HomeMy WebLinkAbout2677 SAUSALITO AVE; ; 86-1237; Permita:
I[ O I hereby affirm that I am licensed under
provlalona of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Prof .. alona Code, and my license Is In
0 full force and effect.
u r I hereby aftmn thal I am exempt tram lhe Contrac· tor·s License Law tor the following reason (Sec. 7031 5
Business and Profess10ns Code: Any city or counly whict. re• quues a permit to construe!, aller. improve, demolish, or
repair any struclure. prior to ,ts issuance also requires !heap· phcant for such permit to file a SIQned statement that he 1s
licensed pursuant to lhe prOYJStons of the t;ontractor s license Law (Chapter 9 commencing with Sect10n 7000 ol
Dwisk>n 3 of the Business and Professions CodeJ or lhat 1s ex· empt therelrom and the basis IOf Ille anegeo exemplton Any
v10lation of Section 7031.5 by an apphcant tor a permit sub· jects the applk:ant to a civil penally of not moce than hve hun• dred dollars ($500).
C J",. as owner ol the property. DI' my employees with wages
Ill as their sofe compensation. will do the work, and the struc·
0 ture is nol mtended or offered for sale (Sec 70-C4. Business ..., and Prolessions Code: The COnlractor's License Law does 5 not apply to an owner ol properly who builds or improves
I thereon and who does such work tumsell or through his own
employees. provided that such improvements are. nol intend·
Ill ed or offered for sale. It. however, the building or ,mprove-z men! Is sold within one year of completion. lhe owner-builder ~ will have the burden 01 proving Iha! he did not build or im·
0 prove lor the purpose of sale).
rJ I. as owner ot the property, am exclusively con1ractmg
with licensed contractors to construct the pr01ect (Sec. 70-C4.
Business and ProfesS.Ons Code: The Contractor's License
Law does not apply lo an owner ol property who bu1kis or ,m-
Ill proves thereon, and who contracts tor each pro,ects with a
contractor{s) hcense pursuant to the contractor's license z Law) 0 ;;: □ As a homeowner I am improving my home. and the lollow· C ing condIhons exisl: er: 1. The work is being performed prior 10 sate C .., 2. I have lived in my heme !or twelve months u prior to completion of this work
Ill 3 I have not claimed lh1s exempt,on during lhe 0 last three years.
0 I am exempt under Se<:. . B&P.C tor this reason I
I
I
I 0 I hereby affirm that I ha¥e a cerUficale of consenl to l
self-insure. or a certilicate of Workers· Compensation In-
surance. or a cert,lied copy thereof (Sec. 3800. Labor Code) I
POLICY NO. I
z COMPANY I 0 I j:: 0 Copy is filed with the city C I Ill 0 Certified copy is hereby furnished I z Ill I G. 2 I 0 CERTIFICATE OF EXEMPTION FROM u WORKERS" COMPENSATION INSURANCE I
Ill (This section need not be completed if the permit I ii: 1s for one hundred dollars ($1001 or less) I Ill 'fl1'1 certify that in the perlorma.nce ot the work for which I "' er: ~~~=~~1
;: ~~s=~~:~~
I
b7:tt~~~i ;r;;:k:;~r~:.~~ I 0 3 sation Laws of California.
NOTICE TO APPLICANT: It, after making this Certificate
of Exemption. you should become subject to lhe Workers·
Compensation provisions of the LabOf Code. you must I forlhwith comply with such provisions or this permit shall
be deemed revoked. L
il 0 I hereby affirm that there is a construction lending
agency tor the performance of the work for which I his per-
mlt is issued (Sec. 3097. Civil CodeJ
Lende(s Name
Lender"s Address
USE BALL POINT PEN ONLY & PRESS HARD
CARLSBAD BUILDING DEPARTMENT
2075 Las Palmas Dr., Carlsbad, CA 92009-4859 (619) 438-1161
JOB ADDRESS AV. ST.AD. NEAREST CROSS ST.
.2.b11 Sausal, Jo _llt._e_ ?ooi:1ae.
CONTRACTOR
APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
APPLICATION & PERMIT
DATE OF APPLICATION BUSINESS LICENSE II VALUATION
/:}.-6-f b
CONTRACTORS PHONE • ZONE b...~ I BLOCK l-rne'.~£Kn~Ltl ASSESSOR PARCEL NO
l:RNEA"S NAME Noeeen IA! ellS /.one I 43i~7;s;H~E
(!J()/'hA-'
1w1·;;;'"
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a/ob "'
OWNERfs MAILING ADDRESS
{).fo 1// Saus a 1,-ko Ave,
CONTRACTOR"S ADDRESS
k
STATE LICENSE NO.
