HomeMy WebLinkAbout2714 LOKER AVE W; MULTI-PERMIT FILE; CB143276; PermitT'
~ City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Plumbing/Mechanical/Electrical (PME) Permit
·11-24-2014 Permit No: CB143276
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
2714 LOKER AV WEST CBAD St: 108
PME Status:
Parcel No: 2090813200 Lot#: 0 Applied:
Entered By:
Reference #: Plan Approved:
PC#: Issued:
Inspect Area:
Project Title: AT & T: REPLACE LIKE FOR LIKE
2 AC CONDENDORS & 2 AC AIR HANDLERS
Applicant:
ELECTRONIC ENVIRONMENTS
410 FOREST ST
MARLBOROUGH MA 01752-3055
714-524-2714
Plumbing Fees
Electrical Fees
Mechanical Fees
Other PME Fees
TOTAL PERMIT FEES
Owner:
CBLLLC
6183 PASEO DEL NORTE #280
CARLSBAD CA 92011
ISSUED
11/24/2014
JMA
11/24/2014
11/24/2014
$0.00
$0.00
$160.00
$0.00
$160.00
Total Fees: $160.00 Total Payments To Date: $160.00 Balance Due:
Inspector:
FINAL APPROVAL
Date: /Z ~~f.(o/ Clearance: ------
$0.00
NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively
referred to as "fees/exactions." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must
follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for
processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack,
review, set aside, void, or annul their imposition.
You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity
changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any
fees/exactions of which ou have reviousl -been iven a NOTICE similar to this or as to which the statute of limitations has reviousl otherwise ex ired.
,f
THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: 0PLANNING 0ENGINEERING 0BUILOING DFIRE DHEALTH 0HAZMAT/APCD
Plan Check No. C
Est. Value
Plan Ck. Deposit
Cicyof
Carlsbad
Building Permit Application
1635 Faraday Ave., Carlsbad; CA 92008
Ph: 760-602-2719 Fax: 760-602-8558
email: building@carlsbadca.gov
www.carlsbadca.gov Date I l SWPPP
JOB ADDRESS 2 41
APN
CT/PROJECT# LOT# PHASE# # OF UNITS # BEDROOMS CONSTR. TYPE OCC. GROUP
DESCRIPTION OF WORK: Include Square Feet of Affected Area(s)
\Q_\:::QLA.<:.G ~ AL c.a1,d) ~N' Ser S, AN~ -~
EXISTING USE PROPOSED USE
APPLICANT NAME •-_::s-
Primary Contact \j fV-.J Ce2LIS. ~
ADDRESS
'1-'20 \<.. I C\-\~I e.. ~ £ti'
GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE
YESO.
AIR CONDITIONING
NoD YEsONoD
PROPERTYOWNER e-@Je-C.0M'6.e-1cc..,AL..
ADORES$ .r,
~aOO AP.MA.DA • £ ~
FIRE SPRINKLERS
YEsONoD
CITY STATE ZIP
()tA C\?N~ A
CITY
0\-2..l>~A
STATE ZIP JJ <!.A q200{ CA
PHONE('-/-52 t/ -2 7 / FAX
EMAIL
DESIGN PROFESSIONAL'
ADDRESS ADDRESS! D ' '4\0
CITY STATE ZIP CITY STATE ~ Q.L.So 12ou~1--\ MA ZIP f!Jt-::J-sz.
PHONE FAX PHON~ '/t I .--5?. i../ -?.:1-I
FAX
EMAIL EMAIL
STATE LIC. # CLASS CITY BUS. UC.# -c,o
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law {Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500)). ,
;;'', >',
Workers' Compensation Declaration: / hereby affirm under penalty of perjury one of the following declarations:
fl] I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work tor which this permit is issued, ~ I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which th~ermit is issued, My workers' compensation insurance carrier and policy
number are: Insurance Co. A Coli) CO%"Q 12.A--"notJ Policy No.VB \{?Cf S2C,3 Expiration Date /2-'31-I'(
~section need not be completed if the permit is for one hundred dollars ($100) or less. inil Certificate of Exemption: 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. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), in
addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, Interest and attorney's fees.
