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HomeMy WebLinkAbout2870 ELMWOOD ST; MULTI-PERMIT FILE; CB972330; PermitB U I L D I N G P E R M I T Permit No: CB972330 08/19/98 16:39 Project No: A9702959 Page 1 of 1 Development No: Job Address: 2870 ELMWOOD ST Suite: Permit Type: RESIDENTAL ADD/ALT Parcel No: 156-190-05-00 Lot#: Valuation: 0 Construction Type: NEW Occupancy Group: Reference#: Status: EXPIRED Description: RAD 684 SF, FULL BATH,BDPN, Applied: 08/20/97 : ENTERTAIN ROOM W/WET BAR Apr/Issue: Entered By: JM Appl/Ownr : BURNETTE GINO 760 758-9299 2870 ELMWOOD STREET CARLSBAD, CA 92008 *** Fees Required *** Fees Collected & Credits Fees: 707.00 Adjustments: .00 Total Credits: .00 Total Fees: 707.00 Total Payments: 314. Balance Due: 93.0 Fee description Units Fee/Unit 7E—fee Data Other > 314.00 4.00 PLANCK PLDA A > .25 3.00 L dK 4721 Q%Z FOR OFFICE USE ONLY — PERMIT APPLICATION S PLAN CHECK NO EST CITY. OF CARLSBAD BUILN& DEPARTMENT 'CA' 92009- '2075 Las Palmas Dr., Carlsbad V. GtV;I -. - . - -Validated By - 760) 438-1161 . / - Date________________ ' _; ...............................I V çri c joo '9T. 1Address (include Bldg/Suite ) Business Name (at this address) V * 8307 08/27101/97,M81 01 :02 Legal Description . •. Lot No Subdivision Name/Number' '' -Unit No; Phase-No Cptal # of uni Assessor's Parcel # Existing Use - Proposed UsV ,. . . eorn7/, 4athwo,Des n ti n,of W It lqff- 7 SQ. FFT #of,Storie!)S ' m 71 // ONTACTPER& ,. . . -'.- 'V JtiC25 CJ(iii' (i6. Address - . .. 'V -City State Z p Telephone P F sZi, PLIC TJ / frsc '- '27. L-iLSOiP V51V i7tSl?kP V 7 7Z°2 V Name ' V Address V V VV . City State Z p Te ephOne P V VOVWNER V J V V V V V Name V Address V , City State Zip Telephoto a P 15• O4T (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, rn:ah 0,relp6ir anystrUcture, prior to its C issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant ,to the Vprovisios of the Contr,actors License Law ,lChapter 9, commending with Section 7000 of Division 3 of .the Business and Professions.Codel or that m , he 'is exept ,therefiom, and VthOVVbS5iS for tile alleged exemption Any violation of Section 7031.5 by any applicant for a permit subjects the applicant1to a civil penalty of not more than five hundred dollars I$5001) Name V V V4 VVV Address V ' VI V ' City V' V ' State/Zip •'' ' Telephone # ' 'V 'V State License # V V. V License Class ' VCitVy Busin'ess License # V V Designer Name , , V , V Address: V V '5 , ' c!ty, •,VV . State/Zip, '. Telephone ' State License j Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: o 11 I have and will maintain a certificateof consent to self-insure for workers' compensation as irovided by.Section.3700 of the Labor Code, for the performance V of the work-for which this permit is issued. V VD I have and will maintain workers' compensation,' as required by Section 3700 of the'Labor Code, for the performance of the' work for which this permit is issued. My worker's compensation insurance carrier and policy number are: ,-- Insurance Company ' ' Policy NOV - V Expiration Date__________________ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS) C] CERTIFICATE OF EXEMPTION: (certify that in the performance of the work for which this permit ii- issued,, I shall notethploy any Vperson in any nianner so as 'V to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage Is unlawful.'and shall subject an- employer to criminal penalties and civil -fines up to one hundred