HomeMy WebLinkAbout2871 SANFORD LN; ; 83-135-44; Permiten z 0 .:: C IIC C ~ u "' a
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O I "-teby affirm that I am licensed under
provlalona of Chapter 9 (commencing with
S.Cllon 7000) of Division 3 of the Business
and Prolaaalona Code, and my license is In
full IOf"J"l(',~act. B-1
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I hereby alhrm that I am exempt from the Contrac· lm's Lteense Law lor the following reason (Sec. 7031.5
Business and Professions Coc:le Any city or county which re· Quires a permit to cons1ruc1. alter, improve, demolish. or repair any structure, prior to 11s issuance also requires !heap-
plicant for such permit 10 hie a signed statement that he 1s
licensed pursuant to lhe provisions of lhe conuactor's license Law (Chapter 9 convnencing with Seet,on 7000 ol otv1s1on 3 ot the Business and Prolessrons Code) or 1na11s ex-
empl therefrom and !he basis tor the aHegeo exemption Any
violation of Sectt0n 7031.5 by an applicant for a perm,1 sub· jects the apphcant to a civil penally of not more than hve hun-
dred dollars ($500)
fJ I, as owner ot lhe property, or my employees w11n wages
as their sote compensahon, will do the work. and the struc-ture is not intended or ollered lor sale (Sec 7044, Busmess
and Proless~ns Code. The Contraciof's License Law does
not apply to an owr.er of property who bmlds or improves !hereon and who does such wotk himself or through his own
employees, provided that such 1mpr0\lements are not intend·
ed Of oflered for sale. II, however. the building or improve-ment 1s sold within one year of completion, the owner-builder
will have the burden of proving that he did not build or im-prove 10< tho purpose 01 sale).
0 I, as owner 01 the property, am exclusively contracting with licensed contractors to coostruct the project (Sec 7CM4. Business and Professions Code· The Conlractor's Ucense
Law does not apply lo an owner of property who buikls °' 1m· proves thereon, and who contracts tor each projects with a
conlractor(s) Ucense pursuanl to the Contractor·s ltcense Law).
O As a homeowner I am improving my home, and the lonow ing conditions exist· 1. The work is being performed prior to sale.
2. I have lived ii:' my home lor twelve months
3. r':!o ~~~ 11~i: =~ption during the
last three years.
□ I am exempt under Sec. ______ . 8 & P.C. for this reason ____________ _
□ I hereb., affirm that Iha.ea cert,hcate of consenl to selt-msure, or a cert1fica1e ot Workers·
Compensation Insurance, Of a cert1t1ed copy thereof
(Sec :iaoo. Labo< Code)
POLICY NOKWP 265 92 50
coMPANv Firement ' s Fund
0 Copy IS hied Wllh the Ctly
O Cet11t1ed copy ,s hereby furnished
CERTIFICATl OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE
(This sect,on need not be completed it the perm11
1s fOf one hundred dollars tS 100> o, less)
0 I cet11ty that in lhe pertormance ol the work tor
which this perm11 1s issued, I shall not employ any
person in any manner so as 10 beeome sub1ec1 to
lhe Workers· Compensation Laws of Cahtom1a
NOTICE TO APPLICANT If. atter makin1 lh1s Cert•
hcate ot Exemption. you shOuld t>eeome sub1ect l'> the WOtkers· Compensation provisions ol the Labor
Code. you must for1h'tll;1th comply w1lh suc-h
prov1s,ons or this oerm1t shall be deemed revoked
O I hereby alhrm that lhere 1s a cons1ruct1on
tending agency to, the performance ol 1he wor11 tor
which this permit 1s issued 1sec 3097 C,v,I Code>
Len<1er_s Nam• ~2~0fl ~s~~
Lencter s AOdress ~--~----~~
San Diego, CA
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USE BALL POINT PEN ONLY & PR_E!S HARO ., APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT
1200 Elm, Carlsbad, California 92008-1989 (619) 438-5525
JOB ADDRESS AV.ST.RD. NEAREST CROSS ST. I ~2T;;~i;;ICATIONI
BUSINESS LICENSE # VALUATION PERMIT N;:Eift
2871 ·--· Sanford Lane l(Rl L/7-:). 4-'f OJ 1717 3 q.~ ,7
L~4 BLOCK cJf~~era0ihns I AS~ogz:iEL NO
CONTRACTOR CONTRACTORS PHONE• ZONE i7 .... \~
Pacific Scene Inc 299-5100
OWNER•S NAME I OWNER•S PHONE
CONTRACToR·s ADDRESS LICENSE NO. PLAN 1.0. # BLDG USE CODE
'T'" --+----Tlnl•-•+--A ?oo. n nf1 3900 Harney St, 5[), CA 92110 272686
OWNER•s MlilL•NG ADDRESS
DESIGNER LICENSE,, STANDARD PLAN# BUILDING SQ. FOOTAGE
3gQQ J.1--,rn,::,u C:.t-r,::,,::,t-C:.<>n Dieoo. CA 92110 Architects: Lorimer & C_ se C-9037 'iS-D OESCRIPTI0N OF WORK
~ Dnnl<>v w;t-h Tr,t-1;n,::, OESIGNER•s ADORESS DESIGNER'S PHONE
3344 Fourtl, Ave, S.D. CA 291-0660 f!£fOte:; f i,.. 1268 • ~; -... ,~-
1-SFD -Plan 1 --F/P FLA ELEV. NO DCC GP EDU
950 living 59.5 Storage vO NO --STOr'ES R~ l
CENSUS TRACT I GP LAND USE I PARK? I RES t'TS I GRADING PERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRE SPA
AREA coi/1/V YO ND vO NO v□ NJSV Not Valid Un~s Machine Certified
QTY. PLUMBING PERMIT · ISSUE 'l ST> QTY. MECHANICAL PERMIT · ISSUE ~ -SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP '2 ir. -INSTALL FURN. 0 UCTS UP TO 100.000 BTU '-l -BUILDING PERMIT 01 ·00·00·8220 ;:z.~~-
EACH BUILOING SEWER L -~ OVER 100.000 BTU SIGN PERMIT 01 ·00·00·8221
EACH WATER HEATER ANO/OR VENT ., J°f' BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01·00·00·8806 1S-Lf. ?o
EACH GAS SYSTEM l TO 4 OUTLETS -i......5 .. BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING 01 ·00·00·8222 /./_'I -
EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE "1.. -ELECTRICAL 01 ·00·00·8223 zo -
EACH INSTAl. ALTER. REPAIR WATER PIPE VENT FAN SINGLE OUCT _lf.-MECHANICAL 01·00·00·8224 ILf -
EACH VACUUM BREAKER MECH EXHAUST • HOOO/OUCTS MOBILEHOME 01·00·00·8225
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MOBlLEHOME PARK INSP
EACH ROOF DRAIN (INSIDE) SOLAR n1.M.nn.a??~
TOTAL MECHANICAL l 't -STRONG MOTION 80-92·33·0519 'A. r"JS -
