The URL can be used to link to this page

Home My WebLink About2808 ROOSEVELT ST; ; 82-333; PermitCl) z 0 .= C a:: j f.{ 0 II: I[ u II: l&I 0 .... 5 I l&I z ~ z 0 .= ,c "' z "' A. ~ 0 u !II a:: l&I "' a:: 0 3 i[ • "J 0 I hereb, -1Irm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is In full force and effect. lie No _______ Class _____ _ I hereby affirm that I am exempt from the Con· ~~o;-~!f:':: ~ ~f~~,~~~r~i~ county which requires a permit to coostruc1 alter. improve, demohsh, or repair any structure, prio, to I1s issuance also requires the ~ltcant lex such penmt to hie a signed statement that he ,s licensed pursuant 10 the pr0Y1sions of thll Con-tractor's License Law (Chapter 9 commenctng with SecttOO 700) of D1v1sl()(l 3 of the Business and Pro- fessions Code) or that Is ex:empt therefrom and the basi~ for the alleged exemphon. Any vtOlahon of I Section 7031.5 by an applicant fOC' a pemut subjects me applicant to a c1v11 penalty ot not fflOfe than hve hundred dollars ($500I C I. as owner of the property. or my employees, ,.,th wages as their sole compensahon, will do the we>nc:, and the structure is not intended or offered for sate (Sec. 7044, Business and ProfessH)ns Code· The Contractor's License Law dOes nol apply 10 an owner ol property who builds or ,mpro-.,es thereon and who does such work. himself or through his own employees, provided thal such improvements are not 1nteode1 or offered tor sale If, however, the building or ,mpro'lement ,s sold w1th1n one yea, of completion, the owner-builder will have the burden of proving that he did not build o, improve lot the purpose of sale). D I, as owner of the property, am exclusively con1ractinw with licensed contractors to construct ◄ the pro1ect (Sec. 70,U, Business and Professt0ns Code The Contractor's License Law does not apply to an owner of property who builds or improves thereon. and who contracts for each pro1ects w,th a contractorts) license pursuant to the Contractor's License Law> 0 I am exempt under Sec _____ , 8 & PC tor this reason D I hereby affirm that I ha.-e a certificate or consent lo self-insure. or a cert1f1cate of Workers· Compensation Insurance. or a cert1f1ed copy !hereof (Sec 3800. Labo, Code) POLICY NO COMPANY O Copy 1s hied with the city 0 Certified copy 1s hereby furnished CERTIFICATE OF EXEMPTION FROM WORIIERS' COMPENSATION INSURANCE (This section need not be completed 11 lhe permit ,s tor one hundred dollars (S 100) or less) 0 I certify that .., the performance of the wort( tor which this oerm1t 1s issued, I shall no1 employ any person 1n any manner so as to become subJect to the Wort(ers· Compensation Laws of Cahtorn1a NOTICE TO APPLICANT If, after makin:;i this Cert1 hcate ot Exemption. you should become subject 1? !he Workers· Compensation prov1s1ons of !he Lat>or Code, you must forthwith comply with such prov1s1ons or this perm11 shall be deemed revoked D I hereby allum thal there 1s a cons1ruct1on lending aoency tor the perlOfmance ol lhe work lo, wr11ch this perm,! 1s ,ssued iSec 3097. C1v11 Codel Lenoer s Name ___________ _ Lenoer·s Address __________ _ ----·------·----·· -·-... -. _. ___ ...... _ -.--,,, • _,_...,_,,. 1 • -1 ,,_,_ 11, 11,1 -1111WI-I I_I, WW I I 1111'1 ~J l"'U~..., "'n""'" "' Lll;.\JL."'n"' I IVI .. ..;> • ') CARLSBAD BUILDING DEPARTMENT (._) APPL~ TION & PERMIT 1200 Elm, Carlsbad, California 92008 (714) 438-5525 JOB ADDRESS w. A~i.T-I OAT:f l,7/iO>f BUSINESS LICENSE ,t VALUATION PERMIT NUMBER J ~,-1~ DiFi1'iS~tJ~t f7__AO I<.~~ ,, ooo ~)./ OWNER'S NAME OWNER'S PHONE PRrJTjR~C~ / I CONTRACTORS PHONE # ZONE 333 ibrB~R-T r .1 J, '/ SO"><./ OWNER'S MAILING ADDRESS CONTRACTOR'S AOORESS LICENSE NO. PLAN 1.0. # BLOG use CODE LOT I BLOCII I SUBOIVISION I ASSESSOR PARCEL NO. DESIGNER STATE LICENSE # STANDARD PLAN# BUILDING SO. FOOTAGE /{)(Jf} DESCAl~N OF \l'IPRK ~~ '~ ~ \~ t. }-A../. I 5 1-rtH A.\ OESIGNER'S ADDRESS DESIGNER'S PHONE ~ "1f:S': __L;_uc..~ -(Jp0~ Bl 1e1a.e 15!5 I I 1.12,7!~ F/P FLR ELEV. NO OCC GP EDU qq□,1 ,rso.r §1yu se l1J2;75 ~ 1Atz-, ~(2.C/ ~ e._ STORIES vO NO CENSUS TRACT GP LAND USE I PARKING SPACE I AES UNITS j GRADING ~ERMIT ISSUED I REDEVELOPMENT TYPE DCC LOAD FIRE SPR AREA CONST y D ND vO NO vO NO Not Valid Unkn Abchine Cerrified QTY. PLUMBING PERMIT -ISSUE 7 .50 QTY. MECHANICAL PERMIT -ISSUE 3.00 SUMMARY/ACCOUNT NUMBER A, ~ EACH FIXTURE TRAP / INSTALL FURN. DUCTS UP TD 100,000 BTU BUILDING PERMIT 01-flM-4220 /JM ' '11) EACH BUILDING SEWER / OVER 100,000 BTU SIGN PERMIT 01-000-4221 -r i--- EACH WATER HEATER ANDIDR,..,l((NT BDILERICDMPRESSDR UP TD 3 HP PlAN CHECK 01-000-4806 ~, {;?' ,,._, EACH GAS SYSTEM I TO 4,,01'.'jTLETS BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING 01-000-4222 EACH GAS SYSTEM 5,P'ff MORE METAL FIREPLACE ELECTRICAL 01-000-4223 EACH INSTAl., ~R. REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01 ·000-4224 EACH VACJJ(!"M BREAKER MECH EXHAUST -HOOD/DUCTS MOBILEHOME 01-000-4225 WAT¢0FTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP _µ6i ROOF DRAIN (INSIDE) ~ SOLAR 01-000-4226 TDH,LMEC~ STRONG MOTION 65-640-0519 TOTAL PLUMBING I . " FIRE SPRINKLERS 01 -000-47?7 ELECTRICAL PERMIT -1ssty 2. ail QTY. ~A-ISSUE PUBLIC FACILITIES FEE 25-000-4933 QTY. BRIDGE FEE NEW CONST EA AMP/SWT BKR _/ ~ r; ./ ,.COLLECTORS SCHOOL FEE • DISTRICT 1 PH PH A /' / .. STORAGE TANKS Garlsbad 65-623-0519 EXIST BLDG EA AMP/~BKR /I ,{ / ,;,,.,,' ROCK STORAGE Encinitas 65-624-0519 1 PH L 3 PH -J/J 17" ;/, .A Pl!J,115 San Dieguito 65-625-0519 REM ODE UA).,l't R PER CIRCUIT /Y I r/1 ~ _... I ./ t'fiLAN CHECK FEE San Marcos 65-626-0519 TEMP P_¢ 200 AMPS A' I i hlv /-~ O\/V200 AMPS / I I I ,-, , , ~ '-fl, ~MP OCCUPANCY I3~YS) J , I • I, V / ./ 1/// V .