HomeMy WebLinkAbout2775 OCEAN ST; ; 81-190; PermitLICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provi•
sions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Profes-
sions Code, and my license is in full force and ef-
fect.
OWNER·BUILDER DECLARATION
:::'-I 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 repair any
structure, prior to its issuance also reQuires the
applicant for such permit to Ille a signed state-
ment that he is licensed pursuant to the provi·
sions of the Contractor's License Law (Chapter 9
commencing Wilh 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 tor a permit subjects the applicant to a
civil penalty of not more than five hundred dollars
($500).
['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 of-
fered for sale (Sec. 7044, Business and Profes·
sions Code: The Contractor's License Law does
not apply to an owner of property who bul\ds or
improves thereon and who does such work
himsell or through his own employees, provided
that such improvements are not intended or of·
fered 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)
::: I. as owner of the property, am exclusively con-
tracting with licensed contractors to con.struct
the project (Sec. 7044, Business and Pri
·~',' Code: The Contractor's License Law\!o•
ply to an owner of property ·•ho ~,ilds
proves thereon, and who contracts lo
jects with a contractor(s) license purs
contractor's License Law).
\ am exempt under Sec .. ___ ~
for this reason _____ _
Date Owner
'rim·
1 pro
ot
PC~
~
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of con·
sent to sell-insure, or a certilicate of Workers·
Compensation Insurance, or a certified copy
thereof (Sec. 3800, Labor Code).
POLICY NO. ____________ _
COMPANY ____________ _
[.'Copy is filed with the city.
,-Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS" COMPENSATION INSURANCE
(This section need not be completed if the per·
mil is for one hundred dollars ($100) or less).
I certify that in the performance of the work for
which this permit is issued, l 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•
tilicate 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
l hereby affirm that there is a construction len•
· · ·-"ormance of the work for ---~ "'"" ,.._..,~,
CITY OF CARLSBAD-BUILDING DEPARTMENT
USE BALL POINT PEN ONLY APPLICATION & PERMIT
1200 ELM AVENUE (714) 438-5525
APPLICANT TO FILL IN INFOR-
MATION WITHIN RED LINES.
NO, JOB ADDRESS AV.ST, DATE OF APPLICATION PERMIT NUM8ER
l1;7,71->1 ,Qc.,e;:,,:,.,,'(, ,8,Ltf',(), I I I I I I I I I I 1111IR1° L{.,.....fu-S\
OWNER OWNER'S PHONE
1 1..\-. ,~,,,-..,£..( py·;~::~::CT~ ~s·!, v&s}
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OWNER'S MAILING ADDRESS 2., '§ > ~ c~~l.... "l 200 i .
CONTRACTOR'S ADDRESS
lj.£T [_BLOCK I S~~91V.Ji5104 / ,J .~ ASSESSOR'S PARCEL NO, r
iel'.i',,<,jO (//o/-1/,;l. ~_/7 __ -J"'_54,.,/t,}d, D_,:3_1 I ;:), 'l10. I/), :;l_, •
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CONTRACTOR'S
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DESIGNER
Sf'AS ~.71/4-'fqy 7
STAT'E LICENSE
DESIGNER'S PHONE
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CENSUS TRACT GP LANO USE ZONING{ • (_ ;___;:.;;....-UN ITS "·
•
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I '" l PARKING SPACE l NUM8ER OF STORIES
Not Valid Unless Machine CMtified
8LDG SQ. FT, BLOG USE occ. o, l su,oAao ecAS • l':s;";~i:31 l TYPE CONST l acc. LOAD I
OTY./ PLUMBING PERMIT AMT. OTY. MECHANICAL PERMIT AMT. ~~
1 EACH FIXTURE TRAP . INSTALL FURN. DUCTS UP TO 100,000 BTU . ~:_// i . ) ~ '//
EACH BUILDING SEWER . OVER 100,000 BTU . _ 7 " ,-·
1 / EACH GAS SYSTEM 1 TO 4 OUTLETS Y'; BOILER/COMPRESSOR 3-15 HP • / /'" / '
' EACH GAS SYSTEM 5 OR MORE • BOILER/COMPRESSOR 16·30 HP . ~~
/ EACH WATER HEATER ANO/OR VENT ").,1: BOILER/COMPRESSOR UPTO 3 HP ~ ,/ ~)le,,... ....
_/ EACH INSTAL., ALTER, REPAIR WATER PIPE ~ VENT FAN Sl~!GLE DUCT -~ /, I fl ""7"1
EACH LA_WN SPRINKLER SYSTEM MECH EXHAUST -HOOD/DUCTS /'0 "1) 1 ,.,.,,4.J 1a,,111'"
WATER SOFTNER I II I RELOCATION OF EA FURNP.CEIHEATER I II BUILOING PERMIT "/
CONTRACTOR
J
TOTAL PLUMBiffa
,, '
OTY. ELECTRICAL PERMIT
./ NEW CONST EA AMP/SWT/BKR -, 1 PH .25 3 PH
EXIST BLDG EA AMP/SWT/BKR
1 PH .25 3 PH
REMODEL/ALTER PER CIRCUIT
TEMP PO LE ZOO AMPS
OVER 200 AMPS
TEMP OCCUPANCY (30 DAYS)
n
J ..,. ./!\ J. b
TOTAL ELECTRICAL
CONTRACTOR
3.00 -lhi
9 -~NTRACTOR
TOTAL MECHANICAL
AMT.
.-,;, .....
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OTY. MOBILE HOME PERMIT
AWNING
PORCH
SET-UP
RAMAOA, CABANA
FENCE OVER 6'
TOTAL MOBILE HOME
~ 3 ,. 0
AMT.
