HomeMy WebLinkAbout2795 OCEAN ST; ; 81-465; Permitell z 0 .:: C IIC C ... u "' 0
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0 .J<eby affirm that I am llcansed under
provlalona of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Profeaalona Code, and my license Is In
full forca and effect.
lie No _______ Class
I hereby athrm that I am exempt trom the Con-
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county which requires a pemut to construct
alt•. 1mp,o1M, demolish, o< repatr any s·1ructure, pnor to its issuance also requues the ai>9hcant fo, such pemut to hie I s,gned statement that he ,s heenMd pursuant to the prov1s1ons of the Con· traeto,'s License Law tChapter 9 COtT"1menc1no with
Sectt0n 7000 of 04v1stQn 3 ot the Business and Pro-
fessions Code) °' tl\at ,s exempt lherefrom and tne basts for the alleged exemphon An-, vt0Lahon of Sect,on 7031 5 by an apphcan, lo, a pem,11 S<ll>teCIS
1ne apphcant to a cw,I penalty of not more than rive hundred dol-($500)
□ I, as owner ol Ille pr()l)erty, o, my employees -.,ch wages as their sole compensation, will do the
wortt, and the structure ,snot intended°' offered for sale lSeC 7044, Bus,,,.,., and Proless,ons Code
The ContractOf's License uw does not appfy to an
owner of property who butk:Js 0t ,mproYes thereon
and who does such wont himself o, through his own
employees, prcwtded that such ,mprovemeilts are
not 1nte-nde1 or offered for sale u. however the bu1k:21ng o, 1mpnwement 1s sok1 within one year of
complehon, the owner tM.uk:Ser will have the burden
of p,ov1ng that he dtO nol build or ,mprO't'e IOI the purpose ol sale)
C I, as own« ot the property, am eicclus,vely
contractInQ with hcensed contrxtors 10 construct the pro,ect (Sec 704A Busmess and Professeons
Code Tt\e Contractor s Ucense Liaw does not apply to an owner of pre>per1y whO bt,olds or improves
~':'~ic!t~ ~:,c;1~~!~~ ~~~~,~~~~;:.:
Lteense Llw)
D I am exempt unOef Sec ___ __, 8 & PC
for this reason
D I hereby affirm that I ha"e a cen,ticate of consent
to self-insure. or a cert1f1cate of Workers·
Compensation Insurance. or a cert1hed copy thereof (Sec 3800, LabO< Codel
POLICY NO _
COMPANY _
~y IS hied with tne city
□ Certified copy 1s hereby lurnlShed
CERTIFICATl OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE
(This section need not be completed 11 lhe permit
IS l()f' one hundred ~lars ($100) Of IHS)
0 I cert1ty that ,n the performance ot the wotk tor
whteh this permit ,s issued, I shall not employ any
perSOf'I ,n any manner so as to become sub1ec1 to
the Wot'kers' Compensation Llws ot ca11torn,a
NOTICE TO APPllCANT "· after 1Nk1n11r11s <:en,
fate ot Exemplt0n. you should Dieeome subfe(:t t? the WOt1lefS Compensa1,on p,ov,sions ot the LabOf
Code, you must lor1hw1th comply with sucn prov,s,ons Of ttus permit shatl be deemed revQlo.e<J
0 I tte,eby affirm lhat there ,s a cons1ructIon
leOO•nQ agency tor 1ne performance ot the wM to, wn1ch tnIs pecm11 is issued (Sec 3097 C,v,1 Cooel
Lendef s Name ___________ _
Len<>er's Add,ess __________ _
USE BALL POINT PEN ONLY & PRESS HARD ~ ~ ... APPLICA ~O FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
CARLSb. .. 0 BUILDING DEPARTMENT
...
APPLICATION & PERMIT 1200 Elm, Carlsbad, Callfornla 92008 (714) 438-5525 . ' JOB ADDRESS AV. ST,, OATE OF APPLICATION I BUSINESS LICENSE # ~I/ PERMIT NUMBER
779.c; r"/l'AA.i
RO. 2"2-/ 7 (J) 8/~r $.-r. JC . 2.'2-~-U
OWNER'S NAME I OWNER'S PHONE PRIME CONTRACTOR CONTRACTORS PHONE • ZONE
7c Al' INJJ,t.~-r M-'t</r ..> 72...'/-22. ~'1' KJ\l>H4,<, f,.-1,. l 727 .. 77//
OWNER'S MAILING ADDRESS CONTRACTOR'S ADDRESS LICENSE NO. PLAN 1,0. # BLDG use CODE
b7~ /2 C e,S,,:-Vt? .. L. I $, C l'{llt.S~.4t> 3.·z_~ E~,vr AL 1P lli.~ @S i
~-T BLO~ ~ABDI VISION ~ As.,ESSOR PARCEL NO o, DESIGNER STATE LICENSE # STANDARD PLAN# BUlLOtNG SO. FOOTAGE
( _t..i.i.. 1v~< I.A.1 Z:: 3 ,2.."2 <"
<SC~ IPTION OF ~RI< ;.i, ,J ... OESIGNER'S ADDRESS DESIGNER'S PHONE
, ~ ~-t:.:!>-~ iv II ~R..;J F/P FLA ELEV. NO OCC GP EDU I 0t~2 /~ _I, 13~~ 23.$0
STORIES I 0/22/ 81 23.5p vO NO --000_11~33
CENSUS TRACT I GP LANO USE I PARK ING SPACE RES UNITS I GRADING J'.ERMIT ISSUED I REDEVELOPMENT TVPE OCC LOAD FIRE SPA AREA CONST
y O ND v O NO vO NO Not Valid Unlt,n Machin~ ~rtifi«J
QTY. PLUM BIN~ PERMIT· ISSUE ?,</) QTY. ~MECHANICAL PERMIT-ISSUE 3-°'1 SUMMARY/ACCOUNT NUMBER .
EACH FIXTURE TRA).. INSTAL~RN. DUCTS UP TO 100,000 BTU BUILDING PERMIT ID ,....
EACH BUILDING SEWER"-"" OVER 100,000 BTU SIGN PERMIT -
EACH WATER HEATER ANOt1Nt VENT BOILER/COMPRE~ UP TO 3 HP PLAN CHECK 7~.---;il"'.
EACH GAS SYSTEM I TO 4 OUTLE'X._ BOILER/COMPRESSOR 3~P TOTAL PLUMBING
EACH GAS SYSTEM 5 OR MORE ~ METAL FIREPLACE ............... ELECTRICAL 7 .-
EACH INSTA~ .. ALTER. REPAIR WATER PIPE .._ VENT FAN SINGLE DUCT ............. MECHANICAL 7
EACH VACUUM BREAKER .............. MECH EXHAUST -HOOD/DUCTS ........... ~ MOBILEHOME __,,,
WATER SOFTNER ~ RELOCATION OF EA FURNACE/HEATER ' MOBILEHOME PARK INSP __,,,
EACH ROOF DRAIN (INSIDE) . ~ SOLAR ~
TOTJ:iL MECHANICAL STRONGM~
TOTAL PLUMBING p-r~ ~PRINKLERS
~ ()1) () ~ PUBLIC FACILITIES FEE
QTY. ELECTRICAL PERMIT · ISSUE QTY. SOLAR · ISSUE BRIDGE FEE
NEW CONST EA AMP/SWT BKR COLLECTORS ' I / SCHOOL FEE -DISTRICT
1 PH 3 PH STORAGE TANKS A , ,/' Carlsbad
EXIST BLOG EA AMP/SWT/BKR ROCK STORAv° f • ~ ,,, • :/ Encinitas
1 PH 3 PH ,_. PUMP ..A ... J"'l"" I -ll j ./'. San D1egu110
REMO0EL.'ALTER PEA CIRCUIT -~ . ,... PLAN CHECK Ff{ _y I . 1 r, ~~ San Marcos
TEMP POLE 200 AMPS /", 9 1'1 "/ A I ,//'
OVER 200 AMPS / I I I VII
TEMP OCCUPANCY (30 DAYSI ~,,,,. ~ I J ,
-----/ ✓
TOTAL ELECTRICAL l --~ TOTAL SOLAR l TOTAL FEES PAYABLE I "'"l.B, Jt) -
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPUC N ANl PERMIT ANO DO HEREBY Exp,rat1on Every permit 1uued by Ille Bu1ldtng Offlc,11 under the provis,ona oflh11 * AN OSHA PERMIT 1$ AE0U1AED FOfl EXCAVATIONS OVEA
CERTIFY UNDER PENAL TY OF PERJURY THAT ALL 0RMATI0N HEREON INCLUDING THE Code shill expire by ltm1t1hon and become null 1nd void If lhe building or work 5' O" DEEP ANO OEMOUTION Ofl COIIISTIU::TION OF
DECLARATIONS ARE TRUE ANO CORRECT AN HER CERTIFY AND AGREE IF A PERMIT IS authorized by such permit 11 not commenced w1th1n 180 days from the date of such STRUCT\RS OVER l STORIES IN HEIGNT permit. or 1f the build•~ Of WM authO(I.Zed by 1uch permit ie suspended or ISSUED TO COMPLY WITH ALL CITY, COUNTY NO STATE LAWS GOVERNING BUILDING CON• abandoned at anv tm1e I ec~ work ,s commenced for a oeriod of 180 d····
STRUCTI0N. WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY~-"':lt:;!! _)'_ k CONTRACTO~ '111:PPROVED If l
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KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AN A s SIG ~L OWNER 0
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF ~ BY PHONE 0 GRANTING OF THIS PERMIT. C-::: -_l . .
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INSPECTION TYPE DATE INSPECTOR
BUILDING
FOUNDATION .
REINFORCED STEEL
MASONRY
GUNITE OR GROUT I
FLOOR & CEILING SUB FRAME
SHEATHING
FRAME
EXTERIOR LATH lNSULATION
INTERIOR LATH & DRYWALL
-PLUMBING ;
SEWER AND BL/CO
PLUMBING UNDERGROUND
PLUMBING TOP OUT I
TUB AND ~HOWER PAN
GAS TEST
ELECTRICAL
TEMPORARY POWER I
ELECTRIC UNDERGROUND ;
ROUGH ELECTRIC ' I
ELECTRIC SERVICE I
BONDING A
G. F. I. -SMOKE DETECTOR. I
MECHANICAL I
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 ' ' '
MECHANICAL
GAS 0 l .
BUILDING
SPECIAL CONDITIONS
CERT OF ~UPANCYISSUED
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTION REO. IF INSPECTOR'S DATE CHECKED APPROVAL
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE 1, OVER 2000 PSI .
PRESTRESSED -
CONCRETE ••,
POST TENSIONED -
CONCRETE
FIELD WELDING
HIGH STRENGTH
BOLTS
SPECIAL MASONRY
PILES CAISSONS
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