HomeMy WebLinkAbout2777 Jefferson St; 102; 86-459; PermitIll z 0 ~ a: ,c .., u w 0
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0 I h«eby affirm that I am licensed under
provlelon1 of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Proleaatons Code, and my license Is in
full force end effect.
I hereby altirm that l am exempt from the Conlrac·
lof s License Law t0< the lollow1ng reason (Sec 7031. 5
Business and Protess1ons Code Any city or counly wt11ch re-quires a perm,t 10 construct, alter, rmprove, demohsh. or repair any structure. prior 101ls issuance also reQuires ?heap-
phcant for such permit to file a sign~ statement that he is licensed pursuant to the prov1s1oos of the c;Onuactor"s
License Law (Chapter 9 commencong w1lh Secllon 7000 of Orv,s,on 3 ot !he Business and Profe5Sl1)RS COdeJ oc that ,sex-
empt therefrom and !he basis lor the allegea exemption, Any violation cl Section 7031.5 by an applicant lor a perm11 sub•
Jecls the applicant to a civl! penally ol not more lhan live hun• dred dollars ($500) •
I .. as owner of lhe property_ Of my employees with wages
as their sole compensation, w1U do the work. and the struc
ture Is not intended or otlered for sale (Sec 7044, Business
and Professions Code The Con1ractor's License law does not appfy to an owner ol property who builds or rmproves
thereon and who does such work himself or through hts own employees. provided that such improvements are not mtend-
ed or oUered lor sale If, however. the building or improve-ment 1s sold w1thm one year ot completion, the owner-builder
will have the burden ol provmg that he did not build or im·
prove tor the purpose ot sale)
I. as owner or the property, am exclus1ve1y contracting with licensed contractors 10 construct the proiec1 (Sec 7044
Business and Professions Code The Contractor's License Law does not apply to an owner ol property who builds or im-proves thereon, and who contracts for each proiects wtth a
contractor(s) license pursuant 10 !he Contraclor' s License Law)
As a homeowner I am improving my home, and the fotlow-
ing cond1t1ons ex,st 1. The work is_ being perlormed pnor to sa!e 2. I have hved in my home for twelve months
rr~~v~ :rp~:::t t'~11: :~!~phon during the tasl three years
0 I am exempt under Sec -------lor this reason 8& P,C
~ I hereby affirm thal 1 have a certificate ol consent to
~-insure. or a cer11ficate of Workers' Compensation In·
surance. or a certllled copy !hereof {Sec. 3800. Labor Code)
POLICY NO
COMPANY
~ Copy IS flled With the City
D Certified copy 1s hereby furnished
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
!This section need not be completed II the permit
is for one hundred dollars {$100) or less)
0 I certify that ,n the performance of the work for which
1h1s permit fs issued. I shall not employ any person In any
manner so as to become subject to the Workers' Compen-
sation Laws of California.
NOTICE TO APPLICANT: U, after making this Certificate
of Exemption. you should become sub1ec110 the Workers
Compensation provisions of the LabOr Code. you must
forthwith comply with such provisions or this permit shall
be deemed re11oked.
D I hereby affirm that there Is a construction lendlng
agency for the performance of the work forwhlch this per-
mit is Issued (Sec. 3097, CiVil Code)
Lenders Name ____ ~--------
Lender's Address•-------------
USE BALL POINT PEN ONLY & PRESS HARO APPLICANT TO Fill IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
. ~
-CARLSBAD BUILDING DEPARTMENT
-... Carlsbad, California 92008-4859 APPLIC'7ION & PERMIT
JOB ADDRESS ' AV ST. RO. NEAREST CROSS ST l DATE OF APPLICATION I BUSINESS LICENSE a VALUATION PERMIT NUMBER
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L -:JP, lo~ ~ , lv,.SO ;w/¥1 LOT RLOCK I suBD11ils1,0N I ASSESSOR PARCEL NO. tTRACTOR
f CY\>ir•h (,~
CONTRACTORS PHONE • ZONE ' 10 y'\ ~; ~I\(., ll ~:>~· ..211 <.... OWNER'S NAME I OWNER'S PHONE
-_s-. ~ tl LTD CONTRACTOR'S ADDRESS STATE LICENSE NO. BU~G ~DOTAGE 3S~-A "£ I CA1r1,~ Kfh I ye ,,~1 OWNE A'' MAI,_ NC. ADDRESS C
V-D {)a?f-511 -(lA--b LJ. (A. '1~00~ \ DESIGNER LC_ \..\A, .... ,, '-·""'• 11-0 :L '1 DESIGNER'S PHONE
' \)('"".)\c;" s;C' vj -
DESCRIPTION Of WO~ -~
-, • ..l-., ,,/-r'OESIGNER'S ADDRESS STATE LICENSE NO.
{.c,/3 ¢ 15".1..b"~A " $1\" VIE'i ,, (" ~ , u(
>-----'-F/P FLA ELEV. NCJ DCC GP r STORIES
vO NO --~ '
I I PARK ING SPACE I RES UNITS I GRADING PERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRE SPA AREA CONST
-y O N 0 vO NO YO NO Not Valid Unless Machine Certified
QTY. PLUMBING PERMIT -ISSUE 1750 QTY. MECHANICAL PERMIT -ISSUE 3 _.... SUMMARY/ACCOUNT NUMBER I =:;----EACH FIXTURE TRAP I../"" INSTALL FURN DUCTS UP TD 100.000 BTU lv . / BUILDING PERMIT 001·810·00·00·8220 ....,.., -
EACH BUILDING SEWER ~I DVE R 100.000 BTU ' SIGN PERMIT 001 ·810·00·00·8221 > ~
EACH WATER HEATER AND ORV~
-----~-~-· --£"--..._ ~'I--BOILER.COMPRESSOR UP TD 3 HP PLAN CHECK 001·810-00-00·8806
EACH GAS SYSTEM 1 TO 4 ()J.;11.ETS ---+-BOILER/COMPRESSOR 3 15 HP TOTAL PLUMBING 001·810·00·00·8222 7.../--EACH GAS SYSTEM ~ORE
--.. METAL FIREPLACE ELECTRICAL 001·810-00-00·82?3 --------
EACH IN,~t· REPAIR W~TER ~ VENT FAN SINGLE DUCT MECHANICAL ®ftfi.10-oqj@.:imti; ·:;uf66f'Ri'li7 -u ti4.; -~---------
EACH V UM BREAKER MECH EXHAUST HOODIDUCTS -<"' MOBILEHOME 001-810·00-00-8225
,
wax'R SDFTNER RELOCATION OF EA FURNACE1~.ly SOLAR 001·810·00·00·8226 -
EACH ROOF DRAIN l'JSIDEl DRYER VENT ti...~,-STRONG MOTION 880·519-92·33 • y;-f --------
TOT1<L MECHAN~ J;..,... ~ ' ... a, ... --FIRE SPRINi<LERS 001·810·00·00-8227
TOTAL PLUMBING I r\.> "\~ PUBLIC FACILITIES FEE 320·810·00·00-87 40
I s--MOB~E HO~'%E~~fl... .. \,.~
.. ',\~ .. -BRIDGE FEE fJA QTY. ELECTRICAL PERMIT · ISSUE QTY. ~~ PARK-IN-LIEU (AREA )
NEW CONST EA AMP SWT BK R CAR PORT ~' -... (\(..'(.ir TIF ,, lk. 001-810·00-00-8835
l PH 3 PH AWNING -,~1 -.. ,\'\ ~. LICENSE TAX 1 001·810·00-00-8162 ~,q_
EXIST BLDG EA AMPISWT BKR GARAGE -..o~~~ MFF PA, 880-519·92-57 ' 1 PH 3 PH ~1<.~"-
REMODEL ALTER PER CIRCUIT JI).--
TEMP POLE 200 AMPS -- -
OVER 200 AMPS
TE MP OCCUPANCY (30 DAYSI -......
CREDIT DEPOSIT <_ £ t!J (T ..::-/
I TOTAL ELECTRICAL I If.-TOT Al TOTAL FEES PAYABLE I ~t/tf'g'f:--
I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION AND PERMIT AND DO HEREBY Exp1rat1on E'w'ery permit issued by the Bwld1ng Off,c1a1 under the prov1s1oruor 1nrs * AN OSHA PERM:T IS REQUIRED FOR EXCAVATIONS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall expire by hm,tat,on and become null and 'w'01d If the bu1ld1ng o• work 5· O" DEEP AND DEMOllTION Ofl CONSTRUCTION OF
DECLARATIONS ARE TRUE ~N!i CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT 1$ authorized by such permit 1s not commenced within 180 days from the date of such STAUCTVRES OVER 3 STOAIES IN HEIGHT
lSSUEQ;.-1"9--CeMPD'~LL CITY •. COUNlY AND STATE LAWS GOVERNING BUILDING CON ~~~r;:~On~ 1!t 1~~v ~~r:!~'~H.~~h:~~r:~!hco~~~e~leJ~~; ::':!~d·~,s~;bc,~~~ or
i:,1RUCTION WHETHER SPEc)Ftf) HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND
APP~~raE ~ OWNERD CONTRACTOR F-APPROVED BY i DATE KEEP HARMLESS Tl:iE CITY Of\;ARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS. COSTS AND /-/--l ~Y-3/$ EXPENSES WHICH MAY IN ANYtAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE BY PHONE 0 GRANTING OF THIS PERMIT
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TYPE I
BUILDING I
I
F FOUNDATION I
IEINFORCED STEEL I
ASONRY I
I
;UNITE OR GROUT I
RI
M
G
s
s
Fl
E
UB FRAMED FLOOR D CEiLING
HEATH ING D ROOF D S~EAR
RAME I
XTERIOR LATH I
INSULATION I
I
INTERIOR LATH & DRYWALL I
I
PLUMBING I
D SEWER AND BUCO D F?UCO
UNDERGROUND D WASTE q WATER
TOP OUT D WASTE D WATER
TUB AND SHOWER PAN I
GAS TEST I
D WATER HEATER D SOLAR \JYATER
I
ELECTRICAL ' ' D ELECTRIC UNDERGROUND l!l UFFER
ROUGH ELECTRIC I
D ELECTRIC SERVICE D TEMPiORARY
D BONDING D POOL I
I
I MECHANICAL ' D DUCT & PLEM., D REF. PIPING
HEAT -AIR COND. SYSTEMS I
VENTILATING SYSTEMS I
I
DATE INSPECTOR ,,,
--
·-
CALL FOR FINAL INSPECT.ION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE BEEN APPROVED.
FINAL I
PLUMBING I
ELECTRICAL I
'
MECHANICAL I " .
GAS I 1 ,/
I J -;J:}7:/ ~1(£.ll BUILDING I . ....
SPECIAL CONDITIONS I __,.,,
I ~ -
' " ~t,4~7
FIELD INSPECTION RECORD ·-
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTION REQ IF INSPECTORS DATE CHECKED APPROVAL
:; '-' .. .. .
' SOILS COMPLIANCE
PRIOR TO -
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRESTRESSED ).··.
CONCRETE ' ·,
POST TENSIONED r~
..;)\ .,.\ ~-CONCRETE
FIELD WELDING "
HIGH STRENGTH
BOLTS -· ; :
SPECIAL MASONRY .. j ·. '~· \ --·-. ' .
~ .. \\ >-
PILES CAISSONS ~
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City of Carlsbad
1200 ELM, CARLSBAD, CA 92008 • TEL. (619) 438-~525
•
r Job ... 111 :'fpffi~. . i'\ . fh vi V}~{d Address
MISCELLANEOUS
"RECEIPT
MISCELLANEOUS FEE RECEIPT
Owner u 11 ~ 1 Vt11~t\r1 I Ju'H. l J;)h, t~ f-D • PLAN CHECK FEE 001-810-00-00-8821
Mailing t11J.~ m ,,
Address "~ D VALUATION , J ,:/ ... -,-
I City
f I-, \j/J.r l I Zip Db Tel. (7 ~ 11H( D
Contractor '\ lJJ\1i1: ., n f ,0vi , " _1 ttllll\ D
Address ..-, {p />( v c,,, I . -1 D V\l . D City 11\~ !-[~ J I Zip Telj "I f () • 0d ~ .. A D
State Lie Lf1.11'1 , f/)~ • -r )
City -;;1,;ti S Class1f Lie. No. D
N Ol' u,, 41, M/'r( I I t-t-Of D
\J I 11\'e, C-11 ') e,P D
LEGAL DESCRIPTION v II xn .., , Tio / I/..-1 iiii.1<+ ~ul ~;
' • D
'le< ( n ., A/\t,d) * ')_()~ , j o . 1 f<. , 1 . :l ~ , r& ._-f • f
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ASSESSORS PARCEL NO n
-tnJZfl),l-,NP..IA.-C., t (IL ~ 1~
DESCRIPTION OF WORK Q I
' ( I <. \...-{ ,Nf _ H (e, IN D
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f")I~"' ~r;~ .¢ ') D
J\\,,J_ L t, I W D \.._ __./
D
PL-L/S9 D
PLAN ID NO. D
D
D
\ TOTAL FEE
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-
$
CONTACT PERSON .-, \~ ~iJ. pl\l V~'Z-1"-'A 'WARNING: PLAN CHECK FEES. WHERE NO ACTION IS TAKEN BY THE
:;l):)... ~ Ix 'n1 C.,f)
APPLICANT IN 180 DAYS AND NO BUILDING PERMIT IS ISSUED. ARE
.AU~ FORFEITED TO THE CITY.
ADDRESS
?;y ~ 10'7 COMMENTS:
ZIP . ,~lU I PHONE# ,,
I Al ~ ll 11A \M t l~leit Signature of Applicant Date -v·
lo.. I
White -Applicant Yellow -File Pink -(1) Finance (2) Data Process Gold -Assessor
"'
~
ADDRESS DATE PLAN CHECK Nof 6-fSZ
Ci) ZONE: £c:y? '
d22z 9~,:a,,., 7
PLANNING
TYPE OF PROJECT AND USE: ___ ~ .... /_. _f ___________ _
CARLSBAD~ SAN MARCOS
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SCHOOL DISTRICT: SAN DIEGUITO ENCINITAS
SETBACKS: FRONT t!5>1.L -SIDE REAR oA:. .=...-----
DISCRETIONARY ACTIONS: --.:----------------------------------
REDEVELOPMENT PERMIT REQUIRED: ~ --------------------------------~
LANDSCAPE PLAN COMMENTS: ___ /~~-----------------------------~
ENVIRONMENTAL REQUIRED: ~~(__ ----------------------------
ADDITIONAL COMMENTS: c:r:ic:_ ---------------------------------.
OK TO ISSUE:-~----------DATE: JiLt I '(/,o
ENGINEERING
LEGAL DESCRIPTION VER IF !ED? ~ APN CHECKED?_?+-= ........ ----------
PARK-IN-LIEU QUADRANT: tJ/& , FEE PER UNIT: ":f!a TOTAL FEE :_N...,,,.._VA-____ _
P.F.F.: N/,4-. TRAFFIC IMPACT FEE PER UNIT: ..pa;J TOTAL FEE: ______ -i
FACILITIES MGMT. FEE: ~ 1!kf,J¢ BRIDGE & THOROUGHFARE FEE: tJje--
IMPROVEMENTS: ,.0/'/st: -•.~--------------------------------------
FIELD CHECK DATE & INITIALS: ________ RIGHT-OF-WAY:_.J!4~~~-----l
DRIVEWAY: JV~ EASEMENTS: ;,)4-
E.D.U. ::1!Q ~ ~ SEWER: .V/h; -LA-T-~R..._A __ L_: -~-.-.---~
INDUS TR I AL WAS TE PE RM IT : Al/.4 ORA I NAGE :_M_,.ft-#-:1--.-.. _______ ~
GRADING PERMIT: tv!Ll.. GRADING COMPLETION CERTIFIED: I~ ------~
ADDITIONAL COMMENTS: ----------------------------------~
OKTDISS~
DPD2:DPD6:07/17/86
1200 ELM AVENUE
CARLSBAD, CA 92008-1989
<!itp of <tl:arl.sbab
FIRE DEPARTMENT
PAGE 1 OF_
TELEPHONE
(619) 438-5523 APPROVED
DISAPPROVED
PLAN CH ECK REPORT PLAN CHECK#
PROJECT 01"/. ADDRESS
ARCHITECT ADDRESS
OWNER ADDRESS PHONE
OCCUPANCY CONST. ,J. " TOTAL SQ. FT. STORIES
D SPRINKLERED 0 TENANT IMP. ~/~ ff}
__ 1.
__ 2.
__ 3.
__ 4_
__ 5.
APPROVAL OF PLANS IS PREDICATED ON CONFORMING
TO THE FOLLOWING CONDITIONS AND/OR MAKING
THE FOLLOWING CORRECTIONS:
PLANS, SPECIFICATIONS, AND PERMITS
Provide one copy of: floor plan(s); site plan; sheets
Provide two site plans showing the location of all existing fire hydrants within 200 feet of the project.
Provide specifications for the following:
Permits are required for the installation of all fire protection systems (sprinklers, stand pipes, dry chemical, halon,
CO2, alarms, hydrants). Plan must be approved by the fire department prior to installation.
The business owner shall complete a building information letter and return it to the fire department.
FIRE PROTECTION SYSTEMS AND EQUIPMENT
__ 6. The following fire protection systems are required:
D Automatic fire sprinklers (Design Criteria: -----------------------
0 Dry Chemical, Halon, CO2 (Location: -------------------------
0 Stand Pipes (Type: -------------------------------
0 FireAlarm(Typ~Location: -----------------------------
...x__ 7. Fire Extinguisher Requirements:
CJ One 2A rated ABC extinguisher for each ____ sq.ft. or portion thereof with a travel distance to the nearest
extinguisher not to exceed 75 feet of travel.
D An extinguisher with a minimum rating of ___ to be located:
D Other: ___________________________________ ~
__ 8. Additional fire hydrant(s) shall be provided------------------------
EXITS
__ 9. Exit doors shall be openable from the inside without the use of a key or any special knowledge or effort.
__ 10. A sign stating, " This door to remain unlocked during business hours" shall be placed above the main exit and
doors_~----'------'--'-----"----'--,__------~------------~
__ 11. EXIT signs (6" x 3A" letters) shall be placed over all required exi~s and directional signs located as necessary to
clearly indicate the location of exit doors.
GENERAL
__ 12. Storage, dispensing or use of any flammable or combustible liquids, flammable liquids, flammable gases and
hazardous chemicals shall comply with Uniform Fire Code.
__ 13. Building(s) not approved for high piled combustible stock. Storage in closely packed piles shall not exceed 15 feet
in height, 12 feet on pallets or in racks and 6 feet for tires, plastics and some flammable liquids. If high stock pil-
ing is to be done, comply with Uniform Fire Code, Article 81.
__ 14. Additional Requirements. ------------------------------
__ 15. Comply with regulations on attached sheet(s).
Report mailed to architect ___ Met with --------------__ Attach to Plans