HomeMy WebLinkAbout2737 JEFFERSON ST; MULTI-PERMIT FILE; CB012483; PermitCity ofCarlsbad
1635 Faràday,AvCarisbad, CA 92008
- - .- - -- .- '-v. . . '. '1 07/24/2001 L Electrical Permit " Permit No CB012483
Building Inspection Request Line (760) 602-2725
Job Address: 2737 JEFFERSON ST CBAD St: TP . :. .
Permit Type: ELEC -' ' .. iStatus: ISSUED
Parcel No 2031100200 at # 0 i Applied 07/24/2001
- Entered By MDP
Reference #:. . . •' Plan Approved: 07/24/2001... .
-• - . Issued: 07/24/2001
Project Title: -,,CITY STORM DRAIN PROJECT" - Inspect Area:
TEMP POWER POLE -
Applicant
TEMP POWER SYSTEMS CASTENS-GLENN D&MARCIA A —
750 N. CITRACADO PKWY. / - 2381.JEFFERsoN:sT #A
ESCONDIDO CA 92025 7
760 439-1999
. 0 . . . . -.•(\ . .
Total Fees: $20.00 TotalPaymenthTo'Date: \OOO BaIande' Due : . - $20.00 7 . . .
\
Electric Issue Fee' ø'"f $1,0.00 , \
-'-;: Single Phase per MF7 . 's 0 -. . .. . rsPiPP1 . . .,
Three Phase per . '0 . $0.00J .. . . Three Phase 480 Per AMP . 0 $0.00 .
Remodel/Alteration per AMP . 0. $0.00
'Remodel Fee . . - . $0.00 Temporary Service Fee
Test Meter Fee $0.00
Other Electrical Fe
$1000
/
Additional Fees . .- . -\ '- $0.00 /
INCORPORATED .. / TOTAL PERMIT FEES 1952 $2000
/ . FINAL APPROVAL -,
Inspector Date ____________ 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 "fees/exactions." You have 90 days from the date this permit was issued to protest imposition of thesO fees/exactions. If you protest them, you must
follow the protest procedures set forth in Governmet 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 you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired.
S-,..
-
I
PRMIT APPLICATION . .-
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
1-.'P11OJEC.TlNFORM41I0N .... S ........ .,.'-,. .. r.
Address (incTude Bldg/Suite #1 Business Name (at thi
FOR OFFICE USE ONLY
PLAN CHECK NO.
EST. VAL.
Plan Ck. Deposit
Validated By__________________________
Date
Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units
Assessor's Parcel # Existing Use Proposed Use
D1gioc/ork ,ç C'1, SQ(Z
3stonesJ # of Bedrooms # of Bathrooms
2. :CONTACTPERSON'(If
Name Address City State/Zip Telephone # Fax #
'APPLICANT :M.Contrator gont.for Contractor 0 O,vier - 0 Agent for Owner . -
L4OfJ1L a'Ia . S'in cEAV ur ViVA qgpS4 '7o a-41- 1171 T
Name Address City State/Zip Telephone #
Name . - Address City State/Zip Telephone #
44 S ,QON1RACI.OR,. COMPANY NAME "-b w. Lit wA
(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
exe ption. .:Any,Mplation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars t$50011.
k4 .9. ç, qtp(fl FE kVc IATh 7(. L/ .1 'q
Name Address City State/Zip - Telephone #
State License # 18 31#33 License Class .. 10 City Business License # lao /__
Designer Narie . Address City State/Zip Telephone
State License#
6 WORKERS COMPENSATION
Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations:
0 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.
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 'Z..j tJ) Policy No. _Si?' -0 b Expiration Date LID 01 Oi
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1$1001 OR LESS)
CERTIFICATE OF EXEMPTION: I certify that in the performar'ce of the work for which this permit is issued, I shall not employ any person in any manner so as
to become sibje the Workers' Compensation Laws of California.
WARNING: Fe ure o ecure rkers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred
thousand dotla 1 ($1 , n ddltion to the coat of compensation, damages as provided for In Section 3706 of he I or code, interest and attorney's fees.
SIGNATURE __... DATE fIJ
7 IONERBUILDE EC RATION
I hereby affirm that I exempt from the Contractor's License Law for the following reason:
0 I, as owner of roperty 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 a 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).
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:
I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES ONO
I (have / have not) signed an application for a building permit for the proposed work.
I have contracted with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors license number):
I plan to provide portions of the work, but (have hired the following person to coordinate, supervise and provide the major work (include name / address / phone
number / contractors license number):
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 DATE
'COW LETEJHISSECTION FOR NON RESIDEN7IA4 BUILDING PERMITS ONLY ,. ..
Is the applièant 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? 0 YES 0 NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 YES 0 NO
Is the facilityto be constructed within 1,000 feet of the outer boundary of a school site? 0 YES 0 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.
1$ CONSTRUCTION LENDING AGENCY
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).
LENDER'S NAME LENDER'S ADDRESS__________________________________________________________
9 APPLICANT CERTIFICATION '-
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 Cit' 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 permitis required for excavations over 5'0' deep and demolition or Construction of structures over 3 stories in height.
EXPIRATION: Every permit su 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 ot co enced •thin 180 days from the date of such permit or if the building or work authorized b such permit is suspended or abandoned
at any time after the work is omm fAll,eriod of .180 days (Section 106.4.4 Uniform Building Code).
APPLICANT'S SIGNATURE DATE L.k 4D_
WHITE: File YELLOW: Applicant PINK: Finance
City of Carlsbad Bldg Inspection Request
tL For: 08/09/2001
Permit# CB012483
V
Inspector Assignment: PY
Title: CITY STORM DRAIN PROJECT
Description: TEMP POWER POLE
Type: ELEC Sub Type: 0
Phone: 7607998703.
Job Address: 2737 JEFFERSON ST V
Suite: TP Lot 0 ;
V Location: S lnspector V
OWNER CASTENS GLENN D&MARCIA A S
Owner: V
V V
S V
Remarks: S
Total Time: V ••
V
Requested By: GARY
V
• • •
V
Entered By CHRISTINE •
V
CD Description V Act Comments • S V
39 Final Electrical
V • • V
•
V
Associated PCRs
Inspection History V V
V
••
V V
V Date Description Act lnsp Comments V
08/03/2001 39 Final Electrical CO PY REPLACE UNREADABLE BREAKER
S .• S •
.-
4.
- - - - BU I: LD L N.G- P;E R M t -I T : Permit No:.CB91O85-
. . '., . ---------------- 02/13/91 12 34 Project No A9100239
Page 1 f 1 Development No
Job Address 2737 JEFFERSON ST Str Ste
Permit Type ELECTRICAL
Parcel No 203-110-02-00 0858 02/13/91 0001 01 02
Valuation 0 -
-.Construction Type: NEW. . . . -;. -, . :. CPRMT:
* -# ., .1 . .. p ..