--- ~L ELECTRICAL I I rv TOTAL SOLAR TOTAL FEES PAYABLE L 14~,7 ~ I HAVE CAREFULLY EXAMINED THE COMPLETED '•APPLICATION AND PElilMIT" AND DO HEREBY Expiration Every permit issuec!bythe8uild1ng0fltc1al undertl>e provis1onsofth,s * AN OSHA~ IS REOUIAED F0A EXCAVATIONS OYER CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall expire by hmilltlon and become null and <0Id If the butlding or work 5' O" DEEP A DEMOLITION OR CONSTIIUCTION OF authorized by suc h permit 1s not commenced within 180 days from the date of such DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS petmil, or 11 the btJildi~ or work authonzed by such permll 19 suspended or STRUCl OVER 3 STORIES IN HEIGHT ISSUED: TO COMPLY WITH ALL CITY. COUNTY AND STATE LAWS GOVERNING BUILDING CON· abandoned at any time a er the work is commenced for a oenod of 180 davs. STRUCTION. WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND f._, NT' APPi OVEDB,~~ 1°Yrv/~1-~ KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS, COSTS AND AP. LICA S SIGNATURE _hj OWNER O CONT~• EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE ~ f_ ( 1~ 8) i~ ~ .... GRANTING OF THIS PERMIT J lJ.' . . ... - INSPECTION TYPE DATE INSPECTOR .. - BUILDING i FOUNDATION ' REINFORCED STEEL I MASONRY GUNITE OR GROUT FLOOR & CEILING SUB FRAME SHEATHING FRAME , EXTERIOR LATH lNSULATION 1 . INTERIOR LATH & DRYWALL ' ' PLUMBING SEWER AND BL/CO I PLUMBING UNDERGROUND I PLUMBING TOP OUT : TUB AND $HOWER PAN l , GAS TEST ' ELECTRICAL TEMPORARY POWER 1 "., ELECTRIC UNDERGROUND 1 ROUGH ELECTRIC ELECTRIC SERVICE ) BONDING 1 · G. F. I. -SMOKE DETECTOR J MECHANICAL 1 DUCT & PLEM., REF. PIPING •-,, -' '' HEAT -AIR COND. -SOLAR SYSTEMS ,-, VENTILATING SYSTEMS l ' '- CALL FOR FINAL INSPECTION !WHEN Alf APPROPklA tE ITEMS ABOVE HAVE BEEN APPROVED. JOB SITE FINAL PLUMBIN"G ELECTRICAL I -' ~ MECHANICAL GAS I I -BUILDING I SPECIAL CONDITIONS CERT OF OCC]'""~NCY ISSUED I .......... -. - - - - - - - - - - - - - - - - - - - , - -~, (._. e .;i ,, 3. 3 3 A . - 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 PRES TRESSED CONCRETE POST TENSIONED CONCRETE FIELD WELDING HIGH STRENGTH BOLTS . SPECIAL MASONRY PILES•CAISSONS -· , -' } ..... ' "';' ,,, . . -~ -. --' . \. )· ( \ I 1 • , .., ' I ,, : •. --~ . ·• .. • 1 \ .t \L .) f ell z 0 ~ C er: j 0 Ill 0 C I[ 8 C Ill 0 ... 3 I Ill z ~ z 0 ~ C ell z "' CL ~ 0 0 ell ic "' ..: er: 0 ~ if 0 I hereby affirm that I am licensed under provlalona of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is In full force and effect. Lie No ______ Class _____ _ I tle<eby attinn that I am exempt from the Con- ~!'(~!f :'::' ~ ~~1=:~~~i~ county which requires a pennit to construc:1 alter, imp,cwe, demolish, or repair any structure, pnor to its issuance also requires the applicant tor such penTllt to tile a signed statement that he is licensed pyrsuant to the provIs""1s ol the Con· tracto,'s License Law (CNl)te, 9 commencing with Section 7(XX) of rnv,sioo 3 of the Business and Pro-fess,ons Code) or that is exempt th&refrom and the basis tor lhe alleged exemption. Any YIOlattOO of Section 7031.5 by on applicant fo, a pemut subjects tne apphcant to a cMI penalty ot not more than five hundred dollars ($500). D I, as owner of the property, o, my employees .. 