ALLOWED UNITS PROVIDED -------------------------- PARKING SPACES REQUIRED PROVIDED ---------------------- -------------% COVERAGE ALLOWED BUILfING HEIGHT ALLOWED ---------- FRONT SETBACK: ALLOWED PROVIDED ------- INTRUSIONS LANDSCAPE & IRRIGATION PLAN ENVIRONMENTAL PROTECTION REQ: ADDITIONAL . " SIDE SETBACK: ENGINEERING DEPARTMENT ~~ J./~? J-1) R.O.W. INDUSTRIAL WASTE PROVIDED PROVIDED REAR SETBACK: IMPROVEMENTS --------------------- SEWER CONNECTION DRIVEWAY LOCATIONS --------------------- GRADING PERMIT -----=--___ EASEMENTS DRAINAGE ____ _ LEGAL DESCRIPTION _/,4 d?7 -~---~-~-v-. --- ADDITIONAL COMMENTS ----------------------- ' 4 • OK TO FINAL DATE ------------ \ FIRE DEPARTMENT SPRINKLING SYSTEM FIRE PROTECTION EQUIP. -------------------- FIRE ALARJlfS EXITS _______________ _ FlRE HYDRANTS LOCATION _________________ ___, ADDITIONAL COMMENTS )K TO ISSUE: _____ DATE _______ OK TO FINAL ______ DATE ___ _ \TER DEPARTMENT :QUIREMENTS OF APPROPRIATE DISTRICTS MET ________ DATE _______ ~