Occupancy Group Class Code - Status ISSUED,
Description REPLACE 5 METER PANEL Applied:'02/13/91
Apr/Issue 02/13/91
-. ValidatedBy DC
Appl/Ownr TOURNIER, GUY 619 599-9054'
730 LAS PALMAS
VISTA, CA,,.92083
*** Fees Required & Credits
------------------------------ T
00( o~MfCredit
Total Fees:: 4 :•.•. . - ' ,*-
:30
Fee description / ,r / Ext fee Data; '
---
00
4
- -
60 or Electr 5.
Other*- 25:. 00' 5METERPANE
ELECTRICAI: TOTA). r~ i mum 30.00
lo
It
--
- . F APPROVAL
INSP.
- 'Ti DATE_-fifl
CLEARANCI
CITY OF CARLSBAD 4 A 2075 Las Palmas Dr' Carlsbad CA 92009 (619)438-1161
PERMIT APPLICATION
City of Carlsbad Building Department
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
1. PERMIT TYPE I
A - [1 COMMERCIAL []NEW [:]TENANT IMPROVEMENT
B - []INDUSTRIAL DNEW DTENANT IMPROVEMENT
C []RESIDENTIAL El APARTMENT 000W00 [-]SINGLE FAMILY DWELLING DADDITION/ALTERATION
[!-DUPLEX DDEMOLITION DRELocATIoN DMOBILE HOME 'ELECTRICAL D PLUMB ING
[]MECHANICAL DPOOL [:1 SPA []RETAINING WALL DSOLAR E] OTHER /
EST. VAL
PLAN CX DEPOSIT_______________________________
VALID. BY
DATE
INFORMATION PLAN CHECK No. u/ /
1.'_I'(,-.- L Building or Suite No.
Nearest Cross Streets
LEGAL DESCRIPTION Lot No. Subdivision Name/Number Unit No. Phase No.
CHECK BELOW IF SUBMITTED:
[]2 Energy calcs [12 Structural Calcs 02 Soils Report Di Addressed Envelope
ASSESSORS PARCEL EXISTING USE PROPOSED USE
DESCRIPTION OF WORK
ofl. m.&c P1na(
BLDG. 50. FIG. H OF STORIES
CONTACT PERSON
NAME ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE
SIGNATURE
APPLICANT - OCONTRACTOR DAGEWT FOR CONTRACTOR DOWNER DAGENT FOR OWNER
NAME ADDRESS -
CITY STATE ZIP CODE • DAY TELEPHONE
PI,QPERTY OWNER OWNER L i []LESSEE DTENANJ
NAME SjUaI+}\ ThoYi't60n ADDRESS 7TI s#rei+ Sul I E
CITY STATE c,1. ZIP CODE 9J ..o0'6' DAY TELEPHONE
CONTRACTOR NAME 6 /rfl ADDRESS 730 Z' 974n/lfJ,
CITY (,,Y, 4. STA ZIP CODE q(. 0 ?J'3 DAY TELEPHONE s q 9 90 S
STATE LIC. 0 1 "71'I't LICENSE CLASS CITY BUSINESS LIC. H I/_,I.46.31.5 1,5
SIGNATURE TITLE DATE
DESIGNER NAME ADDRESS
CITY STATE ZIP CODE DAY TELEPHONE STATE LIC. #
WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm that I have a certificate of consent to self-insure issued by the Director of industrial Relations,
or a certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified by the Director of the
insurer thereof filed with the Building Inspection Department (Section 3800, Lab. C).
INSURANCE COMPANY POLICY NO. EXPIRATION DATE
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.
SIGNATURE DATE
OWNER-BUILDER DECLARATION Owner-Builder Declaration: I hereby affirm that I am exempt from the Contractor's License Law for the following reason:
0 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.).
0 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Cede:
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).
0 I am exempt under Section Business and Professions Code for this reason:
(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, commencing 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).
SIGNATURE DATE
COMPLETE THIS SECTION FOR NONRESIDENTIAL BUILDING PERMITS ONLY:
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?
DYES DNO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
DYES ONO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
DYES E] NO
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED AFTER JULY 1, 1989 UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS
OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.
9 CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 30970) Civil Code).
LENDER'S NAME LENDER'S ADDRESS
10. APPLICANT'S SIGNATURE I certify that I have read the application and state that the above information is Correct. I agree to comply with all City ordinances and State laws relating
to building construction. I hereby authorize representatives 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, JLI4ENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID
CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
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 for a period of 180 days (Section 303(d) Uniform Building Code).
SIGNATURft' J,__. [JOWNER DCONTRACTOR J]BY PHONE APROVED HI: _
7/T,PJ2J'7/A 1721 DATE:
WHITE: File YELLOW: Applicant PINK: Finance
CITY OF CARLSBAD
INSPECTION REQUEST
PERMIT# CB910185 FOR 02/14/91 INSPECTOR AREA PY
DESCRIPTION: REPLACE 5 METER PANEL PLANCK# CB910185'
OCCGRP
TYPE: ELEC • CONSTR. TYPE NEW
JOB ADDRESS: 2737 JEFFERSON ST STR: FL: STE:
APPLICANT: FOURNIER, GUY PHONE: 619 599-905
CONTRACTOR: - PHONE:
OWNER: PHONE:
REMARKS: MH/Gt3Y/941-52 61 INSPECTOR
SPECIAL INSTRUCT: SHOULD. BEADY BY NOON
TOTAL TIME:
CD LVL DESCRIPTION . ACT COMMENTS .
33 EL Service Change/Upgrade
33 EL Service Change/Upgrade :
4t
***** INSPECTION HISTORY *****
DATE DESCRIPTION ACT INSP COMMENTS
- %..
....uSE.BALL POINTPEN.ONLY&.P.RESS HARD..
.;D;'rherebyafllrrn'Fcat l'am"ticensed UAdér 'f
o }...1provlalonaofrchapter_9(ctcmmencing with
J- 'f1-SectIcjn.7000)*of Division 3'otlhéBuslnes '
I' and Proteaslons Code,' and my license is In -
' full forceand effect. '" '"" " 'I
.. - -L,,. No.
4.
Ciass
- -,.hereby affirm that-i am exempt. mm the Conlrac'A., I
tors License Law. for the following reason (Sec. 7031.5 Business and Professions Code: Any city or county which re'
'" quires a permit to construct,atter, improve, demolish, or repair aoy'structure. prior toils issuance also requires the ap- 21 plicant for such permit tu tile a signed statement that he is
. licensed pursuant to the provisions of the Contractor's I
License Law (Chapter 9 commencing with Section 7000 01
' Division 3 of the Businesn'and Professions Code) or that is ex- empt therefrom and the basis for the alleged exemption. Any I 'I violation of Section 7031.5 by an applicant for a permit sub- - jects the applicant,tn a civil penally of not more than tine' hun-'
deed dollars ($500)."