TOTAL PLUMB ING I w.-FIRE SPRINKLERS 01 ·00·00·8227 '7lJ5'"° -
QTY. SOLAR· ISSUE
PUBLIC FACILITIES FEE 32·00·00·8933
QTY. ELECTRICAL PERMIT • ISSUE r-BRIDGE FEE
NEW CONST EA AMP/SWT BK R /Or\ /J.c--COLLECTORS SCHOOL FEE • DISTRICT
I PH 3 PH STORAGE TANKS Carlsbad 80·92· 21 ·0519
EXIST BLOG EA AMPISWT/BKR ROCK STORAGE . .. Encinitas 80·92· 22·0519
I PH 3 PH PUMP San Dieguito 80·92· 23-0519 -
REMOOEL'ALHR .PER CIRCUIT PLAN CHECK FEE San Marcos 80·92· 24·0519
TEMP POLE 200 AMPS -
OVER 200 AMPS / 0 .J' " \ LICENSE TAX 01-00-00-8162
TEMP OCCUPANCY 130 DAYSI ~!]11,,/fl ,y-i J
I C.r"\1,...\0 / CREDIT DEPOSIT
TOTAL ELECTRICAL I '30--~AL soiJ.R_/ TOTAL FEES PAYABLE I I 1-.t~-~ ' -
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT" ANO 00 HEREBV Expiration E"8f)' permit issued by Iha Buitdmg Ot11c1aI under the prov,s,ons of tt>IS * AN,~~IT IS REOUIMO FOfl EXCAVATIONS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code 1hatt exp.re by hm,tat,on and become nutf and void If the building or work 5' o· EP D DEMOLITION OR CONSTRUCTION OF
DECLARATIONS ARE TRUE AND CORRECT ANO I FURTHER CERTIFY AND AGREE IF A PERMIT IS aulhonzed by such perm11 t9 not commenced w1ttun 180 days trom the date of such STRUC S OVER 3 STORIES IN HEIGHT permit or 1f the budd1:ff or WOfk authonzed by suCh permit 1s suspended or
ISSUED· TO COMPLY WITH ALL CITY COUNlY AND STATE LAWS GOVERNING BUILDING CON abandoned at anv>1ma a e, Ille wodP11"\:ommenced for a oerood of· 180 A-•·· -
STRUCTION , WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND APP\.ICA~NATURE r;_7 A OWNER □ CONTRACTOR 0 APPROVE°/Y \__ lof~/41 KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS, COSTS AND ,I
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE V'~. BY PHONE 0
GRANTING OF THIS PERMIT, ,, ,,.~ _A;/~ ..,...-.., I"' , ·c;, . ,
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TYPE I DATE INSPECTOR
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BUILDING I
•. 8 3 ., t ~ -:;-• l.f '-{ ' t-.. "' ' '--, ' __ \ 5 .. • -,
FOUNDATION ! I FIELD INSPECTION RECORD .
REINFORCED STEEL I .
MASONRY I --REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
GUNITE OR GROUT ! l
REQ_ IF INSPECTOR'S . INSPECTION DATE CHECKED APPROVAL ~--FLOOR & CEILING SUB FRAME I
SHEATHING D ROOF I) Sfi~ijA. A 1
FRAME ...., ~ • V I, '1,1 lf,~4.p,,,.t ~ ....
EXTERIOR LATH I l~,t-~ ~ ..
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
INSULATION I 1-t•t'l•& i; le!: ... C
INTERIOR LATH & DRYWALL I l'?J,t.-B-4 1 ...... J -
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PRESTRESSED
CONCRETE
POST TENSIONED I CONCRETE
PLUMBING I ' FIELD WELDING -
SEWER AND BUCO DIPUCO I
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UNDERGROUND D WASTE D WATER
HIGH STRENGTH
BOLTS
TOP OUT D WASTE D WATER 1:t.f-84 & . -SPECIAL MASONRY --.... .
TUB AND SHOWER PAN I ..
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GAS TEST I ,t.zd•Af /"jf-PILES CAISSONS
D WATER HEATER D SOLAR WATER ..
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ELECTRICAL I --.
D ELECTRIC UNDERGROUND D,UFFER
ROUGH ELECTRIC I 'l•l4-A4 Ut I
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D ELECTRIC SERVICE D TEMPORARY •• '-T • , . ~
D BONDING D POOL I . . ~
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MECHANICAL I
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D DUCT & PLEM., D REF. PIPING l-t,1!£-M Af+. .
HEAT -AIR COND. SYSTEMS I \. J
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VENTILATING SYSTEMS I
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CALL FOR FINAL INSPEC1 ON WHEN ALL APPROPRIATE \
ITEMS ABOVE HA, E BEEN APPROVED.
FINAL I .
PLUMBING I
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ELECTRICAL I
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MECHANICAL I }-.. ~ .
GAS 1./2)
BUILDING .,,,_.}..\~\?· 1.t\., l31S-'t \%
't ' .
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SPECIAL CONDITIONS \\' I II
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THIS S TO CERTIFY THAT INStn .~TION EAS BEEN INSTALLED I N
CONFOKMANCE WITH "'ML CURRENT ENERGY REGULATIONS, CALIFOltNIA
'0Mb . St AAT" E C , TITI F' 2 5, STATE OF CALIFORNJ/_, I N THE
oU .1..L~n LOCATED A l:
s1TE ADDRESS: J.. 8,;_7.....;./_,_,) aa Tor o! I_,,, Cqr/slq c/
Nulllber Street ✓ City
EXTERIOR WALLS
Manufacturer Jja7 __ Thickneas/TypeJ~
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R/Val ue-'/"""'/._ __
CEILINGS
Bat ta: Man•1facturer ..;T//11 II
Thickne ss 6, %1 R/Value / 5?
GENERAL CONTRACTOR: __________ ----:LIC. # _______ _
BY TITI..E DA'fE ------------------------
INSULATION CONTRACTOR : APOLLO INSUI.ATION LIC.!f :?86015 ----=------
BY ~ ,%~ TITLE 1/<Z::z DATE "g .... J 5 _-;8 3
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0 I hereby affirm that I am licensed under
provlalona of Chapter 9 (commencing with
S.Ctlon 7000) of Division 3 of the Business
and Professions Code, and my license Is In
full forC',aJl.d. f>flf,;t. B l
L,c No _L._I_L_O_Q_Q_ Class --~-~-~---
! hereby alllrm tllat I am exempl from the Contrac-
tof°s License Law for fhe following reason (Sec. 7031.5 Business and Professions Code: M'/ city or county wlllch re-quires a perm11 to construct, al1er, improve, demolish, or repair any structure. prior to its Issuance also reqUires the ap-
plicant fC< such penr,f to Me a si9neo statement that he " locen...i pursua,,t to the P,OVISJ0nS of the Contractor·s l.Jcanse Law (Chaple< 9 convnencing with SecllOll 7000 ol DMsion 3 or the Bus,ness and Professions Code)« that IS ex·
empt therefrom and the basis lor the alleged exemption. Any violation ol Section 7031.5 by an applicant fC< a permit S<Jb-jects the appiocant to a cMI penalty ol not more than fr,o hun-dred dollars ($500).
0 I. as owne< ol the property. or my employees with wages
as their soJe compensation, 'tlwill do the work. and lhe struc-ture Is not Intended"' ottered for sale (Sec. 7044. Business
and Professions Code· The Contractor·, License Law does not apply to an owner ol property who builds or improves
thereon and who does such work himself or through his own employees. prO'llded that such lrnp,ovements are not ,ntend·
ed or offered for sale. II,-· the bultchng « lmpr-ment is sold within one year ot completion, the owner-builder
will have the bumen of proving that he did not build or im·
prove for the purpose of sale)
0 I, as owner of the properly. am exctusrvely contracting with licensed contr2Clors to construct the prorect (Sec. 7044,
Business and Professions Coclt. The Contractof°s License Law does not apply to an owner ot property who builds 0< im· proves thereon, and who contracts for each projects with a
contractor(s) ticense pursuant to the Contractor·s License Law).
D As a -ne< I am imp<ov,ng my home. and the follow· ing conditions exist t ri:r~~~ be/~ ~rt= f.r'°r~~months
DriOf to completion ot this work 3 I have not claimed this exempt,on during the last three years
g /hf.' r":..:.':' under Sec ------, B & P.C.
0 I hereby alftrm lhat I ha-,e a cer1Ifteiile of consent to self-insure, or a cert1t1cate of wor11;e,s·
Compensait,on Insurance. or a cert1f1ed copy thereof tsec 3800, lalbof Code)
POUCYNO KWP 265_92 50 __
cOMPANv Eiremen.'...s Fund
□ Copy IS filed With !he C1ty
D Cen11ted copy 1s hereby furnished
CERTIFICA Tl OF EXEMPTION FROM
WORKERS" COMPENSATION INSURANCE
(This sechon need not be completed 1f the perm,t Is tor one hundred doOa,s (S 1001 o, less)
0 1 cert,ty that ,n the performance of lhe 'Work tor
which this permit ,s issued, I shall not emplOy any
person in any manner so as to become sub1ect to the Wonters· Compensation Uws ot Ca.Mom,a
NOTICE TO APPLICANT 11. ~tier malun, tnos Cer11 t,cate ot Exemption, you snou5d oecome subIec1 I'>
lhe Workers· Compensation pro<wIst0ns ot the l..abof
Cooe. you must forthwith comply with such
provIsIons or th,s permn shall be deemed revoked
O I hereby affirm that !here ,s a consIr1.1c11on Iend1ng agency tor lhe performance ot lhe work lor
which lh1s perm11 ,s issue<! tSec 3097 C1v1I Code)
Len<1e1SName llni an Bank
Len<ler. A<ldrm~b; Bcxt§2101
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 (619) 438-5525 / /
JOB ADDRESS AV.ST.I DATE Of APPLICATION' BUSINESS LICENSE # VALUATION /° PERMIT NUMB
RO. 1>-?-., ?J Lf 9 _. Sanford Lane Lots 43 & 44 12/9/83 1710 ~-!?,~ OWNER'S NAME I OWNER0S PHONE CONTRACTOR CONTRACTORS PHONE • ZONE
Treetops Unlimited 299-5100 Pacific Scene, Inc 299-5100
OWNER"S MAILING ADDRESS CONTRACTOR'S A00RESS LICENSE NO. PLAN 1.0. # BLOG us"E CODE
3900 Harney Street/San Diego, CA 92110 3900 Harney Street/SD CA 272686
LOT I BLOCK c~!~t:~~;c:t1un~ AScfrS~~~CEL NO. OEt G'ff R • / • •• Chrisman Architect c9i3'gNSE • STANDARD PLAN# BUILDING SO. FOOTAGE
OESCRIRTION OF WORK etaining Wall Type 7 308.22 Sq Ft OESIGNER"S ADDRESS DESIGNER'S PHONE
9939 Hibert St/SD CA 92131 695-3830 ~---------,-·--_._.,.. ----F/P FLR ELEV. NO OCCGP EDU
STORIES
vO NO --
CENSUS TRACT I GP LANO USE I PARK ING SPACE I RES UNITS I GRAOING ~ERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRESPR -AREA CONST
vO ND vO NO vO NO Nor V~lid Unlffs Machin• wrtifi«I
SUMMARY/ACCOU/')T/'jl.J~ ~E~~ r-u/-. d:. ,,,,,,.
QTY. PLUMBING PERMIT· ISSUE QTY. MECHANICAL PERMIT· ISSUE
EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100,000 BTU BUILDING PERMIT 01 ·00·00·8220 ~ ~o<.,
EACH BUILDING SEWER • OVER 100,000 BTU SIGN PERMIT 01 ·00·00·8221 \ --------~ 3'&'•<;"'0 EACH WATER HEATER ANO/OR VENT BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01 ·00·00·8806
EACH GAS SYSTEM I TO 4 OUTLETS 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 INSTA~ .. ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01 ·00·00-8224
EACH VACUUM BREAKER MECH EXHAUST -HOOD/DUCTS MDBILEH0ME 01 ·00·00·8225 -
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP
EACH ROOF DRAIN (INSIDE) SOLAR 0HXl·OO-A??I:
= T0Tt;L MECHANICAL I STRONG MOTION 80·92·33·0519 0--------~, -. .,. ....:....__
,• TOTAL PLUMBING ! FIRE SPRINKLERS 01 ·00·00-8227
QTY. ELECTRICAL PERMIT · ISSUE QTY. PUBLIC FACILITIES FEE 32·00·00·8923 SOLAR · ISSUE BRIDGE FEE
NEW CONST EA AMP/SWT1BKR COLLECTORS ·-SCHOOL FEE • DISTRICT
1 PH 3 PH STORAGE TANKS Carlsbad 80·92·21·0519
EXIST BLOG EA AMP/SWT/BKR ROCK STORAGE I -Encinitas 80·92·22·0519
1 PH 3 PH PUMP . San Dieguito 80·92·23·0519
REMODEL/ALTER PER CIRCUIT PLAN CHECK FEE San Marcos 80-92·24·0519 --~ TEMP POLE 200 AMPS ' J V
OVER 200 AMPS --
TEMP OCCUPANCY (30 DAYS)
. ,-----
~ -.. -. ' --7~ ~
TOTAL ELECTRICAL ' ' '~1 TOTAL SOLAR TOTAL FEES PAY~ I t 6;J. . .5"3 -
I HAVE CAREFULLY EXAMINED THE COMPLETED 'APPLICATION AND PERMIT" AND DO HEREBY -E1Cpirahon. Every permit 1saued by the 8tJlld1ng Offlc111 under the provisions ofth1s * AN L -IT IS RE0U1REO FOfl EXCAVATIONS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall expire by hm1tat1on and become null and void If the bu1ld1ng or work r~ ~D 0£MOllTION OR CONSTRUCTION OF DECLARATIONS ARE TRUE ANO CORRECT ANO I FURTHER CERTIFY ANO AGREE IF A PERMIT IS authorized by such permit 11 not commenced within 180 days from the date of such ST TUA£S OVER 3 STORIES IN HEIGHT permit. or 1f the build,~ o~, 1utho,12ed by such permit is suspended or ISSUED TO COMPLY WITH ALL CITY, COUNTY ANO STATE LAWS GOVERNING BUILDING CON-abandoned •t•nv t,me • er w rk IS commenced for a oenod of 180 davs -STRUCTION., WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND
APPL12 SIGNA~ y ~ OWNER □ CONTRACTOR 0 APPrED:\ lr/A~/f..(" KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE 'A~r~-BYPHONE 0 GRANTING OF THIS PERMIT "-J
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···-· -· -INSPECTION TYPE DATE INSPECTOR
BUILDING
FOUNDATION
REINFORCED STEEL --.
