HomeMy WebLinkAbout2876 LUCIERNAGA ST; ; 87-1050; Permit.. z
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D I hereby affirm that I am llcensed under
provlslon11 of Chapter 9 (commencing with
S.Ction 7000) ol Division 3 of the Business
and Professions Code. and my license 1s in
full force and eflec1
hereby all.rm that I am exempr lrom the Cont'ac
tors L,cense law tor the blow,ng reaso~ rSec 7031 ~ Business and Proress,ons Code Any c,ty or counly wh,c,, -e
quires a perrn,t to consirucl aI1er ,mprove demolish w repa,r any structure p!iOr to ,ts ,ssuance a1so ·eau,res The ap
pl,cant tor such permrl lo Irle a s,qne(l staternenl lhdl he ,o ·,censed oursuant 10 The prov,s,ons ol 'he Lo~1,ac10· s
Lrcc~se Law ,:Chaorer 9 commenc,ng w,th Sert,on 7000 cl Di.·,s,on 3 of the Business ana Proless,ons Code, or 1ha1 ,sex
emol lheretrom and the basis tor the allegeo e,emphon Ani
,,olal,on 01 Sect,on 7031 5 by an appl,canr for a perm,1 oub
1etts me appl,cant to a c,v,I pena'ty of nol more !~an live h,Jn
d'ed dollars [$5001
I as owner of lhe properly or my employees w,m wages
as their sole compensahon w,II do the work ard lhe sl!uc
lure Is ~ot intended or altered for sale 1sec 7044 Business
and Proless,ons Code The Conuacior s license Law aoes
not apply to an owner of properly who builds o, ,mproves
thereon and who does such work himself or through hrs own
emoloyees. provided that such ,mp,ovemenls are no1 intend-
ed or ol!ered lor sale 11. hOwever. lhe building or ,mprove-
menl Is sold w,rn,n one year of compler,on, the owner builder
w,11 have the burden ol prov,ng that he a,d no1 buold or rm
prove lor the purpose ol sale)
I I, as owner ot the properly am exclusively contracting
wr1h I,censea contraclors to construcl lhe pro1ect 1sec 7044
Busmess and Profess,ons Code The Contractor's License
Law does nor apply 10 an owner of prop,erly who bu,lds or ,m
proves thereon. and who contracts for each proIects with a contracror(s) 1,cense pursuant to the Contrac1or's L,cense Law)
I As a homeowner I am ,mprov,ng my home. and !he lollow
,ng cond,hons exost
1 The work rs being performed p11or to sa1e
2 I have lived ,n my home tor 1welve months proor 10 comple1,on of this work
I have no1 claimed 1hIs exempl1on during the
last lhree years
LJ lamexemptuMerSec _____ _ B&PC for lh1s reason ____________ _
I hereby af1,rm that I have a certrl,cate of consent to
sell-insure or a cert1licaIe of Workers CompensatLon In
su,ance or a cert,l,ed copy thereof iSec J800 Labor Code)
POLICY NO
COMPANY
Copy ,s 1iled ,.,,th the c,\y
Certrfoed copy ,s hereby furnished
CERTIFICATE OF EXEMPTION FROM
WORKERS COMPENSATION INSURANCE
ITh1s sec1,on need not be completed tl the perm,I
,s for one hundred dollars 1$1001 or le-ss) = I certify !hat ,n the performance of lhe wmk lor wh,cn this perm,t rs issued. I sllall not employ any person In any 1
manner so as 10 become subJect to the Workers· Com pen sat,on Laws of Calrforn,a
