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D I hereny 9fflrm that I am licensed under
provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Professions Code, and my license is in
full force and affect.
Lie No _ __ _ _ Class
I hereby atfirm that I am exempt from the Conlrac· tor's License Law tor the following reason {Sec 7031 5
Business and Professions Code: Any city or county which re· quires a perm,! to construct. _alter, ,mprove, demolish, or
repair any structure, pnor to_ its issuance also requires the ap· pl1cant for such permit lo hie a s,gned statement that he 1s
licensed pursuant to the provisions Of IM Contracto(s L,cense Law (Chapter !I commencing with Section 7000 of
D1v1s1on 3 ol the Business and Professions Code) or that 1s ex-empt therelrom and the basis for the alleged exemption. Any
v10lat1on of Sect,on 7031.5 by an applicant for a permit sutl-
Jects the applicant to a civil penalty ot not more than five hun-dred dollars ($500)
,J I, as owner of the property. or my employees with wages
as their sole compensation. will do the work, and the strui;-
ture is not intended or offered for sale (Sec. 7044. Business
and Professions Gode· The Contractor's License Law does not apply to an owner 01 property who builds or improves
thereon and who does such work himself or through his own employees, provided that such improvements are not intend-
ed or_offerecl for sale 11. however, the building or improve-ment 1s sold w1th1n one year ol compl€\ion. the owner-builder will have the burden ol proving that he did not build or im-prove for the purpose ol sale)
D 1._as owner of the property, am exclusil'llly contracting with licensed contractors to construct the pro1ect (Sec. 7044.
Business and Professions Code: The Contractor"s License Law does not apply to an owner of property who builds or im-proves thereon_, and who contracts for each proiects with a
contractor(s) license pursuant to the Contractor's License Law).
D As a homeowner I am improving my home, and the follow-ing conditions exist t lh~a~~r~i~:le/~9 :rf~ro~e:i ri~or~0e1:e months
pnor to completion o1 thrn work.
I t\ave not claimed this exemption during the last three years
B& P.C
D I hereby afhrm that I ha~e a cert,t,cate of consent
to sell-insure. or a cert,t,cate of Workers'
Compensat,on Insurance. or a cert,1,00 copy thereor
USE BALL POINT PEN ONLY & PRESS HARD APPLICANT ,o FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
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CARLSBAD ..ilLDING DEPARTMENT
1200 Elm, Carlsbad, California 92008-1989 (714) 438-5525 AF-rLICATION & PERMIT
AV, ST. DATE OF APPLICATION
"~-. /b -( $ -4" l-
OWNfl,t'S NAME OWNER'S PHONE
1 J,., . • , . 75'.5-.u-w
LO: BLOCK ' J SUbOI VISION f ASSESSOR PARCEL NO.
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CENSUS TRACT I GP LAND USE ! PARKING SPACE RES UNITS I
QTY. PLUMBING PERMIT -ISSUE
. .d
CONTRACTOR'S ADDRESS
'"
fY & ~ &J),,...,/
FLA ELEV. NO
STORIES
GRACING f".ERMIT ISSUED I REDEVELOPMENT
AREA
TYPE
CONST
YD NO
QTY. MECHANICAL PERMIT -ISSUE
EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100.000 BTU
8U$1N'ESS LlCENSE # VALUATION PERMIT NUMBER "' .., '5 OtJO c'J -
~ACTORS P~H"ON~.~.--1-z=o=N""=e----"C..::::..;e::.. ___ --I It vi
2.F6--IC 33 /..f"",
LICENSE NO.· PLAN I.D. # BLDG USE CODE
LICENSE# STANOAAD PLAN# BUILDING sa. FOOTAGE
OCC GP EDU
OCC LOAD
vO NO Not Valid Unless Machine Certified
SUMMARY/ACCOUNT NUMBER
BUILDING PERMIT 01-00-00-8220 I---+------------·---------+-------+-----t----------·----------+------->-· ------------------i---EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT 01-00-00-8221
1---+-EACHWATER HEATER,.;;-No,DR VENT=-~ 1-----_ _:_--_-__ .... .__-___:_+_s-0_:_,_:_,-E_R:0~-M_-P_-R_E_Ss~O=R=U=P---_TO 3~_P_-_:__-=----_-.,~_.__.__.__.__.__.___--__-__-__;-__-__-__P-LA_:_N::_C--_H-E-=C_K_ ----~-__--__-__-___o-,_:_-o::_o--oo-8806
EACH GAS SYSTEM 1 TO 4 OUTLETS
EACH GAS SYSTEM 5 OR MORE
EACH INSTA~ .. ALTER, REPAIR WATER PIPE
EACH VACUUM BREAKER I---+-
WATER SOFTNER
-+--801LER/C0MPRESS0R 3-15 HP -----11----+--
METAL FIREPLACE --------------
VENT FAN SINGLE DUCT ------!e-----j----~
MECH EXHAUST -HOOD/DUCTS -------+---RELOCAT10 N OF EA FURNACE/HEATER . -----------+-------+-
TOTAL PLUMBING 01-00-00-8222
ELECTRICAL ____ 01-00-00-8223_--,1--------t----l
MECHANICAL 01-00-00-~82~2~4-+-------l---S
---+----'---+-~M~OB01~LE~H~O~M~E ______ 01·00-00-822_,5-+-----+-----l
MOBILEHOME PARK INSP -·-j--------i--------
~-j~ACH ROOF ORAi~ _\INS IDE~-~-----------+------4 __ _j_ __ 'T"O'T /;~L7M~E~C~H~A7N~l"CA~L-----~-_j_----'----Ji---;>l"T.!l:'.!l0'1oN_G M-0-T-IO_N __ -_-:__:__:__:__:__:_-~;u1/~~9·~;;~~;_:;
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"' iSec 3800. Labo• Code)
F<Juc, NO .:f.~~ \-rl~.€"01...--QTY.
COMPAN' I""'~ ,~..,_/, •
TOTAL PLUMBING --r-__ --·~ 01·0D-00-B227 +------+----f L_ -· FIRE SPR1NKLERCS ___ _
.? !!!-QTY. SOLAR_ ISSUE ___EIJ!!UC FACILITIES FEE 32-00-00-8923
c?( ---+---+---------------------+-------l~BRIDGE FEE
ELECTRICAL PERMIT -ISSUE
oi
0
€
0 Copy ,shied w,tt, 1he ctly
D Cer1tl1ed copy ,s hereby fuin,shed
CERTIFICATE. OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(Th,s sec1,on need not be completed 11 me permit
1s tor one hundred dollars iSlCIO) or less)
D I cert,ty that ,n the performance ot the worl< for
which 1h15 permit ,s ,ssued. I shall not employ any
person ,n any manner so as 10 become sub1ect 10 me Workers· Compensation Laws of Cal,toin,a
NOTICE TO APPLICANT 11. alter mak1n-;i this Cert, 1,cate of E~emp1,on. you should become sub1ect to
the Workers· Compensa1,on provisions of the Labor Code. you must torthw1th comply w11h such
prov1s,ons or !his permit shall be deemed revoked
O I hereby affirm tha! there ,s a construct,on
1end1ng agency to, lhe per!o,mance of lhe wor\o. tor
which this perm11 ,s ,ssued !Sec 3097 C,vFI Code)
Lenders Name_~------~---
Lende, s Address-----------
>-~-+-~--------
NEW CONST EA AMP.'SWT BKR -~---~~-~-+--~---lt----l-c_o_LL_E_CT_O_R_s __________ -----t------c~~S,Cf!OOL Fff_:_ OlSTRICT ---· ---I-----+-----I
l----+-1_P_H ___________ J_P_H ___________________ ~A_9~ TANKS ------------+-------11-~_Is~
EXIST BLOG EA AMP/SWT/BKR
--------ROCKSTOR_AG_E ________ ~-----+-------1~-~Enc_in_ira_s __ _
I PH 3 PH <----+--~-------------REMOOEL.'ALTER PER CIRCUIT
--
------,-----------
PUMP ---------if---+----
PLAN CHECK FEE ----------r---------
--
--11-~---1-----
---t-------11~-
San Die9.!!!!Q______
San Marcos
--ff--·--
·---~-~---------------------t--------11-
80-92-21-0519 -------+~
80-92-22-05_'!.i___ =t--___ 80-92-2}_:_05.:!B______ ----
80-92-24-0519 ----
i
----; ~-~-. ~--~-
--.---
_ _l__ ----------·-- l
I
-- ---~ -----11--------~---------,~-...L-~--~~--~~
I TOTAL ELECTRICAL TOTAL SOLAR TOTAL FEES PAYABLE
t HA~ CAREFULLY EXAMINED THE GOMPi..ETED "APPLICATION ANO ~E~fT" ANo"oo H~REBY 1 E•Ptttmon. Ew,rypermitiSS\ledbvt~Buffdlngotfld°~tundermeprovisionsJttri$-. . · o r · · · N uo ·rH"' Oodeahaft·expirei)y-1imitationand"becomenult&t1dvoid. lftM1>uildingOJ"wot1t= f· CEftTIFY UNDER PENALTY OF PERJURY THAT ALL INF RMA !ON HEREON I ct.. ING c: authorized by such permit is not commenc«t wittllo 180daysfrom the dateotsueh
DECLARATIONS ARE TRUE,AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT ts permit, or if the building or wort. autho,ized b¥ such penn•t is suspended ,Qt
iSSUED: TO COMPLY WITH ALL CITY, COUNTY AND STATE lAWS GOVERNING BUILDING CON-at anv time after the Work is commenced-for a nAriod Of 1-80 :;...:,:._ ~-;.,
* AN OSHA PERMIT IS REOUlRED FOR EXCAVATIONS OVER 5• O" oE£P AND oatot.moH Ofl CONSTRUCTION OF
STNJCTURES OYER 3 STORIES-IN HEtGHT
APPROVED BY DATE -
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L~LL~B~i~~;.~~:~i~~~~~~;:~g j .. ~,cA T·sgr• 1 l1 ,1;:'0WNERD COt+TRACTORE'f
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE ' O BY ~NE tJ
GRANTING OF TH1S PERMIT. I ,t , ~ • I In , r:i, -92..v
"
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
SEWER AND BL/CO
PLUMBING UNDERGROUND
PLUMBING TOP OUT
TUB AND SHOWER PAN
GAS TEST
ELECTRICAL
TEMPORARY POWER
ELECTRIC UNDERGROUND
ROUGH ELECTRIC
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
MECHANICAL I I\
GAS "' ){-'I.I
BUILDING "" -SPECIAL CONDITIONS
CERT OF OC'0!JPANCY ISSUED
&d-'-f~
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR"S NOTES
INSPECTION REQ IF INSPECTOR"$ DATE CHECKED APPROVAL --SOILS COMPLJANCE
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRESTAESSED
CONCRETE
POST TENSIONED --
CONCRETE
FIELD WELDING
HIGH STRENGTH
BOLTS
SPECIAL MASONRY
'
I PILES CAISSONS
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