V
...,, BUILDING SO. FOOTAGE
DESIGNER DESIGNER'S PHONE
1 ~RIPT:;.NOF WOAf-1 5 d /I t I ,.J,.ns a /I a on oP /:::,a c1n e:, as ,2 , DESIGNER'S ADDRESS STATE LIC~ NO.
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J--F/P FLA ELEV . . NO~~&~ l EDU
uii3ii iiiil i~/UJ/~o~KMI
Q) l-5ii. b ii 1
QTY.I
Q T Y.I
vO NO
] PARKING SPACE RES UNITS GRADING PERMIT ISSUED J REDEVELOPMENT AREA
y O ND vO NO -----
PLUMBING PERMIT -ISSUE 1·gJ QTY. MECHANICAL PERMIT -ISSUE
EACH FIXTURE TRAP INSTALL FURN. DUCTS uP TO 100,000 BTU
EACH BUILDING SEWER OVER 100,000 BTU
EACH WATER HEATER ANO/OR VENT BOILER/COMPRESSOR UP TO 3 HP
EACH GAS SYSTEM I TO 4 OUTI ETS BOILER/COMPRESSOR 3-15 HP
EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE
EACH INSTAl . ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT
EACH VACUUM BREAKER MECH EXHAUST -HOOO/OUCTS
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER
EACH ROOF DRAIN ( INSIDE) DRYER VENT
TOTI.L MECHANICAL
TOTAL PLUMBING I
ELECTRICAL PERMIT· ISSUE , {· ()O II QTY. MOBILE HOME SETUP
NEW CONST EA AMP'SWT BK R CAR PORT
1 PH 3 PH AWNING
EXIST BLOG EA AMP/SWT 'BKR GARAGE
1 PH 3 PH
REMOOEL'ALTER PER CIRCUIT
TEMP POLE 200 AMPS
OVER 200 AMPS
TEMP OCCUPANCY !30 DAYS)
TOTAL ELECTRICAL 1 TOTAL
1 STOA }::"">"
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~r L~cc ilil'bt,R~~~~', c NST \'{\ ~ \ ,.. ~'1?!.~ ~ . Not Valid Unlf!<s Machine Cutified
g. o~l o\_~;;<.~1't~MARY1AccouNT NUMBER --7 r .... _
_ C,'T'..,. .. l.i.!ffi.'JING PERMIT 001-810-00-00-8220 f / ...J. tfr} ~,,,4" ..
"
SIGN PERMIT 001-810-00-00·8221
PLAN CHECK 001 ·810-00-00-8821
TOTAL PLUMBING 001 -810-00-00-8222
ELECTRICAL 001-810-00·00-8223
MECHANICAL 001-810-00-00-8224
MOBILEHOME 001-810-00·00·B225
SOLAR 001-810·00-00-8226
STRONG MOTION 880-519·92·33
FIRE SPRINKLERS 001-810-00-00-8227
PUBLIC FACILITIES FEE 320-810-00-00-87 40
BRIDGE FEE 360-810-00-00-87 40
PARK-IN-LIEU (AREA
TIF 134-810·00-00-8835
LA COSTA TIF 133-810-00-00-8835
FMF
LICENSE TAX 001-810-00-00-8162
MFF 880-519-92-5 7
CREDIT DEPOSIT
_/ ;_ --~--. ~ _L.-, UU7
TOTAL FEES PAYABLE l ~o. cro
I HI\ VE CAREFULLY EXAMINED THE COMPLETED 'APPLICATION ANO PERMIT' ANO 00 HEREBY Exp,retoon Every permot IHUed by the Building Ollocoat under the prov,s,ons of th,s CAVATIONS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall expore by hm1tat,on and become null and vo,d If the bu,ld,ng or work RUCTION OF
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY ANO AGREE IF A PERMIT 1$ authorized by such perm,t os not commenced w,thm 180 days from the date of such Ht,11.;Jlll"IES.: "",.~-,.•,,~--.,-.HT
ISSUED TO COMPLY WITH ALL CITY. COUNTY ANO STI\TE LAWS GOVERNING BUILDING CON :~~;:;,n~'~t':~ ':;'~~•J.~;h:~~,:~t~~~..:le~~~~ ,:"'r~,t " suw.,~"~ or
STRUCTION WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND
KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS, COSTS Af APP A TS SIGNATURE CONTRACTOR 0
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OFT E 1,., I j (J' /
GRANTING oF THIS.PERMIT ,.__,.....,,.,._,, .. ~·A..,u,....,,., I _v_.,.., ,,,,..6 '-
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TYPE I DATE INSPECTOR -
BUILDING I && -t ?---~7 \
FOUNDATION ' ' FIELD INSPECTION RECORD
-, .
REINFORCED STEEL J
l
MASONRY I REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES -.
GU NITE OR GROUT l
SUB FRAME □ FLOOR □ CElpNG
SHEATHING □ ROOF □ Stl!EAR
INSPECTION REQ IF INSPECTORS DATE Cf -tC,,f ~ ;.'6 fudv 1-/.r.t-.Q. , CHECKED APPROVAL -'-"'-•. , . ..... , .. . -SOILS COMPLIANCE
PRIOR TO
FRAME i FOUNDATION INSP
EXTERIOR LATH J
l
STRUCTURAL CONCRETE
OVER 2000 PSI
INSULATION I PRES TRESSED
INTERIOR LATH & DRYWALL i
I
1
CONCRETE
POST TENSIONED
CONCRETE
PLUMBING I FIELD Wl:L,DING
□ SEWER AND BUCO D I UCO
UNDERGROUND □ WASTE [ WATER
HIGH STRENGTH
BOLTS
TOP OUT □ WASTE □ WATER SPECIAL MASONRY
TUB AND SHOWER PAN j
GAS TEST I
I PILES CAISSONS
□ WATER HEATER □ SOLAR WATER
j
ELECTRICAL J
□ ELECTRIC UNDERGROUND [I) UFFER
ROUGH ELECTRIC ' □ ELECTRIC SERVICE □ TEMPORARY ti • ·'. •1-:rl • ' , ~ --., I"-:~ ~ \
□ BONDING □ POOL • . \ -·;;.._
... . " ' ',._, ·-~ ... .,; ,.
~ I• t
MECHANICAL l
□ DUCT & PLEM., □ REF. PlijlNG
-,,-
r . . _..,
~ ' . \, .
HEAT -AIR COND. SYSTEMS l
VENTILATING SYSTEMS I )?.~ f?Q: --_ ?'d~i?-:.•'.: i.1 l '2~ •. , --
j .
CALL FOR FINAL INSPEfillON WHEN ALL APPROPRIATE
ITEMS ABOVE H VE BEEN APPROVED.
FINAL • 1::~cL "t..A-.0. 1.~~ r l. --l ,. ,p /_Sl
PLUMBING I ~
ELECTRICAL 1 . ., \. t.
MECHANICAL I ' ~
GAS I ' "\:
-j ~t., ,.;l. '"----d ~. ""t.AJ-..w.~ V
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BUILDING ' ~
SPECIAL CONDITIONS l ' .
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n
PLAN CHECK NO.~ ADDRESS Ji??~ DATE (~J
PLANNING
TYPE OF PROJECT AND USE: ZONE: i-;\
SCHOOL DISTRICT: ---------,--------SAN DIEGUITO ENCINITAS CARLSBAD ~ SAN MARCOS
cO~ SIDE Q;, IL-REAR t;lf"" -SETBACKS: FRONT
DISCRETIONARY ACTIONS: ____ r-"1"~:--------------------
REDEVELOPMENT PERMIT REQUIRE 11•_ --1-+--;L-------------------
LANDSCAPE PLAN COMMENTS: --~-+---------------------ENVIRONMENTAL REQUIRED: -----',-----------,,--------------
COASTAL PERMIT REQUIRED: YES -----NO _.._ __
ADDITI ONAL COMMENTS: _____ __._ __________________ _
OK TO ISSUE:_"""@c.,__ _____ _
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ENGINEERING
LEGAL REQUIREMENTS .,
LEGAL DESCRIPTION VERIFIED? -~ APN CHECKED? ~ ~~ EASEMENTS:
EDU'S: /J/4 ;
IMPROVEMENTS: ))/K
I
PERM ITS REQUIRED
GRAD ING: AJ,at:
J
DRIVEWAY: ,t1/4-
?
FEES REQUIRED
RIGHT-OF-WAY: ~
DRAINAGE: u4= l
tIELD CHECK DATE & INITIALS:
GRADING COMPLETION CERTIFIED:
INDUSTRIAL WASTE: N/4:
l
------
PARK-IN-LIEU QUADRANT: /V@:, FEE PER UNIT:
P.F.F.: dA: TRAFFIC :MPACT FEE PER UNIT:
,Y~ TOTAL FEE:~/0...,..,1!3:-,..._.__,....---
t/4-: TOTAL FEE:_.:.../%-,..=---•
FACILITIES MGMT. FEE: ___ ~,__,{j, .... _____ BRIDGE & THOROUGHFARE FEE:-~,.._@,.__ __ _
SEWER FEE (CONNECTION ): SEWER LATERAL:
~ u C1I ..c:
c: ADDITIONAL COMMENTS: ___________________________ _
U Cll C: Cll ra QI -0 a: ~ QI C'l ....
C) 0 C1I
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QI ~ OK TO I~~~~====~=====JD>AATETE: __ /~~,<-J..,~¼-~--------
DPD2:DPD6:1O/24/86
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