HomeMy WebLinkAbout2842 JEFFERSON ST; ; 86-1066; Permit (2)"' z 0
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O I hereby affirm that I am licensed under
provisions of Chapter 9 (commencing with
S.Ctlon 7000) of Dlvlslon J of the Business
and Profeealons Code, and my license is in
full force and effect.
hereby af11rm thal I am exempl from lhe Con!'C:C
tor's License Law ior the follow,ng reason !Sec 7031 'J
Business and P•otess•ons COCle Any c,ry o, coun•y whrcr, re :iuore, a perm,1 !o :onstruct alter ,rf1prove dernol,s'. m
repair any structure. P'ror to •ts ssuance a so ·eQuns !heap
p1,cant for such oerm,1 to !,le a srqned slatemer.t that ."e ,s
·,censed :iusuant to the orov,sons cl ·he L~r11raccr, . ,cerse '.aw coaoter 9 C~"'"lenc,nq ,.,.,1c Se·' 1:oc,
J:·,,,,o· 3 81 the Bus,iess dnC P•ofess,ons Cude,°"'
ern~• :~ere1rorn a~d the ba1,s for '.he alleged c>err:t,GP
, , at.on or Sectio1 7J31 5 t;y ar, app11cac• h1 a
e:ts :ne aool,cant :ca c·v I ~ena '.y ol 0ot rPC"~ 1•,~
d'eC do1,a,s 1 $~00',
I as owner of the ~,:;r;e'ty or ~y ernplo1~es ,,,·~ w:i<;e\
the,· sole compensat,on ,.,,1 do The wor, one ThB otruL e 15 ·,vt ictended or a'fered 'or sale 1Se: .'Mt,, Bus•ness
,;nd P,01ess10·0 Code ihe Coatractor, ,_ ,ce,se I aw joes
"Jt app'y 'o an owner ~I P'O~erty who bu1'ds or ,r"'pro1es
'hereo1 and wno does such wor~ n,mselt or 1rror,sh h:s r.w•
emoloyees. orovided trat suer, ,m~rovemer•s are not ·nterc
ed or otle'ed ro• sa,e 1• hOweve' the bu1·d1~g :ir ,r,,prove
~ent IS sola w1\h1n one year of com~let,on the owne, builder
.,. I' have the burden o! prov ng •hat he d1a no: ou,ld or 1"1 ~rove for the ;iurpose o! sale!
1. as owner of The wo;ierTy am exclu~1ve1y conlrac1,nq
w,1~ licensed contractors to co%1ruct the pm1ect I Sec 7044
Bus·ness and Pra1ess,ons Code The ContraLtor's License
Law does nm apoly to an owne, of proper!)' who bu1'ds or ,rn proves thereo1. and who contracs lor each p,01ects w•th a
contractor{sl ·1cense ~!JCS'Jant to The Contra;tcr s '.1cense Law)
As a homeowner am ,mp·ov,ng rr,y ho.,e, anc the 'o iow '"Q cond1t1ons ex1sl 1 The won, ,s ne,na perlormed or.or :o sae 2 I cave ivco ,n-c,iy ~ome 'a, tweve months
prior to cJr-1plet,on ot :h,s work
• nave ~ot cla,mecr :h,s exe.,,ption durin~ the last three years
for ih~:,~:~~~I under Sec _____ _ B&PC
I hereb; a'hrm that I ha,e a ce,t1'1cate of consert to
se f insure or a cer:,f,cate otWorse·s Compensa\Lon In
surance. or acer'. t,e(l copy :hereof ,Sec 3800. Labor Code>
POL1CY NO
C0'.1PANY
Copy ,s ,, ed ;,•th the c,ty
_ Cert1'1ed co;iy ,s he·eby furnished
CERTIFICATE OF EXEMPTION FROM
W0'1KERS COMPENSATION INSURANCE
1Th,s section need not be completed d the permd
,s 'or one hundred do•lars <_$100) or less)
_ I cert,ry I hat ,n the performance of the work for v,h,ch
11,s perm,t 1s issued. I shall not employ any persan ,n any
manne• so as to become sub1ect to the Workers Com pen
sat,on Laws of Cal,forn,a
NOTICE TO APPLICANT If. after mak.ng this Cer\dicate
cf E<empt•on. you should become sub1ect to the Workers
Compensation orosis,ons ot the Labor Code. you nust
to,thw,th comply with such pro,is,ons or this permit shall
be deemed revo~ed
; 0 ~ret,·, _,·f •rr, "n: •~ere s a cJns:r~c,t•Jr ·0 ,1,~g
'J' +oa,-c~•t, c _)! ·~,, ;.,~r• •-, '"", r
s 1ss,Jec ,S,c,c ,Jq; ,-.,v,, :=:oce
I CE' S ,.~TC
,·cfo, s "-:icr~»
USE BALL POINT PEN dLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT Carlsbad, California 92008-4859
JOB ADDRESS AV. ST. RO. NEAREST CROSS ST. DATE Of APPLICATION BUSINESS LICENSE# VALUATION PERMIT NUMBER
;)..~4-1 :r~N ~ ~-~ Jo-j,,Jb '3& -cOT BLOCK I SUBDIVIStON l ASSESSOR PARCEL NO CONTRACTOR CONTRACTORS PHONE# ZONE 10&:.to 7)..9",'f'J 1 7 OWNER'S NAME I ,~;/'J;; ;;· _--V,,..,r/ .... ,,._ .LJ.,. J .s r-/Wn CONTRACTOR'S ADDRESS STATE LICENSE NO . BUILDING SQ. FOOTAGE
' N 72,,, y ,I' . / ,.)~ f .,..J t: e-o OWNER'S MAILlNG ADDRESS
'~GY)(
. ' DESIGNER'S PHONE
'?11) 9/ .. ,._ DESCRIPTION OF WORK
-. . ,,.... . -DESIGNER'S ADDRESS STATE LICENSE NO.
~I {)LI :::,H-y--•,v-i"Yl(J Vt" c;;;u ~ / I 7 '
~--~~e-TV~------------a e F LR ELEV NO OCC GP EDU iiiil7 ii iil liiiii8i86Pii:MT :u.r STORIES
.,,= '\C
; I PAPKI"-(, SPACE RES UNITS I GRAOING PERMIT ,ssueo REDEVELOP....,E'-JT TY PE DCC LOAD FIRE SPP
A RF A CONST
-□ ' □ ,'.] -....□ v[J NO Not VJ/id Unlen Milchine Certified -,59---II 3-OTY PLUMBING PERMIT. ISSUE :I QTY MECHANICAL PE9"'/IT -ISSUE SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP
. INSTALL FURN ou;Ts :JP TO liJC· ·u nu BUILOl~G PE8M:T 001 -810-00-00-8220
--I EACH BUILlJING SE'NER I OVER 100 000 BTU SIGN PERMIT 001-810-00-00-8221
~------------+-------II-----+ ---L
EACH WATER HEAi ER ANLJ UR VENT 1 BOILER COMPRESSOR uP TO 3 HP PLAN CHfCK 001-810-00-00-8806
---------11------+---. ---
EACH GAS SYSTEM I l U 4 OUTLETS BOILER COMPRES.SOR 11':i HP ' TOTAi Pl UM RING 001-810-00-00-8222
-----' -.. ------' ---------
b\CH GAS SYSTEM J OR r,,ORf 1/:'~ .'.\i ~IREPLt.:::E ELECTRICAL 001-810-00-00-8223
I----+-· -----------------. -' --------------;----------
EACH INSTA~ All E:.R. REPAIR WATER PIPE VENl ~AN SINGLE [JU[T --MECHANICAL 001-8 l 0-00·00·8224
--------------i --+ ------
EACH VACUUM BREAKER ' MECH EXHAUST HOOD oucrs MOBILEHOME 001-810-00·00-8225
WAltR SO~TNER ! RELOCATION OF EA FURNACE HEATER SOLAR 001-81 0-00·00-8226
--------I -~-..
· A ,·...i R:-:,:1;: --;c,:dJ , 'J) -,L II DRYER VENT STRQl\,G MOT:ON 880-519-92-33
---r -1 ----ii TOTH MECHANICAL ~-1-FIRE SPRINKLERS 001-810-00-00-8227 ~.
TOIAI Pl UMfl;~L
'
. PUBLIC FACILITIES FEE 320-810-00-00-87 40
~/ ' MOBILE HOME SETUP l BRIDGE FEE QTY. ELECTRICAL PERMIT -ISSUE -tTY PARK·IN·LIEU (AREA I
NEW CONSr U• AMP S',\il :lKR CAR PORT 1 TIF 001-810-00-00-8835 -------------
I PH \ PH 1! AWNING LICENSE TAX 001-810-00-00-8162
-------------------
EXISTflLOG EAAMPSWT BKR i ; GARAGE MFF 880-519·92·57 ------?0 I PH 3 PH ' u'e)l,1__Q_
I
----
REMO[]El ALTtR PfR CIRCUIT
. ---l -----· . -L__ ____ -------
TE:. \·1P POLE JQO AMPS ---------------
UV[R 20U AMPS . ---
ft.MP OCCUPANCY ,]Q DAYSI ~L---------~-------~----------------
I ' CREDIT DEPOSIT ,. T ------
T1ITAL flftlRICAl ' I -Tu ;',L TOT AL FEES PAYABLE 'ZL> ' 1: ' "
• HAVE CAREFULL y EXAMINED THE COMPLETED APPLICATION ANO PERMIT' ANO DO HEREBY Exp«at1on Every permit issued byttie Budding Ofl1c1al under the prov,s,o",~"' s * AN OSHA PERM:T IS REQUIRED FOR EXCAVATIONS OVER
CERT·FY ,JNDEP ?ENALTY OF PE:RJURY !rlAT A'-l INICORMATIOl'l HEREON INCLUDING THE Code shall expire by l1m1!at1on and become null and void It the bwld1ng _-,, -,,or~ 5' O" DEEP AND DEMOUTION OR CONSTRUCTION OF ~~;1zed by such perm1! ,snot commenced w,th,n 180 da'fs lrom 1he dale .:if sucn DECLARAT,or,s 4f-'F F1L.E MH) CORRFrT AN[i I FURTHEl'l CERTIFY AND AGREE IF A PEPMIT IS , _o_:j ,1 th u1td1~9. or wurk authorized b)' s~.~_permd 1s suspended or STRUCTURES OVER ~STORIES IN HEIGHT
ISSUED TQ COMP'..." •'.'ITH "'LL cnv_ COUNlY t,•,o STATE LAWS GO\IE>lNING BUILDING co ... on -1 l1m• e• th o•k ,--Qmm-::.-d f !' _,:;,.::_·nod o1 160 da"s