MASONRY
GUNITE OR GROlJT
FLOOR & CEILING SUB FRAME
SHEATHING
FRAME
EXTERIOR LATH lNSULATION
INTERIOR LATH Ii DRYWALL
PLUMBING j
SEWER AND BL/CO
PLUMBING UNDERGROUND
PLUMBING TOP OUT ' 0
TUB AND $HOWER PAN
GAS TEST
ELECTRICAL
TEMPORARY POWER
ELECTRIC UNDERGAOUMO
ROUGH ELECTRIC
ELECTRIC SERVICE
BONDING :
G. F. I. -SMOKE DETECTOR
MECHANICAL
DUCT & PLEM .• REF. PIPING
HEAT -AIR COND. -SOLAR SYSTEMS
VENTILATING SYSTEMS
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE BEEN APPROVED.
JOB SITE FINAL
PLUMBING ·-----
ELECTRICAL
MECHANICAL
GAS
BUILDING
SPECIAL CONDITIONS
CERT OF OCCUPANCY ISSUED
FIELD INSPECTION RECORD
'"" ·, .,. . -
"
\ \
REQUIRED SPECIAL INSPECTIONS
INSPECTION REQ. IF INSPECTOR"S
CHECKED APPROVAL
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRESTRESSED
CONCRETE
POST TENSIONED
CONCRETE
FIELD WELDING
HIGH STRENGTH ' BOLTS
SPECIAL MASONRY
PILES CAISSONS
·,
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-
INSPECTOR'S NOTES e --
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ra I hereby affirm that I am licensed under
provlalons of Chapter 9 (commencing wnh
Section 7000) of Division 3 of the Business
and Professions Code, and my license Is In
full forain~,~~t. B-1
L,c No -------Clm ------
! hereby allirm that I am OXl!ffllll from Ille Contrac· 1or·s License Law !or the lollowmg reason (Sec. 7031.5
Business and Professions Code: Any city or county which re-quires a pe,mIt to construct, aJter, improve. demolish, or repair ~ny structure. prk>r to its issuance also requ11es the ap-plicant !or sucb pem11t to file • >ipned slatemenl that he Is
licensed pursuant to the prov,s,ons of the Contractor's License Law (Chapter 9 cammenong with Section 7000 ot
Oivislon 3 of the Business and Protess,ons Code) or that is ex-empt therefrom and the bas,s tor !he alleged exemptJon. Arry
"101at,on of Sect1011 7031 .5 by an applicant tor a permrt sub-JetlS the awt,cant 10 a ci'ri penalty ol not more than f..e hun-
dred dollars ($500)
0 I, as owner of lhe property, or my employees wIlh wages
as their sole compensation. wilt do the work. and the struc· lure IS noc Intended or ottered for sale (Sec. 70«, Business and Profess,ons COde The Contractor's ucen,e Law does
f:,:,~n~0 :~o :ts!f:etl1::1 ~~i~~:~~~fs':
employees, provided that such Improvements are not Intend· 8d or otttrect tor sale II. _.,.,, the building or~
ment IS sold within one year of cornptet,on, the owner-builder
will have Ille burdl<I of proving Iha! he did not build or im-prove !or the purpose of sale).
D I. as owner of Ille property. am exclusively contracting
with licensed contr>ctors lo construct the project (Sec. 7044, Bus,ness and Professions COde TIie Contraclor's License
Law does not apply to an owner of property who builds or im-proves !hereon, and who contracts tor each projects with a
~;actor(s) license pursuant to the Contractor's License
o As• homeowner I am Improving my home, and lhe tollow· lng conditions exist:
~. [h~i!:l·:~0 ~rt= rior ~~·months
3. l'"°"ha'ie° ~~=:t ~ti;: =PIion during the last three years.
g ~tr=:\'t under Sec.------· B& P.C.
fi I hereby arhrm that I have a cert1f1ute ot consent to self-,nsure. or a cert1t,cate ot Worti:ers Compensahon lnsurMKe, Of a cert1f1ed CoPy thereof
(Sec 3800, Lat,or Code)
POLICY NO _KWP 265 92 50
COMPANY Firemen~ Fund
~,t;oPY 1s hied with the city
0 Cert1t1ed copy 1s hereby furnished
CERTIFICATl OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE
(This section need not be completed 11 the permit
,s tor one hundred dOllars ($100) or less}
D I certify that ,n the performance of 1ne wor1t for
which this penmt 1s issued, I Shall not employ any
person in any manner so as to become sub1ect 10 the WQf1cers· Compensation Laws ot Cahtorn1a
NOTICE TO APPLtCANT If. after makm:;1 this Cer11
ftcate of Exemp11on, you should t>ecome sub1ec1 l'J
the Workers· Compensation prov1s1ons of the Labor Code, you must lorthw1lh comply w1lh such
prov1st0ns 01 this permit shaJI be deemed revoke<!