- - .0-I. as owner of-the property, or'my employees with wages ia
-
s their sole compensation, will do the work, and the struc- I
a lure is not intended or offered for sale (Sec. 7044. Business .... and Professions Code:• The Cootractor's license Law does.eot apply loan owner.ot property who builds'or improves rn " thereon and who does such work himselt or through his ownemployeos provided that such improvements ahe not intendtat ,'.04 or etlered t0rs01e. It. however.. the 6uilding or improveZ meet is sold within one year ot completion. the owner-builderwilt have the burden of proving that he did not buildorim- O " prove tor thdpurpose of sale).
-'0 I, as owner..ot.the properly, am eoclusivety contractingwith licensed contractors to construct the project (Sec. 7044. Businuss and Professions Code: The Contractors LicenseLaw dues not apply loan owner of property who builds or, irn-prenes'thereon; and:who contracts for, each'projects,wilh a contractor((.license' pursoant to the -Contractors License-
°C 0As a homeowner I am improving my home:and the toltOw-ing cdriditidnsexist: l:"..lhe work-is being pertoroied,prior tosale.2. I have lived' prior to completion ot this work.-.tat " " - 3."I"have"not.' cluimed"this ehemplion 'during" the o•last three years.'-"--'-.'-.---•0 tam eoempt under Sec. - - -" B & P.C. ektor thisreason 0' C 4.. '.4'
l hereby affirm that Ihave a certotcate of consent to .setf'inoure. pra: certificate of' Workers'Compensaton Insurance. rb certof ed copy thereof•(Sec. 3809. Labor Codet. • ..-ci -' eb •z' -POLICY NO.' -- - -'- - --- --'
COMPANY-
en 0 Copy is filed with the cify.rZ ' 0Cerlified copy's hereby turnoshed
oCERItFICATI OF EXEMPTION FRcMWORKERS'COMPENSATION tNSURANCEtr,(ThiS.sect,on.need not be completed of the perm, - -'--'"s for one hundred dollars 1910910, less) -qt Di.ceriify that in the performance of the workto, wj*ch Ihes permot is issued. I shall not employ any -'person on any manner so as to become sublect to the Workers' Compensaton Laws-of Calfoina - , ,.. ,', ,,_.,"NOTICE TO'APPLICANT. It.'after makon3 INs Cerl_L..#.ficate of Exempton. you should becomesubtect I')the Workers' Compensation provsons of the.Lab0r Code. you •must torlhwIh 'Comply- w,th 'Such I"-prousons or tlys permI shall be deemed revoked
,0 I hereby affrm'ihàlihere sa COnsluchon- .-Iendflg agency 10, the performance 01 100 wOrk to,' I '1•lwhch'ths pemmI 5 ssued IS.ec 3097. Cvi Code)('N *O*. -. C-.' '"o" .v.*.v_t''"_ -wi Lender's Name ,rdS".t - - i
ddress
APPIi(ANTTfl F1L1 IN INFflRMATIflPJ WITHIN HAflFfl ARFA ANn flF(I ATIfN
_CAFLSB'D BUILDINGDEARTMENT - i : ' APPLICATION IS-, 1200 EIm Carlsbad, California 92008.1989 (619) 438;5525 I 'JOB ADDRESS AV. ST.RD. NEAREST CROSS ST. DATE F APPLI/ATION BUSINESS LICENSE # - 'VALUATION - ' , '- PERMITNUM8ER'
737 /377•LOT BLOCK SUBDIVISION ASSESSOR PARCEL NO. coNTRACToR CONTRACTORS PHONE $ Z
OWNER'S NAME' ' OWNE P'S PHONECONTRACTOR'S ADDRESS LICENSE NO. PLAN 1.0. # -BLDG USE CODE
OWNER'S MAILING ADDRESS DESIGNE LICENSE # STANDARD PLAN # BUILDING SO. FOOTAGE
OESI' DESIGNER'S PHONE
SC
VE
F/P FLR ELEv. ND 0CC GP EDU
6- A4es .2--1Qo /4° -. vD-tv0 '' .STORS4
RACT GP LAND USE 'PARKING SPACE RES UNITS GRADING PERMIT ISSUED REDEVELOPMENT TYPE •0CC LOAD FIRE SPR , -• OAREACONST
______________________ - "YO NO "- - ' • •' YN() - - t:Ncj'ya,,hdnjesshfçhfneCertified
*-. ______f•: --"'-h - •- •'-' •-;_-_-"_ '"' '--'--'----','.'-,v-"',•-
QTY. ' PLUMBING PERMIT -*ISSUE!•-- - QTY. ' MECHANICAL PERMIT - ISSUE .3 no-'___ SUMMARY/ACCOUNT NUMBER -• ' -- ''- EACH FIXTURE TRAP . INSTALL FURN. DUCTS UP 10 BTU - BUILDING PERMIT 01-00-00-8220'100,000 -
- EACH BUILDING SEWER , . - -. :'"-' - ' - , '.- OVER 100,000 BTU' - :'- a -- -- '- -SIGN PERMIT----- - - 01-00-00-8221- -- - ,.,.___,. •,•_, .,._,! _.' - -
(a.Z iE4CH WATER HEA.TERAND/OR VENT' - - ' . . , BOILER/COMPRESSOR UP TO 3 HP • ' ' • PLAN CHECK - 01-00-00-8806; -- . -
EACH GAS StEM'I'TO4'E5U't1,ET'S - . _ _. BOILER/COMPRESSOR 3.15 HP TOTAL'PLUMB(NG 01-00-00-8222 - EACH GAS SYSTEM 5'OR MORE ' 'n-.n- •--'' ' METAL'FIREPLACE - - ---- -- -- n4-f 1.- '- — ,-•e -- —ELECTRICAL------ ------°------- 01-00-00-8223-'- - - - - - - -- - EACH INSTAL:7 ALTER, REPAIR-WATER PIPE VENT FAN SINGLE DUCT ' - ,.0 - MECHANICAL ', 01'00-00-8224- - -
EACH VACUUM BREAKER .. : . - • -. •- MECH EXHAUST - HOOD/DUCTS - .. -. - '• MOBILEHOME , - 01-0O-OQ-8225
EACH ROOF DRAIN (INSIDE) - ' -- ' -• • -- I J_42-'- 'SOLAR - . •- - 01-00-00-8226
TOTAL PLUMBING _FIRE SPRINKLERS - 01:00-00-8227 -
TOTAL 'MECHANICAL- IL] - -• STRNG'MOtiON • 8092-33-0i . - -- -
QTY ELECTRICAL PERMIT ISSUE - QTY SOLAR ISSUE PUBLICFACILITIESFEE 3200008933 - - • ' -- --*- -'----- - ______________ ' ' - • f-f - j BRIDGE FEE
, •"tEW.CONSLEAAM)iSWT!8KR.._j_QO /- 1rJ" ": COLLECTORS , ' , - . - -• ,SCHOOL'FEE-DISTRICT
tjPH - - 3PH' ' ' ' -! STORAGE TANKS . - -• Carlsbad - 80-92-21-0519 - - -.
