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Home My WebLink About2621 ROOSEVELT ST; ; 80-350; Permit,. J.ICENSED 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 un/4r S•cSJi= , B. & P.C. for this reason 1 )..,.,,,.. 1 Date WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of con- sent to sell-Insure, or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Labor Code). POLICY NO ___________ _ COMPANY ___________ _ □Copy Is filed with the city. 0 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 ($100) 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: II, 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 .,pr~vlslons or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY L tleieby affirm that there Is a construction len- CITY O F CARLSBAD-BUILDING DEPARTME N T USE BALL POINT PEN ONLY APPLICATION & PERMIT 1200 ELM AVENUE (714) 438-5525 - HO. JOB ADDRESS ~T, IDATE OF APPLICATION I ..:ti C:, ::2t I I I I I I ,eiei,a,s,G,tl,&,l1 t, I I I I I I I I I 1 I 1 4-lo -86 OWNER OWNER'S PHONE PRIME CONTRACTOR '17.A1d C,01, ... -J-.ia. ~ Crr n ,1p_/'l'Yl,L l,;,e-~Mo Dv NG Gon. ~ - OWNER'S MAILING AOORESt/ p CONTRACTOR'S ADDRESS 7 & s E H 1-; s IO>-< \zt, LOT BLOCK I SUBDIVISION I iSSESSOR'S PARCEL NO. O· DESIGNER ~~;,( h I+ ~G-0 ~3 q?.. 110 , I 1-d-r~, U. I q ~ (b o_, APPLICANT TO FIL L IN INFOR- MATION WITHIN RED LINES. BUS. LICENSE PERMIT NUMBER 202,q J>&-3SO S'°TATE LICENSE J]d..4-DS CONT RACTOR'S PHONE 7<::7~72.D STATE LICENSE -;;. - o;;z-_lPTION or WORK 76 ct:I.. ,,4.,., no~.01 l",('3~ /~ ,,,_ DESIGNER'S ADDRESS DESIGNER'S PHONE 4/10/806074 2;::.5( 0001607'4 4/10/60 r.'.5C' CENSUS TRACT GP LAND USE ZONING sf I RES, UNITS I PA~KING SPACE I NUMBER OF STORIES Not V•lid Un"1ss fbchin1 Cmifi«I BLDG SO, FT. BLDG USE occ. GP I STANDARD PLAN II I PLAN ID II I TYPE CONST l occ. LOAD I .... QTY. ~LIMBING PERMIT AMT. QTY. MECHANICAL PERMIT AMT. . EACH FIXTUR~AP I INSTALL FURN. DUCTS UP TD 100,000 BTU ¥.Uc EACH BUILDING SEN OVER 100.000 BTU -. EACH WATER HEATER A~R VENT ...,_ BOILER/COMPRESSOR UP TO 3 HP >f:":4t. I EACH GAS SYSTEM 1 TD 4 0 UT~ / BOILER/COMPRESSOR 3-15 HP ~--<"'n 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 VALUATI ON: WATER SOFTNER ............ RELOCATION OF EA FURNACE/HEATER BUILDING PERMIT Issue 3 .• (N Issue 3 .1TU SIGN PERMIT TOTAL PLUMBING TOTAL MECHANICAL ~,~() PLAN CHECK CONTRACTOR CONTRACTOR All INCLUSIVE PERMIT "-tLECTRICAL PERMIT AMT. 'MOBILE HOME PERMIT AMT. TOTAL PLUMBING QTY. QTY. ELECTRICAL NEW CONS~ AMP/SWT/BKR AWNIN~ MECHANICAL 1 PH .25 ........... 3 PH PORCH ............ MOBILE HOME EXIST BLOG EA AMP/!Mcr/BKA SET-UP ............ SOLAR 1 PH .25 ........... 3 PH RAMADA, CABANA ......... REMODEL/Al TER PER CIRCUI FENCE OVER 6' ............. TEMP POLE 200 AMPS '· TOTAL MOBILE HOME ............ MICO-FI LM OVER 200 AMPS ......... TEMP OCCUPANCY (30 DAYSI ......... ............ STRONG MOTinN • I ssue ~o ' TOTAL ELECTRICAL --TOTAL FEES PAYABLE I CONTRACTOR ' •AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER SCHOOL FEES: I HAVE CAREFULLY EXAMINED THE COMPLETED .. APPLICATION AND PERMIT. AND DO HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I s·-o--OEEP AND DEMOLITION OR CONSTRUCTION OF FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED; TO COMPLY WITH ALL CITY. STR&V:;l5E 1 ~•✓ COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION. WHETHER SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM- LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS. COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF T HE GRANTING OF THIS PERMIT. APPLICANT"S SIGNATURE• / OWNER□ CONTRACTOR~ !APPROVED BY AGENT 0 BY PHONE n I . I I I j , I I I I . I I I I I I I I I I I I 1.JA, I \"' I I I I I j I I . I j I I . I I I I . I I I I ' I I ; I I ' I I I I ' I I I I I . I _l_} l'IJ -91//~/ t?c> , DATE I • UJ ~ ~ ~ i= ~ a. V) ~ d C) SITE - ADDRESS: OWNER: ' FIELD INSPECTION RECORD INSPECTION DATE INSPECTOR WOOD FLOOR FOUNDATION • FORMS• SET BACK • TOILET . UNDER FLOOR PLUMBING _J ,..., .. 't{-4''-' . ~ UNDER FLOOR HEATING OK TO INSTALL SUB FLOOR SLAB FLOOR UNDER SLAB PLUMBING FOOTING • FORMS• SETBACK • TOILET OK TO POUR CONCRETE FRAME ROUGH ELECTRICAL ROUGH PLUMBING ROUGH HEATING/VENTILATING - FRAME OK• PLACE INSULAT ION 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 ,,,,,., .. .r • FENCE PREPLASTER ~· SHOWN • FRAME • PAN FINAL INSP BY BLDG DEPT OTHER DEPT'S REQ COMPLETED ELEC METER-PERM-TEMP GAS METER-PERM-T EMP , ....... ,, ~' r f· . '',. -, CERT OF OCCUPANCY ISSUED ; ... \ ,,. -PERMIT NO: INSPECTOR'S NOTES •' ,I .... , '·~ , " -~ ... ,., " _,,,.-,._ /,/" .,.,. , ,J' ~ ,,,, ,. ,,. , -,,, ,;· /" " -· ~ .... ,,. - \ - ---,,. ;, -· '. . r -,,-· ,,. , ,, ~ -,:,>'/ .. ,. ✓ .,, ~ . - -,,,, _r , ·' .. 1 .. r .. '-,