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Home My WebLink About2775 OCEAN ST; MULTI-PERMIT FILE; 84-323; Permitr// z 0 .: C IIC ~ u Ill 0 IIC Ill 0 -' 3 ~ Ill z ~ 0 z 0 .: C UI z Ill A. :lE 8 Ill a: Ill ..: IIC 0 3S O I hereby affirm that I am licensed under provlalons of Chapt8f 9 (commencing wltll Section 7000) ol Division 3 ol the Business and Profeeslons Code, and my llconse is In lull force and effect. ~ 3 ~ Lie No~.fi'y(~ass __ t h~~\ ~ l"'exempt from Ille Contrac· tor's Uamse law for the lolfowing mson (Sec 7031.5 Business and Professlons Code: Any c,ty or county which re· quires a peon,t 10 construe!, aller, improve, demolish, 01 re~r any s1ruc1ure. prior to llS Issuance also requires the ap-r,:.,:«i rorp~:.~t :~/'~~ :-t:-i~i:a.!c':.!! License f.3\0/ (Chal)ler 9 eanmenclng with Se,:flon 7000 ol DMsion J ot the Business and Protessions Code) or !hat ls ex· empl therefrom and lhe basis tor the alleged e<empflon. Any violation of SectlOn 7031.5 by an applicant lor a permit sub- jects the appiicanl lo a civil penally ol not more than five hun• dred dol!als IS500) □ I, as owne, of the properly, or my employees ,.,th wages as their sole compensation, w,11 do the work, and the struc· lure is not Intended or o!fered lor sale (Sec. 7044. Business and Proless,ons Code: The Contractor's license Llw does flOI apply to an owner ol ptoperiy who builds or Improves lhe<eoo and wllo does such -k himseH or through his own employee$, pnMded lhat such lmprOY8menls are not Intend-ed or o!fered lor sale. II, hoWeY!f, lhe bUltd1ng or lmprove- menl is sold wi1h,n one year ol completion, the owner·bullder will have the burden or proving that he did not build or im· prove tor lhe purpose ol sale). □ I, as owner ot lhe p,ope,ty, am exclusively contracting th licensed contr2CIOIS to construct the project (51!1:. 70«, Business il1cl Professions Code: The contractor's Ucense ~~:~:'~~~P~~J•;to~o'::J1fr1':'~ct~:~~s ,:n~m~ con1rac10r(s) Ucense pursuanl 10 lhe Conlractor's License law). □ -'• a llomeoWner I am imprO\'lng my home, and the follow- !~ conditions oxlst: 1, The work is being pertormed prior to sale. 2 I have lived in my home for twelve months J. r:: :ri:~or t~I: :;ption during the last lhrae years. □ lamoxemptunderSec. ______ , B& P.C. for this reason ___________ _ □ I hereby affirm that I hai.,e a certificate ot consent to self-insure. or a cer11ftcate ot Workers· Compensa11on Insurance. or a cenifted coc,y lhereot !Sec 3800. Laoor Code) POLICY NO ____ _ COMPANY D Copy is hie<! woth !he c,ty D Cer1olie<I c~by lu,n,she<I CERTIFICATl OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This sectton neeo not De completed •I !ht permit is 10< one hundred <lolla,s (S100J or le55) O I cert,ty that in the per1ormance of 1ne won< IOJ which ltns permit Is issued, , shall not employ any person In any manner so as lo become subIecl 10 lt'\e Wor'ker:f Compensat,on Llws of CaJ1fom1a NOTICE TO APPLICANT If. lllte, malun1 1n,s Cem t1c:ate of Exemptton. you shOuld become subject ,.., the Workers· Compensation pro'W1stons ol the LaboJ Code, you must forlhwith comply wnn sucn provIs1ons or u·us permit SP\all be deemed revoked 0 I hereby affum inat lhe,e 1s a conslruct1on lend,~ agency lo, 1he perlOfmance ot 1he '#0111. for wh,ch !his c,e,mu •S lSSued (Sec. ~7. Cn,il Code} Lenders Name __________ _ Lender·s Adc:l1·ess _________ _ USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMI,-, 1gt1 1200 Elm, Carlsbad. California 92008-1989 (619) 438-552.5 JOB A0OflE~ (!) ~ _{) 0.. Y\ A~iTri: l;L~r;:r1 BUSINESS LICENSE It VA UATION fr• PERMIT NUII/IBEfll ffc-_ ( / ~ 71 S . 