WATER S0FTNER: - - , ,, -- .• '. -.•. RELOCATION DF..EA FURNACE/HEATER- --(..___-J...,. - - MOBILEHOME PARK iNSP. 'S.', - - -*. - .. •- . - - '-'••--'.- --
EXIST BLDG EA AMP/SWT/BKR " '°' ROCK STORAGE ' - EnCnrtas - " - 8092 220519 "
1PH PH 0 -- - . :'- . . PUMP - ' ' ' - -San Dieguilo ' 80-92-23-0519 R.EMODEL.'ALTER PER CIRCUIT - - J •-'' - , - .., PLAN CHECK FEE - , - San Marcos - 80-92-24-0519
'TEMP POL'E200AMPS '.-''-- ,''n
-OVER 20O'AMPS'-' LICENSETAXO1-00-0Ô-8162 - - - -
".._• -f'EMP OCCUPANCY l30.DAY.SI ..------------•--.--
'- "'° ''•' 'n " ------------a.--. CREDIT DEPOSIT. •• •
TOTAL ELECTRICAL TOTAL SOLAR AL FEES - •y-T' - '. - ,.xmJOIPCAE•
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT" AND DO HEREBY Expiration. Every permit issued by the Building Official under the provisions of this * AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall expire by hrnitaflOfl and become null and void the building or workauthorized by such permit is not commenced within 180 days from the date of such 50" DEEP AND DEMOLITION OR CONSTRUCTION OF DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS permit, or it building or work authorized by such permit is suspended or -- -. STRUCTURES OVER 3 STORIES IN HEIGHT ISSUED: TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING BUILDING CON- abandoned at any time after the work is commenced for a period of 180 davu.-111--IION, WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS\TRE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS COSTS A ND APPLICANT'S SIGNATURE * OWNER 0 CONTRACTOR 0APPRDED BY, — EXPENSES WHICH MAY IN ANY GRANTING OF THIS PERMIT. WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE BY PHONE 0 JL -
/
TYPE DATE ANSPECTOR
BUILDING-.'
FOUNDATION
REINFORCED STEEL
MASONRY
GUNITE OR GROUT
FLOOR & CEILING SUB FRAME
SHEATHING 0 ROOF 0 SH:EAR
FRAME
EXTERIOR LATH
INSULATION
INTERIOR LATH & DRYWALL
PLUMBING
SEWER AND BL/CO DIPLICO
UNDERGROUND 0 WASTE 0 :WATER
TOP OUT OWASTE EVjIATER
TUB AND SHOWER PAN 1
GAS TEST
0 WATER HEATER 0 SOLAR W\TER
ELECTRICAL
0 ELECTRIC UNDERGROUND DUFFER
ROUGH ELECTRIC . .
ELECTRIC SERVICE 0 TEMPORARY
BONDING: 0 POOL
MECHANICAL
0 DUCT ,& PLEM., 0 REF. PIPIG::
HEAT - AIR COND. SYSTEMS *
VENTILATING SYSTEMS
CALL FOR FINAL INSPECTf ON WHEN ALL APPROPRIATE
ITEMS A Fin VF HAVE BEEN APPROVED.
FINAL.
PLUMBING I
ELECTRICAL
MECHANICAL vi
BUILDING
SPECIAL CONDITIONS
"7
FIELD FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTORS NOTES
REQ. IF INSPECTORS INSPECTION CHECKED APPROVAL DATE
SOILS COMPLIANCE
PRIOR. TO .,
FOUNDATION INSP
STRUCTURAL CONCRETE -. .
OVER 2000 PSI
PRESTRESSED
CONCRETE .
POST TENSIONED
CONCRETE
a. FIEL0WELD1NG .. . . . ,.
HIGH STRENGTH . .
BOL1S
SPECIAL MASONRY . .. .
PILES CAISSONS
,/. . .
*
t;herebyafflrm 'Ithat; ra!n lcet'sëd jn1e
0)'provialona ofCháter191èômmencIng with
Sect 3of'fh Business ''
uPt and Professions Code, and my license is In
l
LLC' No, .Class
4- hereby affirm, that-. I-am. exempt from the .Contrac- —P
I: ' tors License .Law for the following reason (Sec. 703t .5 Business and Professions Code: Any city or county which re-
- quires a, permit to construct, 'altdr, improve, demolish',' or ' P T)repair any structure, prior to its issuance also requires the ap-
_,, pticant,for. such permit,to.tile a signed statement that he is..,._._-.
licensed pursuant to the ,provisions. of the Contractors
- License Law (Chapter 9 'commencing with Section 7000 of
' DivisiOn 3 of the BUsiness and Prutessions Code) or that is'euç empt therefrom and the basis for the alleged exemption. Any'
violation of Section 7031.5 by an applicant for a permit Sub- ' jects the applicant na civil penally of not more (han tine hun,,,,, - - dred dollars ($500). ,,,
- -I.-as owner of the property. or my employees-with wages' -
- r- 11as their sole compensation. wilP,db the work. and the stroc-
__lure is not intended or ottered for sale.(Sec. 7044. Business
_ ..aod Protesoiuos Code: 1-The Cegtractnr's License law dues l#not apply to an owner of property who builds or improves
- thereon and who doessech work himself or through his own
i,,) employees7prouided that sach,improvonients are not intend- ui •ed or ottered too sale. It, however, the building or improve'-...
, , Z meut is sold within one yea(of completion, the owner-builder " I will •have the burden of proni'ng thai_he did not build or im- 0 '" prove for the purpose of sate
as-owner of the proprty, am exclusively contracting
-' - with licensed contractors to construct the project (Sec. 7044.,
BUsiness and Professiuns Code: The Contractor's License,..,.: I.. - ,-. Law does not apply loan owner of property who builds or rn-
- . ', . proveb'thereoo and who contracts. for eachiprojects with a. contractor(s) license- pursuant to the Contractor's License - I -
- -
- °
0 Asahomeowner tam improving my home, irild the toItow 4 ing conditions euist:';,,, I .,,_ij .1 - ,The work is being-pertormed prior,to,sale,..,.....