25 CONTRACTORSIGNATURE 0AGENT DATE / /-zv-1 t(
I hereby affirm that I am exempt from Contractor's Ucense Law for the following reason:
D
D
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 offered tor sale (Sec. 7044, Business and Professions 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 ottered for
sale. If, however, the building or improvementis sold within one yearof completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale).
I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of
property who builds or improves thereon, and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law),
I am exempt under Section ____ Business and Professions Code for this reason:
1, I personally plan to provide the major labor and materials for construction of the proposed property improvement 0Yes 0No
2. I (have/ have not) signed an application for a building permit for the proposed work.
3. I have contracted with the following person (firm) to provide the proposed construction (include name address I phone/ contractors' license number):
4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name/ address/ phone/ contractors' license number):
5.1 will provide some of the work, but I have contracted {hired) the following persons to provide the work indicated (include name/ address/ phone/ type of work):
25 PROPERTY OWNER SIGNATURE 0AGENT DATE
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the
Presley-Tanner Hazardous Substance Account Act? Yes No
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Yes <t<@
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Yes .1le'
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF
EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
,',',''
I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code).
Lender's Name Lender's Address
,:, '
•, :-,
I certifythatl have read the application and state thatthe above infonnation is correct and that the infonnation on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction.
I hereby authorize representative of the City of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND 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 GRANTING OF THIS PERMIT.
OSHA: An OSHA pennft is required for excavations over 5'0' deep and demontion or construction of structures over 3 stories in height.
EXPIRATION: Every penmit issued by the Building Official under the provisions of this Code shall expire by limitation and become null and void if the building orworl< authorized by such penmitis not commenced within
180 days from the date of such penmit or if the building or mrl< authorized by such penmit is suspended or abandoned at any time after the mrl< is commenoed for a period of 180 days (Section 106.4.4 Unifonm Building Code).
_NS APPLICANT'S SIGNATURE ~--c__...---DATE // ,,.-'2. V -/ C../
STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE.
Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection.
CERTIFICATE OF OCCUPANCY /Commercial Projects 0 n f y l
Fax (760) 602-8560, Email building@carfsbadca.gov or Mail the completed form to City of Carlsbad, Building Division 1635 Faraday Avenue, Carlsbad, California 92008.
I CO#: (Office Use Only)
CONTACT NAME OCCUPANT NAME
ADDRESS BUILDING ADDRESS
CITY STATE ZIP CITY STATE ZIP
Carlsbad CA
PHONE I FAX
EMAIL OCCUPANT'S BUS. LIC. No.
DELIVERY OPTIONS
PICKUP: CONTACT (Listed above) OCCUPANT (Listed above)
CONTRACTOR (On Pg. 1)
ASSOCIATED CB# MAIL TO: CONTACT (Listed above) OCCUPANT (Listed above)
CONTRACTOR (On Pg. 1) NO CHANGE IN USE/ NO CONSTRUCTION
MAIL/ FAX TO OTHER: CHANGE OF USE/ NO CONSTRUCTION
/i5 APPLICANT'S SIGNATURE DATE
... ,,
Inspection List
Permit#: CB143276 Type: PME
Date Inspection Item
12/03/2014 43 AirCond/Furnace Set
12/03/2014 43 AirCond/Furnace Set
12/03/2014 49 Final Mechanical
12/03/2014 49 Final Mechanical
Thursday, December 04, 2014
Inspector Act
PB
PB
RI
AP
RI
AP
AT & T: REPLACE LIKE FOR LIKE
2 AC CONDENDORS & 2 AC AIR HANDLE
Comments
Page 1 of 1
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
09-13-2001 Electrical Permit Permit No:CB012955
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
2714 LOKER AV WEST CBAD St: TP
ELEC Status: ISSUED
09/13/2001
JM
09/13/2001
09/13/2001
Parcel No: 2090810200 Lot#: 0 Applied:
Entered By:
Reference #: Plan Approved:
Issued:
Project Title: INSTALL TEMP POWER POLE Inspect Area:
Applicant:
POWER PLUS
436 N QUINCE ST
ESCONDIDO CA 92025
760 839-9430
0 9696 09/13/01 0002 01 wner: C:GI-
NEWPORT NATIONAUCORNERSTONE LL c' -•
2117 INDUSTRIAL CT. #C
VISTA CA 92083
Total Fees: $20.00 Total Payments To Date: $0.00 Balance Due: $20.00
Electric Issue Fee
Single Phase per AMP
Three Phase per AMP
Three Phase 480 Per AMP
Remodel/Alteration per AMP
Remodel Fee
Temporary Service Fee
Test Meter Fee
Other Electrical Fees
Additional Fees
TOTAL PERMIT FEES
lnspector:~k?.
0
0
0
0
FINAL APPROVAL
Date: /aM.¥" I l
$10.00
$0.00
$0.00
$0.00
$0.00
$0.00
$10.00
$0.00
$0.00
$0.00
$20.00
Clearance: _____ _
NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively
referred to as 'foes/exactions.• You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must
follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for
processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack,
review, set aside, void, or annul their imposition.
You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capactiy
changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any
fees/exactions of which vou have oreviouslv been aiven a NOTICE similar to this or as to which the statute of limitations has oreviouslv otherwise exoired.
02
20.00
FOR OFFICE USE ONLY
PERMIT APPLICATION PLAN CHECK NO. CJ!ii/ Z,f':{tj
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
EST. VAL. _________ _
Plan Ck. Depo,.,.s'-"i ""1-------.----
Validated By-'f-+""--''='--.,...;;w-,,.:.....--.--+-,,,_
Date _________ -br-c,....,r-t-ttt-
' ' \J'\],
Business Name (at this address)
Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units
Assessor's Parcel # Existing Use Proposed Use
# of Bedrooms # of Bathrooms
'< ~ ,.
State/Zip Telephone# Fax#
',,·:.
Address ?o 'B'i-\"\'> z._ City \..A--"11 ~Jc.. State/Zipgob.37Telephone U71c+ 35?! 7979
,:~:.:.~:·:,-:. ~~ <~~-~').','~~:;:-<:.~.--':;',i·:.;~;::;~;~"~'~¼~~-::,,•:,~.;1·~::-,.,-.\:-::·~:;.~-,:\}",N~;)/_;.._'')Lt~i:~~~,-:: ~2.·:": :~:· :,t-:~·,-t.i.~:,_-:,"?N':: :, :
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its
issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law
[Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom, and the basis for the alleged
exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$5001).
:::fo-v-.1'"Ct2-P\0s '-f 2 C,.. h,\ av\.,.;~:< E.sco----. c:.iz...02..S-,/:Clf<3'99c+30
Name Address City State/Zip Telephone#
State License # -=~-L~~~.5'~7~L~--License Class ___,,(_' __,,~.._,__( __ City Business License # / '20 h '2..S::?-
Designer Name Address City State/Zip Telephone
State License # _________ _
(~:~::_wTta!i'..e·l{~rc1>MR~:i'!~A.:tt<>.tf';-,:.: .. .. , _ • , ::'~:'"._. , . . . ,;: : : ;;·z. \ .: :::: ;:;:;, . .:.,:.;.·_.:,~(. w .;. ';; ~-~: ~ ,.,: ~-:. • --;:;,:-: ., • • ..J
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
, D I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued.
D I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is
issued. My worker's compensation insurance carrier and policy number are:
Insurance Company 5-\-.(l.,_., v'\o-1.. Policy No. / S-S-S-J IO ~ cC Expiration Date S "' '$/.-oz.
(Tl:IIS SECTION NEE,D NOT BE COMPLETED IF THE PER~IT IS FOR QNE HUNDRED D_0LLARS [$10~) OR LESS)
0 CERTIFICATE OF EXEMPTION: 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.
WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred
thousand dollars ($100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees.
,;,::~~=:a~~!'.l!~Ql;l(QE~)~m;~·-,: .:· .. :.~ .' .... t,;;_~.: .. .:,,.;~· '', ·:· ':.L :.:.:~~~:~:.:_'.:'"' I '3 r-0 .'
I hereby affirm that I am exempt from the Contractor's License Law for the following reason:
· O 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 offered for sale
(Sec. 7044, Business and Professions 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 offered for sale. If, however, the building or improvement 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).