thousand dollars 1$ 100,000), in addition to the cost of compensation, damages as provided for in Section 3706 of. the Labor code'-interest and attorney's fees. ' SIGNATURE - . V DATE WBUILDDEcLARA1 I 3,reby affirm that I am exempt from the Contractor's License Law for the following reason: - ' I, as owner of the property or my employees with wages as their sole compensation, ill d9 the work and the structure is-not intended or offered for, sale IS 7044, Business and Professions Code: The Contractor's License Law dOes not apply t'on 'owner, of propertywhobuilds orVVimproves thereon, and whoddes. 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).- 0 I, as owner of the property, amV exclusively contracting with licensed contractors to construct thetprojectV (Sec. 7044,' Business 'and Professions Codei 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). Cl I am exempt under Section Business and Professions Code for this reason I 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement.,[-] YES DNP - 2. I (have /,have no) signed an application for a building permit for the proposed work. 3.'--I have contracted with the following person (firm)V to- provide the proposed construction (includename,/ -address /-phone number ./ contractor's license number):. I plan to provide portions 'of the work; but I have hired the folloving person to 060rdinate, suprviCe and prd~idi~thi major work (inclde name I dre/ phone - number / contractors license number): I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated (include.name/ address / phone number I type of work): - •V - . - V - V V -,- V - - - PROPERTY OWNER-SIGNATURE V V V - DATE IFOWNOI V Is the applicant or, future building occupant required tosubmit a business plan, acutely hazardous materials registration form or risk management and prevention program under Sections 25506,t 25533 or, 25534 of the Presley-Tanner Hazardous Substance Account Act? 0'- YES' 0 VNO.. Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 YES 0 NO Is the facility to be constructed within 1,000 feet of the outer boundary of .a school site? :0 'YES- - DNO. , •t' ' V V - V V - " - -'-ii V "IF ANY OF THE ANSWERS ARE YES; A FINAL CERTIFICATE OF OCCUPANCY MAY NOT'BE'ISSUEQUNLESS THEVAPPLICANT HAS MET'OR'IS MEETING THEN V - V l. REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. I8 CONSTRUTlON1LENDlNGtAGENYj 2a . T 'l -'I hereby affirm that there is a construction-lending agency for the performance 'of the work for' which this permit is issued (Sec. 3097.0l Ca,il Code L). V LENDER'S NAME ' V - LENDER'S ADDRESS I9 ANCERTIFIcAiTtON . I I certify that I have read the àpplication and statethat the above inf omCtion is'corrèct and that the ihforriation on V the plahs i accurate. I agree'to comply'wiih all City ordinances and, State laws reléting to building' construction. 'I hereby- authorize represintatives of the Cit, of Carlsbad -to. enter .up'on the, above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD ;AGAINST. ALL LIABILITIES, JUDGMENTS COSTS AND EXPENSES WHICH MAY IN ANYWAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT OSHA An OSHA permit is required for excavations over 5 0 deep and demolition or construction ofstructures over 3 stories in height I EXPIRATION: Every permit issued-by the Building Official under the provisions of this Code Shalll expire by-limita'tion and become null and void if the building or ',,work, authorized by such permit is not commenced within 365 days,fron, the date of such permit or if thOVbuilding ,or work authqrized by such permit is suspended or abandonedat any time after the-worku 0 menc r `a-'Perio'd of)80 days (Section106.4.4 Uniform Building Code): VV jV APPLICANT S SIGNATURE ,._-" DATE - HlTE: File - YELLOW: Applicant PINK: Finance Citv of Carlsbad DATE: 07/01/98 = PLAN CHECK EXPIRATION PC# CB972330 DATE: 08/20/98 TO: BURNETTE GINO ADDRESS: 1`2870 ELMWOOD ST 2870 ELMWOOD STREET * CARLSBAD, CA 92008 You have applied to have your plans checked on the date shown above, and you have-not obtained your building permit. The provisions of Section 304(d) of the Uniform Building Code state: "Section 304(d) Expiration of Plan Review Applications for which no permitis issued within one year following the date of application shall expire by limitation, and plans and other data submitted for review may thereafter be returned to the applicant -: or destroyed by the Building Official. In order to renew action on an application after expiration, the applicant shall resubmit plans and pay- a new plan review fee." Please check the appropriate box indicating your choice and return this letter to the BUILDING DEPARTMENT. PROJECT ABANDONED. I WILL PICK UP PLANS-WITHIN 10 DAYS. PROJECT ABANDONED. PLANS MAY BE DESTROYED. - -\ -. - J - :,i9 ecf h43 4-? If you have any qiIestThns, please contact the Bui1di4g"/6 '-4 Department at (619) 438-1161 extension 4331. - - D pL*i/vs Mr1-y RAENETTE ABBEY - - - - Building Department - - (t.)r rii.v5) 2075 Las Palmas Drive • - Carlsbad, California 92009 • (619) 438-1161 B U I L •D I N G, P 5 R N I T Permit No: CB921295 12/16/92 12:22. - . ' Project No: A9202629 Page 1 of. 1 -' . Development No: Job Address: 2870 ELMWOOD ST . - Suite: 0497 12/16/92 0001 01- 02 Prmit Type: PLUMBING - All . .-: C-PRMT 2700 Parcel No: .156-190-05---00 Lot#: V Valuation: - V V 0, Construction Type: NEW . . . . . Occupancy Group: . . Reference#: .Status: ISSUED Description: GAS REPAIR . - -V - . V Applied: V - VV Apr/Issue:V12/16/92 Entered By: DC V V Appl/Ownr' : BURNETTE, GINO V 619 720-7362 V 2870 ELMWOOD ST V CARLSBAD, CA 920 Co ected & Credits -------- Fees: . /27. ,Adjustments: . /. (\.00 S. .00 Total Fee: / 0/.V 1l yrs:\ .00 V f . - V2700. Fee, description / V pi V V t Et fee . Data V - ------------ ------- ---- Enter P i ping -__V __:----- "Y- for Plu bYig . sue Fe > 0 V 20.00 Y Gas System 7.00 .*.PLUMBING 00 27.00 INCORPORATED V V 1952 V • V llL©c3 . I V t - •1 V - V V V -: . V• VVV SV V V VVVV V VV• V V V . V - •'.--V•- .. V V V V V V V •_ V •- CITY OF CARLSBAD 2075 Las Palmas Dr.,Carlsbad CA 92009 (619) 438-1161 PERMiT APPLICATION City of Carlsbad Building Department 2075 Las Palms Dr., Carlsbad, CA 92009 (619) 438-1161 1. PERMrr rYvi A - U Commercial U New Building U Tenant Improvement B - 0 Industrial 0 New Building 0 Tenant Improvement C - 0 Residential 0 Apartment 0 Condo 0 Single Family Dwelling 0 Addition/Alteration 0 Duplex 0 Demolition 0 Relocation 0 Mobile Home 0 Electrical 0 Plumbing 0 Mechanical 0 Pool 0 Spa 0 Retaining Wall 0 Solar 0 Other__________ 9---2-, PLAN CHCK NO] 7 5 IFsr.vAL I 'PLAN CK DEPOSIT________________ I VALID. I Im I PROJECT INFORMATION J FOR OFFICE USE ONLY 3 5 Building or Suite No. 7 -"n r - v Nearest Cross Street QLV- LEGAL DESCRIPTION uionamèIWumber Unit No. Phase No. CHECK BELOW IF SUBMITTED: 02 Energy Calcs 02 Structural Calcs 0 2 Soils Report 0 1 Addressed Envelope ASSESSOR'S PARCEL EXISTING USE PROPOSED USE DESC OF WORK , Ra.