HomeMy WebLinkAbout2212 PLAZA DE LAS FLORES; ; 81-140-11; PermitLICENSED CONTRACTOR'S DECLARATION
I hereby affirm that 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-
fect.
OWNER·BUILDER DECLARATION
C'I 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 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 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
($500)
LI, 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 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 not intended or of·
fered for sale. If, however, the building or improve-
ment 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).
=.1, as owner of the property, am exclusively con·
tracling with licensed contractors to construct
the project (Sec. 7044, Business <'.nd 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).
I ar:n exempt under Sec. "'<.... \ ¥,
for this reason ____ _
Date Owner
I hereby affirm that I have
sent to self-insure, or a cer
Compensation Insurance, o
thereof (Sec 3800, Labor Code).
POLICY NO. ____________ _ COMPANY _____________ _
~ Copy is filed with the city.
r---:: Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the per·
mil is for one hundred dollars ($1C)()J 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.
NOTICE TO APPLICANT: If, after making this Cer-
tificate of Exemption, you should become subject
to the Workers' Compensation provisions of the
Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction Ian·
ding agency for the performance of the work for
which this oermlt is issued (Sec. 3097, Civil Code).
CITY OF CARLSBAD-BUILDING DEPARTMENT
APPLICATION & PERMIT
USE BALL POINT PEN ONLY 1200 ELM AVENUE (714) 438-5525
. Ii ,,. y
t-:7~t;,,i_ / l __ th ?. , / ) ,-,<}£ '°' AOoa,ss. -::, /.' .
. •A "'-... ,7. C a.--1.4~ ,.£._;_. / --<A: u ~-I I I I I I I I _I I I I I I I l I I I I
AV. ST• 1DATE OF APPLICATION ,o .,
1 , <y-;d-6Y
OWNER = OWNER'S PHONE PRIME CONTRACTOR /
~ f)w, ',,I ti Jlm(;{,J'
OWNER'S MAILING ADDRESS CONTRACTOR'S ADDR(Ss
LOT I BLOCK I SUBDIVISION [ ASSESSOR'S PARCEL NO.
I I I I I I I I I I I
OE~!fV~F WORK . _ /\lo-J ~c--,1 PAifi ... a 1 °GEl...-L"'ri...-v /1./ (./2) // -_ {t:;,C,--A-Ot;;;-C~C.-r. (..A./~~ L1).A... 1
ce,.Jc... Pe-/4:1-J'i'\a?>'Z._ .e,,, ,n....,......,-5/ c:.,,,s~.n<"'.-v0zrtZ--.C:.. /
DESIGNER
DESIGNER'S ADDRESS
CENSUS TRACT GP LAND USE ZONING UNlTS
APPLICANT TO FILL IN INFOR -
MATION WITHIN RED LINES.
BUS. LICENSE
~ ?i 9/
~ STATE LICENSE
;ll(.;l/3'1
CONTRlCTOR'~
PHONE
STATE LICENSE
OES1GNER' S PHONE
PERMIT NUMBER
g1-1 L/-{)-1/
::-I,
!"'· T ""'" seAC, •-1·;"""' o, S,0""
Not Valid Unless MachiM Cartified
BLDG SQ, FT, BLOG USE occ. GP I STANDARD PLAN /j l"~;:·,tk>_ T"" CONST Toce. coAo
I
llTY. 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 AND/OR VENT BOILER/COMPRESSOR UP TO 3 HP
EACH GAS SYSTEM l TO 4 OUTLETS BOILER/COMPRESSOR 3·15 HP
EACH GAS SYSTEM 5 0 R MO RE BOILER/COMPRESSOR 16·30 HP
j)AN?Atrc ~~~
EACH JNSTAL., ALTER, REPAIR WATER PIPE
EACH LAWN SPRINKLER SYSTEM
WATER SOFTNER
TOTAL PLUMBING
CONTRACTOR
QTY. ELECTRICAL PERMIT
NEW CONST EA AMP/SWT/BKR
IPH .25 3PH
EXIST BLOG EA AMP/SWT/BKR
1 PH .25 3 PH
REMODEL/ALTER PER CIRCUIT
TEMP PO LE 200 AMPS
OVER 200 AMPS
TEMP OCCUPANCY (30 DAYS)
TOTAL ELECTRICAL
CONTRACTOR
VENT FAN SINGLE DUCT
MECH EXHAUST -HOOD/DUCTS
RELOCATION OF EA FURNACE/HEATER
TOTAL MECHANICAL
CONTRACTOR
AMT. llTY. MOBILE HOME PERMIT AMT.
