HomeMy WebLinkAbout2757 Inverness Dr; ; 83-200; Permit.. z 0 ~ "' ::l :.l Q
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D I hereby affirm that I am licensed under
provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Professions Code, and my license is in
full force and effect.
lie No~-------Class
I Mreby affirm that I am exempt from the Contrac-
tor's L,cense Law lor the following reason (Sec 7031 5
Business and Professions Code: Any city or coumy which re-
quires a permit to construct. _alter. improve, demolish, or
re_pa,r any structure. prior to_ its issuance also requires the ap-plicant for such penrnl to file a signed statement that he 1s
licensed pursuant lo the prO'l1s,ons of IM Contractor's
License Law [Chapter 9 commencing with Section 7000 ot
o,v1s1on 3 of the Business and Professions COde) or that is ex· empt therefrom and the basis tor the alleged exemption Any
violation of Sect,on 7031.5 by an applicant for a permit sub-1ects the applicant to a c1v1I penalty o! not more than live hun-
dred dollars ($500\
=-: I, as owner ~f the property, or my employees with wages
as their sole compensatoon. will do the work. and the struc-
ture ,snot ,ntended or offered for sale (Sec 7044. Business
and Professions Code: The Contractor's License :..iw does
not apply to an owner of property. who builcls or improves
thereon and who doos such work himself or through hrs own
employees. provided that such improvements are not intend-
ed or offemd for sale. 11, however. the building or improve-ment is sold wJthm one year of completion, the owner-builder
will have the burden of proving that he did not build or im-
prove for the purpose of s.Jle)
~ 1,_as owner of the property, am exclusively contracting with licensed contr~ctors to construct the pro1ect (Sec. 7044,
Business and Professions Code· The Contractor's License
Law does not apply to an owner of property who builds or im-
proves there011, and who contracts for each projects with a
contractor(s) license pursuant to the Contractor's License Law)
0 As a homeowner I am improving my home. aM the follow-ing cond1t1ons exist 1. The work is being performed prior ta s.Jle
2 I _have lived m my h_ome for twelve mon1hs
prior to complet_,on of tti,s work.
I have not claimed this exemption during the last three years
t~r 11h~~/~~;~~t under Sec i :"'} , B & P. C
0 I he•eb)' athrm that I h;,,~e a cert1!1cale of consent
to selt-msure, or a cert,l1cate of Workers
Compensa11on Insurance. or a cen,hed copy thereof
(Sec 3800. Labor Godel
POLICY NO
COMPANY
O Copy 1s filed w,1n the city
O Gert,f+ed copy ,s nereby furmshed
CERTIFICATE OF EXEMPTION FROM
WORKERS" COMPENSATION INSURANCE
(fh,s sec11on need not tie comple1ed 1f the perm,1
,s tor one nundfed dollars ($100\ or less)
O I cert,ty tha1 m 1he performance ol the work tor
wh,ch 1h,s perm,, 1s ,ssued. I shall not employ any
person ,n any manner so as to tJecome sub1ect 10 the Workers· Compensat,on Laws o! Cahtorn,a
NOTICE TO APPLICANT If. af1er mak1n;i this Gen,
f,cate of Exemption. you should tiecome sub1ec1 t'l
the Workers· Compensa!1on prov,s,ons of me Labor Code. you must lorthw,th comply w,th such
prov,s,ons or th<s perm,1 shall De deemed revoked
0 I ne,eby atfirm 1na1 there ,s a cons1ruct1on
lending agency for me performance ot the worl< 1or
which th,s perm,t ,s ,ssued (5ec 3097. c,,11 Code)
Lenders Name~~~--~~----~
Lender's Address-----------
USE BALL POINT PEN ONLY & ~RESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT
1200 Elm, Carlsbad, Cali'fornia '92008-1989 (619) 438-5525
.N?!fflO.!!;sS 'tat .t•.' ' "· , · .> A.~!·l~i£'··· .... ~F.~* S~:.' ,,. ,,81)$1,-.~.'LtCENSE#, ~v~-:;;;._ PERMIT NUMBER
"t. 1,":1 T . 11..1 \i. · · . . ·. . · · · t.a•L.. · :is·• : · · . :-: . n n :.;>;-, B~ . ./7 ,..,,..
