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HomeMy WebLinkAbout2727 LUCIERNAGA ST; ; CB880391; Permit.. z 0 " ~ .. J 0 w 0 C i[ 0 a: w 0 J 3 ~ w z ~. I j z 0 " ;)I z w .. " 0 0 "' i< w " a: 0 3: I l O I hereby affirm thal I am licensed under pro11lslon1 of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profeaaionl!I Code. and my license ,s 1n full force and effect I hereby altrrm Iha! I 0'11 exempt from !he tors lrcerse Law 'or !he lol'·ow,ng reason !Sec Business anc Profess,ons CIXle Any c-ty D' co,,nry wh,cr- qu,,es a perrT11I 10 construe! a11e, ,mprove de,.,or,sh o· repair any structure pr,or to ,ts ,ssuance also reQu,res '.he ao p1,can1 for sue~ ~erm,: lo hie a s,~ned sta'e""e",' ·~a• re ,s 1,censed Pursuant to 'he prov1s1ons 01 The ~on1rac10r, I ,ce~se caw 'C~apter g commenc,~g with Ser· on 7'.l8G ol D111s,on 3 ot the Business and Professions Co~e, or t~ar ., e, empt Therel<om and the bas,s lor lhe alleqen P-xemDlIon Any violat,on of Sec!,on ?031 ~ by an apnIIcan: t~r a perrfl't s,o Iec1s the app',cant 10 a c,v·I 8ena•ty ~f no1 mc,e !~an t,•,e hJ c·ed 80IIars i$500·, I as owner 01 lhe property or my employees ,it· wages as Their sole comoensar,on w.II do the v,ork an~ t~e struc lure ,snot ntended or oflerM to' sale :Sec ?G44, HJ\1ness anc Profess,ons Code The Con1rac1or s License Law does nol apply to an owne, o• proper•y w~o bu, ds ~r ,mproves thereon ano who does such work h, ..... sell or throug~ ~,sown employees prov,ded That such ,mprovemenls ;ire ~01 ,ntend- ed or ottered 'or saIe 11 however the ou,ld,ng or Irnpr0ve "'e~I ,s sold w1th1n one year of comp,et,on. !he owner nu,lder w,I1 have the ourden of proving •hal he did ~01 nu,'d or ,m pr:ive lor lhe purpose ~f saleI as owner ol lhe property am exclu51vely c~ntracr,ng with licensed comractors to construct me ~ro1ect (Sec 7044 Bus,ness and Profess,ons Code The Conrractor s L,cense Law dDeS not apply to an owner ol property who ~u<las or ,rr 8roves the,eon and who contracts to, each oro1ects wI!h a contraclOr(s) ,cerse pursua1! lo lhe Conlracto, s l ,ce~se Law) As a homeowner I am ,mprov,ng my home and the 10II0w ,ng cona,1,ons exist 1 The work ,s being performed prior to sa'e 2 I have I,veo ,n my /lome tor twelve -,onths ~rior lo cornplet,on of This wars I have not claimed tn,s exemption dur nq 'he ast three years I am exempt ,nder Sec _____ _ B & PC ior this reason ____________ _ I nerebv allirm 1na1 I na,e a ce,t,•,cate of consent to self Inscre or a cert1!,cate of 1/ICrke•s Compensation In su,arce or a ce•td.ed copy IM,eol ,,Sec 3800 Labor Code) POLICY NO COMPANY Cop\ s I led w,tn the c,ty Cert1f1ed copy ,s ne•eby furnished CERTIFICATE OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE ,Th,s sect,on ~eed not be C0"1pleted ,f the perm,· Is for one hundred dollars 1$100! or '~ssl 1 ~ert:iy that .n the performance oi the -'Ork to, ... ~.;ch th,s ~erm,t ,s ,ssued I shall not employ any person ,n any marner so as to become suDJect lo the Wor~ers CompM sat,on Laws of Cal,forn,a NOTICE TO APPLICANT. If after making this Certificate of E<empt,on. you should become sub1ect 10 tne Workers Compensation prov,s,ons o! the Labo, Code you must ::,e deemed revoked L '"'"'•'" com"' w•m sec, OCO"•s•ocs cc •c•s pecm•' sea•• ![ _ I hereby all1rm that there ,s a construct,or IendIng agency lo, the perlormarce ol \he work for wh,ch ·n,s per m,: ·s ,ssued ,Sec 3097. C,v,1 Code) Lenders Name Lende, s Address USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS --- CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr .• Carlsbad. CA 92009-1915 (619) 438-1161 APPLICATION & PERMIT ,o:,;o~:1? J ,,,( O <J / e ,f' /Y ;;COM THs.T.s NO. "J7-i:;;J:; COT BLOCK J sueoI VISION I ":lfsy''!j"'.!J'Yt> J ~ -0 I OWNf R'S NAME -< ff IVE T 9'3;w_·e,;;;ro CONTRACTOR S£ ,< .,L:: / C:uNs,,R~:$,:::cp~:~EE ~ ZONE ~Eiiofl { J//~A/f CONTRACTOR'S ADDRESS STATE LICENSE NO. DESIGNER'S PHONE J'3-~•~00Zv0 / ,,G" ,1'/V""h~7"7 ST ~ocf" s E/4 ,,c:- DESCR1PT10N OF WORK / .,,,,. DESIGNER'S ADDRESS STATE LICENSE NO I/.(-~ /..17 >< o<?t:, 0?12:-: 1v ~ ~ 2,,.,, 2,; .,( .u rr,,, ,c: r.~ v,:R1 , - l CENSUS TRACT j 'AP<•", ,>An RES UN•,S l GRADING PERMIT ISSUED tO N 0 F,P FLA ELEV ye -.CJ l REDEVELOPMENT AAfA ,'.] '\,□ NO STORIES TYPE CONST ace GP OCC LOAD EDU FIRESPP YO"'□ . ~DIN:;Q iOOx -- Not Valid Unless Machine Certified ~ tL ~ ~ 0 '" E ill >- D 0 ('.J c QTY PLUMBING PERMIT· ISSUE C) ,5~1 OTY. MECHANICAL PERMIT· ISSUE i5·oo SUMMARY/ACCOUNT NUMBER •L f m \. ~ QTY EArH FIXTURE TRAP EACH BUILlJIN[.; SEWER EACH WA l ER HEATER AN lJ OR VEN I EACH GAS SYSTEM 1 TU ·1 UUTLETS EACH GAS SYSTEM J UR MORt. EACH INST AL ALTER. REPAIR WATER PIPE EACH VACUUM BREAKER WATER SOFTNER :"4'.>-1 RClf:> 'JR;:.\, '.S r,t: T(JlAL PllJMBll'.L 1 ELECTRICAL PERMIT· ISSUE C., ob II QTY NE.WCUNSI E:AAMPSWl KKR I PH ; PH INSTALL FURN DUCTS JP TO 100 000 BTU tlUII_DING PEWY1 OVER 100 000 BTU SIGN PERM·T BOILER-COMPRESSOR UP TO 3 HP PLAN CHECK BOILER·COMPRESSOR 3 lS HP TWAL PLU\<181'!G ~E~AL FiR[~LACE El ECTRICAL VENT FAN SINGLE DUCT MECHAr.lCAL MECH EXHAUST HOOD DUCTS ".108 l HOI/E RELOCATION OF E:A ~URNACE HEATER SOLAR DRYER VENT STRCHsG r,~Cil01, TOT.C.L MECHANICAL FIRE SPKi~Jic_E% PJBL'C FACILIT ES FEE BRIDGE FEE MOBILE HOME SETUP PARK-IN-LIEU ,:Ai1E.,A, CAR PORT ~ 1~ AWNING ~fll"a.~I~ COSTA TIF C·u'1 a·1-10-~,1J-822rJ 0C' -'.) I r)-1][1-(JQ-022' 00 \-81 0-00-00-8891 c:, ·, -ii 1 •J-,J0-Q0-82!? DO' P,1~-,)1-00-8??~ c,~ 1-s, ,~,-uo-oo-s2 24 CO' ~;,c; DC· 00-8225 OC, -0 I U-G0-00-82 26 380-519-92-33 8C 1-b' J-:,,J-:)0-8227 320-81 0-,JC,-00-87 40 360·8' 0-00-00-87 40 312-810-00-00-8835 311·810-00·00-8835 fXISTl:ltlJGE.AAMPSWTHKR I II IGARAGE A•"---i?> II FMF I PH 1 PH LICENSE TAX oo· 3",J-C,C-C•C1-3'6? RE".HJ[)fl t.! TH< PEf.l r 'f-lrLJIT MFF 380-519-92-57 If.MP Pfll E }llO AMPS OVER ?IJll AMP~ f[MP UCCUPA/IJCY 3U [JAYS! CREDIT DEPOSIT ](lfAl fllURll,t.l TOTAL FEES PAYABLE I I ... -~ ;'J~- • ., '7 z...~ ,. l HAVE CARE FULL y EXAM!NED THE COMPLETED ··APPLICATION ANO PERMIT'" ANO DO HEREBY EJ(p,ration e.._ery per~;;°~db;theBuildmg Ofhc1al underthe prov1s,onsofth,s Code shall 8J(plre by lrmttat,on and become null and ~o,d II the bu1ld,ng or work CERTIFY UNDER PENAL TY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE authonzed by such permit IS not commenced within 180days lrom !he date uf such * AN OSHA PERM:T IS REQUIRED FOR EXCAVATIONS OVER 5' 0"' DEEP ANO O01O1..rTION OR CONSTRUCTION OJ: DECLARATIONS ARE TRUE AND CORRECT ANO I FURTHER CERTIFY AND AGREE IF A PERMIT I~ permit or 1f the building or work authorized by such perm,t ,s suspended or ISSUED· TO COMPLY WITH ALL CITY. COUNlY AND ST ATE LAWS GOVERNING BUILO!NG CON [j,~b~,n~do~n~""!!!.•~•c•~•iit~,me!!!!.!•~ft~•!.'~th~•~•~o~,k~••cc~o~m~m'!!!••~c~o~dt.!slo~,J•u::•~';•oo~oQl!_!!ISO!Q.d~•W•i--;::--~~'::::~~~'."'""