NOTICE TO APPLICANT. If. after making 1h,s Cert1f1cate
of Exempt,on. you should become subject to the Workers
Compensation provoswns of the Labor Code you must
forthwith comply w11h such provIsIons or th,s permit sha11
be deemed revoked
C I hereby a!l,rm that there ,s a construction lending
agency lorthe performance of the work for wh,ch I hrs per
m,t ,s ,ssued (Sec 3097 Civil Code)
Lenders Name
Lenders Address
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT 2075 Las Palmas Dr., Carlsbad, CA 92009-1915 (619) 438-1161
JOB ADDRESS AV. ST.RO. THOMAS BROS NO. DATE OFZPLl_fAT,ION BUSINESS~# VALUATION PERMIT NUMBER
'J.,_,:,or__ I ,.,, ,r-,., .. -.~ ~ i;J-, z.'"' Ir; / ;:=;;i&k"' 51 ✓
COT BLOCK I SUB0IVl$!0N -...J I ASSES~ PARCEL NO. CONTRACTOR CONTRACTORS PHONE -ZONE ~
c' !,>-;3 ;,CJ-"15-<>.?, S.lAn.. <1-tvqV2..~~""' 7;;1d...-17 fJ.3 -
OWNER"S NAME I OWNER'S PHONE
wit..i..t,,__"" K"M°" CONTRACTOR'S ADDRESS STATE LICENSE NO. BUILDING SO FOOTAGE
~-''.f-.A~. ----A• v.: tt87.:, :;;:,. :R OWNER'S MAILING ADDRESS .,
::l~7t_ I, ,Q f t--(l..,.J-,., ""--"" ·(111,,n 1---'?~ce9 DESIGNER DESIGN£ R'S PHONE
~
b£SCRJPI!Q~ OF WORK -,;;:;;;,
·OEStGNER'S AODFIE.SS STATE LICENSE NO.
<il-:X' ,v 9 ~ -I -. '?~\\O ooy.:, ~2i27 n1.,J1 . a1s,,,-.. ~c-.·:-· .
" FLA ELEV NO ace GP EDU , STORIES : . vO ..,□
I CENSUS TRACT 1 PAPK•NG SPACE RES ur,.,,1Ts I GRADING PERMIT ISSUED l REDEVELOPMENT TYPE ace LOAD FIRE SPA
AREA CONST
•□ ' □ ,c -.□ YO r-.0 Not Valid Unleu Machme Certified
QTY. PLUMBING PERMIT -ISSUE 7P:... QTY MECHANICAL PERMIT· ISSUE . /(:.,C)
/ . .S --SUMMARY/ACCOUNT NUMBER
EACH ~IXTURE TRAP INSTALL FURN OUCTS UP TO 100.000 BTU 1:!UILUII v ~,,,,,I I IJU 1-81 U-uu-00-8220 -'?
EACH BUI LUING SEWER OVER 100.000 BTU SIGN PERMIT 001-810-00-00-8221 -EACH WATER HEATER AND DR VENT BOILER·COMPRESSOR UP TO 3 HP PLAN CHECK 001-810-00-00-8891 /',)
EACH GAS SYSTEM l TO 4 OUTLETS BOILER/COMPRESSOR 3 lJ HP TOTAL PLUMBING 00; -810-00-00-82 22
EACH GAS SYSTEM J OR MORE: ME'TAl FiREPLACE ELECTRICAL 00 1-810-00-00-8223
EACH INST AL All E.R. REPAIR WA 1 ER PIPE VENT FAN SINGLE DUCT MECHANICAL 001-810-00-00·8224
EACH VACUUM BREAKER MECH EXHAUST HOOD DUCTS MOBILEHOME 001-810-00·00·8225
WATER so~TNER RELOCATION OF EA FURNACE,HEATER SOLAR 001-810-00·00-8226
FACH ~om DR141N ,1~J5.,Jf'1 DRYER VENT STRONG MOTION 880-519-92-33 c:--i)
TOHil MECHANICAL FIRE SPRINKLERS 001-81 (f00!0l-82 ,1..1 ATI"E\T'lr.
TUI Al P[lJi,,.,fliNL I PUBLIC FACILITIES FEE 320-810-00-00-8740 _ ................ ~
s ~ BRIDGE FEE 360-810-00-00-87 40
QTY. ELECTRICAL PERMIT -ISSUE QTY MOBILE HOME SETUP PARK-IN-LIEU IAREA J 1--11~ G ::I ljtiti
NEW CONST EA AMP SWJ tlKR CAR PORT TIF 31~~0-8835
I PH ·1 PH AWNING LA COSTA TIF 311--0·""36 .. ,u
EXIST H LOG EA AMP SWT 8 KR GARAGE FMF --II 'KOCESSING CCDII<
I PH 1PH -LICENSE TAX [)01-8 l'J-D•J-00-8152
REMOOEl ALTtH PfR CIRCUll ' MFF 880·519-92-57
TEMP POLE /00 AMPS
OVl:R 200 AMPS .
