HomeMy WebLinkAbout2410 SACADA CIR; B; 81-124; 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 Pre
sions Code, and my license Is In full force an
feet.
OWNER-BUILDER DECLARATION
0 1 hereby affirm that I am exempt from the
tractor's License Law for the following re,
(Sec. 7031.5,Business and Professions Code).
city or county which requires a permit to
struct, alter, improve, demolish, or repair
structure, prior to Its Issuance also require·
applicant for such permit to file a signed s
men! that he is licensed pursuant to the p
sions of the Contractor's License Law (Chap
commencing with Section 7000 of Division
the Business and Professions Code) or that
empt therefrom and the basis for the alleged
emption. Any violation of Section 7031.5 by a
plicant for a permit subjects the applicant
civil penalty of not more than live hundred do'
(SSOO).
D I, as owner of the property, or my emplo
with wages as their sole compensation, w
the work, and the structure Is not Intended
lered for sale (Sec. 7044, Business and Pr,
slons Code: The Contractor's License Law
not apply to an owner of property who bull,
improves thereon and who does such
himself or through his own employees, pro'
that such improvements are not Intended o
fared for sale. If, however, the building or Imp
ment Is sold within one year of completion
owner-builder will have the burden of proving
he did not build or Improve for the purpo
sale).
'.JI, as owner of the property, am exclusively
tractlng with licensed contractors to cons
the project (Sec. 7044, Business and Profess
Code: The Contractor's License Law does no·
ply to an owner of property \•ho builds o,
proves thereon, and who contracts for such
)eels with a contractor(s) license pursuant t
contractor's License Law).
I am exempt under Sec. B. & for this reaso ... ___________ _ ----Date Owner --
WORKERS' COMPENSATION OECLARATIO
I hereby affirm that I have a certificate of c
sent to self-lnsur6, o, a certificate of Work,
Compensation Insurance, or a certified
thereof (Sec. 3800, Labor Cqde);
POLICY NO 1~~~-~¾
IN
con•
:ers•
:opy
COMPANY S.fufe...); ,.._. --
CERTIFICATE OF EXEMP
WORKERS' COMPENSATIOI
(This section need not be co~eted if n.e
mil is for one hundred dollars ($100) or less).
I certify that in the performance of the wor
which this permit is issued, I shall not employ
person In any manner so as to become sub)ec
the Workers' Compensation Laws of Calllorn
NOTICE TO APPLICANT: If, after making this
tlflcate of Exemption, you should become su
to the Workers' Compensation provisions o
Labor Code, you must forthwith comply with
provisions or this permit shall be deemed revo
CONSTRUCTION LENDING AGENCY
I hereby affirm that there Is a construction
ding agency for the performance of the worl
which this permit Is Issued (Sec. 3097, Civil Code).
I
C IT Y OF C ARL.SBAD-BUIL.DING DEPARTME NT
APPLICATION & PERMIT
USE BALL POINT PEN ONLY 1200 ELM AV ENUE (714) 438-5525
NO. JOB ADDRESS AV. ST -IDATE OF APPLICATION
J I L/-, l ,O 18 1 1.5 1A1C. 1A1"D ,A I 1G1:J;R., C, L,£. RO
I I I I I I I I I I I 1 3' .--;;i_-J' I
OWNER OWNER'S PHONE PRIME CONTRACTOR
11 fJ .. le_i,, -:7<<--073,, r~ J)!:-.. Pl ,1--.L :~ _ _L,,..
OWNER'S MAILING ADDRESS CONTRACTOR'S ADDRESS (7
APPLICANT TO FILL IN INFOR-
MATION WITHIN RED LINES.
BUS. LICENSE ~rE:.MIT NUMBER
~3/<J {,
STATE LICENSE /"J~i 3113 '/.3
CONTRACTOR'S
f
2.'1/oA~ <;o,...c.o..-A.r... 6rc.-lc.. ~kbo..J ¥3¥/1/ II f..) C, /o/ Ei~:. i 7<~-1.IJ~ 3 1 I 218 17 I 77 -,,, -,_.,,. s.o.
'-/J~ BLOCK I SUBDIVISION
1
ASSEr OR'S ?R9.L NO. _ I/ oJ. DESIGNER tr ., STATE LICENSE
:"JI / I ,I -I I O I-I 'Ii I e_,...3(,
---z,t_c.},,IPTION OF WORK M #1't> I"' 41' (..1 _, '-P
1
er <:,,,,riff ,.,,, ' F;tJ,,,_ DESIGNER'S ADDRESS DESIGNER'S PHONE
CENSUS TRACT GP LANO USE ZONING l RES. UNITS I PARKING SPACE I NUMBER OF STORIES
Not V•lid Unlllss Machin, fMtifi«I
BLOG SQ. FT. BLOG USE occ. GP I STANDARD PLAN II I PLAN I O # I TYPE CONST I occ. LOAD I
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 AND/DR VENT BOILER/COMPRESSOR UP TO 3 HP -EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP
/ EACH GAS SYSTEM 5 OR MORE -BOILER/COMPRESSOR 16-30 HP
/ EACH INSTAL., ALTER, REPAIR WATER PIPE ')..,:'-'" VENT FAN SINGLE DUCT
EACH LAWN SPRINKLER SYSTEM MECH EXHAUST -HOOD/DUCTS
WATER SOFTNER .. .A L, RELOCATION OF EA FURNACE/HEATER BUILDING PERMIT I . I I I
<... )_...._ ,, --~-~ SIGN PERMIT I . I I I
TOTAL PLUMBING ~ TOTAL MECHANICAL PLAN CHECK I I I I
CONTRACTOR CONTRACTOR All INCLUSIVE PERMIT I I I I ,_
TOTAL PLUMBING I I <:~
QTY. ELECTRICAL PERMIT AMT. QTY. MOBILE HOME PERMIT AMT. ELECTRICAL I I I
NEW CONST EA AMP/SWT/BKR AWNING MECHANICAL I I I
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 I I I I
REMODEL/ALTER PER CIRCUIT FENCE OVER 6' I I I I
TEMP POLE 200 AMPS TOTAL MOBILE HOME MICO·FI LM ! I I I
OVER 200 AMPS I I I ; I
TEMP OCCUPANCY (30 DAYS) I ' I I I
I ' I I I
TOTAL ELECTRICAL TOTAL FEES PAYABLE I ,& v
CONTRACTOR . I I .
r\ '. I \'
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT, AND DO •AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER
HEREBV CERTIFV THAT ALL INFORMATION HEREON IS TRUE AND CORRECT ANO I :z!_" A"O O<MOC,no" o• =-srnomo" 0, -•
FURTHER CERTIFV AND AGREE IF A PERMIT IS ISSUED; TO COMPLY WITH ALL CITY. S URES OVER 3 STORIES IN HEIGHT
COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER ~ .... / ~ ',_L SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY ANO KEEP HARM-
LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO ,. , EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITV IN CONSEQUENCE
OF THE GRANTING OF THIS PERMIT. AP~ICANT'S SIGNATURE. / OWNERQ CONTRACTOR]jl !APPROVED BY ji#?/;~/ AGENT D BY PHONED /r-P, ,
BP
! ~ ~ >
~ i= hl a..
V)
~
SITE, -ff}-/~ ADDRESS: OWNER: PERMIT NO: .
\ FIELD INSPECTION RECORD
INSPECTION DATE INSPECTOR INSPECTOR'S NOTES
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
FOOTING • FORMS• SETBACK • TOILET
OK TO POUR CONCRETE
FRAME , .
ROUGH ELECTRICAL
ROUGH PLUMBING
ROUGH HEATING/VENTILATING -
FRAME OK• PLACE INSULATION
J ' INSULATION OK • PLACE WALLBOARD --WALLBOARD OK• PLACE TAPE
EXTERIOR LAT H OK• PLACE STUCCO
FIREPLACE '
DAMPER 8: STEEL
PLATE Tl Es/HEIGHT OF CHIMNEY
;
OTHER
TEMP POWER (POLE)
SEWER . -
GAS TEST
SWIM POOL • STEEL BONDING
• PRE DECK
• FENCE PREPLASTER -
SHOWN • FRAME
• PAN
FINAL INSP BY BLDG DEPT ,
OTHER DEP,T'S REQ COMPL ETED 1-Z./ , ,,
ELEC METER-PERM-TEMP i/L.,_/ J/1 J .
G AS METER-PERM-TEMP /< Ifft 7 v"' ./
' IV ~ '
I "
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C
CERT OF OCCUPANCY ISSUED -. -·