D I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The
Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed
pursuant to the Contractor's License Law).
D I am exempt under Section ______ Business and Professions Code for this reason:
1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. D YES ONO
2. I (have / have not) signed an application for a building permit for the proposed work.
3. I have contracte<I _with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors license number):
4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name / address / phone number/ contractors license number): _____________________________________________ _
5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name/ address / phone number/ type of work): _______________________________________________________ _
PROPERTY OWNER SIGNATURE _____________________ _
~GQMPJ:.~ti:',~~1~)~~9ri:19™~~:R!tWPNiQf$iQPN1t!l4.tt.i:!QJtPi}J~1"1BNlitfilQ~ttt;:,;;;£'.-~·:/wt, :,,: ::.
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention
program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardoi:Js Substance Account Act7 D YES D NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? D YES D NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site7 D YES D NO
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE
REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
~f.'.~&9.IIJ~'l;RW119N:@~pj@j,~~gl':{~Y;,:. . ·-,:, -.
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code).
I certify that I have read the application and state that the above information is correct and that the information on the plans is accurate. I agree to comply with all
City ordinances and State laws relating to building construction. I hereby authorize representatives of the Citt of Carlsbad to enter upon the above mentioned
property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND 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 GRAN:rlNG OF THIS PERMIT.
OSHA: An OSHA permit is required for excavations over 5'0" deep and d~molition or construction of structures over 3 stories in height.
EXPIRATION: Every permit issued by the building Official under the provisions of this Code shall expire by limitation and become null and void if the building or work
authorized by such permit is not commenced within 180 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned
at any time after the work is commenced f a period of 180 days (Section 106.4.4 Uniform Building Code).
DATE _ ____,9'-.--__ f_'3_,-_0....:./ ___ _
YELLOW: Applicant PINK: Finance
·UNSCHEDULED BUILDING.INSPECTION.
INSPECTOR. P. cb ------
PERMIT# a, 2> g. S S: ··. PLAN CHECK# -----
DESCRIPTJON_...;.-----------------------
CODE , DESCRIPTION ACT
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COJy.tMENTS
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Thereby affirm that I am licensed undo
provisions of Chapter 9 (commencing wit
Section 7000) of Division 3 of the Buslnes
and Professions Code, and my license is I
full force,:and effect.
I hereby alfirm that I am exempt from the Contra
tor's license .Law for the following reason (Sec. 7031 Business and Protessions Code: Any city or county wh,c~ r,
quires a permII lo construct, alter, improve, demolish, repair any structure, prior to its issuance also reqU1res the a
phcant for such permit to file a Signed statement that he
licensed pursuant to the provisions of the Contractor
License Law (Chapter 9 commencing with Section 7000
D1v1sion 3 of the Business and Professions Code) or that 1s e empt therefrom and the basis for the alleged exemplmn. A vIotatmn of Section 7031.5 by an applicant for a permit su Iects the applicant lo a cIvIt penalty of not more than five hu
dred dollars ($500).
,I I I, as owner of the property, or my employees with wag
as their sole compenSatlon, will do the work, and the stru
lure ,s not intended or olfered·lor sale (Sec 7044, Busine and Professions Code· The Contractor's License Law do
not apply to an owner of property who bmlds or ,mprov
thereon and who does such work himself or through his o~ employees, provided that such·1mprovements are not inten
ed or olfered for sale. If, however, the building or improv ment is sold within one year of completion, the owner-build
will have 1he burden of proving that he did not build or , prove for the purpose ol sale)
I I I, as owner ol the property, am exclusively contracll With.hcensed.contractors to construct the project (Sec. 704
Business and Professions Code The Contractor's llcen Law does not apply to an owner of property who builds or 11
proves thereon, and who contracts for each projects with contractor(s) license pursuant to the Contractor's Licen Law).