11h wages as their sote compensation, will do the wo,tc, and the structure Is no1 intended or often,d fOf safe (Sec 7044, Business and Profess,oos Code: The Contractor's license Law does not apply to an owner of property who builds or 1mpr0¥eS thereon and who does such WOt1l himself or through his own employees. provtded that such imprOYements are not mtende1 or offered for sale. If, however, the building or improvement 1s sok:I within one year of comp~hon, the owner-builder will have the burden of proving that he did not build or 1mpr0Ye for the purpose of salef. □ I. as owner of the property, am exclusively contrach"9 with IH:ensed contrilCtors to construct the p<OjllCt (Sec. 7°", Business and Professions Code: The Contractor's license Law does not apply to an owner of property who builds or imprOYes ~=t~":, f.~nc:~:!~~ ~~rt!'~~~~::.: License law). C lamexemptundefSec _____ ,8 &P.C torth1s reason ___________ _ 0 I hereby affirm that I have a certificate of consent to sell•msure. or a certificate of Worticers· Compensation Insurance. or a cert1t1ed copy thereof ISec 3800. Labo< Code). POLICY NO COMPANY □ Copy IS filed With lhe city □ Cert1hed copy 1s hereby furnished CERTIFICATl OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed ,f the perm,1 ,s tor one hundred dollatS ($100) or less) D I cen1ty that ,n lhe performance of lhe work to, wh1ch this perrrut 1s issued. I shall not employ any 1 person ,n any manner so as to become subJect to the Workers· Compensation Laws of California NOTICE TO APPLICANT If. ofter mak,n~ lh•s Cert,- hcate of Exemption. you shouk1 become sub1ect t? the Workers· Compen~t1on prov1st0ns of the l.at>of Code, you must forthwith comply with such provisions or this permit shaJI be deemed reYOked O I hereby athrm that !here 1s a coostruchoo lend1no agency tor tne perlo,mance of the work tor wl"uch this permit 1s issued (Sec 3097. C1¥1I Code) Lender's Name ___________ _ lender's .Address __________ _ USE BALL POINT PEN ONLY & PRESS HARD -~----~----APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. CARLSBAD BUILDING DEPARTMENT APPLIC"-~ & PERMIT 1200 Elm, Carlsbad, California 92008 {714) 438-5525 JOB ADDRESS A~i.TrAaEr; e ·eeDNI BU~CENSE # VALUATION PERMIT NUMBER J( 200<o R oose..ve.l + StV""t.ct 8:?3~ ;-Ei~ A) ~ I ?~9:;:;;H;E PRIMZjJ-f 0/ CONTRACTORS PHONE • ZONE ~--ow~ D-E7!JILtgA;;ESi~/J (I_JA; ~ /h_:---. & ,~t)r CONTRACTVS AjllDRESS LICENSE NO. PLAN 1.0. # BLOG USE CODE LOT I BLOCK SUBDIVISION I ASSESSOR PARCEL NO. DESIGNER STATE LICENSE# STANDARO PLAN # BUILDING SQ. FOOTAGE DESCRIPTION OF WORK r'\ DESIGNER'S ADDRESS DESIGNER'S PHONE -'Y ,,~~-2_ d /J. , • F/P FLR ELEV. NO OCCGP EDU 6/ IE/82 16! I se~a1 ~ ~. Et. ~ .. ~17 ·~ ,_, .J P"" STORIES ---... -· ...,,.~.,.. _._ , vO NO 000.1,1.~e .1 B/_l€/82 52,00 CENSUS TRACT GP LA~USE '111-'RKING SPACE RES UNITS I GRACING f'.ERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD Fl RE SPA AREA CONST YO ND vO NO vO NO Not Valid Unlffs M.chine wrtified QTY. PLUMBING PERMIT -ISSUE QTY. MECHANICAL PERMIT -ISSUE SUMMARY/ACCOUNT NUMBER EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100,000 BTU BUILDING PERMIT 01 ·000-4220 EACH BUILDING SEWER I OVER 100,000 BTU SIGN PERMIT 01-000·4221 EACH WATER HEATER ANO/OR VENT BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01 ·000·4806 EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING 01 ·000-4222 -~' EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE ELECTRICAL 01 ·000-4223 .'?oZ~ EACH INSTAI,, .• ALTER, REPAIR WATER PIPE VENT FAN SINGLE 0UCT MECHANICAL 01·000-4224 EACH VACUUM BREAKER MECH EXHAUST -HOOD/DUCTS ./ MOBILEHOME 01-000-4225 WATER S0FTNER RELOCATION OF EA FURNACE/HEAli'!f MOBILEHOME PARK INSP EACH ROOF DRAIN (INSIDE) ./ SOLAR 01 ·000·4226 TOTJ:i.LMECH7 STRONG MOTION 65·640·0519 II TOTAL PLUMBING I FIRE SPRINKLERS 01 ·000-4227 rA,.. ~QTY. ~ISSUE PUBLIC FACILITIES FEE 25·000·4933 QTY. ELECTRICAL PERMIT -ISSUE BRIDGE FEE NEW CONST EA AMP!SwT:lU6A.... ' ltoL¢0RS SCHOOL FEE • DISTRICT 1 PH -\( 3 PH) ... r,. ,.. -~ 8fORAGE TANKS Carlsbad 65·623·0519 EXIST BLOG EA AMP/SWT~ • ~.r " P' RfCj4 ~ORAGE ./ Encinitas 65-624·0519 ' I PH /J PH 'If')() A / ~!/ FUM}' -[,-t San 0ieguito 65·625·0519 REMODEL/ALTER PER cfocu1T Jk .J ./.1 ,. }// f\ " JLAN CHE~ F~ '.F San Marcos 65·626·0519 TEMP POLE 200 AMPS l ~-1:'!. ....,.)"\ l' V lif\N V" OVER 200 AMPS ......_. -'/ 1/ (, / I ' TEMP OCCUPANCY (30 0AYSI ./ II ./ TOTAL ELECTR7 I r .. (-,_~ -TOTAL SOLAR TOTAL FEES PAYABLE I 9~--,-a:---' - I HAVE CAREFULLY 0 THE COMPLETED "APPLICATION AND PERMIT"' AND 00 HEREBY Exp,rahon. Ew,y perm,t ISsued bylllll 8ulldlng0111Clal under Ille l)fOYIIH>nS of th11 * AN OSHA PERMIT IS REQUIRED FOR EXCAYATIOHS OYER CERTIFY UNDER PE TY OF PERJURY THAT ALL INFORMATION HEREON INCUIDING THE Code ahall expire by limttatlon and ~ null -,Did II the butld~ or worl< S' 0 .. DEEP ANO DEMOUTION 0A CONS11!UCT10N Of DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS authoriZed by IUCh permit la not commenced wltllin 180 days lrom 11111 e of such STRUCTURES OYER 3 STORIES IN HEIGHT permit. or 11 the IIUildl~ wortr. auU-iz.d by such pe,m,1 11 auapended or ISSUED TO COMPLY WITH All CITY, COUNTY AND STATE LAWS GOVERNING BUILDING CON, abandoned at •nv "-11111 work ii~ for• oenod ol 111D "-• I STRUCTION, WH.ETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND , :~ APPRO~ D BY ;3/rl/}tl KEEP HARMLESS THE CITY OF CARLSBAD AGAINST All LIABILITIES, JUDGMENTS, COSTS ANO APPLICANTS SIGNATURE • OWNE CONTRACTOR 0 EXPENSES WHICH MAY IN ANY WAY ACCffUE AGAINST SAID CITY IN CONSEQUENCE OF THE D~ _ \ _ ~ ~ '\ ~ BY PHONE o ~i .i 0 .. GRANTING OF THIS PERMIT. ,. ,-.1,. \ . ~ - -INSPECTION TYPE DATE INSPECTOR BUILDING I I FOUNDATION I I REINFORCED STEEL I MASONRY i l GUNITE OR GROUT I FLOOR & CEILING SUB FRAME I SHEATHING i FRAME f I EXTERIOR LATH lNSULATION I . INTERIOR LATH & DRYWALL i ,I PLUMBING I ~ ' SEWER AND BL/CO I I PLUMBING UNDERGROUND l PLUMBING TOP OUT I I TUB AND ~HOWER PAN I GAS TEST i ELECTRICAL ' I TEMPORARY POWER I I ELECTRIC UNDERGROUND I - ROUGH ELECTRIC I e,.a.,v~ ~ _/ I "':JnJ ELECTRIC SERVICE I I BONDING ~ I G. F. I. -SMOKE DETECTOR T I MECHANICAL I I DUCT & PLEM., REF. PIPING HEAT -AIR CON □. -SOLAR SYSTEMS VENTILATING