HomeMy WebLinkAbout2653 ROOSEVELT ST; ; 80-89; Permitr; C v--J"q ,c, I
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provl•
slons 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,Buslness 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 provl•
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 wor1<, 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 .. ____ ~ 8. & P.C.
for this reaso,~------------
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 filed with the city.
D Certified copy Is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed If the per•
mil 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: If, after making this Cer•
tlflcate of Exemption, you should become subject
to the ~kers' Compensation provisions of the
Labor tGde, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
~STRUCTION LENDING AGENCY
J.. ~'affirm that there Is a construction len·
--..,. J)erformance of the work for
·ed (Sec. 3097, Civil Code).
·------1 C IT Y O F CARLSBAD-BUILDING DEPAR TMENT
USE BALL POINT PEN ONLY
APPLICATION & PERMIT
1200 ELM AVENUE (714) 438-5525
APPLICANT TO FILL IN INFOR -
MATION WITHIN RED LINES.
JOB ADDRESS DATE OF APPLICATION! 8US. LICENSE iVld / ~tRMIT NUMBER 1-VJ-go
OWNER'S PHONE I PRIME CONTRACT_;l.lJ_ •
----/3o(ck,v, (.;QYJS,t,
I
RES, UNITS
8LOG SQ. n. BLDG USE OCC. GP i STANOARD PLAN II PLAN ID II
J {ec,D I O PP.JC B-2.. v-11
QTY.I PLUMBING PERMIT MECHANICAL PERMIT
OCC. LOAD
~ ~,;r-c~/4
0 ...... :::,
Not V•lid Unless M•chin1 c.rt.ifi-1
'v,
•
•
• ~ c-0 -/17,?4-~-~ VALUATI ON :
WATER SOFTNER BUILDING PERMIT
I ssue SIGN PERMIT
TOTAL PLUMBING PLAN CHECK
CONTRACTOR ALL INCLUSIVE PERMIT
MOBILE HOME PERMIT AMT. TOTAL PLUMBING
ELECTRICAL
AWNING MECHANICAL
PORCH MOBILE HOME
SET-UP SOLAR
RAMADA. CABANA
FENCE OVER 6'
TOTAL MOBILE HOME MICO-FILM
TOTAL FEES PAYABLE
CONTRACTOR
I HAVE CAREFULLY EXA~ ED THE COMPLETED "APPLICATION AND PERMIT, AND DO
HEREBY CERTIFY THAT A L INFORMATION HEREON IS TRUE ANO CORRECT AND I
FURTHER CERTIFY AND GREE IF A PERMIT IS ISSUED;TO COMPLY WITH ALL CITY,
·AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER SCHOOL FEES :
5'-0" DEEP AND DEMOLITION QA CONSTRUCTION OF
COUNTY AND STATE LA GOVERNING BUILDING CONSTRUCTION, WHETHER
SPECIFIED HEREIN QA 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 THE GRANTING OF THIS PERMIT .
STRUCTURES OVER 3 STOA I ES IN HEIGHT
BY PHONE
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INSPECTION
WOOD i;:L_9OR
FOUNDATION• FORMS • SET BACK• TOILET
UNDER FLOOR PLUMBING
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 INSULATION
INSULATION OK • PLACE WALLBOARD
WALLBOARD OK • PLACE TAPE .
EXTERIOR LATH OK • PLACE si,uc'co \. -". ,
FIREPLACE -~-
DAMPER &STEEL . ·: j"'
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 DEPT'S REQ COMPLETED
ELEC METER-PERM-TEMP
GAS METER-PERM-TEMP
L\; i
-CERT OF OCCUPANCY ISSUED
-,
DATE INSPECTOR
• ..
-
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-,..._
---.. ~---
-'',/''• --.
'
-
~ ,._
OWNER:
FIELD INSPECTION RECORD
INSPECTOR'S NOTES
..;._:J ......
'(~ \ ~ ·:-. '
,...
·PERMIT NO:
·'
~
' ' .,, ---..
LICENSED 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
DI 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).
