HomeMy WebLinkAbout2735 OLYMPIA DR; ; CB891171; Permit.,, z 0 ► C CZ: C ..J CJ 1M ,a
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f'3,,r h«eby affirm that I am licensed under
·pro,,lalona or Chapter 9 (commencing with
Section 7000) or Division 3 or the Business
and ProfN alona Code, and my license la In
full force and effect
I hereby affirm that I am exempt from the Contrac· 1or·s L1Cense Law tor the lolk>w1ng reason (Sec 7031 S
Business and Proless,ons Code Any city Of county whicr. re-quires a pe:rrrwt to construct. alter. unprove. Clemohsl\, o,
repa11 any structure. prMH" to I1s issuance also requlfes !heap· pfican1 tor such oermll to file a signed slatement that he ,s
hcensed pursuant to the provisions ol the ton1rac1or"s Lteense Law (Chapter 9 comme'ncmg with Sec11on 7000 of
0rv1swn 3 ot lhe Business and ProteSSK)llS Code) or lhal 1s 11· empt therefrom and lhe basis l<M' the allegea e•empllon Any
vtolahon of SecltOO 7031.5 by an apphcanl tor a permit sub· ,eels lhe applttant to a crv.r penally ot l"IOI mo,e lhan IM hun·
dred dollars ($5001
I. as owner ot lhe property. or my employees with wages
as 1ne1r ~ compensation. will do lhe work. aod !he str11t-
ture 1s not mlended or ollered tor sa~ {Set 7044. Busmess
and Proless1ons COde The ContractOf's license law dOes not apply to an owner of property who builds or 1mpr0YeS
lhereon and who does such work himself or through his own
employees. prOYlded lhat such 1mprovemen1s are nol .ntend-ed or offered tor sale If. however. me butkhng or improve-
ment 1s S(Hd w1th1n one year of complehOn. lhe owner-butldet
wlll have the burden ot proving lhat he dtd not bu1kl or 1m•
p,ove tor the purpose ol salt)
r 1. as owner of the property. am exclus1vety contrac.:llng Wllh lttensed contractors to conslrucl lhe protecl (Sec 7044,
Business and Profess10ns Code The Contractor· s Ltcense law does not apply to an owner of property who builds or im-proves !hereon. and who conuacts tor each prOjecls with a
contractor(s) hcense pursuanl to the Conlrailor"s lteense Law)
11 As a hOmeOwner I am U11p<OYlflQ my hOme. and IIIO lotlOw
Ing cond11JOfts exist·
1 The work. Is t>etng performed pnor 10 sate
2 I have lived In my home for twelve months pnor to compleoon ot this work
3 I have not clauned 1h15 exemption during lhe last lhree years
D I am e11.empt under sec ______ . B & P C for this reason ____________ _
,,,J:;!;, I hereby affirm that I have a certificate of consent 10
sell-insure. or a certificate ol Workers Compensat1or, In-
surance. or a cerllhed copy thereof tSec 3800, Labat Cooel
POLICY NO.
COMPANY
~opy IS hied wiir, lhe City
0 Cert1l1ed copy ls hereby furnished
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need no! be completed if the permll
is for one hundred dollars (S H)O) or less)
D I certify lhat m the performance of u,e wo,k for which
this permil 1s issued. I shall not employ any person in any
manner so as to become .subJecl to the Workers· Comi>en•
sallon Laws of Ca11forn1a
NOTICE TO APPLICANT II. alter making this Cenificate
of E•emption. you should become subject to the Workers·
Compensation provisions of the labor Code. you must
forthwith comply w11h such PfO't'isions or this perm11 shall
be deemed revoked.
![ 0 I hereby affirm that there Is a construcllon lending
agency for the performance of the work for which this per-
mit 1s Issued (5ec. 3097. Civil Code}
Lender's Name _______ _
Lendet's Address, ___________ _
USE BALL POINT PEN ONLY & PRE~S HARD I "
I CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT I 2075 Las Palmas Dr., Carlsbad, CA 92009-191 5 (619) 438-1161 /
APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
I
I JOB A OOA ESS AV. ST.RO. THOMAS BROS NO.
I 08~09:81;ATIOHI
BUSINESS~ ~-;Al;?; PERMIT NUMBER
I 2 731 <(}l<.J,np, tJ b1t, I 'rj:, y;/-I I 11 I LOT BLOCK I S'uB01v1s10N I ASSE/X~.!.-°.a .z.-!S l) CONTRACTOR CQNTAACTOAS PHONE • ZONE
I I'D Ml. 11N 117" JU<{ -r'llM !.JJ I fl--38-d~?O I OWNEA'S NAME I OWNE A'S PHONE
I Lill-4 ,n,u tA,,u, in,,-rJ./ t/3¥~3,I.. CONTRACTOR'S ADDRESS if.. l4trl$ STA TE LICENSE NO. BUILDING SO. FOOTAGE
I o w~;G ADDRESS
Z,77? .:&~,.,., S-r. ~z. . DW;1V1Y
I DESIGNER DESIGNER'S PHONE
I
I O~:tTIOJ OF WORK $Vf,v}~(.,l/l wo-ocl -rn,:, wl I ,le n/JtN DESIGNER'S AOORESS STATE LICENSE NO.
