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Home My WebLink About2808 ROOSEVELT ST; ; 82-437; Permit.,, z 0 s ~ (.) w a IC I[ 8 IC ~ .., 5 I Ill z ~ z 0 .:: ~ z Ill ... :I 0 (.) .,, ir Ill " IC 0 3 ![ O I h«eby alfln, 1 I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Dlvlslon 3 of the Business and Profeaalons Code, and my license Is In full forca and effect. Lie No _____ Class _____ _ I hereby altlrm that I am exempl lrom 1lie Conlrac-lor's license Law lo< the following reason (Sec. 7031.5 Business and Professions Code: Any city or counly which re-quires a permit to construct. alter, improve, demolish, or repair any structure. prior to Its Issuance also requires the ill'" piicant lo< such permit to file a sklned statement lhal he JS licensed pursuant to the provisions al lhe Contractor's license Law (Chapter 9 commencing with Section 7000 01 Division 3 01 the Business and Proless,ons Code) or thal is ox· empt therelrom and lhe basis lor the alleged exemption. Any Ylolalion 01 Section 7031.5 by an applicant lor a permit sub-feels the applicant to a civil penalty 01 not more than fr,e hun-dred dollars ($500). □ I, as owner 01 the properly. or my employees with wages as their sole compensation, wilt do the work, and the struc- ture is not intended or offered tor sale (Sec. 7044, Business and Prolessions Code: The Contractor's License Law does not apply to an owner ot properly who builds or Improves thereon and who does such -k himself or through his own em~s. provided that such improvements are not intend· ed or offered tor sale. II. however. the building or improve-ment is sokt wi1hin one year at completion, the awner-buikler wiU have the burden ot proving lhal he did not build or im-prove lo< the purpose ot sale). □ I, as owner ot the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner ot property who builds or im-prOY8S 1hefeon, and who contracts ror each projects with a contractor(s) license pursuant to the contractor's License Law). □ As a homeowne, I am llnproving my home. and the follow· Ing conditions exist: 1. The work Is being per1ormed prior to sale. 2. I have lived In my home tor twelve months prior to completion 01 thts -k. 3. I have not claimed this exemption during the last three years. □ lamoxemplunderSec. ------· B&P.C. lor this reason ____________ _ COMPAN'\). -/------ □ eop., is filed with lhe city D Certifted copy 1s hereby turn1$hed CERTIFICATE OF EXEMPTION FROM WORKERS" COMPENSATION INSURANCE (Th,s section need not be completed 1f the permit 1s tor one hundred dOllars (S 100) or less) 0 I cer11fy that ,n the performance of the w()l1il f()f which this permit ts issued, I shall no1 employ any person 1n any manner so a.s to t>ecome subJe<:.t lo the Workers' Compensallon Laws of Cahfom,a NOnCE TO APPLICANT It, after malon~ this Cen,-t,cate of Exemption, you should become subJec.t t? the Workers' Compensation prov1s1ons