TEMP OCCUPANCY 130 OAYSI .
. CREDIT DEPOSIT
lfl!Al lllLlRICAl I TOTAL TOTAL FEES PAYABLE I 2'C/-.5cJ
I HAVE CAREFULLY EXAMlNED THE COMPLETED "APPLICATION AND PERMIT'" ANO DO HEREBY E11.l)Jratian. Every permi_t issued byU'le &.111dinQOtflc1al under thepro111$1ona..otthis * AN OSHA Pf.AMIT IS flEOUIAED FOA EXCAVATIONS OYER
CERTtFY 'UNDER PENALTY OF PERJURY THAT All JNFORMATJON HEREON INCLUDING THE Code shall e11.pire by hmtlaJIOn and become null and VOid II the burlding Of WOfk 5· 0 .. DEEP ANO DEMOUTJON 0A CQNSTRUCTIOM OJ'
DECLARATIONS ARE TRUE AND CORRECT AND t FURTHER CERTIFY AND AGR'EE tFf A PERMIT I& author1.Zed by such perm11 is not commenced w,th,n 160days from the dale ol such STAUCT\JA!S OVER 3 STOfllES lf_lf HUGHT permit. , or if the buitdi:X. or wort. authorized by such permit 1s suapenoed or
ISSUED· TO'"COMPLY WITH ALL'CTTY. COUNTY AND STATE LAWS GOVERNING BUILDING CON-abandoned al anu llme • r the .... ork Is commenced for & ..... riod of 180 da--•
STRUCTlON. WHETHER SFiEClFlED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND APPLJC(J SIGNATURE Jf-OWNER □ CONTRACTOR 0 APP~
DATE ,
KEEP HAAMLESS THE CITY'OF CARLSBAD AGAINST ALL UA8IUT1ES. JUDGMENTS. COSTS ANO ~ 1
11rlt? EXPENSES WKICH' MAY IN' ANY WAY' ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE t--: ../V\~1 I\ ,--.... BY PHONE (J GRAITTING'OF THJS PERMIT
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TYPE DATE INSPECTOR
BUILDING
FOUNDATION
REINFORCED STEEL
MASONRY '
GUNITE OR GROUT
SUB FRAME □ FLOOR □ CEILING
SHEATHING □ ROOF □ St-jEAR
FRAME
EXTERIOR LATH
INSULATION ;
INTERIOR LATH & DRYWALL
PLUMBING I
□ SEWER AND BUCO CJ Pl/CO
UNDERGROUND □ WASTE □,WATER
TOP OUT □ WASTE □ '#ATER
TUB AND SHOWER PAN
GAS TEST
□ WATER HEATER □ SOLAR W,t<TER
ELECTRICAL ,
□ ELECTRIC UNDERGROUND q UFFER
ROUGH ELECTRIC
□ ELECTRIC SERVICE □ TEMPORARY
□ BONDING □ POOL I
MECHANICAL I
g_DUCT & PLEM., □ REF. PIPJNG
HEAT -AIR COND. SYSTEMS 1
VENTILATING SYSTEMS
CALL FOR FINAL INSPEC7ilON WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE BEEN APPROVED.
FINAL
PLUMBING
ELECTRICAL
MECHANICAL
GAS
BUILDING
SPECIAL CONDITIONS
i 7 -:oc:7J -
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTION REQ IF INSPECTORS DATE CHECKED APPROVAL
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
---------STRUCTURAL CONCRETE
OVER 2000 PSI
PRESTRESSEO
. ,-, . -, c~ CONCRETE . ' ,' .-_·'.•-· ,· ..
POST TENSIONED
CONCRETE ' ' : ",, ·"'{ r ;:_ :_._:.-{.''.2ft-1
FIELD WELDING
''
HIGH STRENGTH
BOL Ts
SPECIAL MASONRY . ,; -, -~ . , Ir t ~
1 -~ '"':,. ;_
PILES CAISSON~'
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