'.:.w'.'~··sNAME .~ _,.I~'° • ,.... . --rti°:!Al:~; ~,:i; ...... =~C:_.T_o_•_/.,· _· ____ ·_·_: __ ·_··----!··..,-COH:::TR::·,..C-.T:9RS:·::PttON::::··:·::~:zo:,-N-,_,/.·:::::::::::::~+-,--·~-,-L,J../U-----i ~e~·: MAILH\IG.~tiORESS RAC OR'S ADDRESS LICENSE NO. PLAN 1.0. # _!LOG use c~
LOT BLOCK l Sueo1v1s10N t~=rtro·__A-f . DESIGNER LICENSt: # STANDARD PLAN# AD:G so. FOOTAGE
OESCAtPTtON OF WORK -1,t;; 1---------------------·-----··-----··-.. _ .... DESlGNER'S-AODRE§ ·" OE&GNER'S PHONE·
_,., ... 1 ... ;.tr. n_.L ~ \•.\rK.1 ~__. .....-1:tR . F/P FLA ELEV. NO OCC GP EDU
. . . ,o ,o --STORIES 6i'cl!6/B!3.eirl!!, 10 ,'.12
CENSUSTRACT I GP LAND USE IPARKINGSPACE RES UNITS I GRADINGPERMITISSUEO I REDEVELOPMENT TYPE OCCLOAD FIRESPR OOuJ~~5~ iAe.~/ -S~ ,ro~~:f~ • AREA CONST
y D N D YD ND v D ND Not Valid Unless Machme Certified
QTY. PLUMBING PERMIT· ISSUE 'J ~ QTY. MECHANICAL PERMIT· ISSUE .3 -SUMMARY/ACCOUNT NUMBER I
EACH FIXTURE TRAP ' INSTALL FURN DUCTS UP TO 100,000 BTU BUILDING PERMIT 01-00-00-8220 I £~. "J f--+==----~-c-----------~ ------------· ~'---I EACHBUILOINGSEWER OVER100.0008TU SIGNPERMITt • 01-00-00-221 "r
EACH WATER HEAlliAND,OR vENT ----1 --------:;, :o ---801LER1co-MPREssoR-uP To 3 HP ---PLAN CHECll AD A.-~Tbt~s flN'Ai --
EACH GAS SYSTEM 1 TO 4 OUTL~~---__ -+--f ~ BIJllE~~~SSOR 3-1_5 HP TOTAL PLUMBING -_\' • 01-00-00-222 /"J,J _ /JO
'1' EACH GAS SYSTEM~ OR MORE ' J METAL FIREPLACE ELECTRICAL ____ _Q_1-00-00-8223 ll'f ~ (J___JJ____
"'I! E-ACHINSTAi..-~ALTIR. REPA1R WATER P1PE-----~ --vENTFANSING-LEDUCT MECHANICAL 01-00-00-8224 " --
EACH VACUUM BREAK~--_____ _____ 'f J;;jj, _ -~H-~XHAUS_T HOOD/DUCTS MOBILEHOME 01-00-00-8225 __
-WATER SOFTNER ' _;r RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP 1--~-+-----------------. ---·-
: EACH ROOF DRAIN (INSIDE) SOLAR 01-00-00-8226~,-----~c,".o.----/ _ __j - _ -~. '--TOTAL MECHANICAL STRONG MOTION 80-92-33-051-9 r,,'Z.,.
--TO-ill PLUMBING --L --I,,, :71l ~RE SPRINKLERS ~:0_0·_8_22_7--ll-----~------l
' -PUBLIC FACILITIES FEE 32-00-00-8923 QTY. ELECTRICAL PERMIT -ISSUE 5-QTY. SOLAR· ISSUE e---,,.-,o-GE_F_E_E ---. ~~r----
f--+--~---~·-----------!~=---~--· -----1-------------------
NEW CONST EA AMP/SWT:BKR COLLECTORS SCHOOL FEE -DISTRICT
--·. ·-------~;
1 PH 3 PH STORAGE TANKS Carlsbad 80-92-21-0519 ----------·----. -------~-+------·----
EXIST BLDG EA AMP/SWT/BKR ROCK STORAGE Encinitas 80-92-22-0519
1 PH 3 PH --r-----I PUMP San -Dieguito -80-92-23-051·gf--------·-
1--..-l-+--;-:_:_;_;~Af ;OEORAM7S~~-\J ~-___ ---=--: __ ~ _ PLA~HECK r"EE _ San M_~rcos ___ ~0-92-24-0519-i--_ -=
~-------------------------f-----·-_,______ --·-----------~·----. -------t------------
OVER 200 AMPS ,_____ -----------------·-----------t------·--------------1----·
TEMP OCCUPANCY 130 DAYS) -----------------------------------------
-L TOTAL ELECTRICAL -· -·1 -· /{) f/4, -·---~OTA;-;;;;L~R -----· --TOTAL FEES PAYABLE I PQ,/f..