of lhe Labof Code, you must forthwith comply with such provisions or this permit shall be deemed revoke<J • 0 I hereby affirm lhal there 1s a construc11on lending agency for the performance of the work to, wf\Ch th,s permll ,s ,ssued (Sec JO!l7, C1v11 Code) Lender's Name ___________ _ Lender's Address __________ _ USE BALL POINT PEN ONLY & PRE~S HARO APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. r'"\ CARLSBAD BUILDING DEPARTMENT 1200 Elm, Carlsbad, California 92008·1989 (714) ,438..5525 0 APPLICATION & PERMIT I • A () 1 AV.ff, DATE OF ~"(ION SUll\ll'E•il"JI E # VALUATION PERMIT NUMBER ~~~~~"-hl.si~-E~~~--------.;_:-· '..:..·· ...:.~...;-"' ___ IIQ....::J· --~l.:::_"'.l!!.L·. ~:· -~---~·.,,:· . .J .... ~!~~~~~;_:-+=-=---------; .,., OWNER'S NAME .• ~~ •• . OWNER'S l'HONE CONTRACTOR TORS PHONE t ZONE ~~ ~.J.;.-.,t~ 11./1-,0" .1'#67:-? fiG?A-.?vV-~I OWNER'S MAILING ADDRESS ,., .h-JL'J CONTRACToR·s ADDRESS ~ J c ·-y ~'1-7"" lln-Blf'i-~_g_,,,_ SN?"'~ ./>-.I~ 1,;;&? PLAN 1.0. # BLOO USE~OE LOT SUBOIV!StON DESIGNER LICENSE# \ STANDARD PLAN# BUILDING SO. FOOTAGE ~pJ ~ ffe.~? ~~ QC) er/I oes,GNER'SPHONE .£n:~_7!'1. _sf: /tn1 ~A~-~ ,Af1tt ..PA'?'l~ ,4,s~ -~I --· ------F/P FLR ELEV. NO OCCGP EDU ,I_~/ ,11:i /~? ,_~.; 0001615': 10/lfJ ceNsus TRACT I GP LAND use I PARKING SPACE I RES uN1Ts I QTY.I PLUMBING PERMIT· ISSUE EACH FIXTURE TRAP EACH BUILDING SEWER EACH WATER HEATER AND/DR VENT EACH GAS SYSTEM 1 TO 4 OUTLETS EACH GAS SYSTEM 5 DR MORE EACH INSTA~ .. ALTER. REPAIR WATER PIPE GRADING f'.ERMIT ISSUED YO ND vO NO l REDEVELOPMENT AREA vO NO QTY.I MECHANICAL PERMIT· ISSUE INSTALL FURN. DUCTS UP TO 100.000 BTU OVER 100,000 BTU BOILER/COMPRESSOR UP TO 3 HP BOILER/COMPRESSOR 3-15 HP METAL FIREPLACE VENT FAN SINGLE DUCT EACH VACUUM BREAKFR -· -. ·-I I I MECH EXHAUST -HOOO/OUCTS RELOCATION OF EA FURNACE/HEATER WATER SDFTNER EACH ROOF DRAIN (INSIDE) TOT.t.L MECHANICAL TOTAL PLUMBING _I QTY.I ELECTRICAL PERMIT · ISSUE NEW CONST EA AMP/SWT/BKR QTY. I SOLAR· ISSUE COLLECTORS I PH 3 PH STORAGE TANKS EXIST BLDG EA AMP/SWT/BKR ROCK STORAGE I PH 3 PH PUMP REMODEL/ALTER PER CIRCUIT PLAN CHECK FEE ~ TE MP POLE 200 AMPS OVER 200 AMPS TEMP OCCUPANCY (30 DAYS) TOTAL ELECTR ICAL l TOTAL SOLAR STORIES TYPE CONST ,1.()1) OCC LOAD FIRE SPR vO NO Nor Valid Unwss Machine Clrtifil!d SUMMARY/ACCOUNT NUMBER BUILDING PERMIT 01 ·00·00-8220 SIGN PERMIT 01 ·00-00-8221 PLAN CHECK 01 ·00-00-8806 TOTAL PLUMBING 01 ·00·00·8222 ELECTRICAL 01-00-00-8223 MECHANICAL 01 ·00-00-8224 01 ·00-00-8225 80·92-33-0519 FIRE SPRINKLERS 01-00·00·8227 PUBLIC FACILITIES FEE _ ~2-00-00-8923 BRIDGE FEE SCHOOL FEE · DISTRICT Carlsbad 80-92·21-0519 Encinitas 80-92-22·0519 San Oieguito 80-92·23·0519 San Marcos 80-92-24-0519 TOTAL FEES PAYABLE l / ,A ~p I HAVE CAREFULLY EXAMINED THE CQMJl~rJ;O NAPPUCATION AND PERMIT" ANO DO HEREBY ----1!.-y penllil iNued bylllelluilcllngOlfle:lallllldltlllepn,wisioMoflhie CERTIFY UNDER PENALTY OF PER.IURi' ·:c.