'.:iTRUCTION. V·/HE-Hi:.q SPEC1F!ES YEREIN OR. ~.o~ ALSO AGREE TO SAVE INDEMNIFY AND /7.. --,~CONTRACTOr;J> APPRC,r{}d:lJ OAT!: KEEP HARMLESS THE CJ-:-Y OF C<l..RLSBAD AGAINSf ALL i..lABILITIES JUDGMENTS. COSTS AND 1-,
EXPE"iSES WH!CH MAY !r-, A:-.Y ;NAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE /7 ln-9--.~ -I GRANTlt\/G OF TµIS PE8hh' ---• ~ ,, BY PHONE [J I J
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TYPE DATE INSPECTOR '
BUILDING I ~ -IO(Gl..'c,
F FOUNDATION FIELD INSPECTION RECORD :
M
REINFORCED STEEL REQUIRED SPECIAL INSPECTIONS '====_JIN;;S;;,P~E~CT;,;O;:;R,;,'~S;;N,:e;O,;,T:a;ES~='f'' =--============, MASONRY r REQ IF INSPECTORS GUNITE OR GROUT INSPECTION CHECKED APPROVAL DATE I l--------------'------------------1
SUB FRAME □ FLOOR □ CEILING SOILS COMPI IANCE I
SHEATHING □ ROOF □ SHEAR PRIOR TO -1--------------'-;---------------,
FRAME FOUNDATION INSP 1--------------;..' --------------
EXTERIOR LATH STRUCTURAL CONCRETE I
OVER 2000 PSI I 1--------------,---------------INSULATION PRESTRESSED CONCRETE 1
INTERIOR LATH & DRYWALL POST TENSIONED !---------------'--, --------------
' -, ·~;,.:'.:.' _tt'] .!.1.' CONCRETE 1--.::....c:......c.:c::_ ____ +----+------+----I
PLUMBING FIELD WELDING --------+--------+·---" : □ SEWER AND BUCO □ PUCO HIGH STRENGTH 1---------------'--I ---------------1
UNDERGROUND □ WASTE D WATER • soL rs 1--------------~: -----------------1
TOP OUT □ WASTE □ WATER SPECIAL MASONRY • ' 1--------------..---------------
T U BANDS HOWER PAN >---------1----+------l---1-------------~•--------------
GAS TEST PILES CAISSONS I
□ WATER HEATER □ SOLAR WATER 1-----------1------1-------1----1---------------'-: --------------
1
ELECTRICAL >-------1--------+-----1------: □ ELECTRIC UNDERGROUND □ UFFER !--------+----+-----+---f-------------1--------------
ROUGH ELECTRIC -
□ ELECTRIC SERVICE □ TEMPORARY 1-----------1---+-----___ ~-------1---------------'--'' _____________ _
□ BONDING □ POOL !---------+----+-------'----1--------------:.__ _____________ _
• I
MECHANICAL '---------!--------+-----'---'-'--1-------------'--: ------------
□ DUCT & PLEM., □ REF. PIPING l---------+----1-----11----1---------------.-'--------------4
HEAT -AIR COND. SYSTEMS l---------+----1-----11----, VENTILATING SYSTEMS l------------,..-1 --,---------------1
,
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE J : ITEMS ABOVE HAVE BEEN APPROVED. Jl---------1-----+------+----1 1-----------------'-,---------------1
FINAL / H--------+----11-------11-----< 1--------------:-'--------------4
PLUMBING L J : 1-----------------------------1
ELECTRICAL
1
, , " 0 ' "' l---------+----1-----+----' , MECHANICAL " "· • .J "' ~ 1-------------...,_------------~
I
GAS I\ 1\41 V ' 1---------+----f-----+----I 1-------------+'------------------i
BUILDING .\ / • 1 '-1----------1-----+-----+-----t 1 _____________ ..1: ______________ ~
SPECIAL CONDITIONS \ 1 L _______ _,__ __ ~----'---__,
1
\\ ~ 1--------------:--------------_j -----------------''------''-"'------'