HomeMy WebLinkAbout2840 ESTURION PL; ; 80-805; PermitLICENSED CONTHACTOR S DECLARATION
I hereby affirm that I am licensed under provi
sions of Chapter 9 (commencing with Section
7000) of Division 3 of tfte Business and ^ofes-
slons (Dode, and my license Is in full force and ef
fect.
OWNER-BUILDER DECLARATION
Dl hereby affirm that I am exempt from the Con
tractor's License Law for the following reason
(Sec. 7031.5 Business and Professions Code), Any
city or county which requires a permit lo con
struct. alter, improve, demolish, or repair any
structure, prior to its Issuance also requires the
applicant for such permit to tile a signed state
ment that he is licensed pursuant to the provi
sions of the Contractor's License Law (Chapter 9
commencing with Section 70fX) of Division 3 of
the Business and Professions Code) or that is ex
empt therefrom and the basis for the alleged ex
emption. Any violation of Section 7031.5 by an ap
plicant for a permit subjects the applicant to a
civil penalty of not more than live hundred dollars
(5500).
CJ 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 of
fered lor 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 wortt
himself or through his own employees, provided
that such improvements are not Intended or of
fered for sale. If. however, the building or Improve
ment is sold within one year of completion, the
owner-bulider will have the burden of proving that
he did not build or improve for the purpose of
sale),
til. as owner of the properly, 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 property 'ho builds or im
proves thereon, and who contracts for such pro
jects with a contractor(s) license pursuant to the
contractor's License Law).
1 am exempt under Sec. B. & P.C.
for this reason
Date Owner
WORKERS' COMPENSATION
I hereby affirm that I have a ce'
sent to self-Insure, or a certi^a'
Compensation Insurance, c
thereof (Sec. 3800, Lat>or Cod^.
POLICY NO _ 1 „ .1 \
COMPANY C. WURB \
f
f
Work
ied CO
^VQopy is filed with the city.
uCerilfled copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the per
mit is for one hundred dollars (5100) 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 m«nner so as to become subject to
the Workers' Compensation Laws of California.
NOTICE TO APPLICANT: If, after making this Cer
tificate of Exemption, you should become subject
to the Worker.^R.gmpensatlon provisions of the
l.abor Coda, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDIN(3 A<3ENCY
I hereby affirm that there is a construction len
ding agency for the performance of the work for
which this permit Is Issued (Sec. 3097. Civil Code).
USE BALL POINT PEN ONLY
CITY OF CARL.SBAO-BUiL.DING DEPARTMENT
APPLICATION & PERMIT
. 1200 ELM AVENUE (714) 438-5525
APPLICANT TO FILL IN INFOR
MATION WITHIN RED LINES.
NO. JOB ADDRESS
\^S\T[OiRiXiOM\ 1 \PiU.I I I I ' I I ' ( » i I
wned
MicKael O'fJiaJ
OWNER'S PHONE
7^9-9/V/
OWNER'S MAILING ADDRESS
<2840 £sT-ogioM n
OATE OF APPLICATION BUS. L CENS
PRIME CONTRACTOR TATE LICENSE
LOT BLOCK SUBDIVISION ASSESSOR'S PARCEL NO.
DESCRIPTION OF WORK
CONTRACTOR'S ADDRESS
755 \Ll.6rd.t^dft'ie g
:,ll iSi n 3|S|0|-p|(O| I ,
DESIGNER'S ADDRESS
ACTOR'S
CENSUS TRACT
8LDG SO. FT.
QTY.
QP LAND USE
PLUMBING PERMIT
EACH FIXTURE TRAP
EACH BUILDING SEWER
EACH WATER HEATER AND/OR VENT fCOL.
EACH GAS SYSTEM 1 TO 4 OUTLETS
EACH GAS SYSTEM 5 OR MORE
EACH INSTAL, ALTER. REPAIR WATER PIPE
EACH LAWN SPRINKLER SYSTEM
WATERSOFTNER
TOTAL PLUMBING
OCC. 6P
STATE LiCENSE^^^
W Etc
RES. UNITS
STANDARD PLAN tt
AMT.
CONTRACTOR
QTY.
z
ELECTRICAL PERMIT
NEW CONST EA AMP/SWT/BKR
1 PH .25 3PH
EXIST SLOG EA AMP/SWT/BKR
1 PH .25 3PH
REMODEL/ALTER PER CIRCUIT
TEMP POLE 200 AMPS
OVER 200 AMPS
TEMP OCCUPANCY(30 DAYS)
tenL.
AMT.
TOTAL ELECTRICAL
CONTRACTOR 1
QTY.
PARKING SPACE
PLAN I 0 «.
DESIGNER'S PHONE
NUMBER OF STORIES
TYPE CONST
MECHANICAL PERMIT
INSTALL FURN. DUCTS UP TO 100,000 BTU
OVER 100.000 BTU
BOILER/COMPRESSOR UP TO 3 HP
BOILER/COMPRESSOR 3-15 HP
BOILER/COMPRESSOR 16-30 HP
VENT FAN SINGLE DUCT
MECH EXHAUST - HOOD/DUCTS
RELOCATION OF EA FURNACE/HEATER
PERM IT NUMBER
7^?. 7m
Hot V»M Unku Mtehint Ctrtifitd
AMT.
TOTAL MECHANICAL
CONTRACTOR
QTY.MOBILE HOME PERMIT
AWNING
PORCH
SET-UP
RAMADA, CABANA
FENCE OVER 6'
TOTAL MOBILE HOME
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT. AND DO
HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND i
FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED; TO COMPLY WITH ALL CITY.
COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION. WHETHER
SPECIFIED HEREIN OR NOT. I, ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM
LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS. COSTS AND
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE
OF THE GRANTING OF THIS PERMIT.
AMT
BUI
/ Pi
G
PLA
<
O
PERMIT
NPERMI
N
ALL INCLUSIVE PERMIT
PLUMBING
elecYrTcal
MECHANICAL
MOBILE HOME
SOLAR
MICO-FILM
TOTAL FEES PAYABLE
a.
Z
1-t.
•AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER
B'-O" DEEP AND DEMOLITION OR CONSTRUCTION OF
STRUCTURES OVER 3STOR1ES IN HEIGHT
T-S tIGNATUR OWNERO
AGENT^Iitf
CONTRACTORQ
BY PHONE □
APPROVED BY
SD-SOS'
SITE
ADDRESS: OWNER: PERMIT NO:
—FIELD INSPECTION RECORD
INSPECTION DATE INSPECTOR INSPECTOR'S NOTES
WOOD FLOOR
FOUNDATION • FORMS • SET BACK •TOILET •
UNDER FLOOR PLUMBING
UNDER FLOOR HEATING
OK TO INSTALL SUB FLOOR
SLAB FLOOR
UNDER 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 • .PLACE 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 PREPLASTER
SHOWN • FRAME
• PAN
FINAL INSP BY BLDG DEPT
OTHER DEPT'S REQ COMPLETED
ELEC M^ER-PERM-TEMP
GAS METER-PERM-TEMP
^ r f
CERT OF OCCUPANCY ISSUED
K" • J.
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