ç r- '~. FT. # OF STORIES UJNIAUT PEHUN (ii ditlerent from applicant) NAME ADDRESS CITY STATE ZIP CODE DAY TELEPHONE APPLICANT 1] CONIHADOR U AGENT FOR CONTRACTOR U OWNER U AGENI FOR OWNER NAME ADDRESS CITY STATE ZIP CODE DAY TELEPHONE NAME ADDRESS 2- 7. 70 (•l.- -- B AO STATE C 4 ZIP CODE ØLOO DAY TELEPHONE (,I NAME ADDRESS CITY STATE ZIP CODE DAY TELEPHONE STATE UC. # LICENSE CLASS CITY BUSINESS UC. # DESIGNER NAME ADDRESS CITY STATE ZIP CODE DAY TELEPHONE STATE UC. # 7. W01 HUN Workers' Compensation Declaration: I hereby affirm that I have a certiticate ol consent to sell-insure issued by the Director or Industnal Relations, ora 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. Q. INSURANCE COMPANY POLICY NO. EXPIRATION DATE Certificate 01 Exemption: I certily that in the performance ol 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. SIGNATURE DATE S. OWNER-BUILDER DECLARATION Owner-Builder Declaration: I hereby atlirm that I am exempt from the Contractor's License Law for the tollowing reason: 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.). 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). 0 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 alleged 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 [$5001). SIGNATURE DATE COMPLETE THIS 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? DYES 0 N Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? DYES 0 N Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? DYES ONO IF ANY OF THE ANSWERS ARE YES A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED AFTER JULY 1, 1989 UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CX)NThOL DISTRICT. 9. WNSThUCHON LENDING AGENCY I hereby attirm that there is a construction lending agency tor the pertormance 01 the work for which this permit is issued (Sec 3097(i) Civil Code). LENDER'S NAME LENDER'S ADDRESS I certify that I nave read the application and state that the above information is correct. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the City of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS THE CITY OF CARlSBAD AGAINST ALL LLAI3UII1ES, JUDGMENTS (X)STS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS 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 tirnefter the work is commenced for a period of 180 days (Section 303(d) Uniform Building Code). TURE A& DATE: S -n-INSPECTION DATE _-/I INSPECTOR _S PERMIT •_ PLM4CX JOB ADDRXSS __ S 4la~ TIME ARRIVE: TINt LEAVE: 'co LVL DESCRIPTION - ACT COMMENTS S PEP*IT$ S 6/15/Se S S S (n Z 0 I- 4 4 —J a., w 0 APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. CARLSBAD BUILDING DEPARTMENT . .. APPLICATION & PERMIT ' S ' Carlsbad, California 92008-1989 (619) 438-5525 . J08'AOORESS AV, ST. RD. NEAREST CROSS ST. DATE OF APPLICATION USINESS LICENSE ad VALUATION PERMIT NUMBER IQ 9 i1 . /--7--t O/o-?Oo -C •. - - ZONE LOT BLOCK ,,.0 SUBDIVISION , ASSESSOR PARCEL NO. CONTRACTOR CONTRACTORS P ONE a.:-. /llycE GL 7 6 ., OWNE R'S NAME ., ,' OWNE R'S PHONE CONTRACTOR'S DDRESS LICENSE NO PLAN I 0 # BUILDING SO FOOTAGE OWNERS MAILING ADDRESS zLii a1 % DESIGNER - DESIGNER'S PHONE .- - -. . .. DESCRoNWK).. fl'i,*T c-,ej,C DESIGNER'S ADDRESS , LICENSE NO, 271 Zo AM P / mP ___ .. . F/P FLRELEV , .NO OCC GP- EDU STORIES . ..YDND - CENSUS TRACT P O LAND USE PARKING SPACE RES UNITS GRADING PERMIT ISSUED REDEVELOPMENT TYPE - 0CC LOAD FIRE SPA - ç '- AREA CONST YO 0 YO ___•' 'y J Not Valid Unless Machine Certified - CITY. ,. PLUMBING PERMIT - ISSUE - MECHANICAL PERMIT - ISSUE SUN.iMARY/ACCoUNT 'NUMER EACH FIXTURE _TRAP ' ' INSTALL FURN.-DUCTSUPTO100,000BTU' , BUILDING PERMIT 001'810'00'00'8220 - - EACNBUILUINGSEWER -" '' _OVER 100,000BTU . SIGN PERMIT -001-810-00-00'8221 , EACH WATER HEATER _AND/OR VENT _' . BOILER/COMPRESSOR UPTO3 HP. '. --•' PLAN CHECK 001-810-00-00-8806 EACH GAS SYSTEM I TO 4 OUTLETS ' BOILER/COMPRESSOR3.15HP '',- TOTALPLUMBING 001-810-00-00-8222 EACH GAS SYSTEM 5ORMORE __- , METALFIREPLACE _ - .. ELECTRICAL 001-810-00-00-8223 -30._v-V C tam exempt under Sec. , B & P.C. EACH INSTAL.. ALTER, REPAIR WATER PIPE - : VENT FAN SINGLE DUCT ' . -MECHANICAL 001-810-00-00-8224 EACH VACUUM BREAKER '. , - MECH_EXHAUST - HOOD/DUCTS ... MOBILEHOME __001-810-00-00-8225 WATERSOFTNER •' -', RELOCATION OFEA FURNACE/HEATER • ' ,MOBILEHOME PARKINS P EACH ROOF DRAIN (INSIDE) , ' ' - 4_SOLAR ,001-810'0O-00-8226 - '• .- - TOTAL MECHANICAL . . S ,... il_i /_STRONG MOTION /_r 880-519-92-33 - •- TOTALPLUMBING _- . '_F)EPRIN'r(LER",,-"001-810-00-00-8227 QTY c ELECTRICAL PERMIT ISSUE OTY SOLAR _ISSUE _ - (_ _332_810_OOoo - NEW CONSTEAAMP/SWT!BKR J 5 . COLLECTORS . SCHOOLFEE - DISTA_ .,- - 1PH _•TPH "• -... STORAGE TANKS • • • - - • Carlsbad _--•- a.- - - EXIST BLDG EA AMP/SWT/BKR • ' ' ROCK STORAGE _• ' Encinitas _a-•,,,- - 1PH "-3PH - ' - PUMP. . SanDiEuilo .a • San • REMODEL,'ALTER PER CIRCUIT - • . '. -' PLAN CHECK FEE ' . 'San Marcos •',' , '' .• • 'C' • TEMPPOLE _200AMPS __- _C • '' . - • ' OVER 200 AMPS . ,' .LICENSE TAX ' 001-810-00-00-8162 ,.'•- TEMP OCCUPANCY(30 DAYS) -'• • , . MFF •,,-. 880-519-92-57 -. -'.' -. ___L '_._•___'_- ,. ' CREDITDEPOSIT TOTAL ELECTRICAL _ • _1, . ,TOTAL SOLAR TOTAL FEESPAYABLE CAREFULLY EXAMINED THE COMPLETED 'APPLICATION AND PERMIT" AND DO HEREBY Expiration. Every permit issued by the Building Official under the provisions of this * AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER Code shall expire 51e limitation and become null 0n within 8 v 0 od ''rk 50" DEEP AND DEMOLITION OR CONSTRUCTION OF 'CER1'IFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE authorized b such ml is not commenced days from the date of such !DECLARATIONS ARE TRUE AND CORRECT AND IFURTHER CERTIFY AND AGREE IF A PERMIT IS permit, on if the buildin or work authorized by such permit is suspended or STRUCTURES OVER 3 STORIES IN HEIGHT 121SSUED: TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING BUILDING CON abap0j'bed ej _anylimeaertheworkiscommencedforaperiod01180days. TSUCTtON. WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND APLItJAN_'_SIGN_rUR 0 ___________' APPROVED BY A • - DATE OWNER CONTRACTOp1 'KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND / . S "EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE .91 . ' /_ -__________c'D BYPHONE 1.~G ANTI~G OF THIS PERMIT. I USE BALL POINT PEN ONLY & PRESS HARD 0 I hereby affirm that I am licensed under provialons of Chapter 9(commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is In IK L full to Class 'IO 11 I hereby. attires that I am exempt trues the Contrac .1 tars License • Law [or the following reason (Sec. 7031.5 e Business and Professions Code: Any city or County which re- quires a permit to construct, utter, improve, demolish, Or, repair any structure, prier Is its issuance also requires the ap- plicant tor.such permit to tile a signed statement that he is licensed pursuant .10. the provisions 01 the. Contractors License Law (Chapter 9 commencing with Section 7000 of Div isiOn 3 of the Business and Professions Cede) or that is ex- empt therefrom and the basis for the alleged exemption. Any violation at Section 7031.5 by an applicant for a permit sub' (ects the applicant to a civil penalty of not more than tine hun- dred dollars ($500). cc ,, ' .. . . . . 