323 OWNE fl'S NAME Hnt .)Q rt d , f"\nv.:-I OWNER'S PHONE 1\ ')c:~rh0 ~ l l '\ CONTil"CTOIIS PHOl'IE • ZONE l'l Hu 7:2.C, -.:2 J 3d J~/-3ooCJ OW;r7Al~i~ORE~o os e U e.--l + ~r.;~Tol~o~:; L{ 1<{. LICENSE NO. PLAN I.Q. Jj ,/ ,ti BLOG USE CODE :'::i</,(cq j(p LOT BLOCK I SUBDIVISION I ASSESSOR PARCEL NO. DESIGNER ' LICENSE • STAND"J>,R0 PLAN # BUILD1NG SO. FOOTAGE DESCR IPTION OF WORK DESIGNER'S "O0RESS DESIGNER'S PHONE 1 t.1r:: eK-il.ejM-_ -F/P FLA ELEV. NO DCC GP EDU STORIES v□ NO --- CENSUS TRACT I GP LANO USE I PARKING SPACE I RES UNITS l GRADING t=:ERMIT ISSUED I REDEVE LOPMENT TYPE OCC LOAD FIRE SPA AREA CONST YO N 0 vO NO vO NO Not V1/id Unlttss Machine ~rtifil!d QTY. PLUMBING PERMIT· ISSUE 7~o QTY. MECHANICAL PERMIT· ISSUE ,d,,Od SUMMARY/ACCOUNT NUMBER -EACH FIXTURE TRAP INSTALL FURN, DUCTS UP TO 100.000 BTU BUILDING PERMIT 01 ·00-00·8220 EACH BUILDING SEWER ' ' I OVER 100.000 BTU SIGN PERMIT 01 ·00-00·8221 I EACH WATER HEATER ANO/OR VENT / .5C:) BOILER /COMPRESSO R UP TO 3 HP PLAN CHECK 01 ·00·00·8806 EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER /COMPRESSOR 3-15 HP TOTAL PLUMBING 01 ·00·00·8222 I< VJC) EA CH GAS SYSTEM 5 OR MORE MET AL FIREPLACE ELECTRICAL 01 ·00·00-8223 EACH INSTAl .. ALTER, REPAIR WATER PIPE VE T FAN SINGLE DUCT MECHANICAL 01·00·00·8224 EACH VACUUM BREAKER MECH EXHAUST -HOOD/DUCTS MOBILEHOME 01·00·00·8225 WATER SOF TNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP EACH ROOF DRAIN (INSIDE) SOLAR 01 ·00-nn-R?2fi TOTt;L MECHANICAL STRONG MOTION 80·92·33·0519 TOTAL PLUMBI NG I I ('l-n1 "") FIRE SPRINKLERS 01 ·00-00-8227 -QTY. SOLAR • ISSUE PUBLIC FACILITIES FEE 32·00-00·8923 QTY. ELECTRICAL PERMIT· ISSUE !:> .,IJo BRIDGE FEE NEW CONST EA AMP/SWT IBKR COLLECTORS SCHOOL FEE • DISTRICT 1 PH 3 PH STORAGE TANKS Carlsbad 80·92·21-0519 EXIST BLOG EA AMP/SW T /BK R ROCK STORAGE Encinitas 80·92·22·0519 1 PH 3 PH PUMP San Dieguito 80·92·23-0519 REMODEL/ALTER PER CIRCUIT PLAN CHECK i'EE Sao Marcos 80·92·24·0519 TE MP POLE 200 AMPS OVER 200 AMPS /-'{/ / -TEMP OCCUPANCY (30 DAYSI -- TOTAL ELECTRICAL I TOTAL SOLAR TOTAL FEES PAYABLE I 10.00 I HAVE CAREFUU Y EXAMINED THE COMPLETED "APPLICATION AND PERMIT" AND DO HEREBY Expiration. Every ~rm,t •-t,y Ille Bu1tdlng OH1c1al under Ille cro•os1ono of ll'los * AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVEA CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING TliE Code shall expire by llmttalion and beco,,,. null and vo,d If the ulldinf. or worl( S' O" DEEP AHO DEMOUTION Oft CONSTRUCTION OF DECLARATIONS ARE TRUE ANO CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS author,ze<f by ouch permit IS not commenced within 180 daya from the da e of such STRUCTUAES OV£R 3 STONES IN HEIGHT permit. or 1f the bUildl~ work aulhorwad by auch pe,m,t is suspended or ISSUED TO COMPLY WITH ALL cnv. COUNTY AND STATE LAWS GOVERNING BUILDING CON• abandoned It anv 11,,,. a tile work IS com-.d for• ~oc1 of tBll "-· ~ STRUCTION. WHETHER SPECIFIED HEREIN OR NOT t ALSO AGREE TO SAVE INDEMNIFY AND Arc:T; :A:l\ ~ OWNER 0 CONTRACTOR.j2f-, APPROVED BY DATE KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS. COSTS AND ' -€:J _ EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE BY PHONE 0 rC-1'3-J'J GRANTING OF THIS PERMIT. u 'v (!) u:: >-iii ... 