!1117' _________ '.':":':";"":'i"'--':"'-1 STRUCTION. WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND APPLICANT'S SIGNATURE JI. OWNER CONTRACTOR O DA½E ~ KEEP HARMLESS THE C!TY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS, COSTS AND ~ ~ ~ 0 STRUCTURES OVER 3 STORIES IN HEKitH EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE 1/;/ /1 BY PHONE [] 'OJ tf!J GRANTING OF THIS PERMIT ,1 _,,,,,.f A...,,) _--,,....,. / _./ -, '" '" <l'. I X C n: 0 ~ ~ ID ~ ~ <l'. I 3 0 a; >- ID u C m C u: C ID ~ ('.J 0 u ru Q_ ~ C ~ C ,: TYPE DATE INSPECTOR BUILDING FOUNDATION REINFORCED STEEL MASONRY GUNITE OR GROUT SUB FRAME D FLOOR D CEILING SHEATHING D ROOF □ SHEAR FRAME EXTERIOR LATH INSULATION INTERIOR LATH & DRYWALL PLUMBING D SEWER AND BUCO D PL/CO UNDERGROUND □ WASTE □ WATER TOP OUT □ WASTE □ WATER TUB AND SHOWER PAN GAS TEST □ WATER HEATER □ SOLAR WATER ..., ELECTRICAL □ ELECTRIC UNDERGROUND □ UFFER ROUGH ELECTRIC □ ELECTRIC SERVICE □ TEMPORARY □ BONDING □ POOL MECHANICAL □ DUCT & PLEM., □ REF. PIPING HEAT -AIR COND. SYSTEMS VENTILATING SYSTEMS CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE ITEMS ABOVE HA VE BEEN APPR~O~V=E~D-~--- FINAL PLUMBING ELECTRICAL MECHANICAL GAS /) BUILDING .,;?Nr/0 c.~ 4/!Z,/ri-I/ SPECIAL CONDITIONS { ' C6 %'6 0 3 ';', ! FIELD INSPECTION RECORD REQUIRED SPECIAL INSPECTIONS . -.......... ~ INSPECTOR'S NOTES INSPECTION REQ IF INSPECT~ DATE. CHECKED APPRO SOILS COMPLIANCE 8 'V<>' PRIOR TO t! FOUNDATION INSP -~- ~--·-.. STRUCTURAL C0r-.iCRETE *: OVER 2000 PSI ' PRES TRESSED '\! i;>,,. -< CONCRETE ' ~ POST TENSIONED - CONCRETE FIELD WELDING -- HICf---1 STRENGTH BOL.l'S SPECIAL MASONRY --. / ,.,v,1..,-....re-A'; es {")Q/J PILES CAISSON'.-.' u ~/u«. ---._j 6Y.> fllxrJe_ ---------rr . -· -. ------- ' . m c, ~,.. c.f ,, -69. ' -· :c-, ,, -n ;_-;,) :ID z,. "-.., a;; 0 ~-~ ,, ,o < 00 lm 0::, "' ', J> C' ,.., '• ! I I I I ' '--0 'i\:, '\ 0 i I -o ~ ' 0 1~ ! ' ,::,. ,, i r 't ) ~~ ~ ~k ,t~ \\ ~ ~ -B ~ \_, \ i, ' ' ~ t .,, Ir u .. "' 0 ~ 3 ' "' z ~ z ; 0 • ;:: • 0: 5 ~ 0 z g ~ z "' .. "' 8 .,, ic "' " .. ~ i[ O I hereby affirm that I am licensed und'er pro,lalons of Chapter 9 (commencing with Section 7000) ol Division 3 of the Business and Proleaalons Code, and my license 1s in lull force and effect. I hereby aJ1Irm that I am exempt lrom the Contrac 1or's license Law Jor 1M fo1Iow1ng reason (Sec 7031 ', Business and Pro1ess1ons Code Any c11y or county wh1c~ ,e quires a perm,! lo construct aller. improve, demolish or repair any structure, prior 10 ,Is issuance also requires !heap-pl,canl lor such perm11 10 file a s1~ned statement lhal he ,s licensed pursuant to !he provIs1ons of the Conrracrnr s License Law (Chapter 9 commencing with Ser.Iron 7000 ol DIvrs1on 3 ot the Business and Protess,ons Codej or that ,s e,- empt 1here1rom and the basis for the allegea exemption Any v1olat1on 01 Section 7031 5 by an applrc,inr for a permit sub 1ecls the applicant to a CIVIi penalty or not more than Jive hun drea dollars ($500) I. as owner 01 the property, or my employees wrm wages as their sole compensallon_ wI1I do !he work. and lhe struc ture ,snot intended or o1fered for sale (Sec 7044. Business and Pro1ess1on~ Code The Contractor's ucense Law does 1 not apply lo an owner of properly who ouilds or improves !hereon and who doos such work himself or through his own employees. provided tllat such improvements are not 1nlend- ed or offered for sale 11, however. lhe bu,ldmg or ,mprove- men1 1s sold wrth1n one year of completion. !he owner-builder will have lhe burden of proving that he did not ou1ld or im- prove for the purpose or sale) I: I, as owner 01 the properly. am exclusively contracting with licensed contractors to construct the pro1ect (Sec 7044 Business and Protess,ons CIX!e The