HomeMy WebLinkAbout2831 STATE ST; ; 87-963; PermitIll z 0 ;:
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0 I lleteby affirm that I am licensed under
provl1lon1 of Chapter 9 (commencing wllh
Section 7000) of Division 3 of the Business
and Profftslons Code, and my license is in
full force and effect.
I neret>y affirm 11\at I am exempt ltom the Contrac·
lor s License Law tor lhe lollowIng reason (Sec 7031 ~ Business and Prolessions Code Any c,ly or county wtuc.t. re-quires· a perm11 to coostrucl . .tltef, unprove, demolish, or
repa,r any structure. prior to its issuance also requires !heap-
pl,cant !Of sucn perm11 to hie a signed statement that he ,s
hc.ensed pur~ant lo the prov1soos ot the C.:onrractor"s
l,cense Law (Chapter 9 cornrMncmg w1lh Section 7000 o1 Dtv1st0n-3 ol lhe Bos,oess and Protesst00s Code) or lNt ,sex·
empt lherelrom and the basis tor the al1egeo exemp11on Any v!Olahon Of SectM>n 7031.5 by an applicant tor a perm11 .sub-
te(IS 1ne applicant 10 a c1v1I penally 01 not more l~n hve him·
dred dollars iS500)
I, as owner of the property. or my employees with wages
as 1heIr sole compensa110n, will do lhe work. an(I the struc-
ture is not intended Of o11ered tor sale (Sec 7044, Business
arlCS Ptotess1on!io Code The Con1rac1or' s license law does not apply to an owner of property who builds or improves
l!\ereon and who does such wOfk hunsell or through his O'Nn
employees. provtded 1na1 such 1mprovemen1s are no1 intend•
ed Of ottered IOf sale It. however, lhe butldmg or ,mp rove·
men! 1s sold w1th1n one year°' completion. the owner~bu,lder will have the burden of proving thal he did no1 build or 1m·
ptove tor lhe purpose ol sa~)
1 I, as owner of lhe property, am e)llclus1vety con1rac11ng
wllh hcensed contractors lo construe! lhe protect (Sec 7044,
Business and Prolessions Code The Contractor's license
law does not apply lo an owner ol property who builds or im-proves !hereon. and who con1rac1s tOf' each pr01ec1s with a
coniractorfs) license pursuan1 to lhe ContractOf's License Law)
' 1 As a homeowner I am improving my home. and lhe l~low mg condIl100s eIus1 1 The work Is being performed poor to sale 2 I have lived in my home for twetve mooths
prlOf to complellon of th,s work
I have not clauned lhts exemptlOll during !he last three years
O I am exempl under Sec ______ . B &P C
!or this reason -------------
Q I hereby affirm that I ha\le a cer11tccate 01 consent to
sell-insure. o, a cert1ficaIe ol Workers· Compensation In-
surance. or a cerllhed copy thereof (Sec. 3800, Labor Code}..
POLICY NO
COMPANY
_ Copy IS hied With the cI1y
C Cert1f1ed copy ,s hereby furnished
CERTIFICATE OF EXEMPTION FROM
WORKERS COMPENSATION INSURANCE
(This section need not De completed II the permit
1s IOf one hundred dollars ($100) or less)
C I cen1ty that in the performance ol the work lor wh1cn
1n1s permI1 1s issued. I shall not employ any person 1r, any
manner so as lo become sub1ec1 to the Workers· Compen-
sation Laws of Cahforma.