- 2. I have lived in -my 'home, for twelve months . prior to completion of this workj--
ui, "''3"1 "h'ave'nnt ctaimed'this'eaemption doriv'g'ttte"tI' - , '- last three years, -
Ot am exempt under Sec. - ' -' IoU this reason ' •"-' ''''' '-
j 'so4° vC41Lfi' - $ -'-Dl hereby affirm that t have a cerliticate of consent -
to' self-insure, Or a 'certiticate of Workers' '
', Compensation insurance, or U'Ceflit ied copy thereof,'" I
' I - (Sec 3809, Labor- Code) ,
. 'L't
z "- POLICY NO,' '---- " "--- -"-*'--- - 0 -. 1.t) ':4 t: COMPANYr... - --- - ,_ -
4 u, 0 Copy is filed with the City -. C', z •-•-- '--- -. -.-•- --- -- • ' -. 0 Certified copy is hereby'tu,nished
ni- 0 CERTIFICATE OF EXEMPTION FROM , WORKERS' COMPENSATION INSURANCE 'rj (This SeCtion'rieed not be completed it the permit is for one-hundred' dollars l5109Ior'lessl -
le i ' ',_'r'i•J-_'.•Jt ,r
-, I certify that in the performance of the work or,,,
o , , h,Ch this permit is issued. I shalt not employ any
V Op on in any manner so as to become sabfeCt,to the' rtoers' Compensation' Laws of California -
.NOTICE TO APPLICANT It, alTeC making thnS Cern-, - -
ticate o Eremption:,you should become subject to
the Worloers' Compensation provisions of the Labor
Code. you' rust - with Comply - Such'-
,I ' - 'Lp!ovisioimsor hi" er shall be deemed yoked
- _
-c aI 0 I ..t tsereby'aftirmmhat ther,_ is a ,cOnSiruC(iOv
° - lending agency .for the performance 01 the work to,
- -1)r.WhCh-lhS perrhi it is issued (Sec 3097, Civil Codel
LLI v-%M? Lender's Name _-'*4"
U
0
Address '
.sveom.rm ,
_-_-.__-z•, '—-'-—I'
-'
10ING-DEPARTMENT' -T T"
- - • . ', 1200 EIm Carlsbad, California 92008-189 (619) 438-5525 ,it - - , • " . ' •' ' •
JOB ADDRESS , 451, ST. RD. NEAREST CROSS ST. . DATE OF APPLICATION BUSINESS LICENSE -VALUATION - P RMIT NUMBER
72 4
BLOCK SUBDIVISION ASSESSOR PKR EL NO. t CONTRACTOR CONTRACTORS PHONE
rOWNE~R'S
ZONE
NAME 4 , OWNER'S PHONE•-_-'
CONT'RACTOR'S ADDRESS '' - LICENSE NO. - PLANI.O' -BLDG USE CODE' • -,
— OWNERMAluNGADDRESc
DESIGNER
DESCRIPTION OF WORK
LICENSE d STANDARD PLAN # BUILDING SO, FOOTAGE ,
.
' , . - - -
.
DESIGNER'S ADDRESS - - - - -- • DESIGNER'S PHONE -- - ,,,, - , ,., -- •__,, ,,,,_,•
- FIR FLRELEV,
- • STO
NO RIESOCCGP - EDU
- - '-':
----•---- --------------------
- 'rr
' Tfr9 7'-
' Not'Va1!n7esoMacfiineerti?id. .:'J7s5
CENSUS TRACT'' - GP CAND USE 'PRI('tNG SPACE RES UNITS -' -
'GRADING PERMIT ISSUED
.-'
REDEVELOPMENT
-AREA'* - ' " ''
TYPE
'CONST'"-
0CC LOAD
'r"
FIRE SPR
• - '•1 nD'e 0 ' - yD NO ,. YO NO
9 TX PLUMBftG PERMIT ISSUE
-
QTY MECHANICAL PERMIT ISSUE 3 - - SUMMARY/ACCOUNT NUMBER -
EfCH FIXTURE TRAP - - INSTALL FURN, DUCTS UP T0100,000 BTU - , - ,BUILDING PERMIT • 01-00-00-8220 -
- EACH BUILDING SEWER' - -. --'a'- - = --=--- '- .- - -=---'- --- - - '4 ' _--.ovER:100.000 BTU' '' ' '.'-' - SIGN PERMIT' •''. .'- -01-00-00-8221,-
-EACH WATER HEATER AND/ OR VENT : BOILER/COMPRESSORU,PTO' HIP * - PLANCHECK ,- _01-00-00-8806
3 EH'GASSSfEM'f'TO4'OU'TLETS"' _4 / _
- I BOILER/COMPRESSOR 315-HP _. '• TOTAL PLUMBING
- - ECH GAS SYSTEM` 5 OR'MORE'f '- ' - -' _-. ''- -METAL-FIREPLACE','r_',_r,,--'-. __,-' =__ .= -..ELECTRICAL..,.. 01-00-00-8223 -
-EACH INSTAL,:ALTER, REPAIR WATER PIPE , VENT FAN SINGLE DUCT . MECHANICAL 01-00-06-8224 -
=- EACH VACUUM BREAKER .---- _-' MECHEXHAUST _HOOD/DUCTS MO8666ME'-0100:00.8225 - -•
-- WAJERSOFTNER RELOC ATION OF-EA FU,,RNCE/HEATER_ S_-- - .MOBILEHOMLPARK_INSP
'EACH ROOF DRAIN ((NSIOE)'-'• .. '-- _-• ' -
- SOLAR 01-00-00-8226 TOTAL MECHANICAL
'
- - ' - - -
" • - ' - -
"
- - -
TOTAL PLUMBING , -I - / I ."' FIRE SPRINKLERS - - 01-00'00-8227 -
QTY.
- --- - - --------•
'ELECTRICAL PERMIT- ISSUE ',-"
-' •
' QT'o
- -'- PUBLIC FACILITIES FEE 32-00-00-8933 SOLAR - ISSUE
- -
'BRIDGE FEE
NEW CONST.EA AMP/SWT'BKR. , .,j COLLECTORS n- - "" SCHOOL FEE - DISTRICT.
(PH - - ' - -- - 3 PH - ' - ' -' STORAGE TANKS
-
- ' s, Carlsbad 80-92-21-0519 . -
EXIST BLDG EA AMP/SWT/BKR ' - - ROCK STORAGE i°
STRONG MOTION' " - 80-92-33-0519--"'
Encinitas - =' '- 80-92-22-0519 -'---- - - -
I1PH 3 PH 1 PUMP '. '\i ',t- ç,:' 01 San Dtegutlo 80-92-23-0 51 9
REMODEL:ALT-ER PER CIRCUIT 1 2. •-r , • PLAN CHECK FEE - \' Y - - San Marcos • - - 80-92'24-0519
TEMPPO'LE2OO'AMPS' ---=-'-" '• -":'---i,.. 1- • - -- ,,. ,.