·ALL INFORMATION HEREON INCLUDING tH£ ~=--bylllllllaliOflalllt-"'!'falldYOid.Wtlletlalldinllor-,t * AN CJIIM PINIII" 111 RIQIIIIIED RJII PICAVATION& OWSI ·I' er Dill" AND Dlll0LfflON OR CONl1RUCT10N OF STIIUC1UmS OVEIIJ....._. .. HEIGHT .!!! iI ~ <II 0 a. E Cl) I- I 'O 0 (!) c <II .2 0. a. < I• .:,:. C a: 0 "' "' Cl) "' "' < I ~ .2 ai >- rn "' Cl) 0 0 ~ <II iii 0 ff Cl) 0 C <II C iI C Q) ~ (!) 0 0 Cl) a. "' C ~ DECLARATION$ ARE TRUE AND COflflElQt . HER CERTIFY AND AGREE IF A PERMIT 1$ ..... ,. ~ pennil ,a not -,-icec1 willlllt 1a,c1aya 1rom Ille dlieol U:h ISSUED. TO COMPLY WITH ALL CITY, · MIO STATE LAWS GOVERNING BUILDING CON-. « al ::X..°' ._we:,_~ by -= pennll i. -.-idad or STRUCTION, WHETHER SPECIFIED ORMI'. I ALSO AGREE TO SAVE INDEMNIFY ANO~ • • 1 . KEEP HARMU!SS THE CITY CIF . ALL LIABIUTIES, JUDGMENTS, COSTS ANO SfGNATUM • · ;· 111WNER□ CONTRACT EXPENSES WHICH MAY IN ANY WN/. llii:MMIST SAID CITY"IR CONSEQUENCE OF · •· -., GEIANTING OF THIS PERMIT. ' ~ ~ ,.. BY PHONE 0 APPROVED BY - 1!J£ '/q ,<~ ....... I .,... . . ,· ' , ' . ,,,,, . 8d..LJ ~ "'7 • , ;; .. ' ~--•.;._ " BUILDING I FIELD INSPECTION RECORD FOUNDATION I \. REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES REINFORCED STEEL - ' ' INSPECTION REO. IF INSPECTOR'S DATE MASONRY . . I CHECKED APPROVAL . -\. ~ ....... -.. -i . -GUNITE OR GROUT l. SOILS COMPLIANCE FLOOR & CEILING SUB FRAME I PRIOR TO ' FOUNDATION INSP SHEATHING I STRUCTURAL CONCRETE FRAME I OVER 2000 PSI PRESTRESSED EXTERIOR LATH lNSULATION CONCRETE - INTERIOR LATH & DRYWALL POST TENSIONED I CONCRETE PLUMBING -FIELD WELDING SEWER AND BL/CO r HIGH STRENGTH -PLUMBING UNDERGROUND BOLTS I r .. PLUMBING TOP OUT . ' SPECIAL MASONRY ~ '• TUB AND ~HOWER PAN --' .. _ 'h GAS TEST : . I PILES CAISSONS --· Is.• :~ ELECTRICAL -. : TEMPORARY POWER I I ., ELECTRIC UNDERGROUND .. . ROUGH ELECTRIC C I ' --ELECTRIC SERVICE . ·, I BONDING • ·-~ fl•. "" ·-I ,'L, G. F. I. -SMOKE DETECTOR r -.. -- MECHANICAL ' - f ,· ,. . --DUCT & PLEM., REF. PIPING . , ,. . HEAT-AIR COND. -SOLAR SYSTEMS , -~--. VENTILATING SYSTEMS . --. . ' . -. -CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE . ' '\.~-... ~ ITEMS ABOVE HA VE BEEN APPROVED. ' ·-"'._:i.· .; , , ---JOB SITE FINAL --' . . .,.. . -. -~ ) " .,_ "' PLUMBIN.G '~ / . C ,~ ... ~ .. . ELECTRICAL l, ' , i ,., ' f;.. (. . ,' . . /.'fl"" /~ MECHANICAL GAS ,-_,.......... 'LI/ ' -' 1 ,, ~ I"\ t) -r--- \ ' BUILDING ri ' SPECIAL CONDITIONS ,Y n,., -. ---CERT OF OCCUPA" 'ISSUED ... \ ~-~) ,, ' ' ,. ~-' C""'-i h .J " ., ...... '---~ ._-1,,1,.. ' - en z 0 ;:: C a: C .., 0 w a C I[ 8 C .., a ... 5 I .., z :It 0 z 0 ;:: ~ z w A. :I 0 0 1/) a: .., )<: CZ: 0 :It ![ 0 I hereby atth. .,Tat 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 lhat I am exempt lrom the Contrac· tor's Uconse Law tor the totlowing reason ISec. 7031.5 Business and Professions Code: Any city or county which re-quires a permit to construct, atter, improve, demolish, or repair any structure, prior to its issuance also requires the ap-plicant for such permt1 to file a signed statement that he Is lieensed pursuant to the provisions of tile Contractor's ~;: f;,~~t:.'