HomeMy WebLinkAbout2717 FLOWER FIELDS WAY; ; 84-110-113; Permit"' z 0 ;:: .. a: ~ " ... 0
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"'rvf I hereby affirm that I am licensed under
~talons of Chapter 9 (commencing with
Section 70CXI) of Division 3 of the Business
and Professions Code, and my license is in
full for.ca and~ :B-1 L,cNo~ Cla<,1
I hereby af1,rm that I am exempt from 1he Contrac·
tor's L,cense Law lor the 1ollow1ng reason (Sec 7031 5
Business and Professions Code Any c,ry or county wh,cr, re
quires a permit lo construct. alter, improve demol,sh or
repa,r any structure, prior to ,ts ,ssuance also requires the ap plicant for such perm,t 10 f<le a s,qned stalemen! that he 1s
licensed pursuant to the prov1s1ons o! the Connactor's
License Law (Chap1er 9 commencmg with Section 7000 of
D1v1s1on 3 of the Business and Professions Code) or that ,sex-
empt theretrom and the basis !or the alleged e,emplrnn Any
v101a11on of Section 7031 5 by an applicant for a permit sub
1ects the applicant lo a civil penalty ot not more than five hun-
dred dollars ($500)
J I, as owner ol the property. or my employees with wages
as their sole compensation. will do the work, and the struc-
ture 1s not intended or oflered tor sale (Sec 7044, Business
and Professions Code The Contractor's License Law does
not apply to an owner o1 property who builds or improves
thereon and wtio does such work h1msell or through his own
employees. provided ?hat such 1mpr011ements are no1 1n1end-
ed or offered tor sale 11. however, ttie building or improve·
ment 1s sold within one year of completion, the owner-builder
will have the burden 01 proving that he did not build or 1m-
pr011e for the purpose 01 sale)
n I, as owner ol the property, am exclusively contracting
with licensed contractors to construct the proiect (Sec 7044,
Business and Professions Code· The Contractor's License Law does not apply 10 an owner 01 property who builds or im·
proves thereon. and who contracts for each pro1ec1s with a
contractor(s) license pursuant to the Contractor's License C.w)
11 As a homeowner I am improving my home, and the follow
ing cond1t1ons e .. st 1 The work is being performed prior to sale
2 I have lived in my home for twelve manths prior to comple!1on of this work
I have no1 claimed this exemphon dunng !he
last three years
D I am exempt under Sec . B & P C
for this reason
),/ I hefeby atfirm tria! I 11a~e a cert1f,cate ot consent ~ sell-insure. or a certif1ca1e of Workers
Gompensat1on 1nsurance. or a certd,ed copy !hereof
(Sec 3800. Labof Godel
POLICYN~-54 -/":, 71,,-fd,
co•e•Nv Ffe,.0 ,d .::r;.,_J...., :_L A Copy <Stoled w,t11 the c11y .....,. 7
0 Cert,f,ed copy 1s 11ereby furnished
CERTIFICATE:. OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be comple!ed 11 the perm,!