1..;ivi~~tiiljtar',,:ietx,,;Plci'~o ·~#t!CAOO!t>-l'IO~-T::~t,D.OO~r ~~ .. ~,...,~~~~=~~~~~~~:· . •.· .,...~~ ~-1<)11 fXOl1/A1'10H&.QYPI'
~Ef!TlfY'lJNpEl\#ENP+,TY: -C,)F .P~RJURY TffA! A~L 1f:4f{)f(MATfON ~m£dN INCLUDING THE -authortZed t>y such pept111: isrtot cofiut"tenc•ldwithil:i'tlOday,1 ~ ~ebtMft , : ,: '~ lft~AtO,,~ Oft~ OF'
'~l()NS ARf t.fltJE ~o,. G<>AAECT. . ,. , AN'& t, FU~ ... CERTIFY ANQ,'A.nRE$1F A·PERM.tT lfi pertnil, or if the bUikfing· or WOik ,.uthor~ 't,iy ew::h penni\ ia suspjWlded 'ri, , · , ~VIEftl $TOAIES tN nc,unT .~ .TQ~Y·WRl!l\LtCITY,CQUNJY·AM>S'TA:Ti;lAWSGOVER'*ING•aUtL!llNGCOfol-.... -,_-.::c-·-<· .. . . . . . . ... ·.< • • 1"' . •
:~. 1W,~l! .. $f~.· ... ~!:fEFJl;litP!<>!OT,. IA.L$C>AGREETO'-'VEiHDE"1NlfY.AND~•~ '$.·llfGNA.· ~ --1 • ·' ,. APP,OV~EDBY jf!,(\_,.. OATE
~Ii~ IK~~~~~~~'li.~i~~ · ·· : ~»~ · ': :::.::r· · ,., '~ 1" ,.,--r ""r. tw.... <ifj'ANT\NG,0~~~~·:::;, •. >·~ .. ·.•·. ,:: . . . . ·. ·... ~,.....~ . . •. :: ;·c; .•. :'.",, .... 15-µ-;.,c,.7
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INSPECTION TYPE DATE INSPECTOR
BUILDING
FOUNDATION
REINFORCED STEEL ll.. f,..tf!, ! fl _jf
MASONRY p
GUNITE OR GROUT fn,14,Pi~ 1::.ti-·
FLOOR & CEILING SUB FRAME
SHEATHING
FRAME
EXTE:RIOR Lb.TH lNSULATION
INTERIOR LATH & DRYWALL
PLUMBING
SEWER AND BL/CO ~
PLUMBING UNDERGROUND (' AL ""'·I
PLUMBING TOP OUT
TUB AND SHOWER PAN '
GAS TEST "..41.~ P•L
ELECTRICAL \l
TEMPORARY POWER
ELECTRIC UNDERGROUND ,.,11..~ '~
ROUGH ELECTRIC n
ELECTRIC SERVICE
BONDING , ,. .(,, . Pl<t. (,*
G. F. I. -SMOKE DETECTOR ..
MECHANICAL
DUCT & PLEM., REF. PIPING
HEAT -AIR COND. ~ SOLAR SYSTEMS
VENTILATING SYSTEMS '
CALL FOR FINAL INSPECTION WHEN All APPROPRIATE
ITEMS ABOVE HA VE BEEN APPROVED.
JOB SITE FINAL '
PLUMBING -'.....:n 11,'l,',..-L {J.ft'
ELECTRICAL ;;;: '\t{V" ". -VI
MECHANICAL •• •.
GAS
BUILDING .
SPECIAL CONDITIONS
CERT OF OCCUPANCY ISSUED
-
-
--
~· .. "::'.)
. . <3?., ~ ;;)OZ) . -,--
FIELD INSPECTION RECORD
REOU.IRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECT10'i'•J REQ IF INSPECTORS DATE '( \ :(" l \ , .. ~-
CHECKED APPROVAL
. -----------
SOILS COMPLIANlf
PRIOR TO .