01as owner of the property, or my employees with wages '—as their sole compensation, will do the work, and the struc' LU tore is not intended or offered for sate (Sec. 7044, Business i ______________ .J .. 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 intend' W , ed or altered or sale, It, however, the building or improve' Z .. moot is sold within one year of completion, the owner-builder . will have the burden of proving that he did not build or im- prove tsr the purpose of sale). 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 at properly who builds or im- proves thereon, and who contracts for each projects with a conrractor(s( license pursuant to the Contractor's License Law(. e . 'n 0 Asahorrkowoer tam improving my home, and the 10110w' ing conditions exist: - ..The work is being performed prior to Sale. 2. .1 have hued- in my home Or twelve months a . , prior to completion of this walk. 3. I have out claimed this exempliox daring the 1as1 three years. ' for this reason - 0 thereby affirm that ihave a certificate of consent to ,sell-insure. or a certificate of Workers Compensarion In. El suravce. or a certified copy thereof (Sec. 3800. Labor Code) . POLICY, NO. COMPANY ,, ' ' . • - 0 'Copy is tiled with the city 0 Certified copy is hereby furnished • • 'U , '• - • I 0. - • CERTIFICATE OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE .(This section need not be completed 11 the permit or is rue one It dollars (S11010) or less) UJI cc certity that in the performance 01 the work for which • permit is issued. I shall not employ any person in any manner so 3510 become subject to the Workers Compen- satiun Laws of California. NOTICE TO APPLICANT: It, alter making this Certiticate p.. of Exemption. you should become subject to the Workers'" Compensation provisions or the Labor Code, you must forthwith comply with such provisiods or this permit shall - be be deeed revoked. . ' F 0. t hereby affirm that there is a construction lending agency for the performance or the work for which this per. 01 mit is issued lSec.,3097. Civil Code) ZI 'U I Lender's Name C ..11 . ., Lender's Address -- - TYPE DATE INSPECTOR BUILDING I FOUNDATION REINFORCED STEEL MASONRY GUNITE OR GROUT SUB FRAME Li FLOOR Li CEILING SHEATHING Li ROOF Li SHEAR FRAME EXTERIOR LATH - INSULATION INTERIOR LATH & DRYWALL PLUMBING Li SEWER AND BL/CO Li PIJCO UNDERGROUND DWASTE DWATER TOP OUT 0 WASTE Li WATER TUB AND SHOWER PAN GAS TEST Li WATER HEATER Li SOLAR WATER ELECTRICAL O ELECTRIC UNDERGROUND Lii UFFER ROUGH ELECTRIC O ELECTRIC SERVICE Li TEMP9RARY Li BONDING Li POOL MECHANICAL Li DUCT & PLEM., Li REF. PIPING HEAT - AIR COND. SYSTEMS VENTILATING SYSTEMS CALL FOR FINAL INSPECT/ON WHEN ALL APPROPRIATE ITEMS ABOVE HA YE BEEN APPROVED FINAL PLUMBING ELECTRICAL MECHANICAL GAS BUILDING SPECIAL CONDITIONS — FIELD INSPECTION RECORD REQUIRED SPECIAL INSPECTIONS INSPECTORS NOTES INSPECTION - REQ. IF CHECKED INSPECTORS APPROVAL DATE SOILS COMPLIANCE PRIOR TO FOUNDATION INSP STRUCTURAL CONCRETE OVER 2000 PSI - PRESTRESSED CONCRETE POST TENSIONED CONCRETE - FIELbWELDING HIGH STRENGTH BOLTS SPECIAL MASONRY PILES CAISSONS