HomeMy WebLinkAbout2870 STATE ST; ; 84-101; Permit~[
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~eby affirm that I am licensed under
PfOVlalona of Chapter 9 (commencing with
S.Ctlon 7000) of Division 3 of the Business
and Profeealons Code, and my license is In
full fo~~ec,'-a A_/ L1c No~Clm ~ _
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I hereby afhrm that I am exempt lrom .the Contrac·
1of's Licenst Law lor 11,e lollowIng reason (Sec. 7031.5 Business and ProtessK>f1s Code: Any crty or county wh,Ch re-quires a permit to construct, alter. improve, demolish, or repair any structure, pnor lo 11s issuance also requires ?heap· plttant lor such permit lo file a signed statement that he 1s
hcensed pursuant to the PfOY1sions of !he Con1rac1or·s Licenst Law (Chapter 9 commencing with Sec11on 7000 ol
Or,,s,on 3 ol the Bos,ness and Pro1ess,ons Codo) or that 1s ex· empt therefrom and lhe basos lor lhe alleged exempt,on Any
violation o1 Sectoon 7031.5 by an appbcant tor a permit sub-
iec1s the applicant to a civil penalty ol not more lhan live hon-
dred dollars ($500).
□ I, as owner ol the p10perty, or my emptovees with wages
as their sole compensation, wm do the work, and the struc-
ture is not intended or offered tor sale (Sec. 7044, Business
and Professions Code: The Conlractor's l.Jcense Law does
no! apply to an owner of property who builds or improves
!hereon and who does such work htmseff or through his own
employees. provided that such 1mprovemen1s are 001 intend· ed or ottered for sale. If. hoWever. the building or 1t11prove·
ment is sotd within one year ol comp~tion. tt},e owner·btJilder
will have the burden of proving that he dkS not build or im·
prove for the purpose o1 sale).
□ I, as owner of the property, am exclusively contraclmg
with ltcensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not appty to an owner of property who builds or im-
proves thereon. and who contracts tor each projects with a
contractoc(s) license pursuant to the ConlractOf's License Law).
□ As a homeowner I am improving my home. and !he follow·
ing conditions exist: 1. The work is being pertormed prior to sale.
2. I have lived in my home for twelve months prior to compJetion of this work. 3. I have no1 claimed this exempt,on during the Last three years.
D I am exempt under Sec.------· 8 & P.C.
ID< this reason ______ =-,------
O I hereby affirm InaI I ha·-,e a cen,t.cate of consent
to self•insure. Of a cer11tic~te I Workers Compensation Insurance. or a cen I copy thereof
(Sec 3800. Labo< Code)
POLICY NO
COMPANY
Q COpy 1s hied with lhe Ctly
D Cer11fted copy •s hereby furnished
0 CERTIFICA Tl OF EXEMPTION FROM U WORKERS. COMPENSATION INSURANCE !" ~his hon need no1 be completed ,t lhe perm11 ffi or ooe hundred dollars (S 1(X)) Ol less)
~ 1 cer11ty that m the performance of lhe work 10, o which this permit 1s issued. I shall not employ any 3 ~son in any manner so as to beeome subIect to Wotke•s· Compensation Laws of California
TtCE TO APPLICANT If, after malunJ lhtS Cent
ate of Exemption. yoo should beeome subIect t?
the Worke,s· Compensation pr0\1IsIons ol tt,e Labor
Cooe. you must forth>A·,th comply with svcn
prov1s,ons or lh1S permit shall be deemed revokec,
![ O I hereby attirm lhal Ihere 1s a cons1ruc1,on
1end•nQ agency tor the perlormance or !he wo"'-10,
which m,s perm,1 ,s ,ssued (Sec 3CFJ7. C1v11 COOe)
Lenoe, s Name ___________ _
Lenc,e,·sAddress __________ _
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USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
. CARLSBAD BUILDING DEPARTMENT
1200 Elm, Carlsbad, California 92008·1989 (619) 438-5525 APPLICATION & PERMIT
JOB ADOflESS AV. ST.RD. NEAREST CROSS ST-
liT~:S#IONI
BUSINESS LICENSE # VALUATION PERMIT NUMBER
2.~'70 -=:::J I '11 r ~ r-; /''"J~d / .s/!))tJL} J r1 ./J 1
£l-\, /d/ LOT BLOCK I SUBDIVISION ASSESSOR PARCEL NO CONTRACTOR (1_ CONTRACTORS PHONE # ZONE
.2e~\'"1 13-oc..) IJ'ZS-,9~ OWNER"S NAME OWNER'S PHONE 'elP.uNO (::;f . .DIJJ~ Jt:T;
K-HIJ~/>iOHH<t /P3 C;;;;:T:zx~ /1~/~ LICENSE NO. PLAN 1.0. # BLOG USE CODE