'-OVER'200AMPS-4'" - ," -' I -"-i I - - V"-',-, LICENSETAX 01-00-00-8162
.JEMP OCCUPANCY (30 DAYSI - - ,- ,, '-=.fl& L çg._'-'-
- ' - •' -' -
:",.. '': :L'-: .,-',,-=.,' ..j' CREDITD,EPOSIT
- L -Ci Ir—. jALJJf -,
.-
+
TOTAL FEES.
- -
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT" AND 00 HEREBY Expiration, Every permit issued by the Building Official undrfhe prosio'ns'of this - * AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER Code shall expire by1imitation and become null and void. If the building or work
' - - - CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE 50" DEEP AND DEMOLITION OR CONSTRUCTION OF'authorized by such permit is not commenced within 180 days from the d le of su Ch DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS permit, or if the building or work authorized by such permit is suspended r STRUCTURES OVER 3 STOJ$IES IN HEIGHT
CITY, COUNTY STATE GOVERNING BUILDING CON- ISSUED: TO COMPLY WITH ALL AND LAWS abandoned at any-time alter the work is commenced for a period
STRUCTION, WHETHER SPECIFIED HEREIN OR NOT, I ALSO AGREE TO SAVE INDEMNIFY AND APPLICA SI TUnE -KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND OWNER CONTRACTOR
ot'180 days- i
APPROVE0YY DA , r - T - Z
EXPI:N5ES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE
,
- GRANTING OF THIS PERMIT BY PHONE 0 '
-
USE BALI. POINT,P,EN OILY& PRESS HARD_,. APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.'-'
TYPE I DATE INSPECTOR
BUILDING
FOUNDATION
REINFORCED STEEL
MASONRY
GUNITE OR GROUT
FLOOR & CEILING SUB FRAME
SHEATHING 11 ROOF DSHAR
FRAME
EXTERIOR LATH 'V
INSULATION
INTERIOR LATH & DRYWALL V
PLUMBING
SEWER AND BLICO DIPLICO
UNDERGROUND 0 WASTE 0 WATER V V
TOP OUT EJWASTE DVV1ATER V -
TUB AND SHOWER PAN
GAS TEST
WATER HEATER • 0 SOLAR WPTER
ELECTRICAL V
V
O ELECTRIC UNDERGROUND 0 JFFER V
ROUGH ELECTRIC
O ELECTRIC SERVICE 0, TEMPORARY
O BONDING D POOL
MECHANICAL
DUCT & PLEM., 0 REF. PIPII1G V -
HEAT - AIR COND. SYSTEMS
VENTILATING SYSTEMS
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE BEEN APPROVED
FINAL
PLUMBING
ELECTRICAL
MECHANICAL
GAS j
BUILDING
SPECIAL CONDITIONS /
FIELD INSPECTION RECORD-
REQUIRED SPECIAL INSPECTIONS : INSPECTORS NOTES V V
INSPECTION REQ. IF
CHECKED
INSPECTORS
APPROVAL D ATE
V
V V V
PRIOR TO
FOUNDATION INSP
SOILS COMPLIANCE
OVER 2000 PSI
STRUCTURAL CONCRETE
. V
PRESTRESSED
CONCRETE V
' V
POST TENSIONED
CONCRETE
V
V
FIELD WELDING
V
HIGH STRENGTH
BOLTS
SPECIAL MASONRY
PILES CAISSONS
- V V
'V 'V -.
'V •V . V ._ ----'V 'V I
• V - V -
.--
APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
..ARLSBAD BUILDING DEPARTMENT S ' APPLICATION'P .• •
- 1200 Elm, Carlsbad, California 92008-1989 (714),f38-5525 ,
JOB ADDRESS AV. ST. DATE OF APPLICATION BUSINESS LICENSE #
7Z3 res RD. 7
OWNER'S NAME OWNER'S PHONE CO TRACTOR " CONTRACTORS PHONE N
OL ryo'r. ri-'7O 72Zcz,O
- VALUATION
'
PERMIT NUMBER
ZONE
OWNER'S MAILING ADDRESS I
Xoa Re-! ct )i To,
CONTRACTOR'S ADDRESS
'P.Bo)c (/Lf 6:e2Ot'e-
LICENSE NO. PLAN-I.D. # - - BLDG USE CODE'
LOT ASSESSOR PARCEL NO. BLOCK SUBDIVISION
....
DESIGNER
DESCRIPTION OF WORK
LICENSE # STANDARD PLAN # - BUILDING SO. FOOTAGE
DESIGNER'S ADDRESS DESIGNER'S PHONE
741
'
S
. ,. Not Valid Unless Machine Certified
o tore is not intended or offered for sale (Sec. 7044. Business (iioiaQ .___kaL. IL4 Q(/W1..Qltf F/P FLREL'EV.
- YO NO
NO
STORIES
OCCGP EDU 'I
CENSUS TRACT 1 ,,,-GP-LAND,(JSE-
, ... _i.
'
- , . .•
PARKING SPACE
.
RES UNITS
____________
GRADING PERMIT'ISSUED
.,,'
J ) - -
REDEVELOPMENT
AREA..,.
, Y o NO
TYPE
CONST .
0CC LOAD FIZS
Ø
QTY " PLUMBING PERMIT - ISSUE -: - , _________- QTY. - - MECHANICAL PERMIT ZIISE' " to SUMMARY/ACCOUNT NUMBER . -.
'EACI'FIXTiJRE'TRAP - ' INSTALL FURN. DUCTS UP TO 100,000'BTU .) RUILDING PERMIT 01-00-00-8220
EACH BUILDING SEWER - . . - .,..' OVER 100,000BTU - . - / SIGN PERMIT - . - 0100-00-8221
EACH WATER HEATER AND/OR VENT ' BOILER/COMPRESSOR UP TO 3 HP , PLAN CHECK ' 01-00-00-8806
- " -2. I have lived In 'my 'home for twelve months EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER ICOMPRESSOR 3:15-Hp - "11.J' - /' 'TOTAL PLUMBING 01'0000'8222
EACH GAS SYSTEM 5 OR MORE FIREPLACE m1 _METAL J ELECTRICAL 01-00-00-8223
EACH'INSTAL ALTER REPAIR WATER PIPE , VENT FAN SINGLE DUCT ,/ . MECHANICAL 01-00-00:8224 - -
-E'ACH.VACUUM BREAKER.:- '"' " '--'- -' , ' -- - MECH EXHAUST - HOOD/DUCTS . " -. ' MOB(LEHOME 01-00-00-8225 -- .