;/~ I I 11
SIGN PERMIT
PLAN CHECK
ALL INCLUSIVE PERMIT
TOTAL PLUMBING
ELECTRICAL
MECHANICAL
MOBILE HOME
SOLAR
"-7 "If O t'IJG ,n o-t-t Qn..J
MICO-F I LM
TOTAL FEES PAYABLE I
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I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT, ANO DO
HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE ANO CORRECT ANO I
FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED.'TO COMPLY WITH ALL CITY,
COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER
SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM·
LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE
"AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER
5'.Q" DEEP AND OEMOLlTION OR CONSTRUCTION OF
STRUCTURES OVER 3 STORIES IN HEIGHT
/),h A /j -
1#~/i1!r1
OF THE GRANTING OF THIS PERMIT. APPLICANT'S SIGNATURE" OWNER□
AGENT M
-// CONTRACTOR□ IA'7"J?"ff .~.
BY PHONE O y //// d,{,()l,
DATE
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le ~ ~
5 ;:::
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SITE 2\-\11V i
ADiRESS: \ OWNER: PERMIT NO:
FIELD INSPECTION RECORD
INSPECTION DATE INSPECTOR INSPECTOR'S NOTES
WOOD FLOOR
FOUNDATION• FORMS• SET BACK• TOILET
UNDER FLOOR PLUMBING
UNDER FLOOR HEATING
OK TO INSTALL SUB FLOOR
SLAB FLOOR
UNDER SLAB PLUMBING
FOOTING• FORMS• SETBACK• TOILET
OK TO POUR CONCRETE
FRAME
ROUGH ELECTRICAL
ROUGH PLUMBING
ROUGH HEATING/VENTILATING .
FRAME OK• PLACE INSULATION
INSULATION OK • PLACE WALLBOARD
WALLBOARD OK• PLACE TAPE
EXTERIOR LATH OK • PLACE STUCCO
FIREPLACE
DAMPER &STEEL
PLATE TIES/HEIGHT OF CHIMNEY
OTHER
TEMP POWER (POLE)
SEWER
GAS TEST
SWIM POOL • STEEL BONDING
• PRE DECK
• FENCE PREPLASTER
SHOWN • FRAME
• PAN
FINAL INSP BY BLDG DEPT
\ OTHER DEPT'S REQ COMPLETED
ELEC METER PERM TEMP i ri /
: .::;As METER-PERM 1EMP I 'Ayy' A
11 \A -1 V V
l i V
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l_?ERT OF OCCUPANCY ISSUED
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John P. Landry Inc.
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206e 714/729-8974 A 9'.f\ /(i)
CONFERENCE
REPORT.
ARCHITECTURE • PLANNING f V & v-
~----c ~ ,£';:>µ 91 RE:~~ ~ (PC~, . PROJECTNO. 7et)4./~
RECEIV ED
TO: ~ ~~ APR 1 7 1981
FROM B!L.v BCOTH CITY OF CARLSBAD
DATE 4 ·/{p·8I Building Department
COPIES .JEP,(J-'/ ,z.. I TCNY HJ. I rlL-e --------------------------
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'BUILDING DEPARTMENT DATE: :-!E CEIVE D
'°'iuILDING ADDRESS: .2 7}S-Vee..a.,._J
,,A-p,,,/ dl" 3-,;i.35--0~
PLANNING DEPARTMENT
APR lo 1981
CITYOF-CARLs BUIRllng bti,a,iap
ZONE _________ LOT S IZE _________ LOT WIDTH ________ _
:::::N:L:::::-S-R_E_Q_U_I_R_E_D ___ 0_1[_,__UNITS PRO:::::-D-E-D======/5==~~~----_-_-_-_-_-_-_-_-_-_-_-
% COVERAGE ALLOWED ____ _:t:1::..._~~------PROVIDED ___ CJ, _______ _
BUILDING HEIGHT ALLOWED PROVIDED __________ _
FRONT SETBACK:
ALLOWED !J\~
PROVIDED ---~---
INTRUSIONS
SIDE SETBACK:
ate
LANDSCAPE & IRRIGATION PLAN COMMENTS:
ENVIRONMENTAL PROTECTION REQ:
OK TO
ENGINEERING DEPARTMENT Va~,.,,r;;...J:
REAR SETBACK:
D/¢
R.o.w. ______ INDUSTRIAL WASTE _______ IMPROVEMENTS _______ _
SEWER CONNECTION ________ DRIVEWAY LOCATIONS ___________ _
GRADING PERMIT~/;.~IJ~~~~J;,_ ____ EASEMENTS_~~------DRAINAGE
LEGAL DES CRIPTION---,,/4a.~""CJ.<-.=3'--',r--'-'~~½.,_,/c....¥_½'-",;>_=--__,_f.lr...:..::.::.,~_,./4tl!==--..~e:.=~-· ------
4:: (3 -B ) PWI ____ OK TO FINAL ____ DATE ___ _
FIRE DEPARTMENT
SPRINKLING SYSTEM ___________ FIRE PROTECTION EQUIP. _______ _
FIRE ALARMS EXITS _______________ _
FJRE HYDRANTS LOCATION _________________ _
A~P.lTIONAL COMMENTS
OK TO ISSUE: _____ DATE _______ OK TO FINAL ______ DATE ____ _
WATER DEPARTMENT
REQUIREMENTS OF APPROPRIATE DISTRICTS MET ________ DATE ________ _
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POOL
DEPA~TM OF PUBLIC HEALTH
DIVISION O NVIRONMENTAL SANITATION cou I OF SAN DIEGO, CALIF.
ROVISIONAL APPROVAL
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