HomeMy WebLinkAbout2121 SERENO CT; ; 84-365; Permit<II z 0 ~ Cl: < .... u Ill 0
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O I hereby affirm that I am licensed under
provlalona of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Proleaalons Code, and my license Is In
lull force and effect.
L,c No ______ Class
I hereby •lfirm 1ha1 I am exempl lrom Ille ConlrK· 10<"s LIC1lnse L•w lor Ille lollow1ng ,,.son (Sec 7031 5
Business and Proftss1011s Code Any city 01 county which re• quires a permit to construct. alter. wnprove. demoush. °' repatr any structure, poor to ,ts issuance also requires !he JP-pl"itant lor such permit to Ille a ~ned statement that he is
hcensed pursuant to the prov1sJOl'ls of the Contrac1or' s wnse Law (Chapler 9 commencing w,1h Seclion 7000 of
l)ms,on 3 of Ille Busmess and PrOfessions Code) Of lhal is ex-
empl lllerefrom •nd Ille basis fo< Ille allegeG exemplion Any VlOlal,on of Seclion 7031 .5 Dy an apphcanl lo< a perm11 suD-
,ecls !he •pplQnl lo• crvll penalty of not more !hon,.,. hun-dred dollars ($500)
0 I. as owner of ll!e properly, or my employees w11h wages
as their sole compensahon. w,11 do the work. and !he struc• ture 1s not 1nteocted CN' offered toe sale (Sec 7044, Busariess
and Professions Code Tile Contrac:lor's License law does not apply 10 an owner ot property who bu1kis or Improves
!hereon and who does such -k himsen 01 lhrough h,s own
employee>, provided 111a1 such mprO'IOffltflts are not inlend-
ed Of of1ered lo< sale. II, however' Ille Du,ldlng Of improve-
ment is sold within one year ot camplet,on, the owner-builder will have Ille Durden of proving Iha! he dtd not Du11d or im-
prove lor Ille purpose Of sale).
D I, as owner o1 Ille property, am e,clus,vely contracllng with licensed conlrac:tors to construe! Ille project (Sec 70-44,
Busmess and Professions Code The Contractor's Lteense
UW doeS not a.ppty to an owner of property who builds Of im-proves thereon, and who contracts for each proiec1s with a f:!)actOf'(s) license pursuant lo the Conlraclof's L.cense
D As a homeowner I am improving my home, and tile follow· Ing conditions exisl
1. The work ,s Doing performed pnor 10 sale. 2 I l\aYe Hved ,n my home lor lwelve monlhs
3 f:v~ ~~:: ,t:i~ =~ptlon durmg the Last three years.
D I am exernpl under Sec ______ . 8 & PC tor thts reason ____________ _
□ I hereby affirm thal I ha.-e a ce~•cateconsenl to self-insure, Of a cert1hca ot OOlers
Compensahon lnsuraoce. Of a c4:nir c y thereot
(Sec 3800. L.abor Code)
POLICY NO
COMPANY
□ Copy IS ltled With lhe city
D Certified copy ,s he1eby furnished
CERTIFICATl Of EXEMPTION FROM WORKERS COMPENSATION INSURANCE
(This sec110n need not be completed 1f ltle perm11
Is IOf one hundred OOlla,s (S 100) Of less)
0 I certify that in lhe performance ol the wOOI tor which this permit is issued I shall not employ any
person 1n any manner so as 10 become sub1ec1 to
the WM.ers · Compensalton Uws of Cahtorn,a
NOTICE TO APPLICANT tr. afler makmJ lh1s Cen,
tic.ate ot E•emphon_ you shoukJ bee-ome su1>1ec1 t? 1ne WMe,s· Compensa11on pro,,.,,sions ol the Labot
Code. you must tor1n-.,1n comply w111, such provisions o, lh1s perm11 Shall be deemed ,e..,okeo
0 I ne,eby afh,m 11'\al !here ,s a construc11on
lending agency lor the pe'1o,mainct ol lhe """O"'-lo,
which lh1S perm1I 15 ,ssue<J {Sec J097 C1v1I Codel
Lendef s Name ___________ _
LenOer s Address __________ _
USE BALL POINT PEN ONLY & PRESS HARD
,.,. . .,~ CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT 1200 Elm, Carlsbad, California 92008-1989 (619) 438-5525
JOB ADDRESS AV ST RD NEAREST CROSS ST.
