HomeMy WebLinkAbout2770 LOKER AVE W; ; CB881096; Permitf l
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O 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.
I hereby affirm that I am exempt lrom the Contrac· tor's License Law tor the following reason (Sec. 7031,5 Business and Professions Code: Any city or county whicti re-quires ,a perm1l to construe!, alter, improve, demolish, or
repair any structure, prior to 1ts issuance also requires the ap-
plicant for such permit to hie a signed statement that he 1s licensed pursuant to the prov1s1ons of the Gontractor's
License Law (Chapter 9 commencing with Section 7000 of 01v1s10n 3 of the Busmess and Professmns Code) or that 1s ex-
empt therefrom and the basis for fhe allegea exemption Any violation of Secfion 7031.5 by an applicant for a perni1I sub· 1ec1s fhe applicant lo a c1v1! penally ol not more than live hun· dred dollars ($500).
I I I, as owner ol the property, or my employees with wages
as their sole compensation, will do the work, and the struc-ture 1s nof infended or offered for sale (Sec. 7044, Business
and Professions Code: The Contractor's Ucense Law does not apply to an owner of property who builds or 'improves thereon and who does such work himsell or through his own
employees, provided that such improvements are not intend-ed or offered for sale. If, however, the building or improve·
ment 1s sold within one year of co_mplet1on, the owner-builder
will have the burden of proving that he did not build or im· prove for the purpose ol sale).
I I I, as owner ol the property, am exclusively contracfmg with.licensed contractors lo construct the pro1ect (Sec. 7044,
Business and Prolesstans Code The Contractor's License Law does not apply to an owner of properly who builds or im-proves thereon, and who contracts for each projects with a contractor{s} license pursuant to the Conlractor's License Law).
11 As a homeowner I am improving my home, and the follow· ing condit1ons exist: "'
1. The work is being perlormed prior to sale 2. I have lived in my home for twelve months pnor to completion of thiS work 3. I have not claimed fh1s exemption during the lasf three years.
D I am exempt under Sec. -----~-, 8 & P C for this reason
0 I hereby affirm that 1 have a cert1f1cate of consent to
self-insure. or a certificate of Workers· Compensation In·
surance. or a certified copy thereof (Sec. 3800. Labor Code)
POLICY NO.
COMPANY
=:J Copy 1s filed with the city
D Certified copy is hereby furnished
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section .need not be completed jf the permit
Is for one hundred dollars {$100) or less)
D I certify that in the performance of the work for which
this permit Is issued. I shall not employ any person m any
manner so as to become subject to the Workers' Compen-
sation Laws of California.
NOTICE TO APPLICANT: If, after making this Certificate
of Exemption. you should become subIect to the Workers·
Compensation provisions of the Labor Code. you must
forthwith comply with.such provisions or this permit shall
be deemed revoked.
D I hereby affirm that there Is a construction lending
agency for the performance of the work for which this per-
mit is issued {Sec. 3097. Civil Code)
Lender's Name ____________ _
Lender's Address ____________ _
USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONr
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT
,"\ ,.., -,~"-20'75 Las P1ilmas Dr., Carlsbad, CA 92009-1915 (619} 438-1161
J~RjSS,-. , . AV, ST.RD. THOMAS BRO$ NO, !DATE OF APPLICATION I BUSINESS LICENSE# VALUATION PERMIT NUMBER
~E/14 LOI<!~ AVE. e>l-Dl:::i. c... ~--JA-f-\~ /mo tJ (p
LOT BL019: · 1 suac~.!.V.ls10N) I ~SESSOR PARCEL~-CONTRACTOR coNTRAc·ToRs PHONE# zoNE id. Io-f I01ll l11I:, . -,ca-2 ·/~~~ I -z,-~ ..,, u11 i_1 ii=:..h ; ?I"". 1..., .,,..,, O
owNER's NAME I owNER's PHONE 1ni:;; 1 1:./1·. , -~c..·,u,u b~'\/l':ON ~ f.,c.f2:r1.1Ee::, , 14. ~-·~ coNTRAcToR·s ADDRess ~o sTATE LICENSE No. BUILDING so. FOOTAGE
OWNER'S MAILING ADDRESS . ...~uo~oL.ltnr~J~,A,~lLk-...!!~~~l!~~~~'.!.T__Jt!)·~·..e.~16.~,~~-------!--------1-----------l -4l'\'\ GAMPlf::,PfZl\1£ ~ e~o DESIGNER. =~--:-: DESIG::R·SPHONE
DESCRIPTION f'~~ORK . l),ll~.JI J ~~\)l'f2N/l'tJ..,,P ~• ou~ \lt\JiN;t:;.r., I ..A Gl2115 Des1GNER's ADDREss STATE LICENSE No:
, 1 ii.--..... r 21 w1~00tus rn~, N,,.,A., t< 5/.52A'JeN•r>A-eNt:-1,I\JA-~ 1376 oa,10,ss 0001 01 02
\.. • • _ • F/P FLA ELEV. sTi~Es occ GP EDu BldPot 41-0(
YO NO --
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CENSUS TRACT I PARKING SPACE RES UNITS I GRADING PERMIT ISSUED I RtDEVELOPMENT TYPE occ LOAD FIRE SPR AREA CONST
y O N O YO NO YO NO Not Valid Unless Machine Certified
QTY. , PLUMBING PERMIT. ISSUE 7~ QTY. MECHANICAL PERMIT -ISSUE /5; e SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP INSTALL FURN, DUCTS UP TO 100,0QO ~TU tiUILDINu PERMIT u01·81U-00·00-8220 ~.-,..._ .
EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT 001-810·00·00-8221 ~
EACH WATER HEATER AND,OR yENT BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 001-810-00-00·8891 / L!1'
EACH G.A.S SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING 001·810·00·00·8222
EACH GAS SYSTEM 5 0 R MORE METAL FIREPLACE ELECTRICAL 001-810·00-00·8223
EACH INSTAL, ALTER, REPAIR WATER PIPE VENT FAN SING LED UCT MECHANICAL 001·810·00·00-8224
EACH VACUUM BREAKER MECH EXHAUST HOOOIOUCTS MOBILEHOME 001·810·00·00-8225
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER SOLAR 001-810-00-00-8226
EACH ROOF DRAIN (INSIDE) DRYER VENT STRONG MOTION 880·519·92·33 ,,_,.-
TQl/;L MECHANICAL FIRE SPRINKLERS 001-810-00·00·8227
TOT AL PLUMBING I PUBLIC FACILITIES FEE 320·810-00-00-8740
. [5V . BRIDGE FEE 360-810-00-00-8740
QTY. ELECTRICAL PERMIT -ISSUE ;e; QTY. MOBILE HOME SETUP PARK-IN-LIEU (AREA l
NEW CONST EA AMP'SWT BKR CAR PORT TIF 312·810-00-00-8835
1 PH 3 PH AWNING LA COSTA TIF 311-810-00-00·8835
EXIST BLOG EA AMP/SWT.'BKR GARAGE FMF
1 PH 3 PH LICENSE TAX 001·810-00-00·8162
REMOOEL'ALHR PER CIRCUIT MFF 880-519-92-57
TEMP POL~ 200 AMPS
OVER 200 AMPS
TEMP OCCUPANCY (30 DAYS) _ .-
CREDIT DEPOSIT f Fl l.----
TOT AL, ELECTRICAL I TOTAL TOTAL FEES PAYABLE I -l/-/ ,
I HAVE CAREFULL y EXAMINED THE COMPLETED "APPLICATION AND PERMIT" AND DO HEREBY Expiration. Every permiUssued by the Building Off1c1al under the prov1~10nsof this * AN OSH" ~,T IS QUIRE~ FOR EXCAV"T10NS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code ~hall expire by llmita!ion 8nd become n~II and void It the building or work 5' O" DEEP AND OUTION OR CONSTRUCTION OF authonzed by such permit 1s not commenced within 180 days from the date of such DECLARATIONS ARE TRUE AND CORRECT ANO I FURTHER CERTIFY AND AGREE'IF A PERMIT lb permit. or if the building or work authonzed by such permit ,s suspended or STRUCTURES ER 3 STORIES IN-HEIGHT
ISSUED; TO-COMPLY WITH ALL CITY. COUNlY AND STATE LAWS GOVERNING BUILDING CON-.abandoned at anv time after the work 1s commenced for a oenod of 180 davs ~
STRUCTION. WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND , 0 0 APPROVED BIDdp~ • ,,.~ :/: KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL UABILITIES, JUDGMENTS, COSTS AND APPLICANTS SIGNATURE lf. OWNER CONTRACTOR :.. ', ': · .-DJ 8 EXPENSES WHICH MAY IN· ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE /i) _"' • a~ ,.. • Mf'I f1 -_. A BY PHONE O ' . . , .
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GRANTING OF THIS PERMIT. ~1,,V"V"""" L1• ./d'J~ J O (}
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