Contractor"s License Law does nol apply to an owner of property who builds or 1m• proves thereon, and who contracts 1or each pro1ects wilh a contractor(s) license pursuanl lo the Con1ractor's license Law) , ! As a homeowner I am improving my home. and lhe 1ollow Ing condIt,ons exist 1. The work ,s being per1orm€l! p11or to sale 2 I have lrved In my home for twejve months prior to completion of lhlS work • I have no! clarmed this exemption during the last three years _ I am exempt under Sec _____ _ B & PC for this reason I hereby affirm that I have a cert,hcate of consent 10 self-insure. or a cert1ftcate of Workers· Compensat,on In- surance. or a cert1f1eCI copy thereof {Sec 3800. Labor Code) POLICY NO COMPANY _J Copy rs filed wtth the c,ty Cert,t1ed copy rs hereby furnished CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE 1Th•s section neeCI not be completed If the perm,t Is tor one hundred dollars 1$1001 or less) L 1 I cert,ty that ,n the performance of the work tor whrch this permit ,s issued. I shall not employ any person ,n any manner so as to become subJeCt to the Workers· Com pen• sal>on Laws ol Calrlorn,a NOTICE TO APPLICANT· II. alter making th,s Cerlif1cate I of E,empt,on. you should become subject to the Workers Compensation provIsIons of the Labor Code. you must 1orthw,th comply w,th such prov,srons or thrs permit shall be deemed revoked =:J I hereby affirm that there 1s a construction lend,ng agency tor the performance of the work for which th,s per- m,! Is ,ssued {Sec 3097. C1v1I Code) Lender's Name_ Lender's Address_ ----··--. -•n• r1;11 UIILI & t'Nt;:t~ HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. . 2075 ft~~~~sAD~, ~a~l~~P,/~i\R~J'.i1s~Tl~\f~J.1161 ,;' ; 1 /" APPLICATION & PERMIT • JOB ADDRESS AV. ST.AD. NEAREST CROSS ST. DAT"' u,-APPLICATION BUSINESS LICENSE# VALUATION PERMIT NUMBER Z.'1~7 ~,e,r-n--I'~ 7-,s--~7 8S?:>f~'18 g7-_ . LOT BLOCK I SU8OJVIS!ON -I ASSESSO,R PARCEL NO. CONTRACTOR CONTRACTORS PHONE# ZONE /_ ·; ~ > ow-.R·sNAME I OWNER'S PHONE f+,:,,wld:>Jt?{bAJ.~. Co• 'h,2-~ OWN~ 1':::.G AO~E:/ ~ / 1-r?\ Cpo•e::_007:,s~ ~ c/ STATE LICENSE NO, C,C10 11 /(''· 0' () :~l:~•N,::,: FCXJT;; .((! 272.7 1. A,~,,,..,. -_ <!.A,rls.lx,__c/ (!/4 oEs,o,ER -----oEs,oNEa·••"ONE OESCRIPTION OF WOFU,;, , / .,,J • ---- f" -__.. n 1:..lf'i'iD .. __ . ti.~ ---/-...1/r M...L:'A-/T 0Es1GNER'sAooAEss siATtLtcENseNo. jJ~~ /J 7kL£'c;/f___,l!. #PA l7_t)£ _~-u -""-"'-v NO ace Ge -:DU /,:KA ol._,;J-/? .,C-.4,JL J-l-o11se_ ,c ,□ STORIES 90":;f 1:0,130 Mei 02tGdf1.,~ ov••}; I IPARl(1NG SPACE RES uN1Ts I GRADING PERMIT IssuED I REDEVELOPMENT TYPE ace LOAD Ft RE SPR AREA CONST , 0 N □ • C '\JO vO NO Not V;,ltd Unless MKhine Certified 50 c~, QTY. PLUMBING PERMIT. ISSUE ! 1 ~ QTY. MECHANICAL PERMIT. ISSUE I 5 -SUMMARY/ACCOUNT NUMBER =·==~---=-~----< EACH FIXTURE TRAP _ I INSTALL FURN DUCTS iJP TO 100.000 BTU BUILDING PERMIT 001~0~-0D-8ED ___ .3_d___ __ _ ----~~~~~~EWE~----~-1 _______ -L-___ _ --□~ER10ooo_o __ ~rn __ ________ s1GNPERMIT 001-s1 □•□□-oo-s221 --i_ACH WA~~EAT~ ANU J!~~~ ----L ===• ,,____J_!l□I LER ·C0MPRESS0R UP TO 3 HP PLAN CHEC~----001-810-00-00-8821 _ EACH GASSYS~M_!_~_g__~T~ETS +-..-_ +s~ILE_R,~_M!_~~~SQ_RL!_5_~P__ __ _ _ __ __ TOTAL PLUMBING __ 001-810-00-00-8222 ,___4 _E_A_C_H GAS SYSlEM_5 OR~[)~ _____ +-___ __:__ __ 1.-----l~E~~~EPLAC_£_ _ _ _ ____ -~ __ _:._ _ ELECTRICAL ___ ___E_0~0-00-00-~23._J-________ __., >--~ACH~-S~L_:_A~ER.Rt~A!~_W!TER'._IP! --f ___ ~ _ VEN!!_ANSINGL~~~~T__ _ ____ -----·~----+·-MECHANICAL __ 001-810-_00-00-8224_1---______ 7 EACH VACUUM BREAKER I MECH EXHAUST HOOO·OUCTS MOBILEHOME 001-810-00·00-8225 WATE.R SOF1NER RELOCATION OF EA FURNACE,HEATER SOLAR 001-810-00-00-8226 i-------------------------1------;--~---------------l-----~--li--~==-------~~c~~~·~=------~--~ FACl-1 ROOF DRAIN l',N~1nu ------,~---DRYER VENT STRONG MOTION 880-519-92-33 TOTM MECHANICAL FIRESPRINr<LERS 001-810-00-00-8227 ---------- e-------L_ __ TUTAIP1~UMBING ---T-----I __ P~~ACILITl~FEE 320-810-00-00-8740 -----------+----------< C 0.-~ BRIDGE FEE 360-810-00-00-8740 QTY ELECTRICAL PERMIT -ISSUE :J .✓ QTY. MOBILE HOME SETUP f--+==--=-------------1-----"' ''-----!--+---PARK-IN-LIEU (AREA 1 ________________ _ NEW CONST EA AMP SWT BKR ± CAR PORT~ ~--·---------+--TIF _____ 134-810-00·00·8835 _ _ ______ _ 1 PH J PH AWNING \ LA COSTA TIF 133-810-00-00-8835 1----+---------------------------+---t-'-----------------1---------il-------------~----·----------- F X IST BLUG EA AMP:SWT BKR GARAGE.:,· -.\ FMF ----------·----------------- ] PH J PH / i~ _ ''1 LICENSE TAX o□,-810-D0-00-8162 e-----1------------·--------+------+--+--+,.----~----------o+--+------·----------------..,. _________ - REMOOEl AL HR PER CIRCUIT -\:~ '. ·,1 MFF 880-519-92-57 f-----+----~------·--------+--------jj..---b-----~-------·-;--------------------------+--------·-- :::::~~:M~~OAMPS I i~~ .-___ L ______________ · --------___ _ HMP OCCUPANCY !JO DAYSI ',\_. --!=---------~,----_----------+----·--CREDITDEPOSIT -------- ]()[Al El[LTRICAL ~ i! I '0TAL --r--.-TOTAL FEES PAYABLE I . '5L' - I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT" AND DO HEREBY Expiration Every perm1,t is;'uecl bythe8ulldmgOH1cial undef1heprovis1ons oflh1s * AN OSHA PERU:T IS REQUIRED F0A EXCAYATlONS OVER CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code ~all expire by l1mitat1on and become null and void 11 the bwlding or work 5"0 .. DEEP ANO DEMOl:.mON OR CONSTRUCTION OF DECLARATIONS ARE TRUE ANO CORRECT AND IFURTHEA CERTIFY AND AGREE !FA PERMIT 15 authorized by such ~rmit 1s not commenced w1th1n 180 days from the date()f such sr~-fl=• OVER l r=ES permit. or 1f the bulldmg Of" work authorized by such permit 1s suspended or """"'•~ S ..,.... tN HEIGHT ISSUED: TO COMPLY WITH All CfTY. COUNTY AND STATE LAWS GOVERNING BUILDING CON• L~•~b~on~-~~Ode.!•~IO~n!l-'st~ime,,._~,h~•~•~lh~o"'w~o,~•~•~•~c~ome,em~on~,~•~•~•~o~,~•,'!" =••~•o~d~o~l~1~80!!Lld~•~•••~-----1'-, ..... ,-... _____ ,_ ____________ _, STAUCTION. WHETHER SPECIFIED HE.REIN 00 NOT, I ALSO AGREE TO SAVE INDEMNIFY AND O APPROVED BY ~ KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL UABILITIES. JUDGMENTS, COSTS AND APPLICANT'S SIGNATURE • OWNER CONTRACTOR O DA TE EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE [J ., . GRANTING OF THIS PERMIT. BY PHONE ; / -.•:· /-r • /" /·· _ I · ... / .<!e U: ~ ~ 0 0. E w f-- :s! 0 CJ c m ~ 0. 0. « I ~ C 0:: 0 w w w w w « I ~ .2 " >- w u C m C U: :::, C w w c 0 0 w 0. w C ~ " s .,, z 0 ;: " "' " ~ u "' C ~[ : ... z 8 0: "' C ~ 3 ~ "' z 3 0 .. ' z 0 ;: ~ z "' .. ,. 0 u .,, ir w " "' ~ ![ D I hereby affirm that I am licensed under provisions ol Chapter 9 (commencing with Section 7000) of Division 3 ol the Business 1 and Professions Code, and my license is in 1 full force and effect I Mreby alfIrm that I am exempl trom lhe Conrrac tor's License Law lor me lollow,ng reason !Sec 703' s Business and Professions Code My city or counly wh,u, re quores o perm,! to construe!. a·ter. improve demo11sh or repa,r any slruc1ure, pr,or lo 11s issuance also requires !heap pl1can1 lor such oerm11 to hie a s,~ned statement :ha: ~e ,s licensed pursuant to the prov,s,ons of 1he Con1ractor s License law iChaoter 9 commencing with Se~t,on 70C0 ct t D1v,s,on 3 ol the Business and Professions CoGe, 0° Iha' ,sex empt tMre1rom and lhe basis tor the allegeo e,emor,on An·1 vIoiat,on 01 Sec1,on 7031. 