□ 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•
tractlng with licensed contractors to construct
the project (Sec. 7044, Business and Professions
Code: The Contraclor'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. \ \ fl & P.C.
for this reason .,
Date ______ Owner
WORKERS' COMPENSATIO~C\'~
I hereby affirm that I have a certl;~ o con-
sent to self-Insure, o, a certificate of orkers·
Compensation Insurance, or a certified copy
thereof (Sec. 3800, Labor Code).
POLICY NO .. ___________ _
COMPANY ___________ _
□Copy is filed 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 ($100) or less).
I certify that in the performance of the work for
which this permit Is issued, I shall not employ any
person in any manner so as to become subject to
the Workers· Compensation Laws of California.
NOTICE TO APPLICANT: If, after making this Cer-
tificate of Exemption, you should become subject
to the Workers' Compensation provisions of the
Labor~• you must forthwith comply with such
provislo,,s or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I herei:r affirm that there Is a construction len-
ding agtincy for the performance of the work for
whlr.h thlc ninrrnit le ie euart IC:.a,.. 'V'Wl7 ,...1,.11 ,...,..,.A\
CITY OF CARLSBAD-BUILDING DEPARTMENT
USE BALL POINT PEN ONLY APPLICATION & PERMIT
1200 ELM AVENUE (714) 438-5525
APPLICANT TO FILL IN INFOR-
MATION WITHIN RED LINES.
1./ots~ /Ri 0ro s ,e, \J,e I l -b1
JOB ADDRESS ~~oq_:z&~Jo i&icf8 PERMIT NUMBER \-· I I I I I I I I I I l I I I I
OWNER~ F t)/A~~. OWNER'S PHONE
~:. CONr~:Cu,t~ ,~ STATE LICENSE Po--ff/J-; ~.~. .. S -Z12~!2?_ ~ '1"1-., ,. J
OWNE~tfcr ADo~ Ave WI~ Cl/zttl)i Fif fu< 7z4+ <:Msl»d CONTRACTOR'S ~
I~~ /077 ..
l~~LOCK 1;'e~r;~ ~a.sl 2J;,Eg,:.; t~o.Y~ ,-z1, OES~w f: l)4~ STATE LICENSE 0(1J!'fj fi.,,'1 ')./26/80 if;.~.: I G-lf'-1--/ OESCRIP~N 0~ ~ wd <fr~ £~tt,.~ 740~f Ave C¥/$had DESIGNER'S PHONE
($>fficl,__ bdrJ,,u 77f/ Z/12
CENSUS TRACT GP LANO USE ZONING I RES. UNITS I PARKING SPACE I NUMBER OF STORIES
Not V•lid Unless Machin, c.rt;fild
BLOG SQ. FT. BLOG USE OCC. GP 1 STANDARD PLAN II I PLAN IO II I TYPE CONST I occ. LO•D j
QTY. PLUMBING PERMIT AMT. QTY. MECHANICAL PERMIT • AMT. -A --y EACH FIXTURE TRAP A::;.-__;-# INSTALL FURN. DUCTS UP TO 100,000 BTU /~.-:...;;--
'l EACH BUILDING SEWER ~~v I OVER 100,000 BTU
I EACH WATER HEATER ANO/OR VENT :,. . ., -BOILER/COMPRESSOR UPTO 3 HP I
L EACH GAS SYSTEM 1 TO 4 OUTLETS .,,._v-BOILER/COMPRESSOR 3-15 HP
EACH GAS SYSTEM 5 OR MORE BOILER/COMPRESSOR 16-30 HP ·--EACH INSTAL., ALTER, REPAIR WATER PIPE /r VENT FAN Sl~!GLE DUCT ,r-. ,.-v~ EACH LAWN SPRINKLER SYSTEM I MECH EXHAUST -HOOD/DUCTS
WATER SOFlNER ... RELOCATION OE EA FURNACE/HEATER 4>· BUILDING PERMIT I . I I I ./.A .A./_,1__..,, . ") lf_jJ. ...-./ ✓--., .I .:;/.-,C(g SIGN PERMIT I , I I I TOTAL PLUMBING ~ !-"' -TOTAL MECHANICAL :2,7 ?~ PLAN CHECK I . I I I CONTRACTOR CONTRACTOR ALL INCLUSIVE PERMIT I I I