WATER SOFTNER - — , ,' RELOCATION OF E - FU NACE/HEATER / . MOBILEHOME PARK INSP
- EACH ROOF (INSIDE) - _DRAIN .. ' W - ' SOLAR
TOTAL MECHANICAL .- /
' / =
: - - - I - / O 'STRONG MOTION- ' 80-92-33-0519...-
- TOTAL PLUMBING .. '- . FIRE SPRINKLERS . 01-00-00-8227
-, -
OTY' - ELECTRICAL PEAMit - (SSUE - , - QTY. SOLAR -'ISSUE - /
-- ., -
PUBLIC FACILITIES FEE 32-00-00-8923
BRIDGE FEE'
NEW5 C'ONSTEA'MP/SW:T/BK'R - ''' . ' . COLLECTORS SCHOOL FEE - DISTRICT-
.. , -
iPH - '- 3 PH STORAGE TANKS '
- : - - ''
'. - -Carlsbad - ' 80-92-21-0519 -
'EXIST BLDG EA AMPISWTIBKR. "- '. ROCK STORAGE : '- -Encinitas - - 80-92-22-0519 - -
- his section need notbe completed if the permit 1PH - 3'PH , " -- - , __,, PUMP - - - San.Oieguito - - 80-92-23-0519 -
REMODEL/ALTER PER CIRCUIT' . ' PLAN kEdI'FEE ' . ' ' -San Marcos 80-92-24-0519 '-
'TEMP POLE'2O0 AMPS
- . - -0-VE-R-200.AMPS
TEMP OCCUPANCY 60 DAYS) ,..,, ' ' ' - . . . , ' . - ' '''' ''' S • -. ''" 5'
TOTAL ELELTCAL TOTAL SOLAR
-
TOTAL FEES PAYABLE 2 o•-c.."
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT" AND DO HEREBY Expiration. Every permit issued by theBuilding Official underlhe provisionsoflhis * AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER Code shall expire by limitation and become n4ilhand void. If the building or work 5'0" DEEP AND DEMOLITION OR CONSTRUCTION OF CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON I NCLUDING THE authorized by such permit is not commenced wi in 180days from the dateof such DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMITS permit, or if the building or work authorized by such permit is suspended or STRUCTURES OVER 3 STORIES IN HEIGHT
ISSUED: TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING BUILDING CON- abandoned at any time after the work is commenced for a period 01180 days. . " .
KEEP HARMLESS THE C OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS APPLICANT'S SIGNATURE - pwNERO CONTRACTO STRUCTION. WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND APPROVED BY 4 j D
' V I -' EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE II
GRANTING OF THIS PERMIT. ( JJjiyjI,L/ BY PHONE
•
-- ii ' - I
USE BALL POINT PEN ONLY & PRESS HARD
0,A hereby.afflm that Lam licensed under
provisions of- Chapter 9'(commenc(ng' with I SectIon 7000) of Division '3 of the Business I-I. and Professions Code, and my lice nse is in I full force
and effect.
Lic'Ne. _________......_ Class
0 - U -
I hereby atfirm that I 'am exempt from the Contrac-
tor's 'License Law for the following reason (Sec. 7031.5 Business and Protessions Code: Any city or county which re-,
quires a permit to construct, alter, improve, demolish, or rephirany structure, prior to Its Issuance also requires the ap-
plicantIor'such permit to tile aslgn'hd statement that he is licensed pursuant to the provisions of the 'Contractor's '
License Law (Chapter 9 commencing with Section 7000 of Division 301 the Business and Professions Code) or that Is ex-
empt therefrom and the basis,IorIhe alleged exemption. Any violation of Section 7031.5 by an applicant for a permit sub-
.)ects le applicant to a civilpenalty of not more than five hun-
dred dollars ($500). -
- -0 I, us Owner of he property, or my employees with wages -
as their Sole compensation, will do therwork, and the stroc-
and Professions Coyte:"TheCootractsr's License Law does not apply to an. owner of property who, builds or impovès
thereon and who does such work himself or through his own.
'emplsyees, provided that Such Improvements are not ixteod-,- W . ed or- offered for sate. tf, however, the building Or improve- Z ment is sold within one year of completion, the owner-builder will have the burden 'dl proving that he did not build or im-0 - - prove for the purpose of sale).
-s..
- '0 I, as owner of the property, am esclssivhly 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
2 Law)
':'.: , 0 As a homeowner tam improving my home, and the follow- 4 - ing conditions exist-.
,i'. The work is being performed prior to safe.
U - prior to completion of this-work-.'.---.' -
I kayO 001 claimed this exemption during the last three years.
. 0 lam exempt tid& Sec. - . , .9 & P.C. for this reason. ...'' . .
fl I herebyaif rr thall have a'certificate of consent
- to, sell-insure, . or a certificate Of Workers'
- . Compensation tnsurdnce,'or a certified copy thereof
(Sec. 3800, Labor Code). . S
Z POLICY NO.__
CÔMPANY _.
QCopy's filed with the cty \1 j'
Iied,CoPy s hereby furn shed
0 CERTIFICATE OF EXEMPTION FROM 1.
- WORKERS' COMPENSATION INSURANCE
is for one hundred dollars I$1lor'lsslLu ""
-0 I cerfify,thaf i.n the pertormance of the work for
0 whiCh thisperrniI 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, afImak'n3'thisCerti-
ficafe orEoempfion, yoJ'ahould'beEbme sObject to
the WorkersC Compensation provisions of the Labor
Code, you must.- forthwith comply, with suc)r
- ' propisi000 or this permit shall be deemed revoked.
fill herebaffirm that there m a construction
I lending agency for the performance of the work to,
' dhiEIe this permit is issued (Sec 3097,'Civil Code).
zi
LIJ Lender.- s Name
L Lender's Addresd'
: -
-
'IPJSPFflTIflN T'PF I - DATE. INSPECTOR
BUILDING
S...
FOUNDATION
REINFORCED STEEL
MASONRY .. .• ______ _________
GUNITE ORGROUT-
FLOOR &CEILINGSUB FRAME '
SHEATHING,
FRAME
EXTERIOR LATH INSULATION, . .
INTERIOR LATH & DRYWALL
. PLUMBING ,7 -
S EWER AND BL/CO . , . r
PLUMBIrJG'UNDERGROUND - -
PLUMBING TOP OUT
TUBANDSHWER'AN
GASTEST :-
.'ELECTRICAL:
TEMPORARY POWER-
ELECTRIC UNDERGROUND':, -
ROUGH ELECTRIC• ¶- ••- _______ _________
ELECTRICSERVICE.. dJ - _________
BONDiNG?-,
G. F. I. .- SMOKE-DETECTbR
;-,MEcIiANICAL::
.DUCT &'PLEM. REF.,:PIPING
HEAT--- AIR -QOND: SOLAR SYSTEMS .
VENTILATING SYSTEMS
CALL. FOR FINAL INSPECflON-4'HEN ALL APPROPRIATE
ITEMS ABOVE HAVE, BEEN APPROVED
'JOB SITE FINAL..