5 by an app1Icant !or a permI1 sub 1ects The applicant lo a c,v,I penalty 01 nnl more than f,ve hun 1 dred doll;irs iS500J I as owner ol The property or myemoloyees w·t~ wages as their sole compensation. w,I, do the work a~d !he srruc ture ,snot ,nrended or offered for sale {Sec 7044 Buswess and Pro1ess,ons Code The Conlracto,·s L,cense Law does not apply 10 an owner of property who builds or improves thereon and who does such work h1mselt or Through his own employees. prnv,ded lhat such improvements are not ,ntend ed or offered lor sale If, however. the building or Imorove menl ,s sold w1thIn one year of completion, the owner-bJlider will have the burden of proving I.hat he did not build or Im- orove for the puroose of s.ile1 I. as owner of the propefty_ am exclusively contract,ng t with licensed conlractors to construct lhe pro1ect {Se( 7044 Business and Proless1ons Code The Contractor's License Law does nol apply to an owner 01 property who Durlds or Im proves thereon_ and who contracts 1or each pro1ecls w,t~ a contractor(s) license pursuant to 1he Contractor's L,cense Law) As a homeowner I am ,mprov,ng my home and the follow mg cond1t,ons e~1s1 1 The work 1s tie,ng performed pr,or To sale 2 I have lived ,n my home for twelve mo~t~s prior to compler,on of this work I have not claimed th,s exemption during the ;ast lhree years for /h~: r:;~:t under Sec _____ _ B & PC I hereby affirm mat I have a certd1cate ol consent lo I self ,nsure. or a certo11ca1e of Wo•kers Compensation In-I sucance o, a cert,hed copy thereof 1sec 3800 Labor Code) I POLICY NO COMPANY Copy IS tiled W,th the city Cert1f.ed copy ,s hereby furnished CERTIFICATE OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE (Th,s section need oot be completed 1f the permit Is 'or one hundred do"ars 1S700) or less) I cert,fy that in the p.,rformance of the work <or which 1~,s perm,t Is ,ssued, I shall not employ any person In any manner so as to oecome sub1ect to the Workers Com pen sat,o~ Laws c' Cai,fcrn,a NOTICE TO APPLICANT: If. after making this Cert1r1cate of Exemption. you should become sub1ect to the Workers Compensation pro-,sions ot the Labor Code you rr.us1 I forthwith comply with such pro.isions or th,s permit s~all 1 oe deemed revoked L I heret>y affirm that there Is a construct,on 'erd1ng agency for the performance ot the work fer w~1ch lh1s ~e, rnIt Is issued (Sec 3097 CIvII Codel Le~der"s Name Lenders Address_ APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr .• Carlsbad, CA 92009-4859 (619) 438-1161 APPLICATION & PERMIT JOB ADDRESS ,/-Uc'/~ ,f # ,,.,..;;:,,RDJ!:EAREST(?;::.~.d~~ C) l D¢~;,-;DN BUSINESS LICENSE# VALUATION PERMIT NUMBER ..1j,,c5{? '2,i.,, / cOT BLOCK I SUBDIVISION I ASSESSOR PARCEL NO °}:;,;SJ# ,,{ /Y /YE 1<?-1;;;; ·;;; CONTRACTOR tJ )f/ /Y $ -f CONTRACTORS PHONE # ZONE IJ~f CONTAACTOA·s ADO RESS STATE LICENSE NO, BUILDING SQ. FOOTAGE ;,;;;"N:?;~~~.G"" ,f/V nc ,o/ s ;I; ;l;,fjf;,!Ja>, DESIGNER ID~IPTION OF WORK > I Ll"-1 DESIGNER'S ADDRESS I----- QTY --n-'i..-,,.A,,..,. -0 ------ ,,() /1' -Kl. ..L/IYl (SL__ - ----~ ARKING SPACE RCS UN,,S I GRADING PERMIT ISSUED YD ~ D F'P FLA ELEV vC "'□ j REDEVELOPMENT AREA ,[J ..... o PLUMBING PERMIT -ISSUE 1sa QTY MECHANICAL PERMIT -ISSUE NO STORIES TYPE CONST 3.00 DESIGNER'S PHONE STATE LICENSE NQ, ace GP EDU 'l \) l.!. ;,J'L .. ..:. .. --~_,3,j;=-;-:,;,-;--. ace LOAD FIAESPR YO""□ Not Vc1lid Unless Mc1chine Certd1ed SUMMARY/ACCOUNT NUMBER EACH FIXTURE TRAP i INSrAL L FURN_ DUCTS iJP TO 100 DOD BTU BUILDING PERMIT DO I -3 10-00-00-8220 __ ·3_ .... ----- I--EACH BUILLJING SEWER 1--------- EACH WATER HEATER AND DR VENT EACH GAS SYSTEM l TO~ UUI LE TS ---- OVER 100.000 BTU ~ T ~ -. _j__ _ BOILE_R_COMPRESSURJ lSHP SIGN PERl\.11T 00 1 -8 I 0-00-00-8(21 --PLAN CHECK 001-81 0·00-00·8821 TOTAL PLUMBl'<G DO 1-b · 0-00 .. '.JD-82 22 ------ EACH GAS SYSH.M S DR MORE -,- --=r-FL~UMPRESSOR UP TO 3 HP -lME_ AL FIREPIAC: --- _ _-vEN~ FANSINGLE Dun ·+-ELECTRICAL 001-8 1 ::J-DO-::J0-8223 -+---------< . _ __,_ MECHANICAL EACH INSTA~ ALTER REPAIR WATER PIPE , ~ 1------------+ 001-81~-00-8224 --+-------- EACH VACUUM BREAKER MECH EXHAUST HOOD DUCTS M08tLEJ.10ME DD1-8 1U-00-00·8225 WATER SUHNER I RELOCATION OF EA FURNACE.HEATER SOLAR O:J1-8"0-00-00-8226 f-----I----·--·--·---------1-------+----+----------------+-------11------------------+---·------ ~--1-FAr:H RUl_',F rrn~r-~~ ---------+----DRYER VENT STRONG MOTIQr, TOTJ..L MECHANICAL I F'RESPRl\':.(LERS OD1 880-519-92-33 810-'.JO-'.J0-8227 ~ -,--_i -7: - QTY. !UT Al Pl U\.lflt~L ELECTRICAL PERMIT -ISSUE -~~-~~-~-~----,/--360-810-00-00-87 40 ,--~ 1 , t= BRIDGE FEE Q , t)iO I, QTY. MOBILE HOME SETUP PARK·IN:/Au ,:AREA NEW CONST £A AMP S','ll tlKR _____j______ . 1, CAR PORT ______ . _. ____ __ ___ TIF ___ -. -~·810·00-00·8835 ___ _ I PH i ~ ___ __j ____ .c__-rjAWNING ______ __ __ LA COSTA TIF ___ ~3·~10-00·00-8835 PJBL1C FACILlr'ES FEE 320-810-00-00-874,J --·-----------------------7 f--------j EXISTtll[JGEAAMPS\11T8KR r _GARAGE _______ .___ _FM_F_. ______ . __ ·-- 1 PH I PH . t j ------+------II--LICENSE TAX 001-s1-J-'J0-G0-31S_c_+-------- ~:f::r::i~A~ ~UIT · =-= ----.-; i .... -_ -~-=-__ ----MFF----=--=-------sso-519-9_2_·_5'-I-------~=------ r_---J-TEMPoccuPAN_L_Y_,Ju oAv__s,_ ~--=--l ----± ~----=---------------i1---c_R_E_D_1r_o_E_P_o_s_1r __ -__ -___ _, __ ...... ________ __, T[)IAL t.lt-CIRl(A! 1 ·0"1 r TOTAL FEEs PAYABLE 11 I _·?) - ..._~1.,..., I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION ANO PERMIT" AND DO HEREBY Expuahon. Every perm,_! 1.ssued by the Building Off1c1al under the provisions oflh•.• I CERTIFY UNDER PENAL TY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code sha!/ expire by !Pm1tat1on and become null and void ff the bwlding or work DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT I~ a~~~~ized ~l Such permit IS not commenced within 180 days from the date of suc•irll • ISSUED TO COMPLY WITH ALL CITY COUNlY AND STATE LAWS GOVERNING BUILDING CON-~bandClno~ at':~ ~~,;!~'le~;hw~~r:~lhorized by such permit 15 stspended or STRUCTION. WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND 8 s commenced for a riod ol BO da s KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS. COSTS~N ICANT?~IGNAT E. ¥. ·~NERO CONTRACTOR 0 EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OFT ~ ~~ C/ GRANTING OF THIS PERMIT ., _, · ~ P' . BY PHONE fJ 'l~/-1.,4 ?' ~.,, ---- q * AN OSHA PEAM:l IS REQUIAEO FOR EXCA.VATK>NS OVER 5· 0" DEEP ANO DEMOLITION OR CONSTRUCTION OF STRUCT\JAES OVER 3 STORIES IN HEKiMT ,p~y, I C :.,,---::7 I , 1' '---~ /' r~ 0"; / I 'f;:;y~b ~ u: ~ :, 0 0. E ill f- .·. I "·':12 0 CJ c ~ u 0. 