AWNING
PORCH
SET-UP
RAMADA, CABANA
FENCE OVER 6'
TOTAL MOBILE HOME
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION ANO PERMIT, AND DO SHA PERMIT IS AEQUIRED FOR EXCAVATIONS OVER
HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I 5-0" 0 P AND DEMOLITION OR CONSTRUCTION OF
).UOE. -;,.. 7 f) Jr J
BUILDING PERMIT I
SIGN PERMIT -~ Tt-J.-, I
PLAN CHECK ~/':P '17//,/ Kl I
I
ALL INCLUSIVE PERMIT / /
TOTAL PLUMBING
ELECTRICAL
MECHANICAL
MOBILE HOME
SOLAR I
I
I
MICO-FILM I
I
I
I
TOTAL FEES PAYABLE
I I I
~ f-<(
0 ~ >
·~~ . f-u ~ • <>. .,, . £:
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FURTHER CERTIFY AND AGR.EE IF A PERMIT IS ISSUED;TO COMPLY WITH ALL CITY, STA UC URESOVER 3STORIES IN Hcr,G .
COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION WHETHER \ ~ '
SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AN□ KEEP HARM ' /
LESS THE CITY OF CARLSBAD AGAINST A LL LIABILITIES, JUDGMENTS, COSTS AND ll,~~~~:':;c;:-~;-;:;'.'::C:0:-_J___:~~• _:::~ _ __l~_.':.c'~'==~~#2:~~:-!~~~~-".<~~;:,,~~,,!_J(_i~E:!_~~;:i,1c, EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE If
OF THE GRANTING OF THIS PERMIT. OWNER □ CONTRACTOR□
. \ '--' AGE BY PHONE 0
SITE xi-IL\'u-\ I 7 ADDRESS: OWNER: . PERMIT NO: I
' 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 FLOOP
UNDER SLAB PLUMBING
FOOTING• FORMS• SETBACK• TOILET
OK TO POUR CONCRETE
FRAME
ROUGH ELECTRICAL
ROUGH PLUMBING
ROUGH HEATING/VENTILATING . lcJ?' .. tJ;l
FRAME OK• PLACE INSULAT,00•, , '' . ~rJIJ1""F-,d) ,
INSULATION OK • PLACE WALLBOARD /
WALLBOARD OK• PLACE TAPE CU"' .d"-·,---:;J,;Jf t:.---
' . EX1=ERIOR LATH OK• PLACE S.TUCCO
-(JI" . ,/'_l)fU -/ .J,,
Fl REPLACE· ~·., ' . ' -J I::[/ ,._r, • -DAMPER &STEEL ' ,.,v" I ,6,(} (..P, LI pl'r;;, 11 Ilk:' ./ PLATE TIES/HEIGHT OF CHIMNEY " ~Pr' "" n , '7' ~ ,,~:( ~ OTHER
I ',-t5 _., ,(7 ~/_/,~ TEMP POWER (POLE) . J, .1&
SEWER F' /I"'.~~• ..,,-1'-lv,~ _/f I 1;. If'/ I V
GAS TEST of"' ... .-itJf-\_. ! SWIM POOL • STEEL BONDING ,""1\ ' • PRE DECK ~· ' I/
• FENCE PREP LASTER
SHOWN • FRAME
• PAN
FINAL INSP BY BLDG DEPT
OTHER DEPT'S REQ COMPLETED
ELEC METER-PERM-TEMP
GAS METER-PERM-TEMP
CERT OF OCCUPANCY ISSUED ~
SEE
7201
PLAZA DE LA COSTA
FOR ALL
PLAN CHECK
INFO
81-140