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Home My WebLink About2787 STATE ST; ; 86-1007; Permiten z 0 .: < a: ~ iil C II: I[ u II: Ill 0 .J 5 I Ill z ~ z 0 ~ z Ill 0.. :If 0 u en ic Ill :,,:: a: 0 3 if O I hereby affirm that I am licensed under provlalona ol Chapter 9 (commencing with S.C:tlon 7000) of Division 3 of the Business and Profeealona Code, and my license Is In full force and effect. I hereby alllrm that I am e,empt from the Contrac- tor"s License Law lor tho lollowmg reason (Sec. 7031 .5 Busintss and Professtons Code: Any cl1y °' COtJnty whicli re-quires a permit to construct. alter. improve, demohsh, Of repair arry structure, ptlO< to its issuance also requires !heap-plicant tor such permit to tite a signed statement Iha! he is licensed pursuant to the p1ovisions of the t:onuacto( s l.Jc&nse Uw (Chapter 9 commencing with Sect10n 7000 of Divist0n 3 of the Business and Professions Code) or that 1s ex· empt therelrom and the bas>s tor the allegeo e,empt10n Any viOlalion ot Se<:11011 7031.5 by an applicant lo, a perm,, sub· jtcls lhe appltcant to-a cMI penalty of not more than five hun· dred dollars ($500). f I I. as owner ol lhe property. or my employees with wages as their sole compensation, will do lhe work, and the struc- ture 1s not intended or o1fered IOI' sale (Sec. 7044, Business and Professions COde: The Contractor's UCense Law does not appty to an owner ol property who builds or improves thereon and who does such work himset1 or rhroogh his own employees. provlded lhal sucn improvements are not intend• ed or ottered lor sale. U, however, the building °' improve-ment Is sold within one year of comp4etion, the owner-builder will have the burden ol proving that ho did not build or im-prove tor the purpose ol sale) 0 I, as owner of the propeny, am exclus1Yety contracting Wllh licensed conlractors to construct the prOject (Sec 7044. Business and Profess10ns Code The Contractor's Ucense Law does not apply to an owner of property who builds or im- proves thereon. and who contracts 10f' each projects with a contractCN'(S) l~nse pursuant to the ContractOf's License Law). □ As a l!omoowner I am improving my home. and the tol!ow-ing condttions exisl 1. The work 1s being performed prio, to sale. 2. I have lived in rrr., home lor twetve months prior to completion ot this work. 3. 1 have not claimed this exemplt0n during the last three years. 0 lamexemplunderSec. ______ .B&P.C for this reason D I hereby affirm that I have a certificate of consent to self-insure. or a certificate of Workers· Compensation In- surance. or a certified copy thereof l5ec. 380)_ Labor Code) POLICY NO. COMPANY D Copy is liled with the city 0 Cerlltied copy is hereby furnished CERTIFICATE OF EXEMPTION FROM WORKERS" COMPENSATION INSURANCE (This section need not be completed it the permil is for one hundred dollars ($100) or less) 0 I certify that in the peJlormance of the work lo, whieh this permit is issued, I shall not employ any person in any manner so as to t>ecome subject to the Workers· Compen- saUon Laws ot California. NOTICE TO APPLICANT: II, after making this C.rtificale of Exemption. you should become subject to tt'le WOfkers· Compensation p,ovisions ot the Labor Code, you must forthwith compty with such provisions or this permit shall be deemed ,evoked. 0 I hereby affirm that there is a construction lending agency for the performance of the wot'k for w'hich this per- mit is issued (Sec. 3097, Civil Code) Lender's Name ____________ _ Lender's Address, ___________ _ USE BALL POINT PEN ONLY & PRESS HARD APP-1.ICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. ). 7(s,', CARLSBAD BUILDING DEPARTMENT Carlsbad, California 92008-4859 -.i-'. APPLICATION & PERMIT _Ll JOB ADDRESS AV.ST.RO. NEARESTCROSSST. DATE Ji APPLICATION VALUATION PERMIT NUMBER C. a,-I~ ba 13 ..-:-==:-:'::,.,,.~~;~--i:-:--:-::------1 g0 -~~~ ~ ;~? t--:,c=-:,-':-:-::----:-::---~-----_._-----------:-,---OW-N_E_R_'S_P_H_O_N_E--11 -6 !S' / B-a v e. r L v ,,,_, b ._ ...-.} '-/34_ J 1 JI coNTRAcToR·s ADDRESS Bu1Lo1NG so. FOOTAGE -~ ---Jg 2b Haam//s A11e~CP DWNER"S MAILING ADDRESS P.o. DESIGNER V" .Sll!",lll~f!-F/P FLR ELEV. vO NO I PARKING SPACE 1 RES UNITS I GRADING PERMIT ISSUED YO ND REDEVELOPMENT AREA vO NO QTY. PLUMBING PERMIT · ISSUE EACH FIXTURE TRAP L EACH BUILDING SEWER / EACH WATER HEATER ANO /OR vi>i?'° EACH GAS SYSTEM I TO 4 ~ETS EACH VAC~BREAKER WA TEB,6'!)FTNER ~ ROOF DRAIN (INSIDEI TOT Al PLUMBING ] QTY. ELECTRICAL PERMIT -ISSUE _j_ NEW CONST EA AMP'SWT BKR /t:r A .314 I PH 3 PH EXIST BLDG EA AMP/SWT/BKR 1 PH 3 PH REMOOEL 'ALTfR PER CIRCUIT HMPPOLE 200AMPS OVER 200 AMPS TEMP OCCUPANCY 130 DAYSI TOTAL ELECTRICAL 1 /~II QTY. MECHANICAL PERMIT -ISSUE INSTALL FURN. DUCTS UP TO 100.000 BTU / OVER 100.000 ~ BOILER/COMPRESSOR 3-15 METAL FIREPLACE / VENT FANSIN~OUCT MECH EX~ST -HOOOIOUCTS RE~TIDN OF EA FURNACE/HEATER ~YER VENT s--QTY. .._lj()_- ..55-:- TOT J;.L MECHANICAL CAR PORT AWNING GARAGE MOBILE HOME SETUP TOTAL - -,, NO STORIES TYPE CONST ~ DESIGNER'S PHONE STATE LICENSE NO. OCC GP EDU ii ii ii7 ii ii.i ii9i.i