.;s =~~~~:~~~:. empt theretrorn and the basls tor the alleged exemption. Any =I~ ~~=~t",t~3c1J ~~~~::~~ :,:O'/r~ ~~ dred dollars ($500). D I, as owner of the property, or my employees with wages as their sole compensation. will do the work, and the s1ruc· ture is not intended or ottered tor sale (Sec. 7044, Business and Professions Code: The Contractor's license Llw does not apply to an owner of property who builds or lmprO¥eS thereon and who does such work himseU or through his own employees, provided that such imprOYements are not Intend- ed or offered tor sale. If, howev8f, the building or impr0Ye-men1 is sold within one year of completion, the owner-build8f will have the burden of proving that he did not build or im• prove for the purpose ot sale). D I, as owner of the property, am exclusively contracting w~h licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License uw does not apply to an owner of property who builds or im-proves thereon, and who contracts for each prqtets with a con1ractor(s) license pursuant to the Contractor's Uconse uw). O As a homeowner I am Improving my home, and the follow· Ing conditions exist: 1. The work is being pefformed prior to sale. 2. I have lived in my home for twelve months 3. r:v~ ::1Pc~~ot tt~: =ption during the last three years. D I am exempt under Sec.------· B & P.C. 1or this reason ____________ _ □ I hereby affirm that I have a certificate ot consent to self-insure. or a cen11tcate ol Workers' Compensation Insurance, Of a cert,fted copy thereof (Sec 3800. labOr Code} . POLICYNO _ COMPANY D Copy Is hied with the city D Certified copy Is hereby fum,shed CERTIFICATl OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed 11 the permit ,s f0< one hundred dollars ($100) Of less) 0 I cert,ty that m lhe perlormance of the wonc: fOf which this permit ,s issued. I shall not employ any person m any manner so as to become subJect to the Wor11.ers' Compensation Laws of Calitom,a NOTICE TO APPLICANT II, otter mak1n11h,s Gen, t1cate of Exemption, you shouKt t>ecome subIec1 I? the Wonl.ers· Compensation provIsIons of Ille Labor Code, you must forthwith compl)' with such provIsIons Ot' this permit shall be 6eemed revOke<J '"'o I hereby affirm lhal lhere •S a construction lending aoency fOf the performance of the wo~ IOf which u·us perrml +s issued (Sec 3097. C,v,I COdel • Lenoer·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 () APPLICATION & PERMIT () 1200 Elm, Carlsbad. California 92008-1989 (714) 438-5525 ~ JOB ~<t; / ( lk\,~~, A~~Trio ,:?f !t~USINESS LICENSE z, VALUATION PERMIT NUMBER u:: -z.: r""-0~£.\}c:,.L-r-~✓->-iii otj~t~J l OWNER'S PHONE fjNTRACTOR I 7 CONTRACTORS PHONE • ZONE L''.l.. /) 0 ~r-, a. Lt.J 1 \-tE:-.-(2 E , Q) t- O~AILING ADDRESS LICENSE NO. BLOC USE CODE CONTRACTOR'S ADDRESS PLAN 1.0. # I ~-1.~ .. "O LOT I BLOCK I SUBOIVISl~N I ASSESSOR PARCEL NO. BUILDING SO. FOOTAGE 0 DESIGNER LICENSE# STANDARD PLAN # (!} DESCRIPTION OF WORK DESIGNER'S ADDRESS DESIGNER'S PHONE I 0/ 15/c c ' I co -,I .. ~~~ . ~-~ __ L, a)_ C._. A-_,../~ --F/P FLA ELEV. OOC,161~ _IG/lf,/ ft. -. .2 NO 1;-. a. c:; .n -,L; -rrz .A r"J ·a 1V~ .. r. ,,,~ ~ OCCGP EDU a. STORIES < ~ -~'IE-... I • _.. a;;_ ~-,"I YO NO --I CENSUS TRACT I GP LANO USE I PARKING ~ACE AES UNITS GRADING PERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRE SPA -" . AREA CONST C YO NO v O NO YO NO Not Valid Unlt!ss Machine C,rtifi«f a: QTY. PLUMBING PERMIT· ISSUE 7~(. QTY. MECHANICAL PERMIT· ISSUE SUMMARY/ACCOUNT NUMBER 0 rn EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100,000 BTU BUILDING PERMIT 01 ·00-00-8220 rn Q) rn EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT 01·00-00-8221 rn < EACH WATER HEATER AND/DR VENT BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01-00-00-8806 I EACH GAS SYSTEM 1 TO 4 OUTLETS ""'\,,_'{/) BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING 01 ·00-00-8222 n-, ..xr1 3: EACH GAS SYSTEM 5 OR MORE -METAL FIREPLACE 0 ELECTRICAL 01-00-00-8223 a; EACH INSTAl .. ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01 ·00·00·8224 >- EACH VACUUM SR EAKER MECH EXHAUST -HOOD/DUCTS MOBILEHOME 01 ·00·00-8225 WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP ,,; rn Q) EAGJ;l. ROOF DRAIN (INSIDE) C:nl A~ n1.M.nn.naM 0 I ~~~-=---re~ -,__~.) TOTI.L MECHANICAL 0 STRONG MOTION 80·92-33-0519 ~ Q.. TOTAL PLUMBING ~I Ii.--. 0: 'I FIRE SPRINKLERS 01 ·00-00-8227 co iii ' PUBLIC FACILITIES FEE 32-00-00-8923 0 QTY. ELECTRICAL PERMIT -ISSUE QTY. SOLAR -ISSUE §: -BRIDGE FEE Q) NEW CONST EA AMP/SWT/BKR COLLECTORS SCHOOL FEE · DISTRICT 0 C 1 PH 3 PH STORAGE TAN KS Carlsbad co 80-92-21-0519 C EXIST BLDG EA AMP/SWT/BKR ROCK STORAGE . Encinitas 80-92-22-0519 u:: ~ 1 PH 3 PH PUMP I San Dieauito 80·92-23-0519 REMODEL/AL TEA PER CIRCUIT PLAN CHECK FEE San Marcos 80·92-24-0519 I I C TEMP POLE 200 AMPS r Q) ~ OVER 200 AMPS r C, TEMP OCCUPANCY (30 DAYS) -~ -0 - TOTAL ELECTRICAL I . TOTAL SOLAR I /v,-So 0 TOTAL FEES PAYABLE Q) a. . ~ rn E I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMtr• AND DO HEREBY E•p,ralt01> Every per_m,t tssued by the Building Offlctal under the prov1s101>softh,s * AN OSHA PEAMIT IS AEQUIRE0 FOR EXCAVATIONS OVER I CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall exp,re by fimttat,on and become null and void II the building or worll s· O" DEEP ANO 0EMOUTlON 0A CONSTRUCTION Of' authortZed by such perm1f 1s not commenced w1th1n 180 days from the date ot sucli STRUCTURES OY£A 3 STOAIES IN HEIGHT ~ DECLARATIONS ARE TRUE ANO CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS permit, or 11 the buildi~ or work ■uthoriZad by such permit ,s suspended or ISSUED· TO COMPLY WITH ALL CITY. COUNTY AND STATE LAWS GOVERNING BUILDING CON-abandoned at any time a ., the work 1s commenced for a nerlod of 180 """" I .c. STRUCTION. WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY A1~ptJCANT'S SIGNAT • O~~TRACTOR 0 APPROVKY . DfT'Jtj KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AN URE EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF TH rsQJJ. ,~ ~ .... I)~ BY PHONE 0 I ... g\. GRANTING OF THIS PERMIT , ,l _ . ~ ~ .I --!_..I. . . -~ " \ , .... ,~ F5>-<..f 3~ • -, t ' ' ---,t· ~ \ ': .. -' ' .. . BUILDING I -j ' FIELD INSPECTION RECORD FOUNDATION REINFORCED STEEL REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES ' MASONRY INSPECTION REO. IF INSPECTOR'S DATE . j CHECKED APPROVAL GUNITE OR GROUT I SOILS COMPLIANCE FLOOR & CEILING SUB FRAME I PRIOR TO I FOUNDATION INSP ! SHEATHING STRUCTURAL CONCRETE " FRAME OVER 2000 PSI EXTERIOR LATH lNSULATION PRES TRESSED j CONCRETE .. POST TENSIONED INTERIOR LATH & DRYWALL CONCRETE PLUMBING C FIELD WELDING . SEWER AND BL/CO . l HIGH STRENGTH PLUMBING UNDERGROUND I BOLTS SPECIAL MASONRY ' PLUMBING TOP OUT . . ., -' TUB AND $HOWER PAN . ' . GAS TEST I lo •l'l~ '-~ PILES•CAISSONS ELECTRICAL ,. TEMPORARY POWER i ELECTRIC UNDERGROUND ~ . I ~ ' . ROUGH ELECTRIC ! ' I ELECTRIC SERVICE I • --. r BONDING I \ ' ... ' 1 i":' l G. F. I. -SMOKE DETECTOR , ~ - MECHANICAL .. DUCT & PLEM., REF. PIPING k .... I,. •• '. --I "i J/--.. ·-' ' . ' .... ! -. , '• HEAT -AIR COND. -SOLAR SYSTEMS ' ' •---, VENTI LA Tl NG SYSTEMS I .. ~ \.:;_ ' . ,. . .. . CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE ,., ITEMS ABOVE HA VE BEEN APPROVED.,~✓___.. ---' 1 JOB SITE FINAL ~ /\'~I , PLUMBING ,x.\"") _/ .,...~y)/ I -ELECTRICAL ~ •f 1/ -?'-I ~' \ -~ ~ ; r - MECHANICAL ~'V /-· .f\Y ~ ~ .. I •, \ GAS /, (\ ~ ~ (' ~ l \ r ,.,_ '. \ . --! .-.. -\ -:-.-r ·,--:---' .. BUILDING -, 1 .. ,,, ··----' ~ J;. SPECIAL CONDITIONS \ ,. .. -.. CERT OF occup,.v·-w ISSUED ~ ~-.,. ",· » r . ['\ , .. COUNTY OF SAN DIEGO DEPARTMENT OF HEALTH SERVICES 1700 Pacific Highway, San Diego, CA 92101 JAMES A. FORDE, Director DIVISION OF ENVIRONMENTAL HEALTH PROTECTION 236 -2243 PLAN CORRECTION SHEET BOARD OF SUPERVISORS TOM HAMILTON F IRST DISTRICT PAUL W . FORDEM SECONO O ISTRIC T ROGER H EDGECOCK THIRD DISTRIC T JIM BATES FOURTH D ISTRICT PAUL ECKERT P IFTH DISTRICT DATE 10-,s-e ~ CONTRACTOR ------------------- PHONE PHONE ----------- Address of Proposed or Remodeled J:J~ ~ ,,.,.// U-/} ~ . / J Health Regulated Building __ · ___ _..rP:__...g--=Q'---"'8.__ .... ~"F-f'-'-"=..;;;;"-"~:x~----+-~""'flA..._£. ... J:dl.~~=..::c..=.------ 1 Type of Busines,/,l:un,lc!il'/zfl4~ Plan File No .__._.Q__,.a ___ 1...__'3---,.....i ___ _ Checked by: /£mfr~ Recheck Required~/J:L() _______ Approved_,t,,b""A<Z~--- ITEMS DHS:SAN:PC:16 (1/82)