11 As a homeowner I am improving my home, and the folio ing cond1t1ons exist·
1. The work Is being performed· prior to sale. 2 I have lived in my home for twelve mon
pnor to completion of this work 3. I have not claimed this exemption during last three years
0 I am exempt under Sec. _______ , B &'P
for this reason ·
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I hereby affirm that I have a certificate of consen
·self-insure. or a certificate of Workers· Compensation
surance. or a 11;.rt~fied copy :e'J~ISI,·. :JiJO; ',.i/J)r[)J,
POLICY No.WC.~ /j t:7.;:,J /• lJ
COMPAN-:t/,--1..,.,.J. o.~f/t.Jw,.J-
to In-
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~py IS fll:~i C1tt'7 ' 1
D Certified copy is hereby furnished
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE
(This section need not be completed 1f the perm
is for one hundred dollars ($100) or less)
D I certify that in the performance of the work for w
this permit 1s issued. I shall not employ any person in
manner so as to become subject to the Workers' Com
sation Laws of California.
NOTICE TO APPLICANT; If, after making this Cert,11
of Exemption. you should become subject to the Wor
9ompensatIon provision~ of the Labor Code, you m
forthwith comply with such provisions or this permit
be deemed revoked.
D I hereby affirm that there is a construCtion len
agency for the performance of the work for which thI
mit 1s isslJed (Sec. 3097, Civil Code)
ich
,ny
en,
ate
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ust
Iall
1mg
per-
Lender's Name ___________ _ -
Lender's Address __________ _ -
_____ .... --
'
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USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT 2075 Las Palmas Dr., Carlsbad, CA 92009-1915 (619) 438-1161
JOB ADDRESS
.lo/Ctut
AV, ST.RO. THOMAS BROS NO. I 0;;;;7;;tONI :J.¥;;? LICENSE#
VALUATION PERMIT NUMBER
tJ..7/L/ t4,di ~' 41-Yl~ /3;69-it./3 '1 LOT BLOCK I SUBDIVISION 'I ASSESSOR PARCEL NO. 'P ft-~ONTRACTOR CONTRACTORS PHONE # ZONE i fl.fH'ltl Ou µ't cl€cr-.t/ft), f{,/f OWNER'S NAME I OWNER'S PHONE ."'lo.f-~-r r..-,. II"<.•• ,I'."'\.-,; X n, n n-
/tlc.M/1~ l;(jP,p t
CONTRACTOR'S ADDRESS STATE LICENSE NO. Vk1~l '.Fir ::;.QI'" 421' v-.. "·BUftOING SSA=OOTAGE
·ZZZ--0 /Kie 121. pl-, &f c,,pt,r~/M , ·4 Yl'lo? 'I c-PRMT 30n00
OWNER'S MAILING ADDRESS
Z,3's3 vf_ -J N· /),,+,,~~ DESIGNER DESIGNlrR'S P.HONE .
-..,,,,,.v-
DESCRIPTION OF WORK /11 A/:.. . 7~J-vl .... ,. ,,,_,._ ~-~ DESIGNER'S ADDRESS STATE LICENSE NO. ' >lr¥r.l'I •V 7
r .
I ~eir .,,.2,_ r.lor-·ff.> r., ,vy /A,/ F/P FLRELEV, NO OCC GP EDU
1' "' p J)() J'/V
STORIES
vO NO --I CENSUS TRACT· I PARKING SPACE I RES UNITS I GRADING PERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRE SPA AREA CONST
YO ND vO NO --4J.. Nfij,. ~ Not Valid Unless Machine Certified
QTY.· PLUMBING PERMIT -ISSUE 7~ ,_QTY. MECHANICAL PERMIT -ISSUE /5~ ,L 1~.d\. ~~~/ACCOUNT NUMBER
EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100,000 BTU ,,~)J-11..\i-lN~ P~~M hnn uu I ·ti 1U·00·00·8220
EACH BUILDING SEWER OVER 100.000 BTU \..SH;N1PERMIT1 1°v, 001-810-00-00-8221
EACH WATER HEATER ANOiOR VENT BOILER/COMPRESSOR UP TO 3 HP PLAN .. CH~'h. ...,11 t:'fl'".; ~ ~Q.1·810·00-00-8891