SYSTEMS CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE ITEMS ABOVE HAVE BEEN APPROVED. JOB SITE FINAL I PLUMBING ! ELECTRICAL . I MECHANICAL I <" GAS I BUILDING ' ,'><I . -I SPECIAL CONDITIONS I CERT OF OCCUPANCY ISSUED I - -FIELD INSPECTION RECORD REQUIRED SPECIAL INSPECTIONS INSPECTION REQ IF INSPECTOR'S CHECKED APPROVAL SOILS COMPLIANCE PRIOR TO I FOUNOA TION INSP ' ' i STRUCTURAL CONCRETE -t'-· OVER 2000 PSI I PRESTRESSEO ~ I CONCRETE ', POST TENSIONE!3 i· CONCRETE r ' FIELD WELDING ' ~H STRENGTH . BOLTS SPECIAL MASONRY ' PILES CAISSONS ~--""~11 ~ t" ~ 'I . ,___ ~ . -~ .. --g-;1-3 s.";:L -~~-\ \ --.:': \ INSPECTOR'S NOTES DATE --~ ' -- ----- ----~-- -·-.. ~ -- ---] --- . ; .. :;-_ --. - -> • -' ... .,._ ' .. ... . , .. .. t""".Ji ·, ..... II) z 0 ;:: < a:: < ~ 0 11,1 0 a: i[ 0 a: 11,1 0 ~ 3 ~ 11,1 z ~ z 0 ;:: ~ z 11,1 ... 2 0 0 II) ii: w ><: a:: 0 3 i[ . .. D I herei,y affirm that I am licensed under prO'ilalona of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profeaalona Code, and my license Is In full for:,."4';3 !fleet. C _ >o lie No ~ ~ Class 1 hereby att,rm that I Mn exempt from the Con-~!<!:'~~~~::~ ~,~':.~~c!l/~.~ county which req\.ures ii permit to construct alter, improve. demohsh, or rep,aer any structure. pnor to its ,ssu.-.ce also requires the applicant for such pemut to Me • s.gned statement that he 1s hcensed pursuant to the provisions of lhe Con tractor's License Law (Chapter 9 commencmg with Sect,on 7000 of Otv1s1on J of the Business and Pro- fesst0ns Code) or tflat ,s exemp1 the<efrom and the basis to, the alleoed exemptt0n Any v,olahon of Sectton 7031.5 by a,n applicant for a penmt subfects tne ~,cant to a c,v11 penalty of not more than five hundred dollars ($500). □ I. as owner of the propeny. or my emplo- 1111,th wages as their sole compensation, will do the work. and the structure 1s not intended or offered tor sale (Sec 7044, BtJsmess and Professions Code The Contractor's License Law does no1 apply to an owner ot prc,perty wno builds °' improves thereon and who doeS such wont himself Of through his own employees, prov•~ that such 1mprOYemeiltS .,.. not mtende1 Of offered for sale If, however the building or improvement 1s sold w1th1n one year of comp~l!on. the owner-builder w,11 have the burden of pro~mo that he dtd not build or improve fOf' the purpose of sale!. □ I, as owner ot the property, am exclus,vety cootrachnQ with hcensed contractors to construct lhe pro1ee1 (Sec 70,,U, Business anc:, Professions Code The Con1ractor's License Law does nol apply to an owner of pr()perty Who builds Of improves ~':'~ic!.~ ~~~nc;i~~i!~~ ~~rh:'~~~::~-= License Law). O I am exemp1 unoer Sec ,8 & PC f0< th,s reason _ D I hereby affirm that I ha.-e a cer11flcate ot consent to self-insure, or a cer11f1ca1e of Workers· Compensation Insurance. or a certified cocy thereof (Sec 3800. Labor CooeJ POLICY NO w C.JlU t '+,,~ COMPANY 5-----A FY:. C. 0 }l!