HomeMy WebLinkAbout2425 SACADA CIR; ; 84-766; PermitCII z 0 ;::: ,c a: ,c .... u ... C
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·J. I hereby affirm that I am licensed under
~vlalona or Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Professions Code, and my license Is on
full fo!iland ettecq C -, Lt Loe No ~5::1 \ Clm ~
I hereby a111rm that I am exempt lrom !he Conlrac· t01's Lteense Law for lhe loOowmg reason (Sec 7031 5
Business and Pro!ess1ons Code Any city or county whIcn re-quires a perm,! lo construcl. alter. improve, demohsh. or
repair any structure. prior to 11s issuance atso requires !heap· pl1cant for such permit 10 file a s19ned stalement that he 1s
hcensed pursuanl lo !he provistons ol lhe <;on1rac10( s License Law (Chapter 9 commenc,ng wI11, Sec110n 7000 ol
01v1s10n 3 ol lhe Business and Professions Code) or that 1s ex· empl therefrom and the bas,s tor lhe aftegeo exemp1Ion. Any
vrolation o! SechOn 7031.5 by an apphcant for a perm11 sub-1ects rhe appl!cant to a civil penally ol nol more tha!l t,ve hun·
dred dollars ($500),
r. I, as owner ol ltte property. or my employees with wages
as their sole. compensaHon, will do ttie work. and !he struc-
1ure ,s not intended or oUered tor sale (Sec 7044 Busmess
and Prolessions COde: The Conlractor·s Lteense Law does
not apply to an owner of property who builds or improves
!hereon and who does such work h1msel1 or through his own employees, provided that such improvements are not intend·
ed or offered lor sale_ II. however. the bu1ldmg or improve-
ment ,s sold wilh,n one year o1 com~t0n. lhe owner-bu1kle1 will have the burden ol proving !hat he did not build or im-prove for !he purpose of sale).
D I, as owner of the property. a:m exclusively contractmg
wilh licensed contractors to construct the pro1ect (Sec. 7044. BuSlness and Professions Code: The Contraclor's License
Law does not apply lo an owner ol property who builds or im-
pro"es thereon. and who contracts for each prOJecls w1lh a
contraclor(s) license pursuanl to the Contractor's license Law).
O As a homeowner I am Improvmg my home, and lhe follow· mg condll1ons e,,1st.
t The work Is being per1ormect prior 10 sale 2 I ha11e lived in my home for twelve months
prior to complehon ot this WOfk. 3. I have nol claimed this exemption durmg the last three years.
~r :h~;,~x,:;;;1 under Sec ______ . B & P C
----------
J I hereby afhrm 1hat I ha .... e a cen1t1cate of consent f self-insure. or a cer11l1cate ol Workers
Compensation Insurance, or a cemtied copy !hereof
!Sec 3800, Labor Code)
POLICYNO ~';}. i~s7
COMPANY E Mf.. ~r-.e-r~ \-s
0 Cooy 1s filed will'\ the city 'fa. Cert,loe<I copy ,s hereby lurn,she<l
CEATIFICATl OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE
(Th,s section need not be completed d lhe perm11
•s for one hundred dOllars {S 1001 or tess)
0 I cen1ty !hat in 1he pertormance ot the work tor which th,s perm,1 ,s ,ssued. I shall no1 emptoy any
person in any manner so as 10 become sub1ec1 to
the Wol1{ers· Compensation Laws ol Cahtorn,a
NOTICE TO APPLICANT 11. atter makm) tn1s Ceri1
t,cate ot Exemption you should become subIecI ,..,
the Wonters Compensat,on prov,s,ons of lhe Lat>or cooe. you must tonh'tlt1th comply w1lh such
prov1s,ons or 1h1s perm11 shall be oeemect revo1o.eo
0 I hereby affirm lnat there ,s a cons1tucIIon
1end,nQ aoency tor me oertormance ol me wo~ Tor which ttus perm11 1s ,ssueo !Sec 3097 c, ... 11 Cocte)
Lender·s Name ___________ _
Lenoers AOdress __________ _
USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
CARLSBAD BUILDING DEPARTMENT
1200 Elm, Carlsbad. California 92008-1989 (619) 438-5525
APPLICATION & PERMIT
JOB AOORESS AV. ST. RO NEAREST CROSS ST I ;~~01qP~L~4 0NI
BllSINESS LICENSE # VALUATION g-L{;;"MIT NUMBER a~ ~5" So..c.o..An.. C i.f'.. L e v 0-.rtt,0 s+. ?S31
LOT I BLOCK I SUBDIVISION I A~SSOR P-y~L N0 !19_ f'/\ ;~NTg:R~ \ l CONTRACTORS PHONE • ZONE 7t~ -\lo-0-i5S-fnqt:/& OWNER"S NAME I OWNER'S PHONE
Mr # ~ o! \ I). v-. tA. ~ f\;:_:;~~~0
;~: to V/\ l \f'~ R~
LICENSE NO. PLAN 1.0. # BLOG USE COOE
L.J~51 \<\ OWNER'S MA•LING AOORl!'IWI
~,e DESIGNER I LICENSE:, STANDARD PLAN # BUILDING SO. FOOTAGE -
DESCRIPTION OF WORKS /)ltl r Hot \A)ate v-OESIGNER'S ADDRESS DESIGNER'S PHONE
--FIP FLA ELEV. NO OCC GP EDU STORIES
vO NO ---
CENSUS TRACT I GP LANO USE I PARK ING SPACE I RES UNITS I GRADING PERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRE SPA I 'l'Fia-nr' AREA CONST I I
YO ND vO NO vO NO Nor Valid, Uqless Ma,cpi7e Certified l
QTY. PLUMBING PERMIT -ISSUE 7_£!!_. QTY. MECHANICAL PERMIT · ISSUE 3-SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP INSTALL 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 ·-EACH WATER HEATER ANO OR VENT BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01-00-00-8806
EACH GAS SYSTEM 1 TO 4 OUT LETS BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING 01 -00-00-8222
EACH GAS SYSTEM 5 OR MORE ' METAL FIREPLACE ELECTRICAL 01-00-00-8223
EACH INST Al . ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01 ·00·00·8224 -..--
EACH VACUUM BREAKER MECH EXHAUST HOOOIOUCTS MOBILEHOME 01-00·00·8225
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP
EACH ROOF DRAIN (INSIDE) SOLAR 01 ·00·00-R??R Ls--.,__
TOT.l.L MECHANICAL STRONG MOTION 80-92·33·0519 ----
TOT AL PLUMBING I FIRE SPRINKLERS 01 ·00·00·8227
QTY. ELECTRICAL PERMIT -ISSUE .:r--QTY. SOLAR · ISSUE PUBLIC FACILITIES FEE 32·00·00·893)
BRIDGE FEE
NEW CONST EA AMP SWl BKR COLLECTORS SCHOOL FEE • DISTRICT
I PH 3 PH STORAGE TANKS Carlsbad 80·92·21-0519
EXIST BLOG EA AMP1SWT BKR ROCK STORAGE Encinitas 80·92· 22-0519
1 PH 3 PH PUMP San Dieguito 80·92· 23·0519
REMODEL AL HR PER CIRCUIT PLAN CHECK FEE San Marcos 80·92·24·0519
TEMP POLE 200 AMPS -
OVER 200 AMPS LICENSE TAX 01-00-00-8162
TEMP OCCUPANCY 130 DAYS) MFF 80-92-57-0519
CREDIT DEPOSIT
TOTAL ELECTRICAL ! TOTAL SOLAR /:Ju:,., TOTAL FEES PAYABLE I / _(_) ~
I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION AND PERMIT" AND DO HEREBY Exp,rauon _ Every permit issued by the Building Oft,c,al under the prov,sIons of this * AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER
CERTIFY UNDER PENALTY OF' PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall expire by l1m1tahon and become null and vo•d If the building or work 5' o·· DEEP AND DEMOLITION QA CONSTRUCTION OF
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS authorized by such permit ,snot commenced w1th1n 180 days from the date of such STRUCTUR£S OVER 3 STOAIES IN HEIGHT
ISSUED TO COMPLY WITH ALL CITY COUNlY AND STATE LAWS GOVERNING BUILDING CON :~~::On'!:o 1
~t t~~v ~;~~';ffei~h=~~,:~!~~!~e:re~~~~ r~7i~1~?t:r:.~1 or . STRUCTION WHETHER SPECIFIED HEREIN OR NOT, I ALSO AGREE TO SAVE INDEMNIFY AND OWNER□ CONTRACTOR_p\ ;:21/BY DATE KEEP HARMLESS THE CITY Ot CARLSBAD AGAINST ALL UABIUTIES. JUDGMENTS. COSTS A~~ANTS SIGNAio Jf.noJ\.
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE • ~ BY PHONE 0 lld~7~ GRANTING OF THIS PERMIT __ r__ , J A
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TYPE I
BUILDING I
OUNDATION I
EINFORCED STEEL I
IASONRY I
,UNITE OR GROUT I
LOOR & CEILING SUB FRAME I
F
R
M
G
F
s
F
E
HEATHING □ ROOF □ SHEiAR
RAME I
XTERIOR LATH I
INSULATION I
INTERIOR LATH & DRYWALL I
I
PLUMBING I
s SEWER AND BUCO □IPUCO I
UNDERGROUND □ WASTE □ WATER
TOP OUT □ WASTE □ WATER
TUB AND SHOWER PAN I
GAS TEST I
□ WATER HEATER □ SOLAR WATER
I
ELECTRICAL I
□ ELECTRIC UNDERGROUND □ l~FFER
ROUGH ELECTRIC I
□ ELECTRIC SERVICE □ TEMPORARY
□ BONDING □ POOL I
I
.1
MECHANICAL I
□ DUCT & PLEM., □ REF. PIPIN'G
HEAT -AIR COND. SYSTEMS I
VENTILATING SYSTEMS I
I
DATE INSPECTOR
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HA ve BEEN APPROVED.
FINAL I ~ I
PLUMBING I r/Y l ! • ---I'\
ELECTRICAL ,1,-4 ·u 1 // _/ I
MECHANICAL I ·, l J.. V'J IU
l I r'I V""/'# GAS --, .. I 'I J
BUILDING I rT / I
SPECIAL CONDITIONS I ( V
I \,
.. ,, •. _~. ' '\'~ ::"~ ~· .. ··\·~ ---. ,°" . . )( \ i ..•
<;., u ;, , &; <,t;
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES --
REQ IF INSPECTORS •. -, ,, INSPECTION CHECKED APPROVAL DATE -~ .... ¼
. ~ -...,1#1'--.. ~ ---
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRESTRESSED
CONCRETE
POST TENSIONED .
CONCRETE
FIELD WELDING
HIGH STRENGTH
BOLTS
SPECIAL MASONRY
" -, -. . -..... ~ . ,.. .
PILES CAISSOr>.S
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