PLUMBING '4 ELECTRICAL ,.•. - 1t
MECHANICAL . t
-GAS r
-BUILDING
SPECIALCONDITIONS .. --- - - -
CERT OF OCCUPANCY ISSUED •* . - . . -
.FIELD INSPECTION RECORD
1* •'-
- ,*.. .- .-. * . - - ,..-, - . S - - *-'-..•.. - -
REQUIRED SPECIAL INSPECTIONS INSPECTOR S NOTES
INSPECTION- CHECKED APPROVAL DATE
SOILS COMPLIANCE PRIORTO- .-
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
- PRESTRESSED -
CONCRETE , . -. - -- - - - - -
POST TENSIONED
CONCRETE . . -. . - '- - - - -
FIELD WELDING
;'HIGH STRENGTH . - BOLTS
SPECIAL MASONRY •,. - -.
• .6 -
•
-
' * - - 5,.-, -- -
- -S - 2
'! •
- -- •
.
- PILES!CAISSONS . . ft. " * *• .
- .
-S_P
.' •'
.• - ,.-
- . -
-
- . - - .-. - , --:.
-
- . --
- -4.' 5- -5*. . -. - • .5 . * .5 - 5-. 5
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4 — —
I CITY OF CARLSBAD— BUILDING DEPARTMENT
.
LICENSED CONTRACTOR'S DECLARATION AP PL: ICAT ION & PERMIT
thereby affirm that I am licensed under provl• USE BALL POINT PEN ONLY 1200 ELM -
sions of Chapter'9 (commencing with Section -
r7000) of DivIsion 3 of the Business and Profes-
sions Code, and my license is in full force and ef-
fect.
APPLICANTTOFILLININFOR -
-
-- MATION WITHIN RED LINES.
NO. - JOB A ADDRESS -. V. ST. DATE F ATION Bus. LICENSE PERMIT-NUMBER
-I'l' S1+1 I I I I I I I I i
RD
I"i
APPL
T )cDI
STATE LICENSE
OWNER OWNER'S PHONE
fl
MEçROR
OWNER'S MAIL G ADOR , . . .
2>
CONTRACTOR'S -ADDRESS. . - -. ...
B
\CONTRACTORS.
PHONE
. . .
LOT I SLOC147 SUBDIVISION ASSESSOR'S PARCEL NO. -DESIGNER- -
DE CRIPTI - OF WORK.
STATE LICENSE
DESIGNER'S ADDRESS - J - DESIGNER'S PHONE - - - - -
- - - - CENSUS TRACT GP LAND USE - ZONING . - - RES. UNITS -PARKING SPACE - -. -NUMBER OF STORIES
p Not tafin/6é.6(eCernfled
BLDG SQ. FT., - BLDG USE occ. GP STANDARD PLAN N - PLAN to N TYPE CONS OCC LOAD ' . -. .- - -
00018569 4/03/8i e0O
CITY. PLUMBING PERMIT AMT UTY MECHANICAL PERMIT AMT -
-
I -
-
. - .
- -.
_ - -
VENT FAN SINGLE DUCT
EACH FIXTURE TRAP - INSTALL FURN DUCTS UP TO 100,000 BTU
EACH BUILDING SEWER -
OVER 100,000 BTU
- EACH WATER HEATER AND/OR VENT BOILER/COMPRESSOR UP TO 3 HP -.
-
EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3 15 HP -
EACH GAS SYSTEM 5 OR MORE BOILER/COMPRESSOR 1630 HP
- EACH INSTAL, ALTER, REPAIR WATER PIPE - ,. . -
- - - - - -- -
- OWNER-BUILDER DECLARATION
Dl 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'repalr 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 (Chapter9
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)...........
Dl, 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 01 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-
fared 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).
Dl, as owner of the property, am exciusivelycon-
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 r-ho builds or im-
proves thereon, and who contracts for such pro-
jects wlth,a contractor(s) license pursuant to the -
contractor's License Law).
I am exempt under Sec._- , B. & P.C.
for this reason -- -
Date _____________ Owner
-WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of con-
sent to self-Insure, or a certificate of Workers'
Compensation Insurance, or a certified copy
thereof (Sec. 3800, Labor Code).
POLICY NO._________________________
COMPANY
0 Copy is filed with the city.
OCertitied copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the per-
mit Is for one hundred dollars ($100) 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 this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction len- '
ding agency for the performance of the work for
which this permit is Issued (Sec. 3097, Civil Code).
SITE-'.'4.
ADDRESS -. { OWNER PERMIT NO:-,,
..
•
-
•
•
-
-
•
-
FIELD )4SPECTION-;RECORD -
INSPECTION DATE INSPkCTOR ' C INSPECTOR S NOTES -
WOOD FLOOR
- FOUNDATION • FORMS • SET BACK • TOILET
UNDER FLOOR PLUMBING
.-.'-UNDER FLOOR .H EATING -.-. . . . -.
,OKTOINSTALL.SUB FLOOR
5 ..
SLAB FLOOR
UNDERSLABPLUMING t
FOOTING • FORMS • SETBACK • TOILET
OK'TO-.POUR CONCRETE
I
FRAME •.- . . . S Sf - . . S
-S..........---s--
S.ROUGH ELECTRICAL . . . .. .. ,-
- ROUGH PLUMBING-
ROUGH HEATING/VENTILATING
FRAME OK • PLACE INSULATION
-INSULATION OK • PLACE WALLBOARD
WALLBOARD .0K-. PLACETAPE
EXTERIOR LATH OK. PLACE STUCCO - - - - . . - .•... .. - - . . . . -
.•• • •. . .
0
-, - •- -: - • -. .: *5
FIREPLACE.. - • . . - . - . - - -. -
. . . -. - - . . . .
DAMPER &STEEL
J PLATE TIES/HEIGHT OF CHIMNEY
OTHER .-
- -_'.S -
.5
. -S ' , TEMP POWER (POLE) -- *5
-SEWER. •., -.- . ,. . - . - -... , -. '. .
'GAS TEST
SWIM POOL • STEELSBONDING
PRE DECK ... - - - - . -, • .. -
- - - • FENCE PREPLASTER - . . - -- . -. - - - . .
•• .. - -
SHOWN • FRAME
sPAN- . .- - .-- -•-.
S -. - -
. . FINALINSP BY BLDG DEPT -. -. - . - -. . .
--
OTHER ÔEPT'S REQ COMPLETED -
ELECMEtERPERM—TEMP -: -. - - / -
. . -. - --•--- - -. . . ....- -
GAS METER—PERM—TEMP -
- f1( . - .- •S
-
- ;. -. - -
- --- . - - . /- . -• S - - . . . . -
' S .•' . -.-.- - • . '-- -'- --. S - - CERT-OF OCCUPANCY ISSUED - --- - -
..
-- '•,. - - . - -- - - -. . S
t .-1. • .--'- -S
-s.:;............
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- .........-.................S - -
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