(Copy 1s filed with the city . O Certified copy 1s hereby furnished CERTIFICATl OF EXEMPTION FROM WORKERS· COMPENSATION INSURANCE (Th,s sechon need not be completed 1f lhe permn 1s fOf ooe hundred dollars f$1001 or less) 1»'1""cert,ly that 1n the performance ot the w<>OI. t01 ~,Ch th1$ permit tS issued, I Shall nol employ any person ,n any manner so as to become sub1ec1 10 the Wonc.ers· Compensation laws of Cahtorn,a NOTICE TO APPLICANT It, after makin1 this Cert, hcate of E111emp11on. you should t>ecome sub1ect I') 1ne Workers· Compensation p,ov1s1ons of the Labor Code, you must forthwith comply w,1n such prov1s1ons 01 ltllS perm,t Shall be deemed revoke<J , 0 1 hereby alhrm 11'lat lhere 1s a consuuct1on tending agency l()f the performance ol the w~ to, wn,cn tn1s permit ,s issued lSec 3097 Civil Code) Lenders Name ty ~ 'fV' e,_ Lenders A<J<Jresr::,._· _________ _ USE BALL POINT PEN ONLY & PRESS HARD ~ APPLICANT J \ILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS CARLSBAL .&UILDING DEPARTMENT 1200 Elm, Carlsbad, California 92008 (714) 438-5525 APPLICATION & PERMIT ..... JOB ADDRESS AV. ST. DATE OF APPLICATION BUSINESS LICENSE ii RD. 7 -")__ 8 J-, • .,. I~/ 6. ~ PERMIT NUMBER ~8<>8 (jc,;seve..L, ow•.ER'S NAME A-Ve. Ctt&ls lo Prb OWNER'S PHONE -,--CO_N_T_R_A-CT_O_R_S_P-HO_N_E_•-Pll-'-c-----------1 PRIME CONTRACTOH ~7i rfo he ,t.T W, lso~ ,~ I I ,;,~~eh" 'li~~,._A-~ 7 S J..{11&,f) OWNER'S MAILING ADDRESS :).7~7 aooSe..ve..LT LOT l BLOCK I SUBDIVISION J ASSESSOR PARCEL NO. t;;C~R;_~ sv-.ENc. ~;N;;¥o DESIGNER STATE LICENSE # DESCRIPTION OF WORk 1---------------------------------------,I DESIGNER'S ADDRESS &,,M';>,-4 DESIGNER'S PHONE r-- CENSUS TRACT I GP LANO USE I PARKING SPA~C-E I RES UNITS I GRADING ~ERMIT ISSUED y D ND F/P F LR ELEV. vO NO REDEVELOPMENT AREA v □ NO NO STORIES TYPE CONST OCC GP EDU occ LOAD I FIRE SPR v□ NO PLAN t.O. # BLDG USE CODE STANDARD PLAN # BUILDING SQ. FOOTAGE 11i.:07t:,·;.J,;;::i~c COLI 86:3~ 71':.(J/ Not Valid UnMSs lhchine fArtifi«J t9.'.) 19. QTY. PLUMBING PERMIT· ISSUE -;?<Sc)_ II QTY. MECHANICAL PERMIT · ISSUE 3 .l)Q SUMMARY/ACCOUNT NUMBER I----'- QTY. EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100,000 BTU I I BUILDING PERMIT EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT EACH WATER HEATER AND/DR VENT -I I ½ I BOILER/COMPRESSOR UP TO 3 HP .oo PLAN CHECK EACH GAS SYSTEM 1 TO 4 OUTLETS I I I BOILER /COMPRESSOR 3-15 HP TOTAL PLUMBING EACH GAS SYSTEM 5 0 R MO RE i I I METAL FIREPLACE ELECTRICAL 1 VENT FAN SINGLE DUCT MECHANICAL EACH INSTAl .. ALTER, REPAIR WATER PIPE __., /'f;:,;- EACH VACUUM BREAKER MECH EXHAUST • HOOD/DUCTS MOBILEHOME -----~1---------41-----+---- r • WATER SOFTNER R EL O CA Tl ON OF EA FURNACE/HEATER MOBILEHOME PARK INSP EACH ROOF DRAIN (INSIDE) / SOLAR TOT AL PLUMBING _-] TOH,L MECHANICAL ~ ~ STRONG MOTION I I ~ I °I . FIRE SPRINKLERS ELECTRICAL PERMIT · ISSUE ;Q. (lo QTY. SOLAR · ISSUE ~ PUBLIC FACILITIES FEE BRIDGE FEE NEW CONST EA AMP SWT BK R COLLECTORS _/ SCHOOL FEE • DISTRICT I PH 3 PH Carlsbad EXIST BLOG EA AMP/SWT/BKR Encm1tas 1 PH 3 PH I San Dleguilo REMOOE LIA L TE R PER CIRCUIT TEMP PO LE 200 AMPS _L -~ V I AP t1LJJ I II -San Marcos ""'°"""""'"°"': ~ ~: t "" 100 '"" ~ TOTAL FEES PAYABLE I /1'.!