HomeMy WebLinkAbout2415 SACADA CIR; ; 80-47; PermitLICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provi-
sions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Profes-
sions Code, and my license is in full force and ef-
fect.
OWNER-BUILDER DECLARATION
D I hereby affirm that I am exempt from the Con-
tractor's License Law for the following reason
(Sec. 7031.5 Business and Professions Code), Any
city or county which requires a permit to con-
struct, alter, Improve, demolish, or repair any
structure, prior to its issuance also requires the
applicant for such permit to file a signed state-
ment that he Is licensed pursuant to lhe provi-
sions of the Contractor's License Law (Chapter 9
commencing with Section 7000 of Division 3 of
the Business and Professions Code) or that Is ex-
empt therefrom and the basis for the alleged ex-
emption. Any violation of Section 7031.5 by an ap-
plicant for a permit subjects the applicant to a
civil penally of not more than five hundred dollars
($500).
□ I, as owner of the property, or my employees
with wages as their sole compensation, will do
the work, and the structure is not intended or of-
fered for sale (Sec. 7044, Business and Profes-
sions Code: The Contractor's License Law does
not apply to an owner of property who builds or
Improves thereon and who does such work
himself or through his own employees, provided
that such Improvements are not intended or of-
fered for sale. If, however. the building or Improve-
ment Is sold within one year of completion. the
owner-builder will have the burden of proving that
he did not build or improve for the purpose of
sale).
:JI, as owner of the property. am exclusively con-
tracting with licensed contractors to construct
the project (Sec. 7044, Business and Professions
Code: The Contractor's License Law does not ap-
ply to an owner of property 1•ho builds or Im•
proves thereon, and wt)\ contract for such pro-
jects with a contractor'1J lice ursuant to the
contractor's Licens Law)
I am exempt und r Se!Q.'!~--'--• B. & P.C.
for this rea~--11-,,1~--~\------
Date II I:--'\.\
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of con-
sent to self-insure, o, a certificate of Workers'
Compensation Insurance, or a certified copy
thereof (Sec. 3800, Labor Code).
POLICY NO .. ___________ _ COMPANY ___________ _
□Copy is filed with the city.
□Certified copy Is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed If the per•
mil Is for one hundred dollars ($1<)!)) or less).
I certify that in the performance of the work for
which this P!!rmil Is Issued, I shall not employ any
person In any manner so as to become subject to
the Workers' ComJ)8nsatlon Laws of California.
WOTICE TO APPLICANT: If, after making this Cer-
tiflcaje of Exemption, you should become subject
t✓the Workers' Compensation provisions of the
Labor Code, you must forthwith comply with such
~rovlsions or this permit shall be deemed revoked.
. t "CONSTRUCTION LENDING AGENCY
I hereby affirm that there Is a construction len-
ding agency for the performance of the work for
which this oermlt ls Issued !Sec. 3097. Civil Code) .
CITY OF CARL SBAD-BUILDING DEPA RTMEN T
AP PLICATION & PERMIT
USE BALL POINT PEN ONLY 1200 ELM AVENUE (714) 438-5525
APPLICANT TO FILL IN INFOR-
MATION WITHIN RED LINES.