0 I hereby atri,m that there 1s a constructt<>n
~•OQ agency IOf the pertounance ot the wOB; fOf
which 11'us permit 1s issued iSec 3097. C1v1I C-ode)
Len<le<S Nam-Uni an Rank
Lender's AOdress 52 5 B Street
SD, CA 92101
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 (619) 438-5525
JOB ADDRESS AV, ST. I DATE OF APPLICATION' BUSINESS LICENSE # VALUATION PERMIT ~MBE~/ RO. 1~C0 Sanford Lane Spaces 33. 34. 35 . 36. 37. 38 l 7Hl .~r~ OWNER"S NAME I OWNER'S PHONE CONTRACTOR CONTRACTORS PHONE • ZONE
Treetops Unlimited 299-5100 Pacific Scene, Inc 299-5100
OWNER'S MAILING ADDRESS CONTRACTOR'S ADDRESS LICENSE NO. PLAN L O.# BLOG lM c o oE
3900 Harney Street/San Diego, CA 92110 . 3900 Harney Street/SD CA 9211( 272686
LOT I BLOCK JSUBDIVISION L ASSESSOR PARCEL NO. DESIGNER LICENSE '1 ST ANDARD PLAN # BUILDING SO. FOOTAGE
'~ 1 ".,,...-~ J.lTl 1 f"T'O'> 'l L.O . Chrisman/Architect C-9239 /CJ 8' 0 DESCCIPTION ot WOR'f, C arpor -ar ,. DESIGNER'S ADDRESS DESIGNER'S PHONE ,p t ~f • 1/f~ r\;.w j._ ·_1~
aa~a 1..r; l-.--~ c.~~ n f'A Ci'Jl ~1 ~nr: ~o l() -· -----~ -. -----f/P FLA ELEV. NO OCC GP EDU
STORIES
vO NO
CENSUS TRACT I GP LANO USE I PARKING SPACE RES UNITS I GRADING f'.ERMIT ISSUED I REDEVELOPMENT TYPE DCC LOAD FIRE SPR
AREA CONST
y D N D vO NO YO NO Not v,tid Unwss Machine u rrifitld
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 ·00·00·8220 ~~,c:-;o
EACH BUI LO ING SEWER < OVER 100.000 BTU SIGN PERMIT 01·00-00-8221 -'-I 'I.S:S-EACH WATER HEATER ANO/OR VENT BOILER/COMPRESSOR UP TO 3 HP PlAN CHECK 01 ·00·00·8806
EACH GAS SYSTEM l TO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING 01 ·00·00-8222
EACH GAS SYSTEM 5 OR MORE MET AL FIREPLACE ELECTRICAL 01-00·00-8223 ---
EACH INSTA~ .. ALTER. REPAIR WATER PIPE VENT FAN SINGLE 0UCT MECHANICAL 01 ·00-00-8224
EACH VACUUM BREAKER MECH EXHAUST -HO00/OUCTS M0BILEH0ME 01 ·00-00-8225
WATER S0FTNER RELOCATION OF EA FURNACE/HEATER M0BILEH0ME PARK INSP
EACH ROOF DRAIN (INSIDE) SOLAR 01-00-on.aoo,:
TOTJ;L MECHANICAL STRONG MOTION 80·92·33·0519 ,___ --.. ~ l I TOTAL PLUMBING FIRE SPRINKLERS 01·00·00·8227 . PUBLIC FACILITIES FEE 32-00·00-8923 l<rJ,,110 QTY. ELECTRICAL PERMIT · ISSUE QTY. SOLAR · ISSUE BRIDGE FEE
NEW CONST EA AMP/SWT/BKR COLLECTORS SCHOOL FEE • DISTRICT
I PH 3 PH ·' STORAGE TANKS Carlsbad 80·92·21-0519
EXIST BLOG EA AMP/SWT/BKR ROCK STORAGE Encinitas 80·92·22·0519
l PH 3 PH PUMP San 0ieguilo 80·92·23-0519
REMODEL 'AL TEA PER CIRCUIT PLAN CHECK FEE San Marcos 80·92·24-0519 -
TEMP POLE 200 AMPS -
OVER 200 AMPS -
TEMP OCCUPANCY (30 0AYS) .
TOTAL ELECTRICAL 1-TOTAL SOLAR TOTAL FEES PAYABLE I ~" 'I-~5 -
1 HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION ANO PERMIT .. ANO DO HEFIEBY Exp,rat,on E .. ry permit 1aaued by the Buoldfng Officoal un-the proYOsoons of th11 * AN ~IT IS REQUIAEO FOfl EXCAVATIONS OY£R CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall exp,re by hm1talion and become null and vood II the budding or work ~· O" DEEP OEIIIOUTION Ofl CONSTAUCTION Of
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY ANO AGREE IF A PERMIT IS autllo<tzed by such permit 11 not comrnenceo w1t111n 180 day1 from the <late of ouch STIIUC 0\1£R 3 STOAIES IN HEIGHT permit, or If the buitdfnx or -~~orlQCI by IUCh permit 11 1uspended or ISSUED· TO COMPLY WITH ALL CITY. COUNTY AND STATE LAWS GOVERNING BUILDING CON· lbancloned at any tira a er lfle w commenced for a oeriod of 1Ail "-• ~
STRUCTION. WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND
APPLICANTZRE ~~ OWNER□ CONTRACTOR 0 APPROVED½--
1~/1? KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS. COSTS AND
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE BY PHONE 0 GRANTING OF THIS PERMIT
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INSPECTION TYPE DATE INSPECTOR
BUILDING
I IA-,3 ,wf 7:tt-FOUNDATION -1
REINFORCED STEEL I ~ -
' MASONRY ..
GUNITE OR GROUT I
FLOOR & CEILING SUB FRAME
SHEATHING
FRAME \··
EXTERIOR LATH lNSULATION
INTERIOR LATH & DRYWALL ;
PLUMBING
SEWER AND BL/CO .
PLUMBING UNDERGROUND
PLUMBING TOP OUT •.
-TUB AND $HOWER PAN
' GAS TEST -I ..
ELECTRICAL ' I
TEMPORARY POWER I t
ELECTRIC UNDERGROUND
ROUGH ELECTRIC
ELECTRIC SERVICE
BONDING
G. F. I. -SMOKE DETECTOR ;
MECHANICAL
DUCT & PLEM., REF. PIPING
HEAT -AIR COND. -SOLAR SYSTEMS
VENTILATING SYSTEMS
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HA VE BEEN APPROVED.
JOB SITE FINAL
PLUMBING
ELECTRICAL
MECHANICAL
GAS
BUILDING
SPECIAL CONDITIONS
CERT OF OCCUPANCY ISSUED
---.