=-- • o ERE BY Expiration. Every perm,t ,ssued by tt,e Bu1ld1ng Ofhc1al under the provisions oflh,s I HAVE CAREFULLY EXAMINE~COMPLETED ·APPLICATION AND PERMIT ANO D H Code shall exp,re by hm1ta11on and become null and void II the building or work ~ u: >, ro 0 a. E Q) I- I 'O 0 C!l C: "' .S? a. a. ct I -""-c a: 0 Cl) rJ) Q) rJ) rJ) ct I 3: .2 Q) >- Cl) rJ) Q) 0 0 0:: "' i;j 0 § Q) 0 C "' C u: C Q) ~ C!l 0 u Q) a. rJ) C CERTIFY UNDER PEN~ PERJURY THAT ALL INFORMATION HEREON INCLUDING THE authorozed by such permII ls not commenced within 180days from the date of such DECLARATIONS ARE TRUE ANO CORRECT AND I FURTHER CERTIFY ANO AGREE IF A PERMIT IS permit or 1f ttie building or work authorozed by such permit 10 suspended or ISSUED: TO COMPLY WITH All CITY. COUNTY ANO STATE LAWS GOVERNING BUILDING CON· abandoned at an hme after the work ,s commenced for a nod of 180 da s STRUCTION, WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND~PPLICANT'S SIGNATU7E Jf. :&. OWNER □ GONTRACTOR)( * AN OSHA PERMIT it, REQUlflED F0A EXCAVATIONS O\IER 5· O" DEEP AN~~ITION OR CONSTRUCTION OF STRUCT\IRf:S °IJ }JORIE$ IN HEIGHT "'!ii-,--,,--, i APPROVED BY ~ D ~ EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF TH ~ _.. ~ J/ ~ /1/f' BY PHONE 0 KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS, COSTS AND ~ GRANTING OF THIS PERMIT 1/'~ . ~ INSPECTION TYPE DATE INSPECTOR BUILDING I FOUNDATION REINFORCED STEEL MASONRY GUNITE OR GROUT I FLOOR & CEILING SUB FRAME I SHEATHING ' FRAME I . EXTERIOR LATH lNSULATION INTERIOR LATH & DRYWALL I PLUMBING I l -- SEWER AND BL/CO . \ PLUMBING UNDERGROUND r q PLUMBING TOP OUT I I TUB AND ~HOWER PAN 11 GAS TEST l ELECTRICAL r TEMPORARY POWER ELECTRIC UNDERGROUND I ROUGH ELECTRIC ELECTRIC SERVICE BONDING A G. F. I. -SMOKE DETECTOR. MECHANICAL : I . DUCT & PLEM., REF. PIPING HEAT -AIR COND. -SOLAR SYSTEMS I• VENTILATING SYSTEMS CALL FOR FINAL INSPECTION VHEN ALL APPROPRIATE ITEMS ABOVE HAVE. BEEN APPROVED. ' -, JOB SITE FINAL . ~ . PLUMBING ELECTRICAL ,-y' MECHANICAL GAS . ' ~ (' ,' BUILDING I . SPECIAL CONDITIONS I CERT OF OCCIIPANCY ISSUr.D -., - - - - - - - - - - - - - - - - - - - - - -- C ' ~ 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 PRES TRESSED CONCRETE POST TENSIONED CONCRETE FIELD WELDING HIGH STRENGTH - BOLTS SPECIAL MASONRY PILES CAISSONS I "', ..,., , ' ~ - ~ , ' • . ,, C ·-· "' . '-------. -.. ~ .. : . .,. -,_ . .... ; . v . ,. . ''_ ... --~ ,-;-~ . . --~ \ ._ -• -' ' ' ~ r --t -J ' f -. ... . .. .. ~ ' _,, ~ . .J<' . \ \ ' _.. * by Judi Sheppard Missett August 12, 1982 City of Carlsbad Building Department 1200 Elm Ave . Carlsbad, CA 92008 Attn; Carter Darnell * JAZZERCISE®, INC. 2808 ROOSEVELT STREET CARLSBAD, CALIFORNIA 92008 (71 4} 434-2101 This is to acknowledge that Mr. Robert Wilson, owner of leased space 2791 Madison St. Carlsbad, CA is fully aware of the installation of an ~mp~: lunchroom for the Jazzercise, Inc. personnel. Respectful],,{, A ·"