HomeMy WebLinkAbout2833 STATE ST; ; 87-964; Permit.,, z 0 .:: C a: C ..J
irl Q
C
I[
0 0
a: Ill Q ..J
3 ~ Ill z ~ 0
..,_.
z 0 ;:: : z "' A. 2 0 u .,,
~ "' "' a: 0 3
il
O I hereby affirm that I am licensed under
prOYlalona of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Profeaalona Code. and my license is in
full force and effect.
I hereby attirm !hat I am ellempl lrom the Conltac·
tor's L,censt Law tor lhe loltow,ng ,eason (Sec 7031 5 Business and Professions Code Any city or counly whl(.li re,
quires a perm11 to conslruct alter. improve demohsh. or reparr any structure. prlOf to ,ts issuance also requires !heap·
pllcant tor sucn perlTllt 10 Ille a S•llned staIemenI lhal he Is
hcensed pursuant 10 the provisions ol !he 1,;ontrattOJ · s
Llctnse Law (Chapter 9 commencing wIlh SecI10n 7000 of Divis.on J of tne Business and ProfesSJOns COde} or lhal 1s e~·
empl lherefrom and the basis lor lhe allegeo exempllCHl Any v,01a11on ol Sect,on 7031 S by an apphcanl tor a permit sub·
1ects 1he applttanl to a civil penally of not more than hve hun·
dre<I dollars (S500)
1 I. as .owner ol lhe property Of my employees w11h wages
as their sole compensation. will do lhe work. and !he strut· lure ,s no, intended or ollered fOf sate (Sec 7044, Bus,ness
and Prolessions COde The Contract0<'s License Law does nor apply 10 an owner ot propefly Wt¥> builds o, improves
!hereon and who does such work h,msell or through his own employees, prOV1ded that such 1mprovemen1s are not 1nrend-
ed or ottered lor sale 11 however the bu1ldmg or improve·
ment Is s°'d w1th1n one year ot complet10n, the owner-builder
w,n have the burden ot prO\ltnQ lhat he dtd not build or 1m· prove for !he purpose of sate)
I, as owner of lhe property, am e,:c\us,ve1y contraclmg w1lh lteensed contrac1ors to construct the pro,ect (Sec 70◄4.
Susmess and Prolessions Code The Conrractor's License Law does not apply to an ownet of property who buil(ls or im-
proves thereon, and who contracts tor each pn:)lecls wllh a
cootractor(s) hcense pursuanl to lhe Con1rac1or's License Law)
I I As a nomeowner I am tmprovmg my home and ltle follow
mg condmons exist ~ ih~a:'~1;~ be;~g :vrf= ri:cx1:et:e monlhs
prior 10 comp!e110n o1 lt11s work
1 have ~ clain'led 1h1s exempIion during lhe last three years
0 I am exempt under Sec ______ , B & P C tor lhts reason ____________ _
~ I hereby affirm thal I have a certificate ol consent to
self-insure, or a cerlihcate ol Workers" Compensation In•
suraoce. or a cer11lied COPY thereof !Sec 3800. labor Code)
POLICY NO
COMPANY
Copy 15 flied Wtlh !he c11y
D Cerlthed copy Is hereby furnished
CERTIFICATE OF EXEMPTION FROM WORKERS. COMPE.NSATION INSURANCE
(This section need not be completed ,t 1he perm11
Is tor one hundred dollars ($100) o, Ins}
C I certify lhat in the performance ot the WOl'k tor which
this perm,t is issued. I shaJI not employ any person in any
manner so as to become subject to the Workers· Compen·
satt<>n Laws of California
NOTICE TO APPLICANT: If. after making this Certificate
-of Exemption. you should become subJe<:t to the Workers'
Compensatten provisions of lh.e Labor Code. you musl
forthw1lh comply with such provisions or this permit shaJI
be deemed revoked
0 I hereby aHum that there is a construction lending
agency for the performance of the work tor which ttus Pef·
mIt 1s issued (Sec. 3097. Civil Code)
Lender"s Name
Lender"s 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., Carlsbad, CA 92009-1915 (619) 438-1161
JOB AOORESS AV. ST.RO. THOMAS BROS NO.