~-79?/71.9 OWNER•s MAILING ADDRESS
na~ -ST, ~-<'A~M DESIGNER LICENSE• STANDARD PLAN# BUILDING SO. FOOTAGE
• r n "::"""'JfH/~ .M .I ·1 I -
DESCRIPTION OF WORK ,
Of.SJGN.ER'S ADqRESS DESIGNER'S PHONE --
R;°I.CX'/11 ~ r ~.<;JcallJ/G /(~ F/P F LR ELEV. NO OCC GP EDU STORIES
vO NO ---~1oa,~1,,, ,~_. 7.'J CENSUS TRACT I GP LANO USE I PARK ING SPACE RES UNITS I GRADING PERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRE SPR
AREA CONST u, I ... , r
y O N 0 v□ NO v□ NO Not Valid1.tnkss M'ach1n'e C~rtified
QTY. PLUMBING PERMIT -ISSUE 7.¢-QTY. MECHANICAL PERMIT· ISSUE 3-SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP
, INSTALL FURN. DUCTS UP TO 100,000 BTU ...A BUILDING PERMIT 01-00·00·8220
EACH BUILDING SEWER / --Qt.«5!A 188,fHJO BI tJ #-:,,.,,--SIGN PERMIT 01-00-00-8221
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 .A
EACH INSTAl .. ALTER. REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01 -00·00·8224 / g,,.::,.---
EACH VACUUM BREAKER MECH EXHAUST -HOOD/DUCTS MOBILEHOME 01-00-0Q-8225 £
WATER SOFTNEA RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP
EACH ROOF DRAIN (INSIDE) SOLAR 01-00-00-A??O
TOTJ;L MECHANICAL 7~ STRONG MOTION 80-92-33-0519
TOTAL PLUMBING I FIRE SPRINKLERS 01-00-00-8227
QTY. ELECTRICAL PERMIT -ISSUE 5-QTY. SOLAR -ISSUE PUBLIC FACILITIES FEE
BRIDGE FEE
32-00-00-8933
NEW CONST EA AMP/SWT BK R COLLECTORS SCHOOL FEE -DISTRICT
I PH 3 PH STORAGE TANKS ~,/ Carlsbad 80·92-21-0519
EXIST BLOG EA AMP/SWT/BKR ROCK STORAGE / .I Encinitas 80·92-22-0519
I PH 3 PH PUMP I I\A{y ,~ I San Oieguito 80-92-23-0519
REMODEL ALTER PER CIRCUIT PLAN CHECK FEE ( r" V '), I San Marcos 80·92-24-0519
\ -, / TEMP POLE 200 AMPS
OVER 200 AMPS " / LICENSE TAX 01-00-00-8162
TEMP OCCUPANCY (30 DAYS) -./hr~
CREDIT DEPOSIT
_ . ..JOTAL ELECTRICAL I TOTAL SOLAR TOTAL FEES PAYABLE I 7~
I HAVE CAREFULLY EXAMINED THE COMPLETED'·APPUCATION AND PERMIT .. ANO DO HEREBY Expitlllioft. £-.y pem,11-bytheBu~dlng Otttc,el under the provI11ons of 1h11 * AN OSHA PEMIIT 1$ REQUtAEO FOR EXCAVATIONS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code 9hall --by llffl-encl l>econM null end VOtd If the buold1ng o, wort< 5· 0 .. DEEP ANO l>EMOUTION OR ~TRUCTION OF eutllorind by such perm,t la not commence<! wtth1n 180 days from the dale of such DECLARATIONS ARE TRUE AND CORRECT ANO I FURTHER CERTIFY ANO AGREE If A PERMIT IS perm;( or if Ille bu~ work aulhonzed !)y such pe,m1t ,s su-ded or STAUCTUR!S OVER 3 STORIES IN HEIGHT
ISSUED TO COMPLY WITH All CITY. COUNlY AND STATE LAWS GOVERNING BUILDING CON• at -llffle ·tt a.-1, IS com~ for a oer,od of 180 "•v•
STRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY ANO ::-=~ u, OWNER□ CONTRACTOR~ APPROVED BY
~IY KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL UABlllTIES, JUDGMENTS, COSTS A~ EXPENSES WHICH MAY IN ANY WAY ACCflUE AGAINST SAID CITY IN CONSEQUENCE OF THE BY PHONE 0 ~ GRANTING OF THIS PERMIT.. ·
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TYPE DATE INSPECTOR
BUILDING
FOUNDATION
REINFORCED STEEL
MASONRY
GUNITE OR GROUT
FLOOR & CEILING SUB FRAME
SHEATHING □ ROOF □ SHEAR
FRAME
EXTERIOR LATH
INSULATION
INTERIOR LATH & DRYWALL
PLUMBING
SEWER AND BUCO D IPUCO 1
UNDERGROUND □ WASTE □ WATER
TOP OUT D WASTE D WATER
TUB AND SHOWER PAN
GAS TEST
□ WATER HEATER D SOLAR WATER
ELECTRICAL
D ELECTRIC UNDERGROUND □ iUFFER
-ROUGH ELECTRIC 1
0 ELECTRIC SERVICE D TEMPdRARY
D BONDING □ POOL
MECHANICAL
□ DUCT & PLEM., D REF. PIPING
HEAT -AIR COND. SYSTEMS
VENTILATING SYSTEMS
CALLFOR FINAL INSPECTION WHEN ALLAPPROPRIA TE
ITEMS ABOVE HA V.E BEEN APPROVED.
FINAL
PLUMBING
ELECTRICAL
MECHANICAL
GAS
BUILDING
SPECIAL CONDITIONS
,-~~. ' . --• # '
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS
INSPECTION REQ IF INSPECTOR'S DATE CHECKED APPROVAL
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRES TRESSED
CONCRETE
POST TENSIONED
CONCRETE
FIELD WELDING
HIGH STRENGTH ''' ' C •·
BOLTS ---
SPECIAL MASONRY
-
PILES CAISSONS
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INSPECTOR'S NOTES
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