HomeMy WebLinkAbout2409 SACADA CIR; ; 82-301; PermitIll z
0 .:: C
IC C .., u w 0
IC
I[
0 u
IC w 0 ... s ~ w z 3t 0
z 0 .:: C Ill z w a. :I 0 u
Ill a: w :.:: IC
0 3
D I Mreby affirm that I am licensed under
provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Professions Code, and my license Is In
full force and effect. Lie No _______ Class _____ _
I hereby atfinn that I am exempt from the Con-
~~o;·~~!f:'sS: ~ ~f~~.~,~~~e:~ste~
county which requires a permit to construct
after, improve, demohsh, or repa,r any structure.
pnor to its issuance also requires the applicant for such permit to file a signed statement that he is
lfcen.sed pursuant to the provisions of the Con·
tractor's License Law (Chapter 9 commencing with Section 7000 of o,v,s1on 3 of the Business and Pro-
fessions Code) or that 1s exempt therefrom and the
basis for the alleged exemption. Any violation of
Section 7031.5 by an applicant tor a permit subiects tne apphcant to a civil penalty of not more than five hundred <lollars (S5()()).
lil"1, as owner of the propeny, or my employees ~ wages as their sole compensation, will do the wM. M\d the structure 1s not intended o, offered tor
sale (Sec 704,4, 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 wOf'k himself or through his own employees, pr0"1ded thal such 1mprovemerits are
not mtende-1 Of offered for sale If, however, the building o, improvement is sold within one year of
completion, the owner-builder will have the burden
of p,ovmg lhat he did not build Of improve tor the
purpose of sale)
□ I, as owner of the property, am exclusively
contract.in~ with licensed contractors to construe!
the proJect (Sec. 70C..., Business and Professions
Code: The Contractor's License Law does not apply
to an owner of property who builds or improves
thereon. and who contracts !or each proJects with a
contract0t1s) hcense pursuant to the Controetor's
License Law)
D I am exempt under Sec _____ , 8 & P.C
tor1tus reason ___________ _
D I hereby affirm thal I ha.-e a certificate of consent
to self-insure. or a cer11f1cate ol Workers·
Compensation Insurance. or a certified copy thereof
(See 3800. Labo< Godel
POLICY NO
COMPANY
□ Copy 1S hied with the city
0 Cen1fled copy 1s hereDy furnished
CERTIFICATl OF EXEMPTION FROM
WORKERS" COMPENSATION INSURANCE
(Th•s section need not De completed 1f the permit
,s tor one hundred dOllars ($100) or less)
0 I certify that in the performance ol lhe work fot
,;i,h1ch lh1s permit 1s issued. I shall no! employ any
person in any manner so as to Decome suD1ect 10
lhe Wo~ers· Compensation Laws of Cahlom1a.
NOTICE TO APPLICANT If. after makm~ lt11s Cert,
hcate ol Exemption. you sllOuld become sub1ect I?
the Wo,1,r;ers· Compensation provisions of the laDof Code. yov must forthwith comply with such
prov1s,ons or this perm11 shall be deemed revoked
,r-
t[ Lenders Name ___________ _
~ Lender's Address __________ _
0 I hereby affirm that !here 1s a construchon
lending agency tor !he perfOfmance ot 1he work. lor
whit') lh,s permit ,s issued (Sec 3097. C1v11 Cooel
USE BALL POINT PEN ONLY & PRESS HARD -----·-· -----· -----······ .. ------··--------···-·--··--APPLICANT TO _ELL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS
CARLSBAD .JJILDING DEPARTMENT AP• J cATION & PERMIT 1200 Elm, Carlsbad, California 92008 (714) 438-5525
JOB ADDRESS
A~;_T.l
0i/~7;~1 BUSINESS LICENSE # VALUATION PERMIT NUMBER
~4.fA ~r-o..d.o... c_\~c..\t. ~~
OWNER'S NAME lq ll ;~;R~ ~o; PRIME CONTRACTOR CONTRACTORS PHONE # ZONi !J.-30/ \....o\s ~ _,, OW/Jr=. e_ now-,.,,.
OWNER•s MAILING ADDRESS
S "\:C)C\ ~ ra d..o.. _(' \~ ia.. CONTRACTOR'S AOORESS LICENSE NO. PLAN 1.0. # BLOG use CODE
\4\I BLOCK l'{~of ,::~:5{~~K~sEssoR PARCEL NO.~<:' DESIGNER STATE LICENSE # STANOARO PLAN# BUILDING SO. FOOTAGE
DESCRIPTION OF WORK .r~~ l ) (;..o .._ '!;t-£"lee+ n /., DESIGNER'S ADDRESS DESIGNER'S PHONE
~y-.Sff~ ~,~ ~~\-1 --·-------F/P F LR ELEV. NO OCC GP EDU 8/16/821700 STORIES 93.us vO NO ~q0,1,',l,?UO ··~/16/ 82 ~3;45
CENSUS TRACT I GP LANO USE l PARKING SPACE l RES UNITS l GRADING ~ERMIT ISSUED I REOEVELOPMENT TYPE OCC LOAD FIRE SPR AREA CONST
YO N 0 v O NO vO NO Not Valid Unkn Ahchine Ctrtifi«J
QTY. PLUMBING PERMIT -ISSUE 7 c:; () QTY. MECHANICAL PERMIT· ISSUE 3.00 SUMMARVACCOUNT NUMBER --EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100,000 BTU BUILDING PERMIT 01-000-42?0 ~~
EACH BUILDING SEWER . {fl OVER 100,000 BTU SIGN PERMIT 01 ·000·4221 --I EACH WATER HEATER ANO/OR VENT Y -~ BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01 ·000-4806 .'2.P~
I EACH GAS SYSTEM 1 TO 4 OUTLETS -i.., _>_;., BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING 01-000-4222 ./_.2 '" -
EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE ELECTRICAL 01 ·000-4223 ~ -, ~-
EACH INSTAl-. ALTER. REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01 ·000-4224 / ,.
EACH VACUUM BREAKER MECH EXHAUST -HOOD/DUCTS MOBILEHOME 01 ·000·4225
WATER SOFTNER RE LOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP
EACH ROOF DRAIN (INSIDE) ~ SOLAR 01 ·000·4226
•. -~ V -TOTI.L MECHANICAL STRONG MOTION 65·640·0519 ,Jl5"'0 --
TOTAL PLUMBING -r / ,,.,.L -FIRE SPRINKLERS 01-000-4227
QTY. ELECTRICAL PERMIT· ISSUE QTY. SOLAR · ISSUE
PUBLIC FACILITIES FEE 25·000·4933
? (\ (\ BRIDGE FEE
4' NEW CONST EA AMPISWTIBKR COLLECTORS SCHOOL FEE -DISTRICT
1 PH 3 PH STORAGE TANKS Carlsbad 65-623·0519
EXIST BLDG EA AMP/SWT/BKA ROCK STORAGE Encinitas 65-624-0519
I PH 3 PH --() ----PUMP San Dieguito 65·625-0519
/ REMODEL/ALTER PER CIRCUIT ~ _.,_,,~ -<" -PLAN CHECK FEE San Marcos 65·626-0519 , TEMP POLE 200 AMPS ,
OVER 200 AMPS
TEMP OCCUPANCY (30 DAYS) -
-'
TOTAL ELECTRICAL I
_.Jl . I 9!>~ ?~ TOTAL SOLAR TOTAL FEES PAYABLE -
I HAVE CAREFULLY EXAMINED THE COMPLETED ··APPLICATION AND PERMIT"' AND DO HEREBY Expiration Every permit 1uued by the Building Official under the prov1sionsofth1s * AN OSHA PEIWIT IS REQUIAED FOR EXCAVATIONS OYEII
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING Tl~ Code shall expore by lim1tallon and become null and void If the building or wort< 5· O" DEEP AND DEMOLITION OR CONSTAUCTION Of
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMI" S ri:honzed by such permit is not commence.d with'" l80 days from the date ot suet\ STIIUCl\JAES OYER 3 STORIES IN HEIGHT ;( m11. or 1f the buil~i.:2.~r work authorized by such pe~~11 suspended or ISSUED: TO COMPLY WITH ALL CITY. COUNTY AND STATE LAWS GOVERNING BUILDING C N· bandoned at anv time r ,,._ worfc 1s commenced for a of 180 dav•
STAUCTION, WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIF
1
~ ~~ ~ APPROVED BY JU(/_ 1~/f-).~ KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS At PPLICANT A U OWNE CONTRACTOR 0
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE O T -V\UJ\\1J ~ BY p O E 0
GRANTING OF THIS PERMIT H N .
INSPECTION TYPE -DATE -· .. -INSPECTOR -
f BUILDING
a FOUNDATION I
R61~RCED STEEL !
MASONRY i
GUNITE OR GROUT :
FLOOR & CEILING SUB FRAME
SHEATHING .
FRAME
EXTERIOR LATH lNSULATION
INTERIOR LATH & DRYWALL
PLUMBING
SEWER AND BL/CO r
PLUMBING UNDERGROUND I.
I ~ PLUMBING TOP OUT !
TUB AND ~HOWER PAN
GAS TEST
ELECTRICAL
TEMPORARY POWER "',,
ELECTRIC UNDERGROUND
ROUGH ELECTRIC I
'
ELECTRIC SERVICE '
BONDING I I
G. F. I. -SMOKE DETECTOR I
'
MECHANICAL I
DUCT & PLEM., REF. PIPING
HEAT -AIR COND. -SOLAR SYSTEMS
VENTILATING SYSTEMS
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE BEEN APPROVED.
JOB SITE FINAL I
PLUMBIN.G
ELECTRICAL j IA 1..
MECHANICAL 'l ,~ l'f / / . I
GAS 1-_)_ 1/'I /
BUILDING I }·/
SPECIAL CONDITIONS ,/
CERT OF OCCUPANCY ISSUED
.
/,, ~~-3o r \ ' •, I \ I I -
FIELD INSPECTION RECORD
REQU IRED SPECIAL INSPECTIONS INSPECTO R'S NOTES
INSPECTION REQ. IF INSPECTOR'S DATE CHECKED APPROVAL
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
$.TAUCTURAL CONCRETE
OVER 2000 PSI
PRESTRESSED
CONCRETE .
POST TENSIONED
CONCRETE
FIELD WELDING
HIGH STRENGTH
BOLTS
SPECIAL MASONRY
' -'· r-. I
PILES CAISSONS
. .
-'
. ,, ;, --· .. ..,. ... •. •' . ~' . ..
,, . .
l . '. ,
•r
C
. \ --
. ' .. -
. -
-.
INTERDEPARTMENIAL INFORMATION SHEET
BU r LD r NG DEPARTMENT o DATE:
BUI LP ING ADDRESS= 2,(ti'f xi~~ 1.E C,EJ l' "fi',
A.P.N: J.tfo -!'lo -s.,c ~ c.T: .oD
* * ** *** ** ** * ** ,. * ** ** * * * * * t * * ** * ** ** * **** ** ** ** ** ** * *** * A11Gt½ ;"m8t* ** * * *
PLANN J NG DEPARTMENT 'jj7Y OF CA
zoNE: _____ scHooL FEES: sAN DIEGUITo 011d{f}m™ijseAo Mie·""nt.=----
ENCINITAS _____ CARLSBAD _____ _
·UNITS REQ'D: PROVIDED: ----------------------
% COVERAGE ALLOWED: .PROVIDED: -----------
PARKING SPACES REQ'D: PROVIDED: __________ _
BUILDING HEIGHT REQ'D: PROVIDED: ---------
FRONT SETBACK SIDE SETBACK ' REAR SETBACK
ALLOWED: ------
PROVIDED: _____ _
INTRUSIONS: _____ _
RE-DEVELOPMENT APPROVAL REQ'D: ________ _
LANDSCAPE & IRRIGATION PLAN COMMENTS: ______________ _
ENVIRONMENTAL PROTECTION REQ: __________________ _
ADDITIONAL COMMENTS: -.---.::s;::saa'l'tk:='---'c(ff);:e_c;;<""""=,,~L--------------
TO FINAL: ____ DATE: ___ _
ENGINEERING DEPARTMENT
R.O.W: _____ _
PUBLIC FACILITIES FEE:_· __________ SEWER CONNECTION: ___ _
DRIVEWAY LOCATION(S) =-----------"------__ _
GRADING PERMIT=--.,,------,-------------------
EASEMENTS: ~ ~ DRAINAGE: _____________ _
LEGAL DESCRIPTION: ___,7J?'-LJ......;$'>--'5.=3:....,4,,c__ ________________ _
ADDITIONAL COMMENTS: ______________________ _
*CHECK IF ENG,/kRING INSPECJION REQ' D. ON FINAL:
OK TO ISSUE: ~ DATE: ~/1/~/fZ.---PWI:. OK TO FINAL: ____ _
DATE: ----
* IF TIIIS ITEM IS NOT C!IECKED, BUILDING DEPARTMENT \\IILL MAKE
FINAL INSPECTION.