I
flA7t0 IAJ,H,l, <;ul-un 8888 08/09/89 0001 01 I tCl!;c UZI I" -rr,,vo )?zfH'+ 02
UJ~~/it, ~,v4S-F/P FLA ELEV. NO OCC GP EDU BldPmt 69-0<
~,ks lu,u, IAJIHL 01' .,,,._, STORIES
vO "O I CENSUS TRACT I PARKIJ'<G SPACE I RES UNIT/ I GRADING PERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD Fl RE SPA
AREA CONST
YO N 0 vO "-0 vO NO Not Valid Un~s Machine Cemfil!d -
QTY. PLUMBING PERMIT · ISSUE ?~ QTY. MECHANICAL PERMIT · ISSUE /J-oo SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP INSTALL FURN DUCTS UP TO 100.000 BTU 1!{Jl[U1ffl, PtH M 11 UU l·H 10-UU·UU·ouu ~,
EACH BUILDING SEWER OVER 100.000 BTU SIGN PERMlT 001-810·00·00·8221
EACH WATER HEATER AND OR VENT BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 001 ·8 l 0·00-00-8891 ~?
EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3 15 HP TOTAL PLUMBING 001-810·00·00·8222
EACH GAS SYSTEM~ OR MORE MET AL FIREPLACE ELECTRICAL 001-810-00·00·8223
EACH INSTAL. ALTER. REPAIR WATER PIPE VENT FAN SlNGLE DUCT MECHANICAL 001 ·810·00-00-8224
EACH VACUUM BREAKER MECH EXHAUST HOOD DUCTS MOBILEHOME 001-810-00·00-8225
I WATER SOFTNER RELOCATION OF EA FURNACE/HEATER SOLAR 001 ·810-00-00·8226
EACH ROOF DRAIN ilNSIDEl DRYER VENT STRONG MOTION 880-519·92·33 I
TOTI.L MECHANICAL FIRE SPRIN~LERS 001-810-00·00·8227
TQlAI PIUM8INL I PUBLIC FACILITIES FEE 320·810·00-00-8740
~o BRIDGE FEE 360·810·00-00-B7 40
QTY. ELECTRICAL PERMIT· ISSUE QTY. MOBILE HOME SETUP PARK-IN-LIEU (AREA )
NEW CONST EA AMP SWT BK R -CAR PORT TIF 312·810-00-00-8835
1 PH 3 PH AWNING LA COSTA TIF 311·810-00-00-8835
EXIST BLDG EA AMPISWT 8KR GARAGE FMF
1 PH 3 PH LICENSE TAX 001 ·810·00-00-8162
REMODEL ALTtR PER CIRCUIT MFF 880-519-92·57
TEMP POLE 200 AMPS
OVER 200 AMPS
TEMP OCCUPANCY 130 DAYSI
CREDIT DEPOSIT "\
101AL ELECTRICAL I TOTAi TOTAL FEES PAYABLE I ~?,v
HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION AND PERMIT ANO DO HEREBY Exp,rat,on E•ery perm1I issued by the Bu1ld1ng Olltc1al un-lhe provisions ollh1s * AN OSHA PEAM:T IS REOUIAED FOfl EXCAYATIOftS OVEA
CERT1FY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall exp,re by lom,tation •nd become null and void II the building or work 5 O" DEEP ANO OEMOUTION 0A CONSTRUCTION OF • , 1 authorized by such permit 11 not commenced w1tt11n 180 days from the date ◊f such
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT I':, permit. or if lhe build•J or work aulhonzad by such perm,1 is suspencled or STRUCTIJAES OVER 3 STOIIIES IN HEIGHT
I
JSSUED TO COMPLY WITH ALL CITY COUNlY ANO STATE LAWS GOvERNING BUILDING C0'-1· abandon......._•nv ltma a ter the work•• commenced for a oet1od ol 1Ail d•"•
SrRUCTION WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND TZIGNAT ~ OWNER□
APP~~ Ori I KEEP HARMLESS THE CITY OF CARLSBAD AGAINST All LIABILITIES. JUDGMENTS. COSTS AND U ti / CONTRACTOR& 'ff I EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE /, .Md BY PHONE 0
I GRANTING OF fHIS PERMIT ~ 1,i -
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TYPE I DATE INSPECTOR
BUILDING I
I
FOUNDATION ltf Ir r,,. 0, /,
REINFORCED STEEL I
11 -, .., 0 \ r (..\ l
MASONRY I
I
GUNITE OR GROUT I
SUB FRAME □ FLOOR □ CEILIN(p
SHEATHING D ROOF D SHEAF.I
FRAME I
EXTERIOR LA TH I
I
INSULATION I
I
INTERIOR LATH & DRYWALL I
I
I
PLUMBING I
□ SEWER AND BUCO □ PUCO
UNDERGROUND D WASTE D Wft,TER
TOP OUT D WASTE D WAl1ER
TUB AND SHOWER PAN I
GAS TEST I
D WATER HEATER D SOLAR WATE;R
I
ELECTRICAL I
I
D ELECTRIC UNDERGROUND D UF'FER
ROUGH ELECTRIC I
D ELECTRIC SERVICE D TEMPOR.bjRY
D BONDING D POOL I
I
MECHANICAL I
I
D DUCT & PLEM., D REF. PIPING' -
HEAT -AIR COND. SYSTEMS I
VENTILATING SYSTEMS I ' I
,.,
I
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE BEEN APPROVED.
FINAL l
PLUMBING
ELECTRICAL
MECHANICAL
GAS
BUILDING
SPECIAL CONDITIONS
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FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTOR'S ~
INSPECTION REQ. IF DATE CHECKED APPROVAL -...
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRESTRESSED
CONCRETE
POST TENSIONED
CONCRETE
FIELD WELDING
HIGH STRENGTH
BOLTS
SPECIAL MASONRY
'
PILES CAI SSONS
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