l°~~i~F~7;;IONI
BUSINESS LICENSE d VALUATION PERMIT NUMBER
"'2..S!, ~ ~·*o__ -\-~ <:>-t-\~~\.{ \ ~ l::, 7 0 i7-
LOT I BLOCI( I sueo,v1s,0N I ASSESS~ PARCEL NO 0 CONTRACTOR . CONTRACTORS PHONE 1 ZONE 7~✓ O'; -:l.','-l 0~ 0 M Ac..~ ~..-,ruK4.~ \ ~ (_ OWNER"S NAME I ~3::~;p:~NE
':)i...7 .~ \.t Ou
C. -\~ .ii s: C ,..'"'"\ ~ ~ ~ CONTRACTOR'S ADDRESS STATE LICENSE ND BUILDING SO. FOOTAGE
\ 0\ll .. Pr-oo."QC.~ ~--Jk~ ~-, o'--,S~ OWNER"S MAtL,NG ADDRESS
'"2..Cr b~ ~ ~~~·e.-.\-1.. A."<>-C~ ... \~ \Ac\ DESIGNER -, OE SIGNE R'S PHONE
,V/,A
~-,·
OESC<•TIOI\I OF WO'!\.
o \ ~ <..~""" < l\.\. o .lr-<:ic-C l"o M
.. .
'J'l\....i\JQ.r-OESJGNER'S ADDRESS STATE LICENSE NO. Ii~' -. ..
~ C2 ("'" Q __J ~ u tJ A~ -E, r-o I , ..., ~ ~t=l,h.1\ <.: (c,..
~ h1.-.. ·' ... • -:37 -· r. 1 F /P F LR ELEV. NO EDU .... ' OCC GP {~ ) , l STORIES C rv r,,.., ,o NO --., ,-' ,..,
rrry,(11 C f, ( . ' I CENSUS TRACT I PARl(ING SPACE I RESUNITS I GRAOING PERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRE SPA AREA CONST
y D ND vO NO vO NO Nor Valid Un~r M~chine C~rtilitd
QTY. PLUMBING PE~IT · ISSUE 7§:;-QTY. MECHANICAL PERMIT -ISSUE IS9.!2-SUMMAR~ACCdUNrNUMBER J -
EACH FIXTUR~~J Y INSTALL FURN DUCTS UP TO 100.000 BTU t!UILUINu ~tHMI I uul -~1 U·UU·UU-oav .Jl.7} t/ 0 I ~
EACH~IL~~ ... ER OVER 100.000 BTU SIGN PERMIT 001-810·00·00·8221 //
.-iit\H,~{'°R HEATE R(l\i¥V OR VENl BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 001 ·810·00-00-8891 V
~'cH GAS SYS.TE/til f\W4 OUTLET.li. 801LER/COMPRESSOR 3 15 HP TOTAL PLUMBING 001 ·810·00-00-8222
EACH,.<..,f-\'\Y~EM ~ OR_Md~~-.. -1<.,. METAL FIREPLACE ELECTRICAL 001 ·810-00·00-8223
EACH 1WSTAL . Au.£1h..~l~~~,,IPE VENT FAN SINGLE DUCT MECHANICAL 001·810-00-00·8224
EACH VA.ClC)I BR~~., MECH EXHAUST HOOD 'OUCTS MOBILEHOME 001-810-00-00·8225
w~ c_-..).'\, 1'. RELOCATION Of EA FU RNACE1HE A TE R SOLAR 001 ·810·00-00-8226
E8.Cl'CUQ1 lJRAIN !INSIDE I DRYER VENT STRONG MOTION 880-519·92·33
V'" TOT J;L MECHANICAL FIRE SPRINi<LERS 001-810·00·00·8227
TOIAL PL UMBING I PUBLIC FACILITIES FEE 320·810-00-00-8740 -
50°-BRIDGE FEE 360-810-00-00-87 40
QTY. ELECTRICAL PERMIT -ISSUE QTY. MOBILE HOME SETUP PARK-IN-LIEU (AREA )
NEW CONST EA AMP SWl HK R CAR PORT TIF 312·810-00-00-8835
I PH 3 PH AWNING LA COSTA TIF 311-810-00·00·8835
EXISf SLOG EA AMP•SWl BKR GARAGE FMF
1 PH 3 PH LICENSE TAX 001 ·810-00-00·8162
REMODEL ALltR PER CIRCUll MFF 880-519-92-57
TEMP POLE 700 AMPS
OVER 200 AMPS
TEMP OCCUPANCY (30 DAYSI