EACH GAS SYSTEM 1 TO 4 O_UTLETS BOILER/COMPRESSOR 3·15 HP \I. rs;y,-oit..a.e PL1:i1v1·rttf<lG'':-:":' --:OQJ.:fl.1,.0-00-00-8222
EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE DEVEt OP M~llUTR'f ~Lc::):i 1 "u ifoN ,li:00-00-8223 ~ -
~ACH INSTAL., ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 001-810-00-00-8224
EACH VACUUM BREAKER MECH EXHAUST HOODtOUCTS MOBILEHOME 001-810-00-00-8225
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER SOLAR 001 ·810-00-00-8226
EACH ROOF DRAIN (INSIDE! DRYER VENT STRONG MOTION 880-519-92-33
TOTliL MECHANICAL FIRE SPRINi<~ERS 001-810-00-00-8227
TOTAL PLUMBING I PUBLIC FACILITIES FEE 320-810-00-00-87 40
5'¢fd. BRIDGE FEE 360-810-00-00-87 40
QTY. ELECTRICAL PERMIT -ISSUE ""QTY. MOBILE HOME SETUP PARK-IN-LIEU (AREA )
NEW CONST EA AMP'SWT BKR CAR PORT TIF 312·810-00-00-8835
I PH 3 PH AWNING LA COSTA TIF 311 ·810·00-00-8835
EXIST BLOG EA AMP/SWT/BKR GARAGE FMF
1 PH 3 PH LIGENSE TAX 001-810-00-00-8162
REMODEL'ALHR PER CIRCUIT MFF 880-519·92-57
TEMP PO LE 200 AMPS
OVER 200 AMPS
TEMP OCCUPAJJ.CY 130 DAYSI
I -:--1 er~ t CREDIT DEPOSIT
I TOTAL ELECTRICAL I ~r-~ TOTAL I TOTAL FEES PAYABLE ~___,
I HAVE CAREFULL y EXAMINED THE COMPLETED '"APPLICATION AND PERMIT" AND DO HEREBY , Expiration. E~ery per.mi~ issued by the Building Official ~nder the prov1~1ons of this * AN OSHA PERMCT IS REQUIRED FOR EXCAVATIONS OVER CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall exprre by hmitahon and become null and void II the building or work 5' O'" DEEP AND DEMOLITION OR CONSTRUCTION OF · authorized by such permit 1s not commenced within 180 days from the date of such DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT lb permit. or if the buitdinri or work authorized by such permit 1s suspended or STRUCTURES OVER 3 STORIES IN HEIGHT
ISSUED: 'TO COMPLY WITH ALL CITY. COUNTY AND STATE LAWS GOVERNING BUILDING CON-abandoned at any lime a ter the.work 1s commenced for a oenod of 180 davs,
STRUCT-ION, WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AN:~ ~2 ,t'l'fr
:APPR'~ L., IDAf:6~/4 KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND ~;N S Sl~;E .% OWNER O · CONTRACTO
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF TH ~ 7 h \. re,/._ 1'('/':::> BY PHONE 0 GRANTING OFT~.~ ---.. -_, • 'A ~ · .,. •
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CITY OF CARLSBAD
INSPECTION REQUEST
PERMIT# CB891434 FOR 09/28/89
DESCRIPTION: TEST METER ELECTRIC
STR: JOB ADDRESS: 2714 LOKER AV WEST
APPLICANT: DAVIS, DARROLD
CONTRACTOR: PARAMOUNT ELECTRIC
OWNER:
PHONE: 4580440
PHONE:
PHONE:
INSPECTOR AREA TP
PLANCK# CB891434
OCC GRP
CONSTR. TYPE NEW
FL: STE:
REMARKS: T3/RS/PARAMOUNT/480-8619
SPECIAL INSTRUCTIONS:
INSPECTOR Y <:.::: ~D ----~--t-----
TOTAL TIME:
CD LVL DESCRIPTION ACT COMMENTS
32 EL Const. Service/Agricultural ff __ ::z:;;i§_E..=~~7"~@.........,~"--'-'.7:i~c_lt..-~------
--------------------------------------
-------------------
***** INSPECTION HISTORY*****
DATE DESCRIPTION ACT INSP COMMENTS
\
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~ 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
full force and effect.