NOTICE TO APPLICANT;"· after makmg lhtS certiltcate
of E;cempIion. you should become subJecl 10 lhe Workers·
Compensatton provisions ot lhe Labo< Code. you musl
lor1hw1th comply w11h such proY1slons or this permit shall
t>e deemed revoked
0 I hereby aftum that !here is a constructIon lending
agency tor the performance of lhe work for which this pe<·
mIt 1s issued (Sec 3097. Civil Code)
Lender s Name
Lenders Address
USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. ---.. -
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT 2075 Las Palmas Dr., C arlsbad, CA 92009-1915 (619) 438-1161
JOB ADDRESS AV. ST. RO. THOMAS BROS NO. I D~T~/~ ;;;~NI
BUSINESS LICENSE It VALUATION PERMIT NUMBER
"2-$3 i S"T~'TG ~~ \~ F Li l (e <c7 0 /
K' C/6 ~ LOT I BLOCI( I SUBOIVISIQN I ASSESSOR PARCEL NO CONTRACTOR ~ CONTRACTORS PHONE • ZONE
OWNERS I\IAME I L{ 3i.t~E;P~:NE
(\,'\ A(.u s~('\JKoe'") \ ~r °')~'1-, ~';oO
(,4 ➔ ~t=.. C Ar\s\oA~ CONTRACTOR'S A DDRESS STATE LICENSE NO. BUILDING SO. FOOTAGE
to \,,, ~~~"'-A-<=::,A~e ~ \ cl.,<":>~ -~--: ,t, OWNER·s MA•CING ADDRESS
~ Ci (o s ~ a~eve.. \ \ 5 ~ ·-C Ac-\~\.,~~ DESIGNER ' DESIGNE R"S PHONE ,.._
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DES~PTION ~F WORo;+ \ ~ \ -~ jj:y
Q~\J e, Q.. e<:.:: ~ I e r.,,,, o· -e,('"' ""'.,. -M. DESIGNER'S ADDRESS STATE LICENSE NO. t-,r , i~8J ... + -
t"\,lQA~.a A +c UtJ~(2.('."<ct"o..:.V J.....~y -~i ' ! i
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F/P FLA ELEV. NO DCC GP EDU (SI ,,".!TY~1: .'.',U"P' r STORIES \~-,J'Y()F In, (-•o
"~ -9 ~<,-a.~"'.'i::'[i, t'ti' C •
vO NO ' . ,..n ..... I CENSUS TRACT I PARI( ING SPAC\ L>F{es UN IJS \ GRA E~~T SUED I REDEVELOPMENT TYPE DCC LOAD FIRESPR .~ '\ AREA CONST ,\"' t".~ ~ N 0 ,o NO vO NO Nor Valid Unlrsr Machine Cerrified
-~~t QTY. PLUMBING PERMIT · ISSUE 7~~0 MECHANICAL PERMIT -ISSUE IS~ SUMMARY/ACCOUNT NUMBER A
EACH FIXTURE TRAP V"' ,....~"t" INSTALL FURN DUCTS uP TO 100,000 BTU llUILUIN\l rtHMIT oo 1 ·81 o-oo:00-~au ,,..· 1,, J"\ I ,. II ,_
EACH BUILDING SEWER .... ,~~..., OVER 100,000 BTU SIGN PERMIT 001 ·810·00-00-8221
EACH WATER HEATER ANO OR VE NT V"' BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 001-810·00·00·8891
EACH GAS SYSTEM I TO 4 OUTLETS BOILER/COMPRESSOR 3 15 HP TOTAL PLUMBING 00 i ·810·00-00-8222
EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE ELECTRICAL 001·810·00·00·8223 -,-, " -
EACH INSTAL . ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 001·810-00-00-8224
.• EACH VACUUM BREAKER MECH EXHAUST HODO 'DUCTS MOBILEHOME 001-810·00·00·8225
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER SOLAR 001-810-00·00·8226
EACH ROOF DRAIN (INSIDE I DRYER VENT STRONG MOTION 880·519-92-33
TOTt:.L MECHANICAL FIRE SPRINi<LERS 001·810-00-00-8227
TO I AL Pl UMBINL I PUBLIC FACILITIES FEE 320-810·00·00·87 40
S3£-BRIDGE FEE 360-810·00-00-8740
QTY. ELECTRICAL PERMIT -ISSUE QTY. MO BILE HOME S ETU P PARK-IN-LIEU (AREA )
NEW CONST EA AMP SWI llKR CAR PORT TIF 312·810-00-00·8835
1 PH 3 PH AWNING LA COSTA TIF 311-810·00-00-8835