1s tor one 11undred dollars ($1001 or less)
O I cer1,ty !hat ,n tile pertormance ot the work for
which this permit 1s issued. I shall r,ot employ ar,y
person on any manner so as !o become sub1ect lo
the Workers· Compensatmr, Laws ot Cal,forn,a
NOTICE TO APPLICANT II_ alter mak,r,~ this Cert,
f,ca!e ot Exemption. you should become sub1ect v,
!he Workers· Compensat•or, pfov,s1or,s of the Labor
Code. you mus1 !ort11 .. ,th comply w,th such
prov,s,ons or this perm,t shall be deemed re,oked
'>J'. hereby at!irm ltoa! mere ,s a loro<truct,o~
ft1::/:.,rog aQency lor the performanc~ o' the work lor
wh1cto th,s perm,'! ,s ,ssued 1Sec 3097 c,,,1 vei
Lender 5 Name HQP?tO Nd#ta
Ler1der"s Address /OJ J3rood(<)(1t:
5D1 o4 "jzJ I
USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS_
, -t -K, -\ ""2;. CARLSBAD BUILDING DEPARTMENT
1200 Elm, Carlsbad, California 92008-1989 1619) 438-~5~
APPLICATION & PERMIT
Ff o_ iTCROSSST. I (>ATE OF Af>f>LICATION BUSINESS LICENSE # VALUATION PERMIT NUMBER
/ lOz(oz_ I l~
e,4-110-~
~'f~1~~ -· 7438> i:>,W~ ·;i. ' ~ -~ •• Iii. .A ii • I ;, ' -,,...:,j~~i~i~,'""fiissfsiioem¥2<£~~=-=-:-:::-;-CONTRACTORS PHONE It ZONE
j BLDG USEC PLAN 1.0. # E
' ' CONTRACTOA ,, 1 •. ""'. K •. g;'lii',•$1W~ jASSESSOR PARCEL NO. ~ ;,,--":. ·.' • -' I z:
LOJ . L . . • ·..., h!Ft>toN~ · · /4,J-030:::S::r: ~.s'Ji;'u::JloN 'Z:,z-SI
-J , ·, r • OWNER"SPHONE -, LtCENSENO. ow:_J_;;"1 ~ P"l..b¢ . . f%'1-3bco coNT~A~o£~;;,, .~O Z-z$Z-f-4
STANDARD PLAN# I
3.9'¥i ::',::S
OWNER'S MAILING-AOqf!ESS ~· '*, . LtCENSE #
-,t/~1:ljXtsS. C:z /=:, -O Cff1:9tTJON'0,F Wo.f;Jl(•
,., • ¥•-C
TB, f.i..·.~¥#2~;:;_idf@ ~
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CENSUS oRAC, l Ge <.AND USE I ";;:;CE AES UNITS GRADING PERMIT ISSUED
4 vO ND
vO NO
I AEDEVELOPME.NT
AREA ,. /
vO Nll!2.
i ). _:,' QTY. MECHANICAL PERMIT -ISSUE
~,\.·· OES,!Gf'iE_f'S,sPH9N,E,,
NO OCC GP EDU
STORIES ~-1 4 .3
TYPE DCC LOAD FIRE SPR
CONST \I-I~ ,o No<I Not Valid Unless ~chine Certified
:]'. ~· ~ SUMMARY/ACCOUNT NUMBER QTY.I PLUMBING PERMIT -ISSUE
I~ EACH FIXTURE TRAP I _......, -A INSTALL fl'"~' n"!'TC" :,r, Tn ,nn nnn DTH
LL
_ _ ,.1.,1,.LLrunll UUl.,l.>Ur ,u iuu,uuuoiu I BUILDING PERMIT 01·00~00·822~--4,JO 5(21
EACH BUILDING SEWER I zt~.-UY<.H ouv,uvvuou _; nui::11 ,nn nnn QT11 SIGN PERMIT ·00..-10·8221
~ --·---·----~ ~---··--·
A. EACH WATER HEATER AND,OR VENT I 10 -BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK o1Qohl5,l. _ -::,q(p, ,&:5.
A-EACH GAS SYSTEM 1 TO 4 OUTLETS -l-,n.-BOILER/COMPRESSOR 3-15 HP
EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE -I I
EACH INSTAl. .. ALTER. REPAIR WATER PIPE ------
EACH VACUUM BREAKER
WATER SOFTNER
EACH ROOF DRAIN il"JSIDE'1
TOlAL PLUMBING 1
QTY. ELECTRICAL PERMIT -ISSUE
14 NEW CONST EA AMP:SWT BKR VT
I PH J PH
EXIST BLDG EA AMPISWT:BKR
I PH J PH
REMOOEL'Al Tt:R PER CIRCUIT