I hereby afllrm that I am exempt lrom the Contrac-
tor's License L~w for the following reason (Sec 7031.5 Business and Profess10ns Code· Any city or county which re· quires a permit to construct, alter, rmprove, demolish. or repair any structure, prior toils issuance also requires ?heap-plicant for such permit to file a signed statement that he 1s licensed pursuant to the provisions of lhe Gomractor's License Law (Chapter 9 commencing with Ser.lion 7000 of 01v1s1on 3 al the Business and'Profess1ons Code) or that 1s ex-
empt therefrom and the basis for the alleged exemption. Any violatmn of Section 7031-5 by an applicant tor a permit sub·
jects the apphcant to a civil penalty of not more than five hun-dred dollars ($500)
I I I, as owner ol the property, or my employees with wages
as their sole compensalion, will do the work, and the struc-ture is not intended or offered for sale (Sec 7044, Business
and Professions 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-intend-ed or offered for sale. If, however, the building-or improve-
ment 1s sold withm one year of c.omplet1on. the owner-bwlder will have the burden of proving that he did not build or im-prove for the purpose of sale).
I I I, as owner of the property, am exclusively contracting
with licensed contractors to construct the project (Sec. 7044,
Business and Professions Code: The Contractor's license Law does not apply to an owner of property who builds or im-proves thereon, and who contracts for each projects with a contractor(s) license pursuant to the Contractor's license Law). ·
11 As a homeowner I am improving my home, and the lql,low· mg conditions exist. 1. The work 1s being performed· prior to sale
2. I have lived in my home for twelve months prior fo completion of this work. 3. I have not claimed this exemption durmg the last three-years.
D I am exempt under Sec. _______ , B & P:C.
· lor this reason
eft hereby affirm that I have a certificate of consent to
1
self-insure. or a cert1f1cate of Workers' Compensation In-
surance. or a certified copy thereof (Sec. 3800. Labor Code) 1
POLICY N6.
~?ANY
/ Copy is hied with the city
0 Cerhhed copy is hereby furnished
CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE
{This sect10n need not be ,completed if the permit
1s for one hundred dollars ($100) or less)
-0 I certify that in the performance of the work forwh1ch
this permit 1s issued. I shall not employ any person m any
manner so as to bec9me ~ubject to the Workers· Compen-
sation Laws of California.
NOTICE TO APPLICANT: If, after makmg this Certificate
of Exemption. you should become subject to the Workers·
Compensation provisions of the Labor Code. you must
forthwith comply with such provisions or this permit shall
be deemed revoked.
D I hereby affirm that there is a construction lending
agency for the performance of the work for which this per-
mit is issued (Sec. 3097, Civil Code)
Lender's Name ____________ _
Lender"s Address ____________ _
USE BALL POINT PEN ONLY & PRESS HARO
CARLSBAD BUILDING DEPARTMENT 10/g ~PLICATION & PERMIT
APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. ,
2075 Las Palmas Dr., Carlsbad, CA 92009-1915 (619) 438-1161
JOB APDRESS AV.ST.RD, THOMAS BROS NO. ,;J;FA) ;t;iiONI
BUSINESS LICENSE # VALUATION PERMIT NUMBER
d.7/ij J.0/k~ 4'./E W.eJr ~o5@o Cb .
L~ BLOCK I SUBOIVl:'ION I ASSESSOR PARCEL No. R CONTRACTOR CONTRAC~~HONE# ZONE ~~l3'3>Y OWNER'S NAME I OWNER'S PHONE lllZ,A-tne tt JJT [:£.e_ t '/w' c:.. 4Ft>/Y'b'Y
/fl l lHA-J;:w.., /ufiN, ~ /1.,,B.