0. "' I 1 C 0:: 0 w w ill w w "' I ~ 0 © ,. ill u C ~ C LL ,:. C ill ill 0 0 u ill 0. w C C "' s <.!Cit!' of <tl:arlsbab REQUEST FOR INSPECTION REC.ORD / TIME: _____ _ INSPECTOR _________ PERMITNO. _ __:cl...:2-=---c:2-=-_;._=------DATE: 11-;i 't OWNER __________ ~-~-.,_____ __ _,__. ______________ _ ADDRESS ____ __.,.~ ,..2,..,__47:..,:.;,.._7,___,,,Qt_"'----"~'=:....=.--=---=-..:___:_:~------------- REQUESTED BY ______________ PHONE NO. BUILDING D FOUNDATION D FOOTING D SLAB D REINFORCING STEEL Cl MASONRY I J GROUT -GUNITE [I FLOOR AND CEILING SUB FRAME n SHEATHING n ROOF 11 SHEAR Ii FRAME Cl EXTERIOR LATH n INSULATION !J INTERIOR LATH OR DRYWALL ll FINAL PLUMBING n UNDERGROUND PLUMBING II SEWER AND PL/CO ll TOP OUT PLUMBING [J TUB OR SHOWER PAN Cl GAS TEST [J WATER HEATER r J SOLAR WATER D FINAL PERSON TAKING REPORT ELECTRICAL ,I TEMPORARY SERVICE Cl UFFER GROUND D ELECTRIC UNDERGROUND lJ ROUGH ELECTRIC II POOL BONDING A/OT D ELECTRIC SERVICE ~d~O D FINAL _s;,,-."-" 0 ,',Z l!fv1ur. -% _,,,,. Ci>,t1e~ VIIJ""1't"IIN>J.; ~1-z.,11-( .:sl:e I MISCELLANEOUS D CONDITIONED AIR SYSTEMS n SOLAR HEAT n PATIO 11 POOL □ SPA IJ SIGN D GRADING D DRIVEWAY D FINAL SPECIAL INSTRUCTIONS _1.C4..-tA.~~-.'c'.a..~."::'-:-:·'!_• __l~~~~~-~-----J~~-~':'.____J_<j_,i]i_j_/=.J.OLYLU'it~)L_ Ready For Inspection: □ Monday D A.M. D P.M. 0 Wednesday D Thursday ----------------------------------- D Friday <tritp of <trarl.S'bab REQUEST FOR INSPECTION RECORD TIME: _____ _ INSPECTOR ----L---"---------PERMIT NO, __________ DATE: _____ _ OWNER __________________________________ _ ADDRESS ____ --'Z~?c..1..._7,___.L;,,_,e:,./ __ Cc.J/Ll6,<-''i(.=M,_,';l'/"-li;"""'4L-_____________ _ REQUESTED BY V'/Qt:D/9 LA1A/£ PHONE NO. BUILDING 0 FOUNDATION O FOOTING D SLAB n REINFORCING STEEL r7 MASONRY 17 GROUT -GUNITE I' FLOOR AND CEILING SUB FRAME 11 SHEATHING Cl ROOF Cl SHEAR 17 FRAME r I EXTERIOR LATH n INSULATION n INTERIOR LATH OR DRYWALL IJ FINAL PLUMBING 1 l UNDERGROUND PLUMBING rl SEWER AND PL/CO □ TOP OUT PLUMBING 0 TUB OR SHOWER PAN [l GAS TEST n WATER HEATER □ SOLAR WATER n FINAL PERSON TAKING REPORT _____ _ ELECTRICAL 0 TEMPORARY SERVICE 17 UFFER GROUND IJ ELECTRIC UNDERGROUND n ROUGH ELECTRIC 0 POOL BONDING D ELECTRIC SERVICE D FINAL J(Jae, Jj?t)('),IY7,..W.,,:7,V. Cptyl/Jtl ,,f'e-JJVJ/? ~ Coff'· ,,(,1.rr: MISCELLANEOUS [7 CONDITIONED AIR SYSTEMS 0 SOLAR HEAT □ PATIO rJ POOL IJ SPA [_] SIGN n GRADING D DRIVEWAY D FINAL SPECIAL INSTRUCTIONS ____________________________ _ Ready For Inspection: □ Monday □ AM. 0 P.M. □ Tuesday D Wednesday □ Thursday D Friday INSPECTOR -~-9-'-------'c:_:....:....LJ. ___ PERMIT NO. TIME: _________ DATE: ¼----//---?-6 OWNER -----''-"''--'e:1.,"""'--"'"'-----==~~~----~"--------------------- ADDRESS _--.---=o>"?"--r,-;:--,9----L2!'.:.,L.-.,;g:.'-.-'~-"~~£""~~c::::;,".b~-..J.~:L,"'_--,,,.------- REQUESTED BY -1,;,.L_L_.fL--'=c==___i;.zc==:::::=..!:::- BUILDING D FOUNDATION D FOOTING D SLAB C: REINFORCING STEEL C: MASONRY D GROUT· GUNITE D FLOOR AND CEILING SUB FRAME D SHEATHING D ROOF ,J SHEAR D FRAME D EXTERIOR LATH C: INSULATION Ll INTERIOR LATH OR DRYWALL r7 FINAL PLUMBING r-: UNDERGROUND PLUMBING □ SEWER AND PL/CO D TOP OUT PLUMBING n TUB OR SHOWER PAN LJ GAS TEST rl WATER HEATER D SOLAR WATER D FINAL D TEMPORARY SERVICE D UFFER GROUND n ELECTRIC UNDERGROUND -. ROUGH ELECTRIC C: POOL BONDING C: ELECTRIC SERVICE -FINAL MISCELLANEOUS L; CONDITIONED AIR SYSTEMS C: SOLAR HEAT ~PATIO ~-f n POOL D SPA n SIGN Cl GRADING , n _,PRIVE Y ~FINAL ~ SPECIAL INSTRUCTIONS ____________________________ _ Ready For Inspection: D Monday D A.M. D P.M. LJ Wednesday n Thursday LJ Friday