FOUNDATION INSP
-----~ ,_ ____ ---STRUCTURAL CONCRETE
, OVER 2000 PSI
PRESTRESSED
CONCRETE ·-·---POST TENSIONED
CONCRETE
l'"IELO WELDING
HIGH STRENGTH
BOLTS
SPECIAL MASON~Y, .
\, .';,,.·
-'
----I PILES CAISSONS '
~ f-· . '"' ·-! . ' ;. ,-
. -
\ -.c;c: -· '· ··-----
-
------; ': ~e:;. : '·. •' ----'j ;~ .. i • . . ·;;
------'
.
------.
-----
. . .
•
INTERDEPARTMEN[AL INFORMATION SHEET lECEIVED
BUILDING DEPARTMENT DATE: MAY 18 1983
BUILPiNG ADDRESS: ).1S7~
1 D CITY OF CARLSBAD ~ • A. P • N : cx O o -I I! -.)._ 7 c . T : Bulldlng Department
-**************************************************..iU:******************** /
PLANNING DEPARTMENT
' ZONE: SCHOOL FEES: SAN DIEGUITO SAN MARCOS --------------
ENCINITAS ----
·UNITS REQ'D: PROVIDED: -------+-----------,.''--;:---+-,r-r------% COVERAGE ALLOWED: . PROVIDED: --,--,---,-,:r-====--.__ __
PARKING SPACES REQ'D: PROVIDED: ___ ,..._____ _ ___ _,.. ______ _
BUILDING HEIGHT REQ'D: ---------
FRONT SETBACK REAR SETBACK
ALLOWED: _ _,,.._ ___ _,,
PROVIDED: -1----t-----tr--
INTRU S ION
RE-DEVELOPMENT APPROVAL REQ'D: _______ _
'LANDSCAPE & IRRIGATION PLAN COMMENTS~:e:=::::::::..f:::....._,.J'Z-....:_ __________ _
ADDITIONAL COMMENTS:
OK TO ISSU~ DATE:~/'k?{e,'!1 OK TO FINAL: ___ DATE: ___ _
x * * i': * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * * t * * * * * *1;* * * * * * * * * * ,·; il ENGINEERING DEPARTMENT
R.O.W: IMPROVEMENTS: ----------------'-----------
PUBLIC FACILITIES FEE: SEWER CONNECTION:
APptii! DRIVEWAY LocATioNcsJ =---sy-~---~_;;...-... / .... V--£-0--------------
GRADING PERMIT: ~ ---------'~~--------------
EASEMENTS: ________ ........,M 4 ~ RJ-J NA~-------------
"'ft LEGAL DESCRIPTION: C 1983 lf7 Of CAfli
* * * * * * * U * ;1; * * * * * * * * * * * * * * * * * * * * * * * * k:il.fJd .. t< * * * * :kJi1il..1J; * * * * ULU...D.ll * * * * * * * * IF TllIS ITEM IS NOT CHECKED, BUILDING DEPARTMENT WILL MAKE
FINAL INSPECTION.
1200 ELM AVENUE
CARLSBAD, CALIFORMIA 92008
TELEPHONE,
(714) 729-1181
QCitp cf Q.Carl~bab
This document will certify that I am aware of the provisions of the
California Administrative Code, Title 24, Section T20-1406(c),
"Swimming Pool Heating", as shown on form DPL #297. I understand
that neither a swimming pool building permit using a fossil-fueled
heater nor a plumbing/electrical permit for a new or replacement
fossil-fueled heater will be issued until this certification is
executed.
For the swimming pool located at .2757 /tlilc1Z./V£6S .:[)12.11/E
(site address) I certify that all of the following requirements for
fossil-fueled (or electric) swimming pool heaters will be met:
l. Outdoor pools shall be equipped with a pool cover.
2. ON-OFF switch on outside of heater to allow shutdown without
adjusting thermostat and start-up without relighting pilot light.
3. 36" minimum length of plumbing provided between filter and
heater to allow future solar installation.
4. After January l, 1982, new heaters installed must have 75%
thermal efficiency.
5. Time clocks installed to allow pump operation during off-peak
demand periods (unless pump used for active solar).
6. Directional water inlets in pool for good mixing.
Print owners Name:
Date: ¥&.3 7
Owners Signature:
Print Contractors
Contractors Signature: Date: S: /f:~7
Address: