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Home My WebLink About2777 ROOSEVELT ST; ; 79-746; PermitII 11 PLUMBING PERMIT APPLICATION City of CARLSBAD, CALIFORNIA 92008 Applicant to complete numbered spaces only Phone 7 29-1181 Perm 11 No 79-7~(o JOB AOrHII ESS I I , ·-l \- LOT HO. L<GAL I 1 DESC~. I TOACT OWNt" MAIL AODltt55 2 CONT"ACTOIII MAIL A00ft£55 3 '..) ,..~ "" A"CHIT[CT 0111 0(51CN£111 4 [NGIN££111 MAIL ADDfU.55 5 COMPENSATION INS. CARRIER ""'AIL. .ADD"CSS, 6 , t. ., use o, BUILDING 7 I 8 Class of work: 0 NEW 0 ADDITION 0 ALTERATION 9 Describe work : " SPECIAL CONDITIONS: j APPLICATION ACCEPTED BY APP~OVE D F'OR ISSUANCE av DATE NOTICE THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUC· TION AUTHORIZED IS NOT COMMENCED WITHIN 120 OAYS,OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM• MENCEO. I I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. ZIP PHONC PHOM E STATE LIC. NO. CITY LIC. NO, • ..II :c.i 1 l. I l ,_ -,. PMON£ LICENSE. NO. PHOHC LICENSE NO, < ' > IJIANCH }< f I 11 ~ 0 REPAIR t PERMIT FEES No. Type of Fixture or Item Fee WATER CLOSET (TOILET) $ BATHTUB LAVATORY (WASH BASIN) SHOWER KITCHEN SINK & DISP. DISHWASHER LAUNDRY TRAY CLOTHES WASHER I WATER HEATER URINAL I I DRINKING FOUNTAIN FLOOR-SINK OR DRAIN SLOP l>INK I . GAS SYSTEMS. NO. OUTLETS -- WATER PIPING & TREATING EQUIP. WASTE INTERCEPTOR VACUUM BREAKERS LAWN SPRINKLER SYSTEM SEWER NUMBER CLEAN0UTS CESSPOOL '\ ' ) ( SEPTIC TANK & PIT ..:\,'"'"~~=-:-c-~.,.,-~_,,,,--•::-,,,::-'-~::,-,'-:-::c=:-:,.....,.,:'::•~~, .=;:«=-.--.:..,:•c;-:c::-,--'---'" _____ R_o_o_F_D_R_A_I_N_s _________________ _ 51GNATUftl o, CON'TlltA(TOIII 0111: AUTHOIIIIZCO AGCNT (DAT£) ISSUANCE FEE $ S!CNAT11,tr 0,-OWN[ft 11, OWN£" IUII..DE.IIIJ DATt) TOTAL FEES $ WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH .. INSPECTOR p Tt. ...... II) z 0 ~ a: <( ...I 0 "' Q a: I[ 0 0 a: "' Q ...I :i I "' z ~ z 0 ~ ~ z "' G. ::I 0 0 II) ic "' "' a: 0 3 ![ 0 I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business r0~f~::: _m_l1_!~_ez=e-,-IG=ln I hereby affirm that I am exempt tram the Cootrac-tor's License law fa, the following reason (Sec. 7031.5 Business and Professions Code Any city or county which re-quires a permit to construct. alter. Improve, demolish, or repair any structure. Pfk>r torts issuance also requires the ap- plicant lo, such permi1 to file a signed statement that he is licensed pursuant lo the prov1Sions of the Con1ractor' s ::.;:. :\-".;',~;'::1~s =:.~~~s:r::~~e:. empt 1herefro,n and the basis for the allegeo exemption Arrt '10iat,on of Sec1,on 7031.5 by an apDiicant for a permd sub-jects the appilcant to a clvil penalty ol n01 more than five hun-dred dollars ($500) □ I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and lhe struc-lUre Is nol !mended or offered fa, sale (Sec 7044, Business and Professions Code: The COntracto,' s License law does not apply to an owner of property who builds or improves thereon and who does such -k himself or through his own employees, provided that such Improvements are not Intend-ed o, offered for sale. If, however, the building or improve-ment Is sold within ona year ol completion, the owner-builder will have the burden of proving that he did not build o, Im-prove fo, the purpose of sale). □ I, as owner of the propeny, am exclusively contracHng with licensed contractors to construct the project (Sec. 7CM4, Business and Protessions Code: The contractor's License Law does no, apply to an owner of property who builds or Im-proves thereon, and who contracts for each projects with a contractor(s) license pursuant to the Contractor's License Law). □ As a homeowner I am Improving my home, and the follow-ing conditions exist: 1. The work Is being performed prior to sale. 2. I have lived In my hO<ne for twelve monlhs prior to completion of this _k_ 3. I have not claimed this exemption during the last three years. g ihf."r:t under Sec. ______ , B& P.C. D I hereby affirm that I ha~e a certificate or consent to self-insure, 01 a cert1r1cate of Workers' Compensation Insurance. or a certified copy !hereof (Sec JMO. labor Code) POLICY NO _______ _ COMPANY □ Copy IS filed With the city □ Certified copy 1s hereby fum1shed CERTIFICATl OF EXEMPTION FROM WORKERS" COMPENSATION INSURANCE (This section need not be completed 11 tt,e perm it •s tor one hundred dollars ($100) OI less) 0 I cen1ty !hat ,n the performance ol the wont IOf which thts pemut 1s issued, I shall not employ any person ,n any m.inner so as to become subJect to the Workers· Compensation Laws of Cal'lfom1a NOTICE TO APPLICANT II. atte.r makin~ ttus Cer11 flcate of Ex-emption. you should become sub1ect t'l the Workers· Compensatton provisions ol the Llbor Code. you mus! forthwith comply with such prov1s10ns o, this permit sflall be <reemed revoked 0 I nereby attirm that there 1s a cons1ruct1on tending agency to, lhe perto,mance ol the wor1( Im which !his permH 1s issued lSec XF.J7, C1v1I Code) lenders Name ___________ _ Lender's Address __________ _ USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. --.. -. -··---·····-----· .... ------------------ CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT 1200 Elm, Carlsbad, California 92008-1989 (619) 438-5525 JOB 2R7s77 , +2 o o".5.eue j--\-AV. ST., OA.3 OF APPLICHI BUSINESS LICENSE # VALUATION PERMIT NUMBER RO. ..:..22 l~/t?./ 0 ~cf [c\ d I f\~Ot.10 ~ I c1J7J:_s~i~ ~ f:,~T~' IS Pl LUY\ \11~ CONTRACTORS PHONE • ZONE '1c2/~3cnC OWNER'S MAILING ADORESS 2:7 ~-~ ~ oo so, u O ;{--~~c~g;:ess 4-l 4-~~~qf(o PLAN 1.0. # BLDG USE CODE rf 0't\ 1'"' lb . \4Ar cC _ -Sc-. n es _ . : LDT I BLOCK .l SUBDIVISION I ASSESSOR PARCEL NO. ots,~ (> -fil-YtS Ld[p LICENSE 11 STANOARO"PLAN # BUILDING SQ. FOOTAGE OESCRIPTlON OF WORK I DESIGNER'S ADDRESS DEStGNER"S PHONE { C 1n 121 -{'\-ecJxe-_ --F/P FLA ELEV. NO OCC GP EDU STORIES vO NO -- CENSUS TRACT I GP LANO USE I PARKING SPACE 1 RES UNITS 1 GRADING ".ERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRE SPA AREA CONST YO ND vO NO vO NO Not Valid Unwss Machine Certifi«J QTY. PLUMBING PERMIT · ISSUE 7,S'a QTY. MECHANICAL PERMIT -ISSUE ,3,t70 SUMMARVACCOUNTNUMBER EACH FIXTURE TRAP INS'l-4.LL FURN. DUCTS UP TO 100.000 BTU BUILDING PERMIT 01-00-00·8220 EACH BUILDING SEWER ' OVER 100,000 BTU SIGN PERMIT 01-00-00-8221 I -/-~ BOILER/COMfl'MsSOR UP TO 3 HP EACH WATER HEATER ANO/OR VENT f) PLAN CHECK 01-00-00-8806 I ' EACH GAS SYSTEM 1 TO 4 OUTLETS 801LER/COMPRESS~15 HP TOTAL PLUMBING 01-00-00-8222 l ( J.UC... EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE "-ELECTRICAL 01·00-00-8223 . EACH INSTA~ .. ALTER , REPAIR WATER PIPE VENT FAN SINGLE DUCT ........... MECHANICAL 01-00-00-8224 EACH VACUUM BREAKER MECH EXHAUST -HOOD/DUCTS ---.......__ MOBILEHOME 01-00-00·8225 WA TEA SOFTNER •· RELOCATION Of EA FURNACE/HEATER ........... MOBILEHOME PARK INSP EACH ROOF DRAIN (INSIDE) SOLAR 01-00-00-8?26 , TOTt.L MECHANICAL STRONG MOTION 80·92-33-0519 TOTAL PLUMBING I I l ) -n, f) FIRE SPRINKLERS 01 ·00·00-8227 - QTY. ELECTRICAL PERMIT -ISSUE ./ ,_j;,t:)() QTY. SOLAR -ISSUE PUBLIC FACILITIES FEE 32-00·00·8923 BRIDGE FEE NEW CONST EA AMP/SWTIBKR COLLECTORS SCHOOL FEE • DISTRICT 1 PH \ 3 PH . STORAGE TANKS Carlsbad 80·92·21-0519 EXIST BLOG E¼MP/SWT/BKR ROCK STORAGE Encinilas 80·92-22-0519 1 PH "' 3 PH ' PUMP San Dieguilo 80·92-23-0519 REMODEL/ALTER PE~IRCUIT PLAN CHECK FEE San Marcos 80·92·24-0519 TEMP POLE 200 AMPS "' -. - OVER 200 AMPS --........ XLr TEMP OCCUPANCY (30 DAYS) "' - . - -~ < TOTAL ELECTRICAL I -'· TOTAL SOLAR 1 /O.oo ' TOTAL FEES PAYABLE -- I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT" ANO 'oo HEREBY Exporabon Every perm,t -by Ille Building Olllaat under Ille prov1sIons of th,a * AN 06HA P£Fl,ffT IS AE0UIAEO FOR EXCAVATIONS 0VtR CERTIFY UNDER PENAL TY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall exp,ra by hm,tet,on and become null and void If Iha bu1ld1ng or work !l'O" DEEP ANO 0EMOUTlON 0A CONSTRUCTION OF DECLARATIONS ARE TRUE AND CORRECT ANO I FURTHER CERTIFY AND AGREE IF A PERMIT IS aulho,ized by such perm,t II not commenced wittun l80days from the date of such STAUCl\lRES OVER 3 STORIES IN HEIGHT permit. o, •f the build•~ o, work autho,ozad by auch permit ,s suspended or ISSUED: TO COMPLY WITH ALL CITY, COUNTY ANO STATE LAWS GOVERNING BUILDING CON-abandoned at anv time a er the work ta commenced fore penod of 180 "••• "\. STRUCTION, WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY ANO . \~ CONTRACTOR__A APPROVED BY ~ DATE KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO (JPLICANT s SIGNATURV _ ER 0 EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE I~ . BY PHONE O ~ j5~6-J' 1 GRANTING OF THIS PERMIT. f/fvee>-- ~ u:: >, ;;; 0 a. E Q) I- I -0 0 CJ c '° .2 a. a. < I _,,, C ci: 0 <I) <I) Q) <I) <I) < I ;;: .Q Q) >- vi <I) Q) 0 0 rt '° (0 0 ~ Q) 0 C '° C u:: ::::. C Q) ~ CJ 0 0 Q) 0. <I) E ~ .c 3 """ ··----. -· -·-INSPECTION TYPE DATE INSPECTOR BUILDING FOUNDATION REINFORCED STEEL MASONRY GUNITE OR GROUT FLOOfni, CEILING SUB FRAME SHEATHING FRAME ' EXTERIOR LATH lNSULATION INTERIOR LATH & DRYWALL PLUMBING SEWER AND BL/CO I PLUMBING UNDERGROUND t PLUMBING TOP OUT ' TUB AND $HOWER PAN ' GAS TEST I • . . ELECTRICAL i TEMPORARY POWER , ELECTRIC UNDERGROUND I ROUGH ELECTRIC r ELECTRIC SERVICE BONDING G. F. I. -SMOKE DETECTOR MECHANICAL 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 -· PLUMBING ELECTRICAL . ~ MECHANICAL /-J.) ', GAS V .. ,..; -·./ '\ BUILDING I~ }J ~ I SPECIAL CONDITIONS (~ . I CERT OF OCCUPANCY ISSUED'-. \ --- FIELD INSPECTION RECORD REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES INSPECTION REQ. IF INSPECTOR'S DATE CHECKED APPROVAL . . SOILS COMPLIANCE PRIOR TO FOUNDATION INSP STRUCTURAL CONCRETE OVER 2000 PSI I PRESTRESSED I, CONCRETE POST TENSIONED a CONCRETE FIELD WELDING ' HIGH STRENGTH -I. BOLTS -.. SPECIAL MASONRY r- PILES•CAISSONS -'I -. ' '-'-,..,· .I ---- -. ~ ~ , •' -I, . ·,