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Home My WebLink About2772 ROOSEVELT ST; ; 81-48; 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 D 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 five hundred dollars ($500). D 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 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). '.JI, as owner of the property, am exclusively con- tracting with licensed contractors to construct the project (Sec. 7044, Business and 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 am exempt under Sec .. ____ ~ B. & P.C. tor this reasa-,~------------ Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of con- sent to self-Insure, o< a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Labor Code). POLICY NO•------------COMPANY ____________ _ □Copy is flied with the city. □Certified copy Is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the per- mit Is for one hundred dollars ($10!)) or less). I certify that In the performance of the work for which th!'s permit Is lssl!JlSI, f 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 EJemption, 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. COf:!.STRUCTION LENDING AGENCY 1 n.,,.,_,,+fflrm that there Is a construction len- ding agency for the performance of the work for which this permit Is Issued (Sec. 3097, Civil Code). CITY OF CARLSBAD-BUILDING DEPARTMENT USE BALL POINT PEN ONLY APPLICATION & PERMIT 1200 ELM AVENUE (7 14) 438-5525 APPLICANT TO FILL IN INFOR - MATION WITHIN RED LINES. NO. I ~pf>,€~ 1eiL;f; JOB ADDRESS tRr· 1~};grATION 333/? P [RM IT MUM BER 7_ 11 (1 i'Z1 I I I I I I I I I I I I I j I ~1-1! owNER Wm .'/,(), lSeA.:z...lc:-r,-_ owNER's PHONE ~ME CONTRACT~ STATE L ICENSE u~1W~~1U. ~-~ ,,r:;,;Tbf,; ~ t>12->~ OWNER'S MAILING ADDRESS 1,0f20R~cr ~~ CONTRACTOR'S 57/o~ Mk-~"· j ~ ~, _<"' . ,.. Ut;'31b i?:X 1<.~ 1 ~ ~BLOCK l;,u~~oN ~I A~SEs.so_;;s PARCEL NO. )g' ~ J ST ATE L ICENSE .,J/:l1 ~ O, ':?, ~~I) ,0 v,19:::..-, ~ • (~~10 r;;/t/-.'J'/;;l0R"!7--:-~ 6/f! IP:¥ {_~ ":--1 ~IGN'f:!§;S ADW!ESS _/ 4-v5 DESIGNER'S PHONE ?-EFI? r-: vr L,r -z-ss~1o3 1/tRl'~D CENSUS TRACT GP LAND USE ZONING I RES. UNITS I PARKING SPACE I NUMBER OF STORIES Not Y.f®'~ _ ~ ... _ , ifi,d IS:. I. t:.r BLDG SQ. FT. BLDG USE occ. GP I STANDARD PLAN II r iN,I:_: '/J> I TYPE CONST I occ. LOAD I 000)~23! -2,0~101 ISl,tiO QTY. 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 ANO/OR VENT BOILER/COMPRESSOR UP TO 3 Hf' ~ EACH GAS SYSTEM 1 TO 4 OUTLETS I BOILER/COMPRESSOR 3-15 HP D1 i,._ .'f"'"" ~ , EACH GAS SYSTEM 5 0 R MO RE BOILER/COMPRESSOR 16-30 HP- EACH INSTAL., ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT c:;a,u. ~,.>, /7/(3 0 I EACH LAWN SPRINKLER SYSTEM MECH EXHAUST -HOOD/DUCTS -..,, , W~ER SOFTNER !lELOCATION OF EA FURNACE/HEATER BUILDING PERMIT F I I 2S I "2F011'> . LJ-"'-"I1# _ -:S _ov...-\}_ . ,. ,., -?~ SIGN PERMIT I I I I --TOTAL PLUMBING TOTAL MECHANICAL i.§t./4 r> i .r-PLAN CHECK I . CONTRACTOR CONTRACTOR ALL INCLUSIVE PERMIT I I I ELECTRICAL PERMIT AMT. TOTAL PLUMBING I I I QTY. AMT. QTY. MOBILE HOME PERMIT ELECTRICAL I I 7.&)i 7J NEW CONST EA AMP/SWT/BKR AWNING MECHANICAL I 1J'_DI,, 1 PH .25 3 PH PORCH MOBILE HOME I I I EXIST BLOG EA AMP/SWT/BKR SET-UP SOLAR I . I I I 1 PH .25 3 PH -RAMADA, CABANA () / M/J...1--:. I . I I I REMODEL/ALTER PER CIRCUIT . \. r FENCE OVER 6' ../ /.,. --,. /%-./, . , I I I I TEMP POLE 200 AMPS -TOTAL MOBILE HOME M-fCO ·FI LM I I I I OVER 200 AMPS I . I j : I TEMP OCCUPANCY (30 DAYS) -I . I I I (/.,,.,-, " ...7 _(JC~ I . I I I TOTAL ELECTRICAL ,~ TOTAL FEES PAYABLE I . JL.(j I.' O CONTRACTOR . I I I HAVE CAREFULLY EXAMINED THE COMPLETED "'APPLICATION AND PERMIT, AND DO "AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER 'e/4-~,- HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I 5'-0" DEEP AND DEMOLITION OR CONSTRUCTION OF FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED; TO COMPLY WITH ALL CITY, STRUCTURES OVER 3 STORIES IN HEIGHT COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER SPECIFIED HEREIN OR NOT. 1,ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM- LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND /"I ,\ -J / EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. 1?tJNT\ s~E_URE;_ OWNERQ CONTRACTOR□ rPPR~,ED BY ~I AGENT':x.. ~ .,_.. ,I _,_ .. - BY PHONED .... ,n;,,--- I u ., BP ;,~~- ~ < 0 ~ > ~ j::: ~ Q. V) ~ SITE ADDRESS: :-. INSPECTION DATE INSPECTOR WOOD FLOOR \ FOUNDATION• FORMS• SET BACK • TOILET UNDER FLOOR PLUMBING ~ ~ UNDER FLOOR HEATING ,. ; "t -··- OK TO INSTALL SUB FLOOR --:-..:· c. ...... - SLAB FLOOR UNDER SLAB PLUMBING FOOTLNG • FORMS• SETBACK • TOILET OK TO POUR CONCRETE FRAME R"OUGH ELECTRICAL ROUGH PLUMBING ROUGH HEATING/VENTILATING FRAME OK• PLACE INSULATION INSULATION OK • PLACE WALLBOARD WALLBOARD OK • PLACE TAPE '· EXTERIOR LATH OK • PLACE STUCCO ,· FIREPLACE DAMPER 8:STEEL PLATE TIES/HEIGHT OF CHIMNEY . OTHER TEMP POWER (POLE) SEWER GAS TEST SWIM POOL• STEEL BONDING • PRE DECK • FENCE PREPLASTER SHOWN . FRAME A I /" \ I • PAN 'hi I I ..Mi' FINAL INSP BY BLDG DEPT ✓f'y' I iY\ 'l V OTHER DEPT'S REQ COMPLETED I' 1• I ELEC METER-PERM-TEMP GAS METER-PERM-TEMP CERT OF OCCUPANCY ISSUED -OWNER: . FIELD INSPECTION RECORD . . -. ' ' \.,::: ; ~ ~c. ,. \ . _,., ~~ .. t·: . '· -., "' ~ r •~ > "\ ... - : I . I -PERMIT ,N_O: . I NSPECT0R'S"NOTES ' ., f -·\ ", ' ~ 'i•\l - C -~-: ,-.... !-.. .~ )• ' - <;3 .) , • '-{,If<, . -- ~-.. ''\ ~, ; . _, ; , --.. ; -• , ... . I INTERDEPARTMENTAL INFORMATION SHEET .... BUILDING DEPARTMENT BUILDING ADDRESS: PLANNING DEPARTMENT nv~ e=RLSBAD Building Department ZONE _________ LOT SIZE _________ LOT WIDTH ________ _ UNITS ALLOWED ____________ UNITS PROVIDED ____________ _ PARKING SPACES REQUIRED PROVIDED ---------------------- -------------% COVERAGE ALLOWED BUILDING HEIGHT ALLOWED FRONT SETBACK: ALLOWED PROVIDED ------- INTRUSIONS ---------- SIDE SETBACK: LANDSCAPE & IRRIGATION PLAN COMMENTS: ENVIRONMENTAL PROTECTION REQ: PROVIDED PROVIDED REAR SETBACK: ----"-___ OK TO FINAL ________ DATE ____ _ ~ =r;;~,.c:{L/ ENGINEERING DEPARTMENT (Y~=: crx1u;,..i: I 71 t 3 0 R.O.W. ______ INDUSTRIAL WASTE _______ IMPROVEMENTS _______ _ SEWER CONNECTION r3,L}V S DRIVEWAY LOCATIONS ------------- GRADING PERMIT EASEMENTS DRAINAGE --------------------- LE GAL DE s cR Ip TI o N ________ =c:Z~o:;..__'3 _ _,l'--'~"'-------'o=--__ o__._g.,__ ______ _ ADDITIONAL COMMENTS~----------------------------~ji~~ =l, DATE ~ PWI ____ OK TO FINAL ____ DATE ___ _ FIRE DEPARTMENT SPRINKLING SYSTEM FIRE PROTECTION EQUIP. -------- FIRE ALARMS EXITS ________________ _ FIRE HYDRANTS LOCATION ----------------------------- ADD IT ION AL COMMENTS OK TO ISSUE: DATE OK TO FINAL DATE ----------------------- WATER DEPARTMENT 'REQUIREMENTS OF APPROPRIATE DISTRICTS MET ________ DATE ________ _