TEMPPOlE ?OOAMPS
OVER 200 AMPS
TEMP OCCUPANCY 130 DAYSI
TnTAL ELECTRICAL I
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_____£_a .1
ID")
/06 -
A VENT FAN SINGLE DUCT --------
MECH EXHAUST HOOOlOUCTS
RELOCATION OF EA FURNACE1HEATER
TOTt.l MECHANICAL
QTY. I SOLAR -ISSUE
COLLECTORS
STORAGE TANKS
ROCK STORAGE
PUMP
PLAN CHECK FEE
TOT Al SOL AR
i
p, MECH
MOBILEHOME PARK INSP "fiOr1:~'"':_/Ji&.d
~--__ O:l·Q
. S_!__RON_G MQJIQ!'! 80·92·33·051 rs._l/..<zz:_ z-, FIRE SPRINKLERS 01 ·00·00·8227
PUBLIC FACILITIES FEE 32·00·00·8933 3-""f:Q:;,_ -
BRIDGE FEE
SCHOOL FEE · DISTRICT ·---
Carlsbad v LTK 80·92·21·0519
Encinitas 80-92· 22·0519
San Dieguito 80·92·23·0519
1--San Marcos 80·92·24·0519
Pai, }:_ ..,.,: L .,..._ 4:@ 434 J 73&:, -
LICENSE TAX 01-00-00-8162 -M ,=:,=. 4-= Bi:3D 3'52D
"c\ifc,IT DEPOSIT ..I'. zA.-~ .'{_ =
TOTAL FEES PAYABLE J 958/. 53
1 HAV~,CAAEFUL_L"\' EXA,M1NED'THE 6oMP"-Erer} ,'·APPt1cATioN ,.~·JSEA~rt" AND 00 fttfleev * A,N ~ F:'ERlffl tS AEQUNED FOR EXC,4VltTIONS OVER
CER:t!F)' UNDER. PENAL.TY OF PERJURY Tl'(AT, ALL, INFOfffliAT10Ntrf1E'A~ON ·1NOLtJOWG' THE , S'.O'"" moN'<)R CONSTAUCTION OF
DECLARATIONS ARE Tft]E AND CORRECT lliD f FURTHEPI l;,ERTfft.-'&NO-,AGFIEE If Pi,,~J\MtT IS ST R) SlORd IH,HEIGHT
lSSUEO: TO-COMPLY "'tt-LALL,CIT.Y, COUNTY ANO ST~tE4-AW$-~NG-BUflOINGJX>~
S.TAUCTION. WHET. HE8.SPEt;:;tflED HERE~;Qf-NQT. l A.LSQ AGRE§ TO SAYE l,NO;,MNtFY AND , KEEP F1:ARMLES$ THE4'.ft QF CARLSSA~AiNST All ~~,,,JUDG¥EtiTS, COSTS AND
EXPEN~ES, '1(1il.~ MA'(i,!l'-l "rtf-'W!'-~ 1'G~f. A;,~$T 5'10 -~ GQNSEQUENCI): 0¢ THE:
,,G:RM!lllf'iJGj:)f THIS ~tT. , :. ;. "*"', ?''%. , 2
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TYPE ' DATE INSPECTOR
BUILDING ' I
FOUNDATION I
REINFORCED STEEL I
MASONRY ' I
GUNITE OR GROUT I
FLOOR & CEILING SUB FRAME I
SHEATHING D ROOF D SHF'AR
FRAME I
EXTERIOR LATH I
INSULATION ' I
INTERIOR LATH & DRYWALL I
I
PLUMBING I
'
SEWER AND BUCO DIP UCO I
UNDERGROUND D WASTE D WATER
TOP OUT D WASTE D W.j\TER
TUB AND SHOWER PAN I
GAS TEST I
D WATER HEATER D SOLAR WATER
I
ELECTRICAL I
D ELECTRIC UNDERGROUND D UFFER
ROUGH ELECTRIC I
D ELECTRIC SERVICE D TEMPORARY
D BONDING D POOL I
'
I
MECHANICAL I
D DUCT & PLEM., D REF. PIPING
HEAT -AIR COND. SYSTEMS '
VENTILATING SYSTEMS I
I
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE BEEN APPROVED
FINAL '
I
PLUMBING I . I ' ELECTRICAL I -. t""" -•./J /
MECHANICAL I l J ,, ,fl /
GAS I /:' l /
BUILDING . ' ',·. -·,' 'J ' I
SPECIAL CONDITIONS ' ' I
-
,I i<+-110~ \ \3·
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTION REQ IF INSPECTORS DATE CHECKED APPROVAL
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRESTRESSEO
CONCRETE
POST TENSIONED
CONCRETE
FIELD WELDING
HIGH STRENGTH
BOL Ts
SPECIAL MASONRY .~·
t1 1.'<>· ·
. ·:,";'\"1·'~ .,.Al.
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