,:;;, :&+ION'
BUW-ICENSE # VALUATION PERMIT NUMBER
~\1..-1 ~C?F'~JO C('. 1i.6(X)-64-3h.5 LOT BLOCK sueo, VISION ,~~~R~ / .,-,.z.. CONTRACTOR CONHIACTORS PHONE • ZONE
~i?· t)UJlt# /Cld~J ~9'2--?LIL OWNE R"S NAME . l OWNER'S PHONE ei. V' ..... ~ J .1 ~Jt-JDe,#2$ CON~~OR"S ADORESS ~ "'• LICENSE NO PLAN 1.0. 4' BLDG use CODE ri~~-?Jl87 ~ I C,()~~ e.J • Ol}J ~., l'r_,-.ID..,__ ~, fboL OWNER'S MA,LING AOORESS ,
..-A_L.Af1. DES•GNER LICENSE • STANDARD PLAN #
GoGo;TAGE ~ ...... 4-~-£_ OESCRIPTlON OF WORK
APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. I ~ u::
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OESIGNER"S ADDRESS DESIGNER'S PHONE c
~M\NC:7 ftd-~~ 6l.Z..7 ,&c $ t!#lf/. 'J'1' .2 r-0 YI 1J
--. F/P fLR ELEV. NO OCC GP EDU
STORIES
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CENSUS TRAC"T I GP LANO USE I PARKING SPACE I RES UNITS I GRADING PERMIT ISSUED I REOE VELOPMENT TYPE OCC LOAO FIRE SPR AREA CONST
y D ND vO NO vO NO Not V•hil Unlt!ss ,,.,hint Ctrtdi«J
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QTY. PLUMBING PERMIT · ISSUE 7.f:!!-QTY. MECHANICAL PERMIT· ISSUE 3'-SUMMARY/ACCOUNT NUMBER --0 "' EACH FIXTURE TRAP . INSTALL FURN. DUCTS UP TO 100,000 BTU BUILDING PERMIT 01-00-00-8220 -,-n ~u
EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT 01-00·00·8221 , -4--~ BOILER/COMPRESSOR UP TO 3 HP PLAN CHEC"-C,ff,OJ; f2H_. 0'111-ua ~ EACH WATER HEATER AND/OR VENT
EACH GAS SYSTEM 1 TO 4 OUTLETS /'JO) BOILER/COMPRESSOR 3-15 HP TOTAL PLUM BIN~ 01·00·00·8222 /h,vO
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illl ;;, EACH GAS SYSTEM 5 OR MORE
.
METAL FIREPLACE ELECTRICAL 01·00•00-8223 1,:;.00
VENT FAN SINGLE DUCT \ . -
EACH INSTA~. ALTER, REPAIR WATER PIPE MECHANICAL 01·00·00·8224
.2
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EACH VACUUM BREAKER -'f __ z:::r MECH EXHAUST HOOD/DUCTS " " MOBILEHOME 01·00·00·8225
WATER SOFTNER RELOCATION OF EA FURNACE/HEATE~., MOBILEH0ME PARK INSP ,,;
<II
EACH ROOF DRAIN (INSIDE) \ SOLAR 01-00-00-•??~ -
TOT/;L MECHANICAL ~ STRONG MOTION 80·92-33-0519 ~Mt> -·
TOTAL PLUMBING I /?-, .Ul-FIRE SPRINKLERS 01 ·00·00·8227
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SOLAR • 1ssJ~ /" PUBLIC FACILITIES FEE 32·00·00-8933
QTY. ELECTRICAL PERMIT • ISSUE f--QTY. -" BRIDGE FEE
NEW CONST EA AMP SWT BKR COLLECTORS \ \. ~ SCHOOL FEE · DISTRICT
0
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I PH 3 PH STORAGE TAN KS '\." ~'\ Carlsbad 80·92·21-0519 C1l C
EXIST BLOG EA AMP/SWT 'BKR ROCK STORAGE \ ~\ \-Encinitas 80·92·22-0519 u::
1 PH 3 PH PUMP \\ .., 'f" San Dieouilo 80·92-23-0519
/J REMODEL 'AL HR PER CIRCUIT L.o --PLAN CHECK FEE \. \ San Marcos 80·92-24-0519
,....