EXISI llLOG EA AMP•SWT BKR GARAGE FMF
I PH 3 PH LICENSE TAX 001·810·00-00-8162
REMODEL ALT I: R PER CIRCUIT MFF 880-519-92-57
TEMP POLE ZOO AMPS
OVER 200 AMPS
TEMP OCCUPANCY 130 DAYSI
I r .A."!r>\ A ,. • ... M ~ .1/v 0 CREDIT DEPOSIT r-'
TOTAL ELELTRILAL I -/71)(, TOTAL TOTAL FEES PAYABLE l ~
I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION ANO PERM1r AND 00 HEREBY Exp1r1t1on Every permit issued by the Bu1ld1ng Ott1c111 under the provIs1ons of 1h11 * AN OSHA P£Ml:T IS IIE0UIAED FOR EXCAVATIONS OVER
CERTiFY UNDER PENALTY OF PERJURY THAT All INFORMATION HEREON INCLUDING THE Code shall expire by ltm1tat1on and become null and ..-o,d If lhe building or work 5· O" DEEP ANO DElolOllTIOfl OR CONSTRUCTION OF
DECLARATIONS ARE TRUE AND CORRECT ANO I FURTHER CERTIFY AND AGREE IF A PERMIT I!>
authorized by suctt permit 11 not commenced w1th1n 180 days from 1he oate of such STFIJCT\JAlS OVER 3 STORIES IN HEIGHT permit or ,t the t>udd1:X or work authorized by such perm11 ,s suspended o,
ISSUED TO COMPLY WITH All CITY COUNlY ANO STATE LAWS GOVERNING BUILDING CON-abandoned at anv time er the work 1s commenced for a oeoOd of 180 dav•
STRUCTION WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND ~z· OWNER[] CON TR AC TO~ APPR~ ~ DATE
t<;EEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES JUDGMENTS COSTS ANO ._ .
I 1i/fr4? EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE
GRANTING OF THIS PERMIT ~~/{. ;-~ BY PHONE fJ
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TYPE I DATE INSPECTOR
BUILDING I
I
-?i7--C!iv 3 -
FOUNDATION I FIELD INSPECTION RECORD
REINFORCED STEEL I
MASONRY I ;
I
GUNITE OR GROUT I
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTION ' REQ IF INSPECTORS DATE CHECKED APPROVAL r
SUB FRAME □ FLOOR □ CEiii.iNG
SHEATHING □ ROOF □ SHEAR
FRAME I
SOILS COMPLIANCE .
PRIOR TO
FOUNDATION INSP
EXTERIOR LATH I
STRUCTURAL CONCRETE
OVER 2000 PSI
INSULATION I
I
INTERIOR LATH & DRYWALL !
PRES TRESSED -, CONCRETE
POST TENSIONED
I CONCRETE -
PLUMBING : FIELD WELDING
□ SEWER AND BU CO CJ PU CO
UNDERGROUND D WASTE □1 WATER
HIGH STRENGTH
I BOLTS
TOP OUT D WASTE D \NATER SPECIAL MASONRY .
TUB AND SHOWER PAN I • -
GAS TEST I PILES CAISSONS
D WATER HEATER D SOLAR W,A TEA
I -' ---,.
ELECTRICAL I
_, .
D ELECTRIC UNDERGROUND d UFFER i}-_
ROUGH ELECTRIC I -.r ,, ,
D ELECTRIC SERVICE D TEMP<DRARY ,. !: ,,(_ ... . -
D BONDING D POOL I I
. -,,,.
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MECHANICAL !
D DUCT & PLEM., D REF. PIPING
I
( ' .. /"•-, -it ,. ~
HEAT -AIR COND. SYSTEMS ! !-.r. f .~ -
VENTILATING SYSTEMS I
I /f', ..
CALL FOR FINAL INSPEC11JON WHEN ALL APPRCf'A ATE
ITEMS ABOVE HA 'fE BEEN APPROVED.
~
FINAL I ,
PLUMBING l _;/ J /
ELECTRICAL I lr\,~,l'() L ✓
MECHANICAL I IV ... .
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GAS I
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BUILDING I .
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SPECIAL CONDITIONS I
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