NO. JOB ADDRESS AV. ST. ID ATE OF APPLIC ATION -£b-,'Sl1 . PERMIT NUMBER
2 ,41115 1 1.S1 Ac., A i>,A1 l~I I ,R1C 1L l~I I I I I I I I I I I I I R~
"·ft-17 OWNER OWNER'S PHONE PRIME CONTRACTOR STATE LICENSE V
t> ,A I S:, LJ L YI )AJ.J ,=',;'~Lo Sot-I. '13~~2-:z~.s S~A-SCAPG. PooLS 2."=r5S~3
OWNER'S MAIL ING ADDRESS CONTRACTOR'S ADDRESS ENC.. CONTRACTOR'S
2 '-115 SAc.A:t>J\ ~(JI • C.AE!' 'C' ~At, <:::: A 'f zoo,i
PHONE
1qq "" ~I.. c .. ,.,., :i,., Pe.&,I • I-U~-S'-'L4 I /2c:ttiu c27 66•u"-'
13C\I BLOCK I SUBDIVISION .,f,f -d..11EZOR'S PARCEL NO. 133 DESIGNER , STATE LIC~NSE 0□(;•( 687 I t2P/ 80 6•·,ar
L.A. Co~/J. s~,.JJ. 1/1 ~ a t I
DESCRIPTION OF WORK
C::-• .,,·.--·,: _, C Pc,.I :I:. SPA ~20 Q7 DESIGNER'S ADDRESS DESIGNER'S PHONE
CENSUS TRACT GP LAND USE ZONING I RES. UNITS I PARK! NG SPACE I NUMBER or sTORIEs
Not Valid Unless Machin• c.rtifilld
BLDG SO, FT. BLOG USE occ. GP I STANDARD PLAN II I PLAN ID II I TYPE CONST I occ. LOAD l
QTY. PLUMBING PERMIT AMT. QTY. MECHANICAL PERMIT ./AMT. _,, -r , EACH FIXTURE TRAP6fl YP,-J;>:UV INSTALL FURN. DUCTS UP TO 100,000 BTU/
EACH BUI LO ING SEWER -OVER 100,0~U
EACH WATER HEATER ANO/OR VENT BOILER/COMPRESSOR UP TO..l-ffi'
EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR.,l-15 HP
EACH GAS SYSTEM 5 OR MORE BOILER/COMPR_P5'6R 16-30 HP . ~ ,..._
EACH INSTAL., ALTER, REPAIR WATER PIPE VENT FAlj.9!1!GLE DUCT P;" //Y ;..--
EACH LAWN SPRINKLER SYSTEM ME~XHAUST -HOOO/OUCTS
WATER SOFTNER _,,AELOCATION OF EA FURNACE/HEATER BUILDING PERMIT I .JLU"'.~ ...
(' _,,,,,. J . ~ --z,.fr'-' -SIGN PERMIT I 1' I I .
TOTAL PLUMBING //?-TOTAL MECHANICAL PLAN CHErfr_lJ~#" d 7F /~ 1J I "1~ I I I I .
CONTRACTOR CONTRACTOR ALL INCLUSIVE PERMIT I I I
ELECTRICAL PERMIT AMT. AMT.
TOTAL PLUMBING 1.A/.IJV
QTY. QTY. MOBILE HOME PERMIT ELECTRICAL I 16'7. (?t'l/1
./' NEW CONST EA AMP/SWT /BKR -~-~ AWNING ./ . MECHANICAL I f . I . 1 PH .25 3 PH PORCH ...i.--MOBILE HOME I I . I
EXIST BLOG EA AMP/SWT/BKR SET-UP ./ SOLAR I , I I . I
1 PH .25 3 PH RAMADA, CABANA _/ I . I I • I
REMODEL/ALTER PER CIRCUIT FENCE OVER 6' ./ I I I . I
TEMP POLE 200 AMPS TOTAL MOBILE~E MICO-FI LM ! . I I • I
OVER 200 AMPS ./ I . I I : I
TEMP OCCUPANCY (30 DAYS) -/ I . I I I
C L.-. J ~rrv I/ I . I I I
TOTAL ELECTRICAL 7~ TOTAL FEES PAYABLE I l~i-~~ CONTRACTOR . I I
I HAVE CAREFULLY EXAMINED THE COMPLETED .. APPLICATION AND PERMIT, AND DO 0AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER
HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I 5'-0 .. DEEP AND DEMOLITION OR CONSTRUCTION OF
FURTHER CERTIFY ANO AGREE IF A PERMIT IS ISSUED; TO COMPLY WITH ALL CITY, STRUCTURES OVER 3 STORIES IN HEIGHT
COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER
SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM-
LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE
OF THE GRANTING OF THIS PERMIT. APPLICANT'S SIGN?RE • OWNERQ CONTRACTOR□ ~DB~Y ~/ ~DATE ~ .... -,,z.,_ 1 .. d ---7£: -AGENT BY" BY PHONED -V ?,/, _,,,, I //~
./ /./ / /
T
! < Cl ~ >
SITE \ . t. 4._ . 8t)-lV7 ADDRESS: ' .... r OWNER: 1:-PERMIT NO: . \ ... ., ~
'. 't FIELD INSPECTION RECORD
INSPECTION DATE INSPECTOR INSPECTOR'S NOTES
WOOD FLOOR
-· : FOUNDATION• FORMS• SET BACK• TOILET -· ----
UNDER FLOOR PLUMBING I .. -. J J ;. -·• : ,.,::• ~ J. -..,--. . 'le,
UNDER FLOOR HEATING • ! -. ~-i . ~ ' ( C ~ ,.. ! '! OK TO INSTALL SUB FLOOR -·-... -
., -. --
SLAB FLOOR
UNDER SLAB PLUMBING
FOOTING• FORMS• SETBACK • TOILET
OK TO POUR CONCRETE
FRAME .. ,
ROUGH ELECTRICAL
..... . ..... .
