HomeMy WebLinkAbout2801 Jefferson St; ; 83-404; Permiten z 0 j::
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O I hereby affirm that I am licensed under
p,ovlalone of Chapter 9 (commencing with
S.Ctlon 7000) of Division 3 of the Business
and Profeaslons Code, and my license is In
full force and effect.
Lie No Class
I hereby alllrm Iha! I am exempl lrom lhe Conlrac· tors License Law lor the 1011ow,ng reason (Sec 7031 5 Business and Protesst0ns Code Any city or counly which re
quires a pemul to construct. alter. ,mprove, demollsh, or
repair any structure, prior to its issuance also reQuires !heap·
phcant lor such permit to Ille a s,Qned statement that he 1s licensed pursuant to lhe prOVJstOns of the Gontractor· s License Law (Chapter 9 commencing w1lh Sec1ton 7000 ol
01V1s1on 3 of the Business and Proless,ons Code) 01 Illa! 1s ex·
empt therefrom and the basis !or the allegeo exemption Any
:~1~: :~~~rit",t~3c~V~ ~~~,:~~~~~! tJ~',r~ ~~~:
dred dollars (S500)
1, as owner ol lhe property. or my employees w11h wages as their sole compensatt0n w,11 do the work, and the struc·
ture 1s not intended Of offered IOt' sale (Sec. 7044, Business
and Professions Code The Contractor's License Law does not apply lo an owner ot property who builds or improves
thereon and who does such work h1mse11 or lhrough h1s own employees. prov1ded !hat such 1mprovemen1s are not 1nlend·
ed or ollered for sale II. however. lhe building or improve· ment 1s sold w1lhtn one year ol completion. the owner-builder
will have the burden ot proving thal he did not build or 1m--prove tor lhe purpose ol sale)
D I, as owner of the property, am exclusively contracting with li<ensed contraclors 10 cons1ruc11he prOjecl (Sec 7044,
Business and Prolessions Code The Contractor's Lteense Law does not ipply to an owner ol properly who builds or 1m·
proves thereon. and who contracts for each proiects with a contraclor(s) lteense pursuant to the Contractor·s License Law)
D As a homeowner I am 1mprovtng my home, and the follow
mg cond1hons exist 1. The work ,s being pe~ormed prlO< 10 sale 2 I have lived In my home tor twelve months pr,or lo complellOn ol lhlS work
I have not claimed this exemption dunng the lasl lhree years
0 1 am exempt under Sec , B & PC for this reason ____________ _
D I hereby affirm that I ha'le a cen,hcate of consent to self insure, or a cert1t1cate ot Workers
Compensahon Insurance. or a cen,t1ed copy I hereof
(Sec 3800. Labo< Code>
POLICY NO
COMPANY
0 Copy 1s filed with the city
0 Cen1hed copy 1s tieret>y furnished
CEATIFICATl OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(Ttus section need not be compleled 11 !he perm,t
1s tor one hundted dollars ($100) or less)
0 I cen,ty that 1n the performance ot the work tm
which lh1s pemut 1s issued I shall not employ any
person in any manner so as to become sub1ec1 10
the Wott1;er5· Compensation Laws ot Cahtorn1a
NOTICE TO APPLICANT If. after makmJ this Cert,
t,cate of E,cempllon you should oecome sub1ec1 n
the Wont.ers· Compensait1on prov1s,ons ot the Ubor
Code you mus! f0f1h"A1th comply with such
provisions or this perm11 shall be deemed re\loked
O I hereby atltrm that there 1s a cons1ruct1on
lending aoency to, the per\ormance ol the wot11. tor
wf'uch lh1S permit ,s 1ssue<J 1Sec x,;J7 Civil Godel
Lender s Name ___________ ~
Lenders Address ------------
USE BALL POINT PEN ONLY & PRE~S HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS
CARLSBAD BUILDING DEPARTMENT I APPLICATION la PERMIT
1200 Elm, Carlsbad. California 92008·1989 (619) 438·5525
;°j :;;s~ J e,.f' {'~IP S ~¥Av sr Ro N~R:T:: sd I ;;;F ;PLICATION I eus1N,~~ENSE • i'J4; PERMIT NUMBER
'.iT;l BLOCK I SUBOIVISION l ASSESSOR PARCEL NO. CONTRACTOR CONTRACTORS PHONE. ZONE (L,, , t/,oLI-,
OWNfR·s NAME J OWNER'S PHONE C .. 1t 11t bl/ ~, r'. L .. -n °:7T (?/"/) '1 9~ ·1"•J:::, 7J? ~-,-7-...., "")( ,.-J 753•/e,,S.¥ CONTAACTOR'SAOORESS / ~LICEN§ENO PLAN l.0.# BLDGUSECOOE r , , 7 r, ~ ,~ l \!,. 1' r 1 ~ ,AJ h1 A
OWNER.SMAl,INGAODRESS -, .1.4/.7:JL E~~t:N/'U.'I -~IP 1131~3
...., "'T"". ~ .,i -A J / ) OES1GNE A --::::,, ~ , LICENSE # STANOAAO PLAN # BUIL~I G SO FOOTAGE ...Lg(t)/ ve.~-r·e1'..5e,/I/ SJ , r~,Aafr,l.z,6_ ::PAJYA •1 "'. I)
DESCRIPTION OF WORK .., , •• , .,.,,..i,z,.. •• . ·
'i/'_---.., , 1111} Gl./fl.AiS c... ,... /. .... I? .u DESIGNER'S AOORESS DESIGNER'S PHONE OOOP.i6U6~·s.1a7.1 -, d"
A f 7 L. ·-. ~--.. . I;).., Iii • ~ ':b.l> -,=~ '··'-y-~-~t '7 :J· F/P FLA ELEV NO OCCGP EDU \ ~ ~~ /~11 /J ~T7itl4r ,~~ YONO
CENSUS TRACT GP LANO USE I PARKING SPACE I AES UNITS I GAAOING PERMIT ISSUED I REDEVELOPMENT TYPE occ LOAO FIRE SPA AREA CONST
y O N O v O NO YO NO Nor Valid Unlffs Machine Certd1td
QTY. PLUMBING PERMIT. ISSUE 7..f!-QTY. MECHANICAL PERMIT -ISSUE 3-SUMMARY/ACCOUNT NUMBER _
EACH FIXTURE TRAP ' / INSTALL FURN DUCTS iJP TO 100.000 BTU LJ-. -BUILDING PERMIT 01·00·00·8220 // U, ~\ F)
EACH BUILDING SEWER T OVER 100,000 BTU SIGN PERMIT 01·00·00·8221 '
EACH WATER HEATER AND/OR VENT BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01·00·00·8806 -//, lj_..
EACH GAS SYSTEM I TO 4 OUTLETS BOILER /COMPRESSOR 3 15 HP TOTAL PLUMBING 01-00-00-8222 '.-:.
EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE ELECTRICAL 01·00·00·8223 //) --
EACH INSTA~. ALTER. REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01·00·00·8224 -, .,.
EACH VACUUM BREAKER MECH EXHAUST HOOD/DUCTS MOBILEHOME 01·00·00·8225
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP
EACH ROOF DRAIN (INSIDE) SOLAR n1.nn.nn.oooc
TOTJ;L MECHANICAL STRONG MOTION 80·92·33-0519
TOTAL PLUMBING I 7. ,, -FIRESPRINi<LERS ---01-0'-'0'--·0::.:0:...c·8:.::2.c.c27'--J'-----------1
s: f PUBUC FAClUTIES FEE 32·00·00·8933
QTY. ELECTRICAL PERMIT -ISSUE ..--QTY. SOLAR • ISSUE BRIDGE FEE
NEW CONST EA AMP'SWT BKR COLLECTORS SCHOOL FEE · DISTRICT
1 PH 3 PH STORAGE TANKS Carlsbad 80·92·21·0519
EXIST BLDG EA AMP/SWT BKR ROCK STORAGE Encinitas 80·92·22·0519
1 PH 3 PH ~ PUMP San D1egu1to 80·92·23·0519
REMODEL AL HR PER CIRCUIT .... . -PLAN CHECK FEE San Marcos 80·92-24·0519
TEMP POLE 200 AMPS
OVER 100 AMPS LICENSE TAX 01-00-00-8162 -
TEMP OCCUPANCY 130 DAYS) 1 ~ •
' CREDIT DEPOSIT 7 v..1, '1 r' ~ ~
TOTAL ELECTRICAL 1 /0 ~ TOTAL SOLAR TOTAL FEES PAYABLE l I '-74-, ~
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT AND DO HEREBY Exp,rahon Every permit 1SIU8CI by the Buildtng Official under the provisions of this * AN OSHA PEIWIT IS REOUIAEO FOA EXCAVA TlONS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall expire by hmitatlon and become null and void II the building or work S' 0 .. DEEP ANO OEMOl.lTIOH OR CONSTRUCTION OF . authorized by such permit 19 not commenced wtth1n 180 days from the date ol such DECLARATIONS ARE TRUE AND CORRECT ANO I FURTHER CERTIFY AND AGREE IF A PERMIT IS permit, or ,f the building or work authorized by such permit ,9 suspended or STAUCT\JR£S OVER 3 STORIES IN HEIGHT
IBSUEO TOCOMPLYWITHALLCIT~COUNlYAND~ATELAWSGOVEANINGBU~rnNGCON ~a~ba~n~~~n~~~a~ta~n~~~h~m~e~a~ft~~~t~he~wo~rk~~Llc~o~m~m~~~c~ed~~~r~aupe~n~~~~U1~~~da~•~•~~~~~~~~~~~~~~~~~~~~~~~~
STRUCTION WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND . [1 [) APPAi VED BY ~ ~ KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS, COSTS AND APPLICANTS SIGNi#ATURE If,~ O~WNER CONTRACTOR ~·
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE ~ _ A.Jt' ,j BY PHONE n i\ ... .. • , • • I 1 (7~
GRANTING OF THIS PERMIT .,...-.-~ -~.-, ---_ l) ?-
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f. ~ ~ .... . ~. -. . • r rL-· \ ,. : TYPE DATE INSPECTOR \ I .., -~
BUILDING ! 83 -lfO<f ......... :",
FOUNDATION I FIELD INSPECTION RECORD
I ·-REINFORCED STEEL .------I REQUIRED SPECIAL INSPECl IONS INSPECTOR'S NOTES MASONFiY I ---= -· -~·-~ :-=--=·--~~ I -· --REQ If INSPE:CTOR S ' A -"'"': ..
GUNITE OR GROUT I INSPECTION CHECKED APl-'HOVAL DATE \
I ·-----------=--..-·-:,... ~-a,_:;_· __ __.:.
FLOOR & CEILING SUB FRAME \ ... "'•. • -· 1:-
I -------------SOILS COMPLIAN CE ;
SHEATHING D ROOF n S!if_AK _ 1'1110R TO ------·---· -·-------------~--/'
t11k'~ 1?.W"i rOUNDATION INSP . .
FRAME I
EXTERIOR LA TH -,-' --,.., STRUCl URA!,_J.:ONCRE TE
I OVER 2000 PSI
I / ---· INSULATION l'RFSTRESSED i CONCREl E INTERIOR LATH & DRYWALL I {A ,2f(K~ 4X() ~ -----POST TENSIONED I I .
CONCRETE I .... -~-.
PLUMBING I I lf.L D WELDING ' SEWER AND BUCO DIP UCO ----,-----.. --I HIGH STRENGTH I
UNDERGROUND D WASTE 0 YJATER ~ BOLTS '-)· ,-.. ---. SPECIAL MASONnY -TOP OUT D WASTE D WATER '"··-'
,· ~ TUB AND SHOWER PAN I
GAS TEST I ,___ .
I PILES CAISSON~-
D WATER HEATER D SOLAR WATER '
I -\ ... .
ELECTRICAL I . ',' ..
I --·· D ELECTRIC UNDERGROUND OiUFFER / .. • ., ..;,i -~
' •l. -ROUGH ELECTRIC 11~7:X~ ·217~ -... -. I ' . ..
D ELECTRIC SERVICE D TEMPQRARY i . ' .. I, ,-• • -' .. -• I
D BONDING D POOL I . -,, -. -= ' . I .
I ' MECHANICAL ' D DUCT & PLEM., D REF. PIPING ~. ~ I \ ~ l .• '· .. ..... \. t ..
HEAT -AIR COND. SYSTEMS I \ -. ~ 1
VENTILATING SYSTEMS I t°""'"T , 1' v -.:.'\, .'\. . . ' .. ' '~ .. -.. ' 'I• .___. ' ' I -· " -• T' "' ....... . .. ~ ,. J .. -. . ,. .. .. I .
·-~\ :i> ~~ .• ~. :, CALL FOR FINAL INSPECTIPN WHEN ALL APPROPRIATE -
.. _ 0 A -. . ,... . .,._ \. .
ITEMS ABOVE HAVE BEEN APPROVED. .. -' ..
FINAL I ·,. ·-. . ':-· ..... ": . \ ~ .. ,. \ .. . .. , ""'\'.· ..
PLUMBING I ... -.. . . ' . ..
ELECTRICAL I ~,~_{'.::"' V' • " \I ·-.,., : . . .
I """ ·-. . . • . ~ , .. . ; ~'.......· MECHANICAL I .. /4! ~~v .. -'" ·1
GAS I -.1.a---l~ -l) y ;;' .-. \ ' ~ I( .. ~ .. ~ \ t. ~ ' BUILDING I . 1, ' 'l . . I C _,,,r / T. j
SPECIAL CONDITIONS I ~ .
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GRADING CUBIC YARDS RU~NER NOTIFIED -------------~ V
INTERDEPARTMENl"AL INFORMATION SliEEI
BUILDING DEPARTf1ENI Q_~/b ~
rr, 1 6 1983
DATE: ~~~~;=;,.--
BurLPING ADDREss, ~Yo I c:zTL-~
A. P. N: --C. T: __,~~.:::;.JL...._-· ..:.=..~~cf.,____ ________ _
**********************************************************N~tt~*********
, eLANN I NG DEPARTMENT
. ZONE: SCHOOL FEES: SAN DIEGUITO SAN MARCOS · --------------
, ENCINITAS CARLSBAD ------
. UNITS REQ, D: __________ PROVIDED: _____ __,b1---+-l ~~'-----
% COVERAGE ALLOWED: .PROVIDED: ------11---------
PARKING SPACES REQ'D: PROVIDED: ____ ___;=-:; __ __,~,--
BU IL DING HEIGHT REQ'D: PROVIDED: -----~---
ENVIRONMENTAL PROTECT I ON REQ : _·1::_ ....... Y_~_lll\_.c......c.P_.-.a7_-___________ )_ i] ~~~~~~~~~~~(~t
ADDITIONAL COMMENTS: -----------------------'--·
I I
PUBLIC FACILITIES FEE_:· SEWER CONNECTION: --------------
DRIVEWAY LOCATION(S) =------------''-----
GRADING PERMIT:
·-·--·----
-------------------------EASEMENTS: DRAINAGE: -----------------------
LEGAL DESCRIPTION: ------------------------
ADD IT ION AL COMMENTS: ----------------------~
*CHECK IF EN
OK TO ISSUE: ~----P\fl: -q.-C-4,-=---__.. ----TO FINAL: -----
DATE: , .
j:_j;._ti.j;_;};_j_J;,_J_;,i;_:,,'CLLJJ:.:.'f1W..:1d.:L£J.JJJ;Ji]Jd0J._:1;_);...:k3·:J.....:};_1;.__:};_;,'0;..,'1_;.·;j;_:,V...£.c:£H~-( * i~ t * -~ * £ * * * * £}..:l;..;k_;v._
* IF TIIIS JTHI IS NOT CIIECKED, 13UILDING DEPJ\RH,IENT WILL ~!AKE
FINAL INSPECTION.