CONTRACTOR'S ADORES$
,,s:}3LiE;7~
BUILDING SQ. FOOTAGE
7..Z.2,,o ' £t.1v,r~/-" OWNER'S MAI.LING ADDRESS /11IC/l.t!) J).L
DESIGNER DESIGNER'S PHONE
'DESCRIPTION OF.WORK<;"/, -
l'JC,,-1 , ~p f>Ch.Je-R. OESIGNER'S ADDRESS STATE LICENSE NO. 223110/03/88 000101 02
Bldf'mt 15 .. 0{
F/P FLA ELEV. NO OCC GP EDU STORIES
vO NO __ , I CENSUS TRACT I PAR Kl.NG SPACE I RES UNITS I GRADING PERMIT ISSUED I REDEVELOPMENT TYPE o·cc LOAD FIRE SPA AREA CONST
YO N 0 vO NO ... ~ ~ vO NO Not Valid Unless Machine Certified
"'---~ r
QTY. PLUMBING PERMIT· ISSUE ?@. ~QTY. MECHANICAL PERMIT· ISSUE /, -SUMMARY/ACCOUNT NUMBER ,,,,._...,,. y
EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100,000 BTU ~.i::"". °'"(llUILOING PERMIT UU1·810-00-00-8220
EACH BUILDING SEWER OVER 100,000BTU r..., >y . ), Y-SIGf'!J'~~ _,\'-). 001-810-00-00·8221
EACH WATER HEATER ANOiOR VENT BOILER/COMPRESSOR UP TO 3 HP v· . ", ~l--.l~liE~~"' 001·810-00-00·8891
EACH GAS S_YSTEM 1 TO 4 0 UTLETS BOILER/COMPRESSOR 3-15 HP \ \\) -,:~~fOJ~'Pt.UMBING 001 ·810-00-00-8222
EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE _, ~ .-..Q\;..Yl.ECTRICAL 001-810·00-00-8223 f""S'-
EACH INSTAL., ALTER, REPAIR WATER PIPE VENT FAN SING LEO UCT ~1\t~ -::~'\
.
MECHANICAL 001·810-00-00-8224
EACH VACUUM BREAKER MECH EXHAUST HOOO!OUCTS ~,. r..1¢V:-...... MOBILEHOME 001-810-00-00-8225
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER ~~~...,_-. SOLAR 001-810-00-00-8226
EACH ROOF DRAIN (INSIDE) DRYER VENT V STRONG MOTION 880-519-92-33
TOTJ;L MECHANICAL FIRE SPRINKLERS 001-810-00-00-8227
TOT AL PLUMBING I PUBLIC FACILITIES FEE 320-810-00-00-87 40
C ELECTRICAL PERMIT . 1ssu"D ~ BRIDGE FEE 360-810-00-00-87 40
QTY. QTY. MOBILE HOME SETUP PARK-IN-LIEU (AREA )
NEW CONST EA AMP'SWT 8KR CAR PORT .. TIF 312·810·00-00-8835
1 PH 3 PH AWNING LA COSTA TIF 311-810-00-00-8835
EXIST BLOG EA AMP/SWT'BKR GARAGE FMF
1 PH 3 PH --LICENSE TAX 001 ·8·10·00-00-8162
REMODEL 'AL HR PER CIRCUIT -· MFF 880-519-92·57
I TEMP PO LE 200 AMPS IC/.
OVER 200 AMPS
TEMP OCCUPANCY (30 DAYS)
CREDIT DEPOSIT
TOTAL ELECTRICAL I IS-TOTAL TOTAL FEES PAYABLE I JS--
I HAVE CAREFULL y EXAMINED THE COMPLETED "APPLICATION AND PERMIT" AND DO HEREBY Expiration. Every per,mo_tlssued by the Building Official under the-provisions ofth1s * AN OSHA· PERMIT IS REQUIRED FOR EXCAVATIONS OVER CERTIFY' UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shalt expire by l1m!tatoon and become null and void If the·bu1ld1ng or work 5" O" DEEP AND DEMOLITION OR CONSTRUCTION OF authorized by such permit os not commenced wothm 180 days from the date of such DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT lb permit. or if the buildinft or work authorized. by such permit 1s suspended or STRUCTURES OVER 3.STORIES IN HEIGHT
ISSUED· TO COMPLY WITH ALL CITY. COUN1Y AND STATE LAWS GOVERNING BUILDING CON· abandoned at any time a ter the work 1s commenced for a oenod of 180 davs. -,
STRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I ALSO .A:GREE TO SAVE INDEMNIFY A~ICANT'S SIGz..: OWNERD CONTRA~ APPROVED BY" f (
i D;o I:!>/ rr KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND C
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE .//4 /4 L ~p BY PHONE 0 GRANTING OF THIS PERMIT. -i,r:.... f'A,.
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