AMT. TOTAL PLUMBING 1?..J.Y'V ,-QTY. Af. 1JiL5.C,:_RICAL PERMIT AMT._,, QTY. MOBILE HOME PERMIT ELECTRICAL /1/11.d"fO ., ,. ,. '~ .. ;ONST EA AMP/SWT/BKR Jtrf). ~ AWNING MECHANICAL -I.A?-~ I-• ,
1 PH .25 3 PH / PORCH MOBILE HOME I r' . I
EXIST BLOG EA AMP/SWT/BKR SET-UP SOLAR I . I I I 1 PH .25 3 PH RAMADA, CABANA J_ -----; I I I I
REMODEL/ALTER PER CIRCUIT FEN CE OVER 6' ~~./7JA//4--.J I . I I . I
/ TEMP POLE 200 AMPS /?'-"-TOTAL MOBILE HOME MICO ·F,K..)" I I I I ,,, OVER 200 AMPS I . I I ; I TEMP OCCUPANCY (30 DAYS) I I I I -.A .A
I /~_.,,,,,,,,,..,~ _. .-V I . I I
TOTAL ELECTRICAL /1:i-~ ~ TOTAL FEES PAYABLE I /t7~ -CONTRACTOR . I I
~ ~ .. -,
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION ANO PERMIT. ANO 00 ·AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER V -
HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE ANO CORRECT ANO I 5'-0" DEEP ANO DEMOLITION OR CONSTRUCTION OF
FURTHER CERTIFY ANO AGREE IF A PERMIT IS ISSUED; TO COMPLY WITH ALL CITY, STRUCTURES OVER 3 STORIES IN HEIGHT
COUNTY ANO STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER /V,w.06~£-~~A,/ :~ IN-.) SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY ANO KEEP HARM-
LESS THE C ITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS. COSTS ANO
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAIO CITY IN CONSEQU ENCE . ~
OF THE GRANTING OF THIS PERMIT. t:;f NT'S SIGNATURE" OWNERl9-,.-CONTRACTOR irPPROVEO BV ./ fJJ ~fO AGENT vl' BYPHONE 1
• w ~ ~
~ i= ~ a.
I.I) ~
AC f'RESS: ., ' OWNER: PERMIT NO: .
( ' ' .._,_ FIELD INSPECTION RECORD
INSPECTION .. DATE .tNSPECTOR
"'
INSPECTOR'S NOTES
WOOD F'f..OOR .. :
FOUNDATION• FORMS • SET BACK• TOILET ..
UNDER FLOOR PLUMBING
UNDER FLOOR HEATING -
OK TO INSTALL SUB FLOOR , . .
SLAB FLOOR
UNDER SLAB PLUMBING
FOOTING• FORMS• SETBACK • TOILET
OK TO POUR CONCRETE
f
FRAME
ROUGH 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
• PAN
FINAL INSP BY BLDG DEPT
OTHER DEPT'S REQ COMPLETED
ELEC METER-PERM-TEMP
GAS METER-PERM-TEMP
. ~
CERT OF OCCUPANCY ISSUED
_,
. '"\.
REQUEST FOR INSPECTION TIME._· _____ _
•
INSPECtO"----c=c----~---PERMIT NO, __ .r _ _,.,__ __ DATE:
OWNER, __ • _/3'-""-J.£.~=..==~.,.____.,_J---'..A,u_=-=c..==~"-"---=->""'--------
4-/1/-/'/
ADDRESS--C-'-b-~_J.=_ __ .,_f?.L-!:o'--"'-O.,.,_S_,,£"---'VwEe,.,;-+-/_,7=L.._ ______ _
BUILDING
D FOUNDATION
D REINFORCING STEEL
D MASONRY
D GROUT· GUNITE
D FLOOR AND CEILING FRAME
D SHEATHING
D FRAME
D EXTERIOR LATH
D INSULATION
D INT~OR LATH OR DRYWALL
~INAL
PLUMBING
D UNDERGROUND PLUMBING
D UNDERGROUND WATER
0 ROUGH PLUMBING
D TOP OUT PLUMBING
0 SEWER AND PL/CO
0 TUB OR SHOWER PAN
D GAS ST
D
READY FOR INSPECTION: ~AV
DP.M.
~AV
ELECTRICAL
D TEMPORARY SERVICE
D ELECTRIC UNDERGROUND
D ROUGH ELECTRIC
D POOL BONDING
D ELECTRIC SERVICE
D CEILING HEAT
OG.F.I.
O_§1140KE DETECTOR
cz!' FINAL
MISCELLANEOUS
0 PLENUM AND DUCTS
D COMBUSTION AIR
D PATIO
D SIGN
0 GRADING
D DRIVEWAY
D CONDITIONED AIR SYSTEMS
□~ PIPING
□ FINAL
□WEDNESDAY D THURSDAY D FRIDAY
SPECIAL INSTRUCTIONS _________________________ _
REQUESTED BV _ ___;~"-"'"'--"===------------PHONE NO.~....,,_--+----
/ PERSON TAKING REPOR~~
·-•-. •····---------·
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•
1200 ELM AVENUE
CARLSBAD, CALIFORNIA 92008
January 8, 1980
James Weber
740 Oak
Carlsbad, CA 92008
Cit!' of Carlsbab
RE: Existing· sewer Connections at 2653 Roosevelt
TELEPHONE:
(714) 438-5621
The City shows two (2) sewer connections existing at the
above address. A 3600 square foot office complex would be
allowed to replace the existing structures providing City
Codes are met.
Patricia Cratty
Development Proces ng Coordinator
PC:rnrnt
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)'( A~~AM~~MAAMlvA AA/4,AM.../4A~~A/AM X ~ --~ ►
} Qirrtifiratr 11f QDrr1t1,1aur1t f
~ CITY OF CARLSBAD
~
3
~ This Certificate issued pursuant to the requirements of Section 306
of the Uniform Building Code certifies that at the time of issuance ,::
this structure complies with applicable ordinances of the City 3 regulating building c~nstruc~ion use.
Bldg. Perm;, No. 8 0 -8 9 ~ Use Class;f;c0t;on Commercial Office Bldg.
~ Group _____ Type Construction _____ Fire Zone _____ Use Zone _____ _
~ Occupant Lood ___ ,,..-________________________ _
~ OwnerolBu;id;n~, . ,J~rnes _F'.. Weber 'Address 740 Oak Ave.
~ Bu0d;n9 Address • 26~3 Rooseyel t St, Local;ty C~rlsbad, CA. 92008
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A NOTE: Alterotions, chonges, odditions or changes of occupancy <
-<i: I 1/ ~ ·-vrw-..,•wr Post In conspicuo1,1s place) ~
.. \"f\'fWW~ ~ M M M °' "-'W'~'~•t'/f M ':'f'lf\Yj'll/\~ff'1V""''!~CT,✓,w_..,. .
INTERDEPARTMENTAL INFORMATION SHEET
BUILDING ' DEPARTMENT BtCEIVED
BUILDING
Building Department
PLANNING DEPARVENT Q ZONE ___ ~-----LOT SIZE ________ LOT WIDTH __ &pZ.....__..=--_I ____ _
UNITS ALLOWED ___________ UNITS PROVIDED ___________ _
PARKING SPACES REQUIRED Wl (j\ PROVIDED _____ ~-----
% COVERAGE ALLOWED ✓ PROVIDED ----------------------
BU IL DING HEIGHT ALLOWED PROVIDED
• FRONT SETBACK:
~ ALLOWED Z0 j
PROVIDED ~o
INTRUSIONS
SIDE SETBACK:
./p
----------
REAR SETBACK:
1-Z-----
LANDSCAPE & IRRIGATION PLAN COMMENTS: ~ ~ J"?:e:PJ
~ 2t::\::E:1===1 L-1
ENVIRONMENTAL PROTECTION REQ: __._..~w...-==----'---l,-..---------------
ADDITIONAL COMMENTS:
'OK TO ISSUE:
ENGINE~RING DEPARTMENT
¥~HJ . I
R.O.W. /2,82)/l) INDUSTRIAL WASTE )V ~
SEWER c;,;;;;-c T ION[~~ ~.-I-✓-rE:~A_Y_L_O_C_A_T_I ON s ____ ~--------===-_,
GRADING PERMIT fl/-~ EASEMENTS_---1,~n ~~~:::::::::~ ,I •
LEGAL DESCRIPTION --------------7""'----------------
A DD IT ION AL COMMENTS _________ ~------------------
ADDITIONAL COMMENTS
... To Iss~ __ DATE g-:J.J-fl OK TO FINAL __ 2_,_/ ...... ~_,../_f_l _DATE __ _
~ ~ (7
' DEPARTMENT
.EMENTS OF APPROPRIATE DISTRICTS MET ________ DATE _______ _
. . > >
•
BRIAN ~M I TH E~GJNEERS , I NC .
2656 State Street
Cl jent: James F. Weber
740 Oak Avenu
CarJ 2bad, CA 92008 Carl sbad , CA 92008
Job No. 5014
J anuary 14, 1~80
Structural calculations for a
prop ose d offic e building at
2653 Roose v e lt Street,
Carlsbad, CA .
SH F'ET
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c.Ji·, I iJ I TRI CITY Ef.ulNEERS
• A CALIFORNIA CORPORATION
336 Ol.lVt: AVENUE · VISTA, CALIFORNIA 82083
(714) 7 58·2220
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SHEET NO ----+--+-------OF--~\~~----
CALCULATEO evU. Jt:~-\}.).M, e DATE~l~\+-/~n+-Pf-4--'-'......_ __
CHECKED BY __________ DATE ______ _
SCALE
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------·--------
JIM WEBER, ARCHITECT
APARTMENT. COMMERCIAL REAL IESTATE DEVELOPMENT
January 24, 1980
740 OAK AVENUE
CARLSBAD, CA 92008
714 / 729-2192
Building Inspection Dept.
City of Carlsbad
1200 Elm Avenue
Carlsbad, Ca. 92008
ATTENTION: Ray Green, 2653 Roosevelt Street, soil bearing.
Dear Ray,
I have inspected the soils on the subject site and find it
a natural undisturbed sandy loam material. I am therefore
using a bearing value of 1,350 P.S.F. which should give me
a safty factor of 2.5 to 3.
Very truly yours,
o_/(_ ~
'
•
•
, '·••"-------·-•··· .. ,. ··------
1200 ELM AVENUE
CARLSBAD, CALIFORNIA 92008
TELEPHONE:
(714) 729-1181
Building Department
Citp of Carl~bab
rmRESIIB[IAL ENERGY DESIGN CERTIFICNION
Permit.No. _____ _
Issue Date. _____ _
CEITTIFirAlE Cf W'1PLIANCE Willi ENERGY CDNSERvATION DESIGN REQUIREMENTS
CDNTAINED IN ARTICLE 2, PART 6, TITLE 24, CALIFORNIA AI11. CODE.
1 • ,/arvt~s E Wa,er
Designer .
..
hereby.certify that I
am familiar with the state energy conservation standards mandated
in CAC Title 24, Section T20-145l through T20-1542, and that the
plans and other documents submitted in support of the application
fof a Building permit at
2~53 f<.oosevel-1:. $-l:. . . 2o3 .. 101-21
Address
' '4-~-10,
Assessor's Parcel No. • Dated
comply with all curr'ent requirements of these regulations.
Indicate method of compliance:
A: RI
B. D
C. D
D. 0
Component Performance (Standard Design)
Energy Budget Analysis (Alternative Design)
Non-depletable Energy Analysis (Alternative Design)
Other (specify)
Signature""'~ · .. ~~
T i t l e ( A.~ t U r:-t,
"-....::-~....uu ·tect, Engineer, Contractor
State License or Certificate No._.C,""""-_-~2~,~4:_f.,_,f..._ _______ ~
Date ~ ~ /'/80
Submit to the Building Department with permit application .
• •