" ' ---.. I .:_j-'
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES • _
REQ IF INSPECTOR'S c 1 • ' • INSPECTION CHECKED APPROVAL DATE
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRESTRESSED
CONCRETE
POST TENSIONED
CONCRETE
FIELD WELDING ; t
HIGH STRENGTH · ~,, • ( 1. BOLTS ., • ... • . -
SPECIAL MASONRY , f--------.:;._-----------------------i
PILES CAISSONS
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G I hereby affirm that I am licensed under
provlelons of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Professions Code, and my license Is In
lull forC'J..l(llt y~J-
Loc No __L.L.Lhtit)_ Clm --,B.-='-"1-----
I hereby alfirm that I am oxornpl lrom the Conirac• Ior·s License Law lor the l0ilow1ng reason (Sec. 7031.5
Business and Professions Code. Any city or county whk:h re-quires a permit to construct, alter, Improve, demofish, or repair any structure, pnor to its issuance also requiras the ap-plic.int lor sueh permit ID lile a s,gned Slalemenl lhal he IS
licensed porsuanl lo the provis,ons of lht Contractor's Ucenst Law (Chapter 9 commencing wijh Sect,on 7000 of
Division 3 of the Business and Protess,ons Code) or that is ex· empt therefrom and the basis for the aUegeo exempt10n. Any
Yiolat,on ol SeclJOO 7031.5 by an appi,cant !-Or a pemvl sub-iects the applfcant to a civfl penany ol not mare than five hun·
dred dollars ($500)
0 I. as owner of the property, or my employees w,th wages
a. their sole compensat,on. W1fl do the work. and the struc· ture is not Intended or offered for safe (Sec 7044. Business and Professions Code The Connctor·s License Law does
not apply to an owner of property who builds or Improves thereon and who does such work hlmstlf or through his own
ernployeH, prO¥ided that such lmprO¥emenls are not Intend·
ed or oltt<ed for safe If,-· the building or impfwe-ment Is sold within one year 01 toml)letJon. the owner-builder
will have the burden 01 l)IDYlng that he did not build or im-p, ... for the purpose of sale).
D I. as owner of the property, am exclusively contracting
with lansed contr,ctors to construci the project (Sec. To«. Business and Professions Code· The Contraclor' s Ucenst
Law does not apply to an owner of property who builds or im· pr ... s thereon. and who contracts for each projects with a
contraclor(s) licenst porsuant to the Contractor's Llcenst Law).
o As a -nor f am lrnprDYing my home, and the follow· ing conchtlOf'ls exist: 1. The work Is being performed prior to sale.
2 I have lived ,n my home for twelve months
3, r::'!-!' :;1P~l:t l~I~ ~pllon dunng the fast three years.
□ I am exempt under Sec. ______ . B & P.C.
for this reason -------------
□ I hereby athrm that I ha,... a cen,ttcate of consent to selt-,nsure. or a cert1t,cate ot Wortce,s
Compensation Insurance, OJ a cen1hed CoPy thereof
(Sec 3800, Lab<>< Code)
POLICYN0 KWP 265 92 50
COMPANY [iremen' s -Fund
l:] Copy 15 filed with the City
O Cen1t1ed CoPY 1s hereby furnished
CERTIFICA H OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE
(This section need not be completed 1f lhe permit
,s tOJ one hundred doHars ($100) or less)
D I cer11ty that in the perlotrnance of lhe wor1t to,
wtuch this permit 1s issued. I sl'\all not employ any
person in any manner so ~ to become subJecl to the WQf1cers· Compensation Laws of California
NOTICE TO APPLICANT If. afte:r makinJ ttus Cen1
hcate ot Exemption, you should become sub1ect t'l
the WMers· Compen~t•on prov1s1ons of the Labot' Code. you musl forthwith comply with such
prOY1st0ns o, this permit shaJI be deemed revoked
JJ. I hereby all um that I here 1s a cons1,uc1,on
~,no agency '°' lhe pe-rtor~nce ot lhe wOfk tor which this perm11 1s issued tSec JC97 C1v1I Code)
Lende<sNam• Union Bank
Leno.rs A<l<l•••s5 2 5 B Street
SD. CA 92101
USE BALL POINT PEN ONLY & PRE1S HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
CARLSBAD BUILDING DEPARTMENT ' APPLICATION & PERMIT I ~ 1200 Elm, Carlsbad, California 92008-1 989 (619) 438-5525 .,
JOB ADDRESS
A~i.Tr;;;;;j~'ONI
BUSINESS LICENSE ti VALUATION PERMIT :rER ~
Sanford Lane Spaces 23, 24 , 27, & 28 1710 ~0'10 t1J)~~ OWNER'S NAME 1 OWNER'S PHONE CONTRACTOR CONTRACTORS PHONE • ZONE
Treeton~ llnl;m;rpn ?oo .c; 1 nn P,,r;f;r <.!r=.,o Tnr ?QQ c;1nn
OWNER'S MAILING A00RESS CONTRACTOR'S ADDRESS LICENSE NO. PLAN 1.0, # 8LOG"t1liE CODE
3900 Harney Street, San Diego , CA 92110 3900 Harney Street , SD . CA 272686
LOT I BLOCK I SUBDIVISION .1 ASSESSOR PARCEL NO DESIGNER LICENSE • STANOAR0 PLAN# BUILDING SQ, FOOTAGE Calavera Hi ls CT 82-2 L.O. Chrisman/Architect C-9239 7;.o DESCRIPTION OF WORK ,a.,_' I~ • &.<I'• :J/t.
Caroort -4 Car DESIGNER'S ADDRESS DESIGNER'S PHONE -,c_" -. 9939 Hibert St/SD, CA92131 695-3830 ----· ---··-.. V ----. . ----..----F/P FLR ELEV. NO CCC GP EDU
STORIES
vO NO
CENSUS TRACT I GP LANO USE I PARKING SPACE I RES UNITS I GRACING f'.ERMIT ISSUED I REDEVELOPMENT TYPE CCC LOAD FIRE SPR AREA CONST -·
YO ND vO NO vO NO Not Valid Unlffs Machin~ C.rtifi«J
QTY. PLUMBING PERMIT· ISSUE QTY. MECHANICAL PERMIT· ISSUE SUMMARVACCOUNTNUMBER
EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100,000 BTU BUILDING PERMIT 01 ·00·00-8220 ...,,. ::,1;.;
EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT 01·00·00·8221 -1..(.. '7 ~ EACH WATER HEATER ANO/OR VENT BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01 ·00·00·8806
EACH GAS SYSTEM 1 TO 4 OUTLETS 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 INSTAl, ALTER. REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01 ·00·00·8224
EACH VACUUM BREAKER MECH EXHAUST -HOO0/OUCTS MOBILEHOME 01 ·00·00·8225
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP
EACH ROOF DRAIN (INSIDE) SOLAR n1-on-on-A22F\
TOTt.L MECHANICAL STRONG MOTION 80·92·33·0519 ---~--r -'-I TOTAL PLUMBING FIRE SPRINKLERS 01 ·00·00·8227 '
' PUBLIC FACILITIES FEE 32·00·00·8923 7 Iii✓() a
QTY. ELECTRICAL PERMIT · ISSUE QTY. SOLAR -ISSUE BRIDGE FEE
NEW CONST EA AMP/SWT1BKR -.. COLLECTORS SCHOOL FEE · DISTRICT
1 PH 3 PH STORAGE TANKS carlsbad 80-92·21·0519
EXIST BLOG EA AMP/SWT/BKR " ROCK STORAGE Encinitas 80-92·22·0519
1 PH 3 PH PUMP San Dieguito 80·92·23·0519
REMODEL/ALTER PEA CIRCUIT PLAN CHECK FEE San Marcos 80·92·24·0519
TEMP POLE 200 AMPS ►
OVER 200 AMPS -
TEMP OCCUPANCY 130 OAYS) --
TOTAL ELECTRICAL -1-TOTAL SOLAR TOTAL FEES PAYABLE r 1r'l-iS-
I HAVE CAREFULLY EXAMINED THE COMPLETED .. APPLICATION AND PERMIT'" AND DO HEREBY E•p1rat1on Every perm,1 •-by the Butlcling Offictaf under the prov,s,ons of th,s * A.N OSHA~ AEOUIAEO FOfl EXCAVATIONS OVER CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall exp,re by hm,tallon and become null and void fl the butldmg or wort< S' o-DEEP ANO MOUT10N OR CONSTRUCTION ~
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS author,zed by such perm,t II not commenced w,th,n 180 days from the dale of such STAUCTURES R 3 STORIES IN HEIGHT permit, or ,f the buildr~ work author!Ud by such permit ,s suspended or ISSUED: TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING BUILDING CON· abandoned at acu, time a ~Ori< 1s commenced for a nAnod of Ulil d•u•
STRUCTION, WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND
APPLICAZGN~tY // OWNER□ CONTRACTOR 0 APPROVED BY U---('~/~ KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE BY PHONE 0 GRANTING OF THIS PERMIT. '/1 h ""' .,,/'1(/1,j/ ..I.A,
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INSPECTION TYPE DATE INSPECTOR
' BUILDING I
FOUNDATION t IA,3 ·M r.J.1-
I
REINFORCED STEEL 1 -
MASONRY
GUNITE OR GROUT ;
' . FLOOR & CEILING SUB FRAME ~
SHEATHING I -
FRAME
EXTERIOR LATH lNSULATION . !