0 C. E Q) I- I 'O 0 C, c <II E a. C. < I .:,,: r:: a: i5 rn rn Q) rn rn < I 3: .2 Q) >- tll ai D # §: (!) u r:: <II r:: u:: r:: Cl) (!) a 0 0 (!) C. rn r:: INSPECTION TYPE DATE INSPECTOR BUILDING - FOUNDATION REINFORCED STEEL MASONRY GUNITE OR GROUT ,, FLOOR & CEILING SUB FRAME SHEATHING ' - FRAME EXTERIOR LATH lNSULATION '' .. INTERIOR LATH & DRYWALL PLUMBING I ,.L -- SEWER AND BL/CO PLUMBING UNDERGROUND PLUMBING TOP OUT TUB AND !:;HOWER PAN GAS TEST - ELECTRICAL ' I TEMPORARY POWER ELECTRIC UNDERGROUND l ROUGH ELECTRIC I ELECTRIC SERVICE BONDING 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 HAVE BEEN APPROVED. JOB SITE FINAL PLUMBING ELECTRICAL 1 I MECHANICAL ,,........, ~ 1 I GAS ..1 1/l I BUILDING ~ Xi { I),/ SPECIAL CONDITIONS ( II{/- CERT OF OCCUPANCY ISSUED V \,, V ' 8 ,. 3:;:). <i ) FIELD INSPECTION RECORD REQUIRED SPECIAL INSPECTIONS INSPECTOR"S NOTES INSPECTION REQ IF INSPECTOR'S DATE CHECKED APPROVAL 0 SOILS COMPLIANCE PRIOR TO ' FOUNDATION INSP STRUCTURAL CONCRETE OVER 2000 PSI PRESTAESSED CONCRETE POST TENSIONED CONCRETE ,, FIELD WELDING HIGH STRENGTH . BOLTS SPECIAL MASONR\' I ~ • PILES CAISSONS t, . - . ' • . . ' -~ - ,__ . -I •. r I,~ •' ···,. • ,i; I ,NSEj eby I ~, ct >I DI :ode, OW\ eby i 's Lil 031.5 · coJ alte Jre, p ant le that I of 1h~ encln ,slnet thereI on. At 11 for .,nal S OWi wage! orf<, for s . Codf pply I )Y8S off or such for s1 is SC w-bul~ Id no! ,s owr Ing irojec ,:The o a.n JS th~ with actor 1m exl 1ls rec >RKE 1ereb) lo SI pens1 101 (S ICY N IPAN' >PY is 1rtlfle CE.F l'ORK his St s for ,ertlll :h l~il 0n1nl Norl<l 'ICEl ateol 18 wi Jr Cd f&fon co Ill z 0 ~ a:: C ..J f,,) Ill 0 -1[ ~ 0 f,,) z 0 ~ en z Ill a. 2; 0 f,,) Ill a: Ill :.:: a: 0 3 I J, ~BALL POINT :'EN ONLY • PRESS HARD 0 I hereby .,llm1 that I em~ u: f jlll)Yf&lona of Chapter 9 (commencing with Section 7000) of Division 3 01 the Business CA, CARLSBAD BUILDING DEPARTMENT £\PR APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA ANO .LARATIONS. • I APPLICATION & PERMIT and Profeaslona Code, and my license Is In full force and effect. L,c No. _____ Class ____ _ I he<wby att,rm thal I ..,, exempt Imm the Con-~:~-~~=;:' ,:.~,::.:i:~;e;~I~ county winch raqoon,s a pe,n,11 lo cons1f\JCt attl!tf. irnp,oye, demolish. « ~r .-iy structure, prlo< IO Its issuance also requlrn the applicant tor such permit to lile a signed sutement that he Is lice-pu~t to the pro¥1StonS of the Con-tractor" s license uw !Chaplet 9 commencing with Sect,on 1000 of Otv,s1on 3 of lhe Business and Pro- fessions Code> or thal is exempt therelr0111 a,,ct the basis lor the alleged exemptl()fl, Any vlol,llion of Section 7031.5 by an IPl)licant lor a permit su!Jt«ts me applicant to a CIVIi ~ty of not"'°"' than ,,..., hundred dol!Ms (S500I. □ I, as owne, ol the propeny. or nw employees •ilh wages as their sole compensatton-. ...-,11 do lhe ..o,1,.. and the structure ,s no1 lntaoded or otfenod for sale lSec 10W. Bu$lneM and ProlesslOlls Code· The Contraclor"s License uw aoes not apj)ly to an owne, ol proper!)' who builds or improves thereon and who does such wen himself or thlough h,s own employees. provided thal such 1mproveme.~1s are N>t int.ende-:1 or ollered for .ale II, however, the buttding or tmpr.OYement 1s sold wdtim OfM!-yea, ol cornptet,on, the owner,bu1lder w,11 -the bu1'lell of proving that l'Mt O•d not burld or improve for the wrpose of sale) . D I, as owner of the property, am e11:clusivety contractmg with lteensed COl"ltr~tors Lo coosU\JCI the P'OJ9CI (Sec. 10W. Bus,neu and Proles.stOnS Code: The Contractor·$ License uw does not apply IO an owner of property who builds or improves =,~ ti:ne:1~~ ~~~t!'~~~;::-: license uwl. 0 famexernpl underSec. ___ , B & PC fortru!;rea5Qn _________ _ -- t'I I hereby affirm 1roa1 I ha,e a cert,t,cate ol consent HI self-insure, or a certificate of Workers· Compens.allOf'l lnsurattCe. or a cenit1ed copy thereof (Sec. 3800, Labo< Code) POLICYN0 __ COMPANY ___ _ O Copy ,s t,led w1tn the c,ty. □ Cert11ted copy ,s hereby lurn1shed CERTIFICA Tl OF EXEMPTION FROM WORKERS" COMPENSATION INSURANCE (Ttus section nee<1 no·1 C>e completed 11 lhe permII •• tor one hundred dollars 1$100) or less> 0 I certIly that m the performance of the wori< lo, whK:h this pem,it 1s ,ssued, l shall noi empl0y any pef'50f'I 1n any rnat1r.et '50 as co become subjecl lo lrte WMet5' Co,npen~tt()f'I u -ws ol ~htom.a NOTICE TO APPLICANT 11, atter mak,n~ thos Cet!• fie.ate ot Exemplton, you should become :sut)Jec1 t") the Workers' Com~saJtO(I ptov1s10ns ot the Labor Code. you must fonhw, h comply with s~ provtsions o, u·us pe:rrr111 shall be oeemed ,evoke<J O I hereby affirm lhat there ,s c11 cons1ruc1~n 1e.nd1ng ~ency to, the perto,mance ot lhe woriL lor which ttus permit 1s issued {Sec 'ml, C1v1I Code) Lende< s Name _________ _ l ender·s Address ________ _ . , 1200 Elm, Carlsbad, California 92008 (714) 438-5525 JOB AODRESS "-" sT., °""Te°" .IO'PL'lcATIONI ~w;,l;NS£1t VALUATION PERMIT NUMBER .:l??< 0~7rµ IIO. &,-~rz-:Y OWNER'S NAME l OWNER•s PHONE PRIME CONTflACTOftl OONnlACTORS fltt0NE. ZONE ~317 NI.IV /.Iv, .. ~ ---h,ve,-~ 7~q_2,;z...3cJ ,,Vt.t 17-rN~ J ~"714.,,,q'" 7~;l.-300o OWNER'S MAILING ADDRESS CONTRACTOfl'S AODMSS UCENIENO. PLAN I.O. # BLDG USE CODE 3-7~ Roose-U€(..;.r 'Jo 7 !k :~ o. (!! ... ( .. EW:V __, b LOT I BLOCK r SUBOIVISION I ASSESSOR PARCEL NO. OESIGNER STATE LICENSE It STANDARD PLAN # BUlLDtNG SQ. FOOTAGE DESCRll'TtON OF WORK ~~'JP& 61 1 I 7 11 l □h DESIGNElfll'S ADDRESS 0£SIGNER'S PHONE ~O~EO If 61 TTi7 ae I 0.1 . /.1 )R7e:"';e l¼--7?-r~ )2<!::77f~~~'1'-1 7 --F/P FLR ELEV. NO OCCGP EDU STORIES vO NO --- CENSUS TRACT I GP LAND USE I PARKING SPACE I RES UNITS I GRADING f'.ERMIT ISSUED I REOEVEL0PMENT TYPE OCCLOA0 FIRE SPR AFIEA COI\IST YO NO vO NO vO NO Not Valid Uner MilchiM <Artifitld QTY. PLUMBING PERMIT · ISSUE ?,,~ QTY. MECHANICAL PERMIT -ISSUE SUMMARY/ACCOUNT NUMBER EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO I00 ,000 BTU BUILDING PERMIT n1-Mn.422n EACH BUILDING SEWER OVER 100.000 BTU SIGN PERMIT 01·000-4221 I EACH WATER HEATER AND/OR VENT !JI ~ BOILER/COMPRESSOR UP TO 3 HP Pl.AN CHECK 01-000-4806 EACH GAS SYSTEM I TO 4 OUTLETS BOILER/COMPRESSOR 3 15 HP TOTAL PLUMBING 01-000-4222 //'i~5V EACH GAS SYSTEM~ OR MORE METAL FIREPLACE ELECTRICAL 01 ·000-4223 EACH INSTAI, •. ALTER. REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01-000-4224 EACH VACUUM BREAKER MECH EXHAUST HOOD/DUCTS MOBlLEHOME 01·000·4225 WATER SOFTNER RHOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP EACH ROOF DRAIN ( INSIDE) SOLAR 01-000-4226 TOT.GL MECHANICAL STRONG MOTION 65-640·0519 TOTAL PLUMBING T /().~0 FIRE SPRINKLERS 01 -Mtl.4227 QTY. ELECTRICAL PERMIT -ISSUE QTY. s~~ PUBLIC FACILITIES FEE 25·000-4933 BRIDGE FEE NEW CONST EA AMPISWT/BKR CSJU.E~~..,,,-7 SCHOOL FEE • DISTRICT 1 PH 3 PH .c~OE-~ LC"\ Garlsbad 65-623-0519 EXIST BLOG EA AMP/SWT/BKR ..... ~R~J,.Y Encinitas 65-624·0519 1 PH 3 PH f -.V/ J>U,W' ~ SanOieguito 65-625·0519 REMODEL/Al TEA PER CIRCUIT ~/, N,KHECK FEE San Marcos 65-626-0519 TEMP PO LE 200 AMPS V/ /l -V OVER 200 AMPS ·<c,;...... \v TEMP OCCUPANCY (30 DAYSI V - TOTAL ELECTRICAL l TOTAL SOLAR TOTAL FEES PAYABLE I /0 -~ I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION AND PERMlr' ANO 00 HEREBY Exl)lratiOn ~perlllll--byltleBuldlngOIJICialundarU.=iiflllie * AN 011M PEMIIT 15 REQUIIIED FOR EXCAVATIONS OYER CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code Sllall expire by llllllllllan and i.o-null Incl tfOld If 1M or wm11 5• tr DEEP ANO DEM0U1l0N Oii OONSTRUCTION o, DECLARATIONS ARE TRUE AND CORRECT ANO I FURTHER CERTIFY AND AGREE lF A PERMIT IS IWlhortzed by IUCII parmll • •-ocedwllhin llOIMyafrom the of 9Udt STIIUC1\NS OV£fl 3 STONES• HEIGHT parmi~ or ,1 a. =:z.,or worti ..-tDd by 9IICh ~ le or ISSUED· TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING BUILDING CON· at>an-a1 -time ._ worti •-•-~tor a -ar 11111 --. STRUCTI0N WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND A~S SIGNATURE • '-' /../ -OWNER□ ~ ~PROVED BY ~ 1°3/tw/7 KEEP HARMLESS THE CITY OF CARLSBAD AGAINST AU LIABILITIES. JUDGMENTS. COSTS ANO CONTAACTu- EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE .,,,~I_,,.,. -8YPHONE 0 GRANTING OF THIS PERMIT ... ., ----- "O 0 (!) ~ <II .2 a. a. <{ I 0 rn rn (I) rn rn <{ I 3 .2 ai > rn rn (I) 0 0 a:. Ill ~ 0 §: (I) 0 C Ill C u: 0 0 (I) a. <I) C 1- 1 ___ __, ____ I SITE ADDRESS: " INSPECTION WOOD FLOOR FOUNDATION• FORMS• SET BACK • TOILET UNDER FLOOR PLUMBING UNDER FLOOR HEATING OK TO INST ALL SUB FLOOR SLAB FLOOR UNDER SLAB PLUMBING FOOT! NG • 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 Tl Es/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 OTl-!ER DEPT'S REQ COMPLETED ELEC METER-PERM-TEMP GAS METER-PERM-TEMP CERT OF OCCUPANCY ISSUED _) -- .. OWNER: PERMIT NO: " FIELD INSPECTION RECORD DATE INSl?ECTOR INSPECTOR'S NOTES " .. --.. , -, -, ,, .. . -.. . -'. - ' . LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provl• 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 et• feet. OWNER-BUILDER DECLARATION DI 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 file a signed state- ment that he Is licensed pursuant to the provi- sions of the Contractor's License Law (Chapter 9 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). D I, as owner of the property, or my employees wltb 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 builds or Improves thereon and who does such work himself 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). CJI, as owner of the property, am exclusively con• tractlng 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 t•ho builds or im• proves thereon, and who contracts for such pro- jects with a contractor(s) license pursuant to the contractor's License Law). I am exempt under Sec _____ B. & P.C. for this reaso,._ ___________ _ Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate ~f sent to self-Insure, or a certificate of w, Compensation Insurance, or a certified thereof (Sec. 3800, Labor Code). POLICY NO I ' COMPANY l _pf \ □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- 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' Compen~l~.J;aws 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- .._ --"Qency for the performance of the work for L '"Armlt ,~ l!;,~IIM (SAr. :3097. Clvll Code). CITY OF CARLSBAD-BUILDING DEPARTMENT APPLICANT TO FILL IN INFOR- MATION WITHIN RED LINES. USE BALL POINT PEN ONLY APPLICATION & PERMIT 1200 ELM AVENUE (714) 438-5525 NO. /ll'.e.t'J.N, JOB ADDRESS ;VR~T. 10Aiol~11A;:N y~Luq< PERMIT NUMBER 2;i.151 ,S ,ti I I I I I I I I I I I I I I I I ioj-~/ OWNER OWNER'S PHONE nT~hA~Y~ 1 ''"'~b,., ,, STATE LICENSE ToN Ll 4,.\,.._.,.,'A12,..t :Soh.e.s. 0-3~ 027'85 AOOR~o Os e O e., \ + rP~R•~~S~D04/ 4 '-....: CONTRACTOR'S .,; ~2 6 Ut.:.!1/,,_ ~ .,_ ') LOT BLOCK I SUBDIVISION I ASSESSOR'S PARCEL NO. DESIGNER ST ATE LICENSE I I I I I I I I I I I 2LJl.C19l ... 'ESCRIPT_t'_"....01' wo'i_l_ .J...-~ .0 0 ~r,,o')'\'\,OJII A-411~ . .., • --,,, DESIGNER'S ADDRESS DESIGNER'S PHONE . I CENSUS TRACT GP LANO USE ZONING . I ,J r ..,, . ../,:HI 1;:::J ~ _,.LI .. I RES. UNITS jP;KINGsPACE sf I NUMBER OF STORIES Not V•lid Unless M1chin, c.rt.ifi«I BLDG SO. FT, BLOG USE occ. GP I STANDARD PLAN /I I PLAN ID /I I TYPE CONST I occ. LOAD I t. -,~/ QTY. PLUMBING PERMIT AMT. QTY. MECHANICAL PERMIT AMT. t11l EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TD 100,000 BTU EACH BUILDING SEWER OVER 100,000 BTU f \ EACH WATER HEATER AND/DR VENT -? .l'V'l 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 16-30 HP EACH INSTAL., ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT EACH LAWN SPRINKLER SYSTEM MECH EXHAUST -HOOD/DUCTS VALUATION : WATER SOFTNER RELOCATION OF EA FURNACE/HEATER BUILDING PERMIT I . I I I Issue 3.uu Issue :J •• U l SIGN PERMIT I . I I I TOTAL PLUMBING TOTAL MECHANICAL PLAN CHECK I . I I I 5.Ct> CONTRACTOR CONTRACTOR ALL INCLUSIVE PERMIT I I j ELECTRICAL PERMIT AMT. TOTAL PLUMBING I I <' Yr'\ • QTY. AMT. QTY. MOBILE HOME PERMIT ELECTRICAL I I I NEW CONST EA AMP/SWT/BKR AWNING MECHANICAL I I I 1 PH .25 3 PH PORCH MOBILE HOME I I I EXIST BLDG EA AMP/SWT/BKR SET-UP SOLAR I I I I 1 PH .25 3 PH RAMADA, CABANA I I I I REMODEL/ALTER PER CIRCUIT FENCE OVER 6' I . I I I TEMP POLE 200 AMPS TOTAL MOBILE HOME MICO-FILM I . I I I OVER 200 AMPS I . I I ; I TEMP OCCUPANCY (30 DAYS) STRONG MOTION : I I I I Tc::c-nn 2. 00 I ' I I I TOTAL ELECTRICAL TOTAL FEES PAYABLE I CONTRACTOR I I I 1.5' I<:) SCHOOL FEES: I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT. AND DO "AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I 5'-0" DEEP AND DEMOLITION OR CONSTRUCTION OF FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED;TO COMPLY WITH ALL CITY, u;~UR;S,:: ~~TO~IE}J~~ J _, IJ COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM-111,/1 LESS THE CITY OF CARLSBAD AGAINST A LL LIABILITIES, JUDGMENTS. COSTS AND -I EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. APPLICANT'S(jNATURE • ' 0"'1mrR0 CONTRACTOR□ rPPR~ fV/3 , J tff)ATE AGENT D BY PHONED I , ") ! ~ C ~ > ~ i= ~ a. Vl ~ SITE . ADDRESS: OWNER: PERMIT NO: \. r-l 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 f ' -' , ROUGH PLUMBING ROUGH HEATING/VENTILATING c• I FRAME OK• PLACE INSULATION -INSULATION OK • PLACE WALLBOARD WALLBOARD OK• PLACE TAPE . l ._ EXTERIOR LATH OK • PL ACE STUCCO -- FIREPLACE ' . . . , DAMPER &STEEL . PLATE Tl Es/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 . GAS METER-PERM-TEMP . ,. . • CERT OF OCCUPANCY ISSUED I LICENSED 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 D I hereby affirm that I am exempt from the Con- tractor's License Law for the following reason (Sec. 7031 .5,Buslness 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 file a signed state- ment that he Is licensed pursuant to the provi- sions of the Contractor's License Law (Chapter 9 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 lhan five hundred dollars ($500), 0 I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and lhe slructure 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 builds or Improves thereon and who does such work himself or through his own employees, provided that such improvements are not intended or of- fered for sale. If, however, lhe 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). '.JI, as owner of the property, am exclusively con- 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 1•ho builds or im- proves thereon, and who contracts for such pro- jects with 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 ____________ _ □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- mit is for one hundred dollars ($10IJ) or less). I certify that in the performance of the work for which this permit Is lssu_eg, 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 perm II shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction len- ... 1 .......... -......... ,, •-• • .__ ..,,...,,,..._.,..,.,...,.. .-.f tha ""'"""'I,, fn.,. CITY OF CARLSBAD-BUILDING DEPARTMENT USE BALL POINT PEN ONLY APPLICATION & PERMIT 1200 ELM AVENUE (714) 438-5525 I I I I I I I OWNER 1\0\'\I~ I -Uf"\1 ,,~ J_ ... \-,yv•-'2 OWNER'S PHONE LOT BLOCK I SUBDIVISION ASSESSOR'S PARCEL NO. I I I I I I I J I I I DESIGNER DE,<;CR \l;:T~~ Of WORK I I"\ I U 'J,h r t y ~Pn.rP~ DESIGNER'S ADDRESS CENSUS TRACT GP LAND USE ZONING l sf APPLICANT TO FILL IN INFOR- MATION WITHIN RED LINES. PERMIT NUMBER CONTRACTOR'S Plt.2.NE ") _,,77;;, ..., .. ~- STATE LICENSE DESIGNER'S PHONE ) I 80 I RES. UNITS l PA~KING SPACE I NUMBER Of STORIES Not V1/id Unless Machin, 'Clrtifi«I BLDG SQ, fT. BLDG USE QTY. PLUMBING PERMIT EACH FIXTURE TRAP EACH BUILDING SEWER \ EACH WATER HEATER AND/OR VENT EACH GAS SYSTEM 1 TO 4 OUTLETS EACH GAS SYSTEM 5 OR MORE EACH tNSTAL., ALTER, REPAIR WATER PIPE EACH LAWN SPRINKLER SYSTEM WATER SOFTNER T,-,.,,,... TOTAL PLUMBING CONTRACTOR QTY. 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/Al TER PER CIRCUIT TEMP POLE 200 AMPS OVER 200 AMPS TEMP OCCUPANCY (30 DAYS) TOTAL ELECTRICAL CONTRACTOR occ. GP I STANDARD PLAN II I PLAN ID II I TYPE CONST I occ. LOAD I AMT. QTY. MECHANICAL PERMIT AMT. INSTALL FURN. DUCTS UP TO 100,000 BTU OVER 100,000 BTU BOILER/COMPRESSOR UP TO 3 HP BOILER/COMPRESSOR 3-15 HP BOILER/COMPRESSOR 16-30 HP VENT FAN SINGLE DUCT MECH EXHAUST -HOOD/DUCTS VALUATillON: RELOCATION OF EA FURNACE/HEATER BUILDING PERMIT Issue 3.00 SlGN PERMIT TOTAL MECHANICAL PLAN CHECK CONTRACTOR ALL INCLUSIVE PERMIT AMT. QTY. MOBILE HOME PERMIT AMT. TOTAL PLUMBING ELECTRICAL AWNING MECHANICAL PORCH MOBILE HOME SET-UP SOLAR RAMADA, CABANA FENCE OVER 6' TOTAL MOBILE HOME MICO-FI LM ?