CREDIT DEPOSIT ./
TnfAL ELECTRICAL I TOTAL TOTAL FEES PAYABLE I ~/fl..J-
I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION AND PERMIT AND DO HEREBY Exptrat,on Ew-ry permit issued by the Bu1ld1ng Ott1c11t under lhe provisions of this * 4N OSH4 PEAM:T IS AEOUIAE* EXCAVATIONS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code snall expire by hm,tation and become nult and void If the bu1ld1ng o, •ork ~· O" DEEP ANO DEMOUT10N CONSTRUCTION OF
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT I~ authorized by such perm,t 11 not commenced w11han t80 days hom the date of such STAUCT\llltS OVER 3 STORIES IN HEIGHT
ISSUED TO COMPLY WITH ALL CITY. COUNlY AND STATE LAWS GOVERNING BUILDING CON-=~,:, '!, '~~y ~,;:·~:;r:<:6r:~!hc~~:'~le:~6~ r~~·~r'r:rdn.~ or
STRUCTION WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND A~?d/~ OWNERn CONTRACTOFR'S-._API ~~ DATE/ i<EEP 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 BY PHONE n
1 'Ylflf7 GRANTING OF THIS PERMIT. I
~ u::
>, ;;;
0 a. E Q) r
-0 0 CJ
C
0)
-~ a. a.
<(
I
.:,:;
C a:
0 "' "' Q)
"' "' <(
I
;;:
2
ai >-
Q)
(.)
C
0)
C
lL
::.
C
Q) ~ CJ
0 u Q) a. "' C
~
.c ~
TYPE T
I
BUILDING I
OUNDATION I
,EINFORCED STEEL .
I
IASONRY I
iUN1TE OR GROUT I
F
R
M
G
s
s
F
UB FRAME D FLOOR D CElt;.ING
HEATHING □ ROOF □ SljEAR
RAME I
I :XTERIOR LATH I
INSULATION I
INTERIOR LATH & DRYWALL I :
PLUMBING !
D SEWER AND BUCO CJ PL/CO
UNDERGROUND □ WASTE □jWATER
TOP OUT D WASTE □ WATER
TUB AND SHOWER PAN !
G'AS TEST ' I
□ WATER HEATER □ SOLAR WATER
I
ELECTRICAL !
_l
□ ELECTRIC UNDERGROUND □ UFFER.
ROUGH ELECTRIC !
□ ELECTRIC SERVICE □ TEMP_Q_RARY
□ BONDING □ POOL l
I
MECHANICAL I
I
□ DUCT & PLEM., □ REF. PIPING
HEAT -AIR COND. SYSTEMS I
VENTILATING SYSTEMS I
.l
I
DATE INSPECTOR
-..--rr,. ,
=~--/-:~~
""·~ ) ... ; I .. ~ .. ·-. . ~ .....
..
:r.:.,
-~ -; . .., ""' -' \ ~
0 '
CALL FOR FINAL INSPECTilON WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE BEEN APPROVED.
FINAL I I
PLUMBING I ' ii
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS
REQ IF INSPECTORS INSPECTION CHECKED APPROVAL
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRESTRESSED
CONCRETE
POST TENSIONED
CONCRETE
FIELD WELDING
HIGH STRENGTH
BOLTS
SPECIAL MASONRY
PILES CAISSONS
,,
.
. -
-
--~ -
-
_L'J_ ~v
ELECTRICAL I ll).~.3Q _U,tlY ,I -
MECHANICAL I ---/
GAS I / /.,
BUILDING ' ( I .•
SPECIAL CONDITIONS I
I
&'7--4(/-f
INSPECTOR'S NOTES
DATE
-l ..
j
.
-..
-i
~
.
~ '
'<c
. -
-l
-
-C -·
'· '•
~ ' ' . .. -
.. -