INTERIOR LATH & DRYWALL
PLUMBING ,
SEWER AND BL/CO • r
' PLUMBING UNDERGROUND
PLUMBING TOP OUT I
•
TUB AND $HOWER PAN
GAS TEST 1 .'
ELECTRICAL .,
TEMPORARY POWER
ELECTRIC UNDERGROUND I
' ROUGH ELECTRIC !
ELECTRIC SERVICE I ' I
BONDING
G. F. I. -SMOKE DETECTOR '
MECHANICAL •,
DUCT & PLEM., REF. PIPING
HEAT -AIR COND. -SOLAR SYSTEMS
VENTILATING SYSTEMS
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HA VE BEEN APPROVED.
JOB SITE FINAL
PLUMBING
ELECTRICAL
MECHANICAL
GAS
BUILDING
SPECIAL CONDITIONS
CERT OF OCCUPANCY ISSUED
" g' 6 ~t3-b -~~
FIELD INSPECTION RECORD " ,
REQUIRED SPECIAL INSPECTIONS INSPECTOR"S NOTES
REO IF INSPECTOR'S I======,;,=:;;,;,,~~=='=====~~.=.-~ -~======<=:.;\r. ~:i_"':.:==i,;a;;·=.=.==-=,
INSPECTION CHEC.KED APPROVAL DATE ~--
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP :
1---------------------------------i STRUCTURAL CONCRETE
OVER 2000 PSI I-------------'-'----------------------, PRES TRESSED
CONCRETE
POST TENSIONED
CONCRETE
FIELD WELDING •
1-------------------------------i
HIGH STRENGTH • , \ ~ \' •~ "I
BOLTS ~ •
SPECIAL MASONRY
PILES CAISSONS : '
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0 I hereby affirm that I am licensed under
provision, of Chapter 9 (commencing with
S.Ctlon 7000) of 0Mslon 3 of the Business
and Profusions Code, and my license Is In
full lor.11t.~cj ,!~t. lie No L.L.Lbl:itl_ Class B J.=.1.J ____ _
I hereby affirm 11\al I am 1!XOff191 lrom lhe Conlrac· !or's license Law lor !ht following reason (Ste. 7031.5
Business and Professions Code: Any city or county which r .. quires a permit to construct. alter. ,mp,ove, demohsh, or repatr any structure, prior to Its issuance ilso requues the ap-phcanl for such permil lo ~It a s,gned statement Iha! he Is
licensed pursuant lo the provisions of the ContractDf'S License Law (Chapter 9 commencing with Secbon 7000 of
OIYISiOII 3 ol the Bus,ness and Profess,ons Code) or that is l!X· ""91 therefrom and the basis for the alftved exemphon. AlPJ
Ylolahon of StctiOll 7031.5 Dy an al>Olicant for a penmt sub-)OCts the apptlcant to a clvN penalty ot not more than live hun•
drtd dollars ($500). -
0 I, as OWntf of the l)foperty, 01 my lll19ICJyets With wages as their sole compensation. will cto the -k. and the struc· ture Is not lnttndtd or ottered tor sale (Sec. 7044, Business
and ProfessiOns Code: The Contractor's License Law ctoes
not apply to an owner ol p,operty who builds or ,mpro,es
lheraon and who does such -himsett or through htS own employees, provided that such improvtmtnts are not intend· ed or otte<ed tor sale. It. however, the building or imprOY&-
men1 is sold within one yoar of cornplttJon, the owner-builder
WIii have the burden of p,CMng 11\at he did not build or im-prove tor the purpose of sale).
□ I, as owner of the property, am exclusively contracting with licensed contractors to construct the prOjeCI (Sec 7044,
Bus,ness ....s ProfessiOns Code: The Conlrllctor's License Law does not apply to an owner of property who builds or Im-proves thereon, ind who contrac1s for each projects wl1h a
conlraclor(s) Ucense pursuant to the Contractor's License Law).
0 As a homeowner I am improving my home, and the toltow· Ing condiUons exist:
1. The work 1$ being performed prior to sale. 2. I have lived ,n my home lor twetw, months
3. r:: ':'~of 1\~ :;'!ption during the last three yoars.
g ~':'=lundefStc ------. B&P.C.
D I hereby athrm that I ha..,e a cer11ha1e ol consenl
to self-insure. or a cer11t,ca1e of Workers'
Compensation Insurance. or a cer11fled copy lhereof
(Sec 3800. Labor Code)
POLICY NO .KEW 2.65--92 50 --
COMPANY Ri-remen ' s--Fund
0 Copy 15 filed With lhe city
□ Cert1hed copy 1s hereby furnished
CERTIFICATl OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the perm11
,s tor one hundred doUars (S 100) ex less)
0 I cer11ty that m the pertor~e ol lhe woo '°' which th,s permit 1s issued, I shall no! employ any
person in any manner so as to become sut>Ject 10
the wooers· Compensatton Laws ot Caflf'om.a
NOTICE TO APPLICANT II. alter mak1n1 th,s (;er,,
t,ute of E..xempt,on. you shoukl become sut>Ject I?
the W0f1<ers· Com~sahon prOY1s1ons of lhe Labor
Code. you must for1hw1th compty w11h such
provisions or 1h1s perm11 shall be deemed revotleo
□ I hereby athrm that there ,s a cons1tuct1on X-nd1ng agency fQf the pef'10fmance of tn.e wOOt for
wtucl'I this permit 1s issued (Sec .3097 C,v,I Code)
Len<1e,sNafllf'Ut:1iot:1 Bat:1k
Len0e,·sAOO••·· 525 B Street
SD . CA 92101
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 (619) 438-5525
JOB ADDAESS A~;_T. I o;;,;;~;;10NI
BUSINESS LICENSE It VALUATION PERMIT NrER
Sanford Lane Sn<>rA<:: 2() 30 31 32 1710 5'0'-/0
OWNER'S NAME I OWNER'S PHONE CONTRACTOR CONTRACTORS PHONE • ZONE ei}l~~ Treetops Unlimited 299-5100 Pacific Scene , Inc 299-5100
OWNER'S MAILING ADDRESS CONTRACTOR'S A0ORESS LICENSE NO. PLAN 1.0 . # BLDG USE COOE
3900 Harney Street, San Diego , CA 92110 3900 Harney Street/SD CA 272686
LOT I BLOC!( ~UfOIVISION •. i ASSESSOR P~,E~NO Orl<oER jlCENSE • STANOARO PLAN# BUILDING SQ. FOOTAGE a avera Hil s ct -..• Chrisman/ Architect C-~2 9 7B. C OESCRtPTION OF WORK Carport -4 Car . DESIGNER'S ADDRESS DESIGNER'S PHONE
~ 9939 Hibert ST/SD, CA 92131 695-3830
I ~ ---F/P FLR ELEV. NO EDU !2t"i:0/~ 60 OCCGP I ") i. • ~ STORIES
vO NO --
CENSUS TRACT I GP LANO USE I PARKING SPACE I RES UNITS I GRADING ~ERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRE SPR
AREA CONST
Y □ H □ vO NO vO NO Nor Valid Unlffs Abchint Ctrtifil!d
QTY. PLUMBING PERMIT · ISSUE QTY. MECHANICAL PERMIT -ISSUE SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TD 100,000 BTU BUILDING PERMIT 01 ·00·00·8220 5"~ ·.S-0
EACH BUILDING SEWER OVER 100.000 BTU SIGN PERMIT 01-00-00·8221 --. ·-EACH WATER HEATER AND/OR VENT BOILER/COMPRESSOR UP TO 3 HP PlAN CHECK 01 ·00-00-8806 ~J:. ?.S
EACH GAS SYSTEM I TO 4 OUTLETS 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 INSTAl .. ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01 ·00·00·8224
EACH VACUUM BREAKER MECH EXHAUST -HOOD/DUCTS MOBILEHOME 01 ·00·00·8225 --WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP
EACH ROOF DRAIN (INSIDE) SOLAR 01 .M.M.A'71:
TOT.t;L MECHANICAL STRONG MOTION 80·92-33·0519 ----r~ --.-·_:___
TOTAL PLUMBING --FIRE SPRINKLERS 0H)0-00·8227
QTY. SOLAR -ISSUE PUBLIC FACILITIES FEE 32-00·00·8923 101•"0 QTY. ELECTRICAL PERMIT -ISSUE BRIDGE FEE
NEW CONST EA AMP/SWT BK R COLLECTORS SCHOOL FEE -DISTRICT
I PH 3 PH STORAGE TANKS Carlsbad 80-92-21·0519
EXIST BLDG EA AMP/SWT/BKR ROCK STORAGE Encinitas 80-92· 22·0519
1 PH 3 PH PUMP San Dieguilo 80-92·23·0519
REMODEL ALTER PER CIRCUIT PLAN CHECK FEE San Marcos 80-92·24·0519
TEMP POLE 200 AMPS -
OVER 200 AMPS I ---,. -TEMP OCCUPANCY (30 DAYS) I -----
l
TOTAL ELECTRICAL -r ~-TOTAL SOLAR ' I I 9'-1, ;;.s-TOTAL FEES PAYABLE -,
I HAVE CAREFULLY EXAMINED THE COMPLETED -APPLICATION AND PERMIT" ANO 00 HEREBY ~ e.p;rat,on E .. ry permit tSau.c:I by the 8u1ldt"9 Ott1c1a1 unde<lhe pro•1S1on1 orth11 * AN OSHA PEINIT -FOfl EXCAVATIONS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Coda shall expire by hm,tation ond become null and •Old If the building or work S' O" OU ~ION 0A CONSTAUCTION OF
DECLARATIONS ARE TRUE ANO CORRECT AND I FUflTHER CERTIFY AND AGREE IF A PERMIT IS aulhortzed by such pa,m1I IS not commenced within 180daya from the date of such STAUCl\lRES 3 STONES IN HEIGHT
ISSUED TO COMPLY WITH ALL CITY. COUNTY AND STATE LAWS GOVERNING BUILDING CON• =~,::;., ,~1 t~v ~'jl.,°' ~~~.,~~"\~ ~i;::~,i'~,•~ or
STRUCTION. WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND
APPLICANZATURZI, OWNER□ CONTRACTOR 0 APPROVED BY ~
ID~/(~
KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO ,-'
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE BY PHONE 0 GRANTING OF THIS PERMIT. ~~ ~
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INSPECTION TYPE DATE INSPECTOR
BUILDING
FOUNDATION I ~R4 ~JL
• I
REINFORCED STEEL •
MASONRY I
GUNITE OR GROUT
FLOOR & CEILING SUB FRAME
SHEATHING
FRAME
EXTERIOR LATH lNSULATION
INTERIOR LATH & DRYWALL
PLUMBING
SEWER AND BL/CO
PLUMBING UNDERGROUND
PLUMBING TOP OUT '
TUB AND $HOWER PAN
GAS TEST I .
ELECTRICAL
TEMPORARY POWER ..
ELECTRIC UNDERGROUND
' ROUGH ELECTRIC
ELECTRIC SERVICE ' :
BONDING
G. F. I. -SMOKE DETECTOR I,
MECHANICAL I
-DUCT & PLEM., REF. PIPING
HEAT -AIR CONO. -SOLAR SYSTEMS
VENTILATING SYSTEMS
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
I TEMS ABOVE HA VE BEEN APPROVED.
JOB SITE FINAL
PLUMBING
ELECTRICAL
MECHANICAL
GAS
BUILDING
SPECIAL CONDITIONS
CERT OF OCCUPANCY ISSUED
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS
INSPECTION REQ. IF INSPECTOR'S
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 .. '.
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INSPECTOR'S NOTES
' DATE
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