-() ( TOTAL FEES PAYABLE -----SCHOOL FEES: 1 HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION ANO PERMIT, ANO DO •AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER 5'-0" DEEP ANO DEMOLITION OR CONSTRUCTION OF scrl:::s;;: 3;:Rl:S Kl:d A O 0 'I I HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE ANO CORRECT ANO I FURTHER CERTIFY ANO AGREE IF A PERMIT IS ISSUED; TO COMPLY WITH ALL CITY, COUNTY ANO STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY ANO KEEP HARM- LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. APPLICANT'S Sit TURE' • OWNERQ AGENT D CONTRACTOR□ APPROVED BY BY PHONE 0 I • I I ' I I . I I I I I I I I I , I I I ! I I . I I • I I , I I I • I I I I I I I I I I -5,. rv"l I I I I I I I I I I I I I I I : I I I I I ,.s ~' DATE I ----- SITE ADDRESS: OWNER: PERMIT NO: FIELD INSPECTION RECORD - INSPECTION DATE INSPECTOR . INSPECTOR'S N.OTES WOOD FLOOR -FOUNDATION• FORMS• SET BACK• TOILET --·- UNDER FLOOR PLUMBING UNDER FLOOR HEATING , i OK TO INSTALL SUB FLOOR . SLAB FLOOR UNDER SLAB PLUMBING -- FOOTING • FORMS• SETBACK• TOILET OK TO POUR CONCRETE FRAME ROUGH ELECTRICAL ., ROUGH PLUMBING ' I ROUGH HEATING/VENTILATING . FRAME OK• PLACE INSULATION . INSULATION OK • PLACE WALLBOARD WALLBOARD OK• PLACE TAPE EXTERIOR LATH OK• PLACE STUCCO .. I . FIREPLACE . - DAMPER & STEEL PLATE Tl Es/HEIGHT OF CHIMNEY I \ 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 EL_EC METER-PERM-TEMP GAS MET ER-PERM-TEMP CER1-. OF OCCUPANCY ISSUED . 11 l PLUMBING PERMIT APPLICATION I • City of CARLSBAD, CALIFORNIA 92008 Phone 7 29-1181 Applicant to complete numbered spaces only 7~-l t'f'j Permit No Joe AOOJI t:SS ' '"') (f. (--' c~l LOT NO, I eL• I HACT L(GAL I 101:sc~. OWN£fl MAIL AOOIIIIESS llP ,b~ PHOto,ll 2 c_ . .-. p'l" ,\ \v""""· .c .. 11:A Pue l •l,-' (_ CON TfllAC TdA M;.1L ADOAESS PHONE. STATE LIC. NO. CITY LIC. NO. 3 \U.d._\ ;.,,.,._ 1. !d (__,~£a. • '~. ~t ~QU(J 'J ,,, ; . I \ \ I I . . --.,,.(HIT[CT OR OESICNt.A tJ MAI L. ADDRESS PHONE LICENSE NO. 4 ENGINEER . MAIi. ADOAESS PHONE LICENSE NO, J 5 ' . ' . ,, COMPENSATION (NS. CARRIER MAIL AODIH.SS BRANCM 6 USE OF !IUI L.DINC. 7 8 Class of work: □ NEW 0 ADDITION □ ALTERATION 0 REPAIR 9 Describe work: Lu"' \ -t-''-k ~ L, .. ..\-t L. ~ l" v \ ,,, ·t--1, ..r_,,_ ... J-, {, 4f~ ¥) 1 J t-/ . ,_ PERMIT FEES No. Type of Fixture or Item Fee SPECIAL CONDITIONS. WATER CLOSET (TOILET) $ BATHTUB -· " LAVATORY (WASH BASIN) SHOWER . ~-~ KITCHEN SINK & OISP '"' ... . DISHWASHER '\ < APPLIC:ATION ACCEPTED BY PLANS CHECKED B'I' APPROVE 0 FOR ISSUANCE 8V LAUNDRY TRAY L ~::Jt . CLOTHES WASHER ,i.1 ·~. 7-_5-_71 DATE ' WATER HEATER .J './ t~-~. NOTICE URINAL THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-DRINKING FOUNTAIN TION AUTHORIZED IS NOT COMME[i!.?ED WITHIN 120 DAYS,OR IF FLOpR-SINK OR DRAIN f CONSTRUCTION OR WORK IS SUSPE: OED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM· SLOP SINK MENCED. GAS SYSTEMS NO. OUTLETS T Hli~BY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPL! ATION AND KNOW THE SAME TO BE TRUE AND CORRECT. WATER PIPING & TREATING EQUIP. ALL PROVISIONS OF LAWS ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED WASTE INTERCEPTOR HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE VACUUM BREAKERS PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. LAWN SPRINKLER SYSTEM SEWER NUMBER CLEAN0UTS CESSPOOL ► 112 SEPTIC TANK & PIT -1 I ROOF DRAINS S!(;Jl'.TVN:E or CONTRACTO" OR AUTH0,.11.tD AGENT (OATEI ISSUANCE FEE $ SIGNATURE o, OWNER 1,-OW~EA 9U ILOU'1 DAT£) TOTAL FEES $ -J WHEN PROPERLY VALIDATED IIN THIS SPACE) THIS IS YOUR PERMIT PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH INSPECTOR