ROUGH PLUMBING h I
ROUGH HEATING/VENTILATING .
FRAME OK • PL ACE INSULATION . .
I NSULATION OK• PLACE WALLBOARD r
WALLBOARD OK • PLACE TAPE
EXTERIOR L ATH OK • PLACE STUCCO .. .. -
. J FIREPLACE -.... -. ' . . .
DAMPER &STEEL
PLATE Tl Es/HEIGHT OF CHIMNEY .
.
OTHER
TEMP POWER (POLE) -SEWER
GAS TEST
SWIM POOL • STEEL BONDING •.
• PRE DECK
• FENCE PREPL ASTER
SHOWN • FRAME .
• PAN .k J J
FINAL INSP BY BLDG DEPT rA/111/JIJ ' -
OTHER DEPT'S REQ COMPLETED ~ r
ELEC METER~PERM-TEMP .. -. ~ ~--GAS METER-PERM-TEMP
. -...
CERT OF OCCUPANCY ISSUED .... t ·
PLANNrNG DEPARTMENT
ZONE _______ -'-_LOT SIZE _______ ___:_•_LOT WIDTH ________ _
UNITS ALLOWED ___________ UNITS PROVIDED ____________ _
PARKING SPACES REQUIRED PROVIDED __________ _
% COVERAGE ALLOWED _____________ PROVIDED __________ _
BUILDING HEIGHT ALLOWED PROVIDED
FRONT SETBACK:
ALLOWED
PROVIDED -------
INTRUSIONS
SIDE SETBACK:
LANDSCAPE & IRRIGATION PLAN COMMENTS:
ENVIRONMENTAL PROTECTION
ENGINEERING DEPARTMENT~~ Jc)-o /:;;:J
REAR SETBACK:
.AMOtJNT:
£>' // .;i_ , 0 o o__,, -
R.O.W. ______ INDUSTRIAL WASTE _______ IMPROVEMENTS· _______ _
SEWER CONNECTION DRIVEWAY LOCATIONS ___________ _
GRADING PERMIT _______ EASEMENTs_---=V~m~--· _____ DRAINAGE ____ _
LEGAL DESCRIPTION ____________________________ _
ADDITIONAL COMMENTS __________________________ _
OK TO ISSUE: J.OC. DATE (-(~-1f'.O PWI ____ OK TO FINAL ____ DATE ___ _
FIRE DEPARTMENT
SPRINKLING SYSTEM ___________ FIRE PROTECTION EQUIP. _______ _
FIRE ALARMS EXITS _______________ _
FIRE HYDRANTS LOCATION _________________ _
ADDITIONAL COMMENTS
OK TO ISSUE: _____ DATE _______ OK TO FINAL ______ DATE ____ _
WAT ER DEPARTMENT
REQUIREMENTS OF APPROPRIATE DISTRICTS MET ________ DATE ________ _
1200 ELM AVENUE
CARLSBAD, CALIFORNIA 92008
Citp of ~arlsbab
TELEPHONE:
(7J.C) n9.11a1
This document will certify that I am aware of the provisions of the
California Administrative Code, Title 24, Section T20-1406(c),
nswirnming Pool Heating", as shown on form DPL :297. I understand
that neither a swimming pool building permit using a fossil-fueled
heater nor a plumbing/e lectrical permit for a new or replacement
fossil-fueled heater will be issued until this certification is
executed.
For the swimming pool located at 2 4 / < 5 A~D&
(site address) I c e rtify that all of the following require me nts for
. fossil-fueled (or electric) swimming pool heaters will be met:
1. Outdoor pools shall ?e equipped with~ pool cover.
2. ON-OFF switch on outside of heater to allow shutdown without
adjusting thermostat and start-up without relighting pilot light.
3. 36" minimum length of plumbing provided between filter and
heater to allow future solar installation.
4. After January 1, 1982, new heaters installed must have 75%
thermal efficiency.
5 .. Time clocks installed to allow pump operation during off-peak
demand periods (unless pump used for active solar).
6. Directional water inlets in pool for good mixing.
Print Owners ·Name:
OWners Signature:
Print Contractors Name:~~ I
Date: J~J -f O
' . '
Contractors Signature: Date: J.-3-81}
Address: