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2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
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PLAN CHECK NO.
City of carlsbad Building Depart111ent
2075 Las Pal.as Dr., Carlsbad, CA 92009 (619) 438-1161
1. PEllMI I IYPE
A -D Commercial O New Building D Tenant Improvement
B -□ Industrial □ New Building □ Tenant Improvement
C -'9iResidential □ Apartment □ Condo □ Single Family Dwelling fl.Addition/ Alteration
□ Duplex fill Demolition □ Relocation □ Mobile Home □ Electrical □ Plumbing
□ Mechanical □ Pool □ Spa □ Retaining Wall □ Solar □ Other ____ _
2. PROJECT INFORMATION
Address .2. 8 \ O \-\c, pe..., "S. '\-
Nearest Cross Street Ho~ e... s.\--.
Building or Suite No.
3814 09/ 9;q3 0001 1
C-P T
FOR OFFICE USE ONLY
LEGAL DESCRIPTION Lot No. subd1V1s1on Name/Number Unit No. Phase No.
Z.9 mA-p tt-G-l 'i~
CHECK BEWW IF sDBMI 11 ED:
□ 2 Energy calcs 76 2 Structural calcs D 2 Soils Report □ I Addressed Envelope
ASSESSOR'S PARCEL PBQPQSED USE
DESCRIPTION OF WORK
e..,-F
. 1 1 eren rom app 1can
ADDRESS \-\o PE. -s+ NAMER>,...'/ &Av.+hte..,
CI1YCA~Sl2>AD STATE c~ ZIP CODE 9 ~OO8DAY TELEPHONE (:, 2 ?--o S40
4. APPUCANi □CONIRACIOR □AG£NI FORCONIRACIOR ~WNER □AGENI fOHOWNEil
NAME Rf>tj ~+h\~ ADDRESS c).~ \C \-\of>e-~t
S. 'i;i16£:frf~ STATE (!_A:• ZIPCODEq~o'o DAY TELEPHONE '=>~~-0840
NAME'RPti ~"'..\hH.f" ADDRESS ~lO HcJi>f:~+
6
_ 'ib11~B-Pr() STATE Cf\ ZIP CODEC,~~ DAY TELEPHONE
NAME ~ ADDRESS
(!) vJ ,N~ STATE CllY
STATE LlC. #
DESIGNER NAME
CllY C) (/J rJ ~. STATE
7. WOIUffiRs' WMPENSAl10N
ZIP CODE
LICENSE ClASS
ADDRESS
ZIP CODE
DAY TELEPHONE
CilY BUSINESS LlC. #
DAY TELEPHONE STATE LlC. #
Workers' Compensation Oeclarauon: I hereby at!Jrm that I have a cerulicate ol consent to sell-insure issued by the Director ol lndustnal
Relations, or a certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified
by the Director of the insurer thereof filed with the Building Inspection Department (Section 3800, Lab. C).
INSURANCE COMPANY POLICY NO. EXPIRATION DATE
t. •
Ceruhcate of Exempuon: I ceruly that in the performance of the work for which this permit 1s issued, I shall not employ any person in any manner
so as to become subtt to t~erorkers' Compensation Laws of califomia.
SIGNATURE ~;r•~~ DATE ~ " 1 'q q~ s. oWNER-BUllDER Ii L Owner-Builder Declarauon: I hereby athrm that I am exempt lrom the Contractor's License Law tor the lollowmg reason:
f"' I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is not intended or
offered for sale (Sec. 7044, Business and Professions 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 offered for sale. If, however, the building or improvement 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.).
D I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions
Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for such projects
with contractor(s) licensed pursuant to the Contractor's License Law).
D I am exempt under Section _______ Business and Professions Code for this reason:
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish, or repair
any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the
provisions of the Contractor's License Law (Chapter 9, commencing with Section 7000 of Division 3 of the Business and Professions Code)
or that he is exempt therefrom, and the basis for the a lleged exemption. Any violation of Section 7031.5 by any applicant for a permit
subjects the applicant to a civil penalty of not more than five hundred dollars ($500]).
SIGNATURE DATE
COMPLETE 'l'Als SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY:
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and
prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act?
□ YES □ NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district?
□ YES □ NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site?
□ YES □ NO
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCx:tJPANCY MAY NOf BE ISSUED AITER JULY 1, 1989 UN1F.SS 11-m APPLICANT
HAS MET OR JS MEETING nm REQUIREM.ENTS OF nm OFFICE OF EMERGENCY SERVICES AND 11-IE AIR POUlJTION OONTilOL DISIRICT.
9. WNS'i R0CI ION LENDtNG AGENCY
I hereby affirm that there 1s a construction lending agency for the performance of the work for which this permit 1s issued (Sec 3097(1) C1V1! Code).
LENDER'S NAME LENDER'S ADDRESS
10. APPUCAN"t cilt'i1FICAl1oN
I cert1ty that I nave reaa the apphcauon and state that the alXlve inlormauon 1s correct. I agree to comply wuh ail City ordinances and State laws
relating to building construction. I hereby authorize representatives of the City of earls bad to enter upon the above mentioned property for inspection
purposes. I ALSO AGREE TO SAVE INDEMNIFY AND KEEP IIARMLF.SS nm CTIY OF CARISBAD AGAJNSf AIL IJABWTIES, JUDGMENTS, CDSTS
AND EXPENSF.S WI-DOI MAY IN ANY WAY Aa:RUE AGAJNSf SAID CTIY IN OONSEQUENCE OF nm GRANTING OF 11-DS PERMIT.
OSHA: An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height.
Expiration. Every permit issued by the Building Official under the provisions of this Code shall expire by limitation and become null and void if the
building or work authorized by such permit is not commenced within 365 days from the date of such permit or if the building or work authorized by
such permit is suspended or abandoned at any time after the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code).
DATE: ,_ 'f(f~ APPLICANTS SIGNATURE R ~ ~
°'.),
V Wl-IlTE: File YEllOW: Applicant PINK: Finance
... -CITY OF CARLSBAD
INSPECTION REQUEST
PERMIT# CB930958 FOR 02/15/95
DESCRIPTION: 52 SF ADDITION, RE-ROOF W/TILE
DEMO 148 SF, NEW ELEC. SERVICE
TYPE: RAD
STE:
INSPECTOR AREA PY
PLANCK# CB930958
OCC GRP R-3/M-1
CONSTR. TYPE VN
LOT: JOB ADDRESS: 2810
APPLICANT: GAUTHIER,
CONTRACTOR:
HOPE AV
RAY PHONE: 619 622-0840
PHONE:
OWNER:
REMARKS: BJN/RAY/729-6821
SPECIAL INSTRUCT:
TOTAL TIME:
CD LVL DESCRIPTION
19 ST Final Structural
29 PL Final Plumbing
39 EL Final Electrical
49 ME Final Mechanical
PHONE: I
INSPECTOR -f-tt-/-+----------
ACT COMMENTS
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***** INSPECTION HISTORY*****
DATE
022394
010694
123093
123093
122193
122193
122193
120993
120993
120993
111893
110393
102993
DESCRIPTION
Interior Lath/Drywall
Service Change/Upgrade
Interior Lath/Drywall
Exterior Lath/Drywall
Frame/Steel/Bolting/Welding
Rough Electric
Rough/Ducts/Dampers
Interior Lath/Drywall
Gas/Test/Repairs
Rough/Topout
Roof/Reroof
Ftg/Foundation/Piers
Underground/Under Floor
ACT INSP
AP PY
AP PY
PA PK
AP PK
AP PY
AP PY
AP PY
NR PY
AP PY
AP PY
AP PY
AP PY
AP PY
COMMENTS
GARAGE WALL
SVC CHANGEOUT
IN HOUSE RE CHK GRG
OK TO STUCCO
ND FRAME
OK TO WRAP