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Home My WebLink About2810 PIO PICO DR; ; 80-8; PermitLICENSED CONTRACTOR'S DECLARATION I hereby affirm lhal I am licensed under provi- sions of Chapter 9 {commencing with Section 7000) of Division 3 of the Business and Profes- sions Code, and my license is in full force and ef- fecl. OWNER-BUILDER DECLARATION CI hereby affirm that I am e,empt from the Con- tractor's License Law lo, the following reason (Sec. 7031.5,Business and Professions Code). Any city or county which requires a permit to con- struct, alter, improve, demolish, or repair any structure. prior to its issuance also requires the applicant for such permit to file a signed state- ment that he is licensed pursuant to the provi- sions of the Contractor"s License Law (Chapter 9 commencing with Section 7000 of Division 3 of the Business and Professions Code) or lhat is ex- empt therefrom and the basis for the alleged ex- emption. Any violation of Section 7031.5 by an ap- plicanl for a permil subjecls the applicant to a civil penally of nol more lhan five hundred dollars ($500). LI, as owner of the property, or my employees with wages as their sole compensation, will do lhe work. and the structure is not intended or of· fered for sale [Sec. 7044, Business and Profes- sions 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 nol intended or ot- tered for sale. If, however, the building or improve- ment is sold within one year of complelion, the owner-builder wil I have the burden of proving that he did not build or improve ror lhe purpose of sale). ).1. as owner of the property, am exclusively con- tracting with licensed contractors to construct the project [Sec. 7044, Business and Professions Code: The Contractor's License Law does not ap- ply to an owner of properly ·.•ho builds or im- proves !hereon, and who conlracts ror such pro- jects with a contractor(s) license pursuant lo the contractor's License Law). I am exempt under Sec. , B. & P.C. for this reason Date----::V.:b/ 2'? Owner ~ e,~ WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate ot con- sent to self-insure, or a certiticale of Workers' Compensalion Insurance, or a certified copy thereor (Sec. 3800, Labor Code). POLICY NO. ____________ _ COMPANY -----. r: Copy is filed with the city. D Certified copy is hereby rurnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE {This section need not be compleled if the per- mit is for one hundred dollars [$100) or less). I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. NOTll .. TO APPLICANT: II, after making this Ce,- lificate of Exemption, you should become subject lo the Workers' Compensation provisions of the Labor Code, you must forthwith comply Wilh such pr~" ·~ons or this perm ii shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that !here is a construction len- ding agency for the perfo,mance of the work for which this permit is issued [Sec. 3097, Civil Code). CITY OF CARLSBAD-BUILDING DEPARTMENT APPLICATION & PERMIT 1200 ELM AVENUE (714) 438 5525 USE BALL POINT PEN ONLY -;'\_ .i -LJ.,. ·... £). -_ --,. NO, ~V<J '~v, -,, • JOB ADDRESS AV.ST, !°ATE OF A!'PLICATION _) I ). 2. .:; ,/ • J • , -,.. {\ r ,-I R~ 1J,/?/7'i 1\t lYIV1W1 ._, i:;;, jl i •.1V1;....l I I I I I I J I I I I I I OWNER Br1.C; !ey OWNER'S PHONE PRIME CONTRACTOR Joh,n L/~!./-' 7 3 2 OvJ•l'?.~r -_ . • .'.J OWNER'S MAILIN'G" Apt>ifrss I fi",,Je_. CONTRACTOR'S AOIJIRESS i MS K"ovJ;.e, ", LOT BLOCK I SUBDIVISION l ;~::.s pr,.;-;:-o/. DESIGNER Al S..R '11-7T I I I (?,r J/.Jvr110R AJE OESCR IP Tiit.:.,I w;7. af;, E:::: i ,,;-[. .... ~ 64.....-~qe.. ~r ,_ .. :, ~ . --., ··''-DESIGNER'S ADDRESS ~(:_e, UsG J v V/5,A _.,. ft ---CENSUS TRACT Ga LANO us~ ~ RES, UNITS sf APPLICANT TO FILL IN INFOR - MATION WITHIN RED LINES. BUS. LICENSE PERMIT NUMBER STATE LICENSE ftP-i CONTRACTOR'S PHONE STATE LICENSE /279 DESIGNE'Fl!'S PHONE 7:24-3s""~ , "" /r. 'U ---~AJA -~K~17 Rp:&J -e>-I ;ARKING SPACE I NUMBER a/TORIES Nor V•lid Unless lhchine C,rtifi«l BLOG S~-4.Jb BLOGU;.~ OCC. GP STANDARD PLAN 11 179:~~ ITYPE CVS# 10cc. L/g I R- QTY. PLUMBING PERMIT AMT. QTY. MECHANICAL PERMIT AMT. EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100.000 BTU EACH BUILDING SEWER OVER 100,000 BTU EACH WATER HEATER ANO/OR VENT BO I LERICOMPRESSOR UP TO 3 HP EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP t.£-:t", EACH GAS SYSTEM 5 OR MORE BOILER/COMPRESSOR 16-30 HP l EACH INSTAL., ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT 8; 4700 -/ EACH LAWN SPRINKLER SYSTEM T.. -MECH EXHAUST -HOOD/DUCTS VAWATION: WATER SOFTNER RELOCATION OF EA FURNACE/HEATER BUILDING PERMIT I ' 1~,01 ; c,c,1, ... 3_QQ issue 3.00 SIGN PERMIT I . I T. I • w I-< C ~ > ts ;:: TOTAL PLUMBING TOTAL MECHANICAL PLAN CHECK I I 1l. 8""' !UX ) u ~-..... , C. CONTRACTOR CONTRACTOR ALL INCLUSIVE PERMIT I I I V) ~ ELECTRICAL PERMIT AMT. AMT. TOTAL PLUMBING I I oJlf"[-'"' QTY. QTY. MOBILE HOME PERMIT ELECTRICAL I I 71_.. NEW CONST EA AMP/SWT/BKR AWNING MECHANICAL I I I 1 PH .25 3 PH PORCH MOBILE HOME I I I EXIST BLDG EA AMP/SWT/BKR SET-UP -• . S0LA6 , -I I I I ' ,, 1 PH .25 3PH RAMADA, CABANA ("-----.-.A. ---"' ~ ..... ~:n.·-----~ r I r I ' r REMODEL/ALTER P@fl C 11'1 ett+-T !!J . --FENCE OVER 6' "(f . "" . ·1 d') V I . I I I - TEMP POLE 200 AMPS TOTALMOBILEHOM£{"""'"------'-'~ __ .., -v-~.A ~.-P. I ".E"" I - ~ V L.111.:6 I OVER 200 AMPS (../ J , I I I TEMP OCCUPANCY (30 DAYS) I . I I I ; ...... ,, ... 2~00 issue I --I I ,--.L. TOTAL ELECTRICAL "'7"d TOTALFEE~YABLi '--j (i I ---t;i V'-... CONTRACTOR ,LUL1 ) --,, "ANOSHAPERMITISREQUIREDFOREXCAVATIONSOVER 70-; 4,.J.---';1"_ ~ ~ ~ I HAVE CAREFULLY EXAMINED THE COMPLETED '"APPLICATION AND PERMIT, AND DD HEREBY CERTIFY THAT ALL INFORMATION HEREON ,s TRUE ANO CORRECT AND I 5'-0" DEEP ANO DEMOLITION OR CONST-r:e, f:) FURTHER CERTIFY AND AGREE IF A PERMIT 15 ISSUED;TO COMPLY WITH ALL CITY. %~OVER 3~TjRIE'" l<>HT : /. COUNTY ANO STATE LAWS GOVERNING BUILDING CONSTRUCTlON, WHETHER SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM-a 'O ~ocJoC &>~ ~ -.~Z-:_,., k.lJ .14 ~11~,t, LESS THE CITV OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANV WAY ACCRUE AGAlNST SAID CITY lN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. APPL~%T'S S~,URE" ~1h~ DWNERO CONTRACTORQ IAPP'(D_N'BY D~ ,,,,~.:, a. ~ --AGENi[ BY PHONE n _I~ ~ ~ ...,,,., /A ·11.;, 7 .J ,...; ,,.r ./ --f -Ll-'C,A SITE ADDRESS: I----- INSPECTION DATE WOOD FLOOR FOUNDATION• FORMS• SET BACK• TOILET UNDER FLOOR PLUMBING UNDER FLOOR HEATING OK TO INSTALL SUB FLOOR SLAB FLOOR UNClER SLAB PLUMBING FOOTING• FORMS• SETBACK• TOILET OK TO POUR CONCRETE FRAME ROUGH ELECTRICAL ROUGH PLUMBING ROUGH HEATING/VENTILATING FRAME OK• PLACE INSULATION INSULATION OK • PLACE WALLBOARD WALLBOARD OK .. • PL.ACE TAPE EXTERIOR LATH OK• PLACE STUCCO - FIREPLACE DAMPER &STEEL PLATE TIES/HEIGHT OF CHIMNEY OTHER TEMP POWER (POLE) SEWER GAS TEST SWIM POOL• STEEL BONDING '!!.• • PRE DECK .. ~, • FENCE PREPLASi"ER' SHOWN • FRAME J I • PAN I /1\ I FINAL INSP BY BLDG DEPT ./ I I OT.HE0R DE°F'."t'S REQ COMPLETED I / I ELEC MEl"ER:.:PERM-TEMP I y I GAS METER-PERM-TEMP (\ .r '-.J .. r--1-----I ~ CERT OF OCCUPANCY ISSUED lo----·- "'i -- INSPECTOR ('\ . \ I/ -... / ..• / 1 1 ~J ' / ' t-.Y / IJ / I /. II J J \ . ( I f\. \ I \1 \ I \ \ \. OWNER: FIELD INSPECTION RECORD . .. ~ . •. ., .. . . ,.... h x- \) .. t\• .• ~ ,. V "" . / I .. INSPECTOR'S NOTES '·· ' . .. ·- PERMIT NO: ·- - 1 ·,, ., . ~ CITY OF CARLSBAD Building Department PLANNING DEPARTMENT UNITS ALLOWED UNITS PROVIDED ---------------------- PARKING SPACES REQUIRED PROVIDED ·-:.-~... . ~ ---------- % COVERAGE ALLOWED PROVIDED -----+--+----------------BU IL DING HEIGHT ALLOWED PROVIDED FRONT SETBACK: ' . ALLOWED --......._ __ _ PROVIDED ------ INTRUSIONS ------LANDSCAPE.& IRRIGATION ENVIRONMENTAL lADDI:IoNu ENGLNEERING DEPARTMENT ---------- REAR SETBACK; . -~11' -~ fO R. 0. W. -=ce,,td'D INDUSTRIAL WASTE "/A IMPROVEMENTS ,-'-\fl) ,-.EI) S·EWER .CONNECTION uA DRIVEWAY LOCATIONS /tS SHOWJ ON spr 7'1-r -7--»?, ....... ""'-. --. -I 11·. · . GRADING PERMIT --c,.-I,.__.,;;;...,""'..,.,__ __ EASEMENTS 'l:»:!~tr,'1'~---.~ DRAINAG_E O .I(.... FIRE DEPARTMENT SPRIUKLING SYSTEM ____________ FIRE PROTECTION EQUIP·------- -• FIRE ALARMS EXITS ______________ _ r J-_ ,f I RE. HYDRANTS ____________ LOCATION _______________ _ \ ADDITIONAL COMMENTS .. r::;)o ISSUE• DATE ______ OK TO FINAL_· _____ DATE ____ _ WATER DEPARTMENT REQUIREMENTS OF APPROPRIATE DISTRICTS MET _______ DATE _______ _