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TEMP PO LE 200 AMPS '-' Q) Q)
OVER 200 AMPS LICENSE TAX 01-00-00-8162 (5
fEMP OCCUPANCY (JO DAYSI ~~p
CREDIT DEPOSIT 0
TOTAL ELECTRICAL I IGP0 TOTAL SOLAR TOTAL FEES PAYABLE I Jt'f.~8
I HAVE. CAREFULLY EXAMINED THE COMPLETED APPLICATION AND PERM!T · AND DO HEREBY Exp.ration Every perfflft tssued by the Buddeng Off1c1al under the prov1s,ons of th•• * AN OSHA PERMIT IS IIEOUIAfD F()fl EXCAVATIONS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT All INFORMATION HEREON INCLUDING THE COCle shall 9llptre by fim,tataon end beeome null and v0tt1 tf the burld,ng Of work s· o· DEEP ANO D£MOUTION OR CONSTR\JCT10N OF
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE If A PERMIT IS luthor,zed by such pernut es not commenced w,thm 180 oays from the date of suet, STAUCT\JAES OYER 3 STOAIES IN HEIGHT pe,m,t, or ,t the IIUlld•:;H: WOtk authorized by such pe,m,t ,s suspended or ISSUED TO COMPLY WITH ALL CITY COUNlY AND STATE LAWS GOVERNING BUILDING CON· abandoned aa anv bme a 1119 wort< ,s commenced tor• oar,c,<1 of tao"••• -STRUCTION WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND APPI.ICA T'S SIGNAT~ • ~ O~ER0 CONTRACT~ ~ D1,2JJ •Bf 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 ...
GRANTING OF n41S PERMIT .,. --.....---...... -BY PHONE 0 I -....;
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TYPE I DATE INSPECTOR I
BUILDING I
FOUNDATION I
REINFORCED STEEL I
I
MASONRY I ,
GUNITE OR GROUT I
FLOOR & CEILING SUB FRAME ' I
SHEATHING D ROOF D SHF.AR
FRAME I
EXTERIOR LATH ' ..
I -.,_.
INSULATION I
INTERIOR LATH & DRYWALL .I
I
I
PLUMBING I
SEWER AND BUCO □IPL/CO I
UNDERGROUND D WASTE D Y..,ATER
TOP OUT D WASTE D WATER
TUB AND SHOWER PAN I .
GAS TEST I ~•.M,I A.A f-J.f.. I
D WATER HEATER D SOLAR WATER • t -, ~~
I
ELECTRICAL I
D ELECTRIC UNDERGROUND OtUFFER
ROUGH ELECTRIC I 'f·l't·M (JM.
D ELECTRIC SERVICE D TEMPQRARY l,\
D BONDING D POOL I
I
MECHANICAL I
D DUCT & PLEM., D REF. PIPING
HEAT -AIR COND. SYSTEMS 1
I " -.
VENTILATING SYSTEMS I ,1 i . j ' ~ .
I
CALL FOR FINAL INSPEC-~ON WHEN ALL APPROPRIATE ITEMS ABOVE HA E BEEN AP.PROVED.
FINAL I
PLUMBING ~-. I \ ., 1
I ...
ELECTRICAL I --.x.. I -'--J
MECHANICAL I '-J'-' ,~ I .
GAS I ' .... ~ .
BUILDING I -~__,/ I -
SPECIAL CONDITIONS I ~ .......___
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fr'-f-3~. .. -~ ·, • "'
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSP~TION REO IF INSPECTORS DATE CHECKED APPROVAL "' . --
SOILS COMPLIANCE ' PRIOR TO
fOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRESTRESSED -· CONCRETE
POST TENSIONED
CONCRETE
/
FIELD WELDING
HIGH STRENGTH .
BOLTS . -_,; ' I
SPECIAL MASOt,iRY ·t,_,n . ..... "'-'
•
PILES CAISSONS
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THE ITEMS LISTED BELOW MUST BE INCLUDED WITH
THE PLANS FOR NEW BUILDING CONSTRUCTION
BUILDING, PLANNING, ENGINEERING, AND FIRE DEPARTMENTS WILL REVIEW THESE PLANS
* Items 1 through 6 ~ be on .the front page of plans
.
1. Site Address.
2. Legal Description.
3. Assessor•s Parcel Number .
4. Contact Person -Name and Daytime Phone Number.
5. Sewer Letter, if project is in Leucadia County Water District or San
Marcos County Water District.
6. Provide any Planning Commission or City Council Action Number on this
property (if applicable).# -------------Variance Number; Conditional Use Permit Number; Tract or Parcel
Map Number; Zone Change Number; Planned Development Number;
Redevelopment Permit Number; Specific Plan Number, or Site Development
Plan Number.
7. A Plot Plan clearly showing all new and existing buildings on the property.
On remodels show where building footprint is revised:
A. Quantity of Grading in cubic yards. (If no Grading is required, write
11 NO GRADING 11 on Plot Plan.)
If a Grading Permit is required, a separate plan {prepared by a
Registered Civil Engineer) is required. CONTACT ENGINEERING DEPARTMENT
FOR SPECIFICS.
NOTE: Grading must be complete and accepted {Compaction Report(s)
submitted) by the City pr1or to issuance of the Building
Permit.
B. Distance between structures and distance to property lines.
C. Existing slopes and drainage facilities on the site and adjacent
properties.
D. Existing adjacent public improvements.
E. All easements on property.
F. Existing water and sewer services {if applicable).
(Colffllercial industrial and apartment buildings RRJst show service size
and provide necessary calculations supporting service sizing.)
G. Proposed lot drainage pattern.
H. Property lines and approximate lot dimensions.
To the best of my knowledge, all the above listed information has been provided on
the plans.
NOTE: FAI~URE TO SUPPLY THE ABOVE INFORMATION MAY RESULT IN THE REJECTION OF
YOUR BUILDING PLAN SUBMITTAL, OR A TIME DELAY IN YOUR PLAN CHECK.
~-< -:/44~ Appicarif Dai'e
. . -·•-··--·· -------
..
• PLAN ~HECK,.NUMBER /1-3(.lADDRESS c2../ .2/ L ci: HECEIVE
DATE
..,JU.-:-:-L-1_9_79-84-
• PLANNING: TV PE oF srRucTuRE /Pd ~w =o -7-++ /...........,.;;_.,a_ ________ BUlldlng.,...F+g'"lt-)!\pa.Rt ...... ts~o-A-D
v ar m.,nt SCHOOL FEES: SAN DIEGUITO ENCINITAS --------
CARLSBAD ----+-----SAN MARCOS -----+---+---
% COVERAGE ------1~---+--,1-----REQUIRE O SETBA
B U IL O ING HEIGHT ----------FRONT ---+-+--t--++---
FENCES/WALLS ----+-+--+---II--------'~--S IDE ---,i--~_,._ ___ _
-TWO CAR GARAGE REAR c::
Lu 3 I.U
--~-,--~---~,------------
;: ~ COMMENTS: __________________________ _
uJ < 0:: C
0~ □ roA< REDEVELOPMENT APPROVAL REQUIRED: 6 ~ □ _______________ .;.,..-__
Lu-~ ~~□LANDSCAPE PLAN CCM1ENTS: _____ __.,fJ __ ~--------------
~ □ ~8 □ u a:: ~;; □ ex: O' 01.U u c::
ADDITIONAL COMMENTS: ------------------------
OK TO ISSUE: ~ DATE: 1il~ OK TO FINAL: ___ DATE: ____ _
**********************************************************************************
A.P.N. CHECK ED?~
____________ E.D.U: 54'! ~
SEWER: _/)0. # T -/hJCJ/-( ./IP -,
/3?0L. /~A-7tl Jc>Jex., ~YS75n'J
l
LATERAL: €f\/V,-DRIVEWAY: E:7Y' f-r-
GRAOING PERMIT: ~µ;---,k.½LA-__:._ _________________ _
ORA I NAGE: MA.KC ~.UR b ./'6 t:J L ~d /\J' eJ7=j= ,£)./<A/~ ~~ ~ EASEMENTS: )(}D7Af€ ~~~/ ADDITIONAL COMMENTS: ______ _
OK TO ISSUE: --'+--.4=--------
* ENGINEERING INSP C N REQUIRED: --."--__ ...,... __ _
PUBLIC ~!ORKS INSPECTOR: ---------,,------~
FINAL OK: ----------~
* IF THIS ITEM IS NOT CHECKED, BUILDI G DEPARTMENT WILL
\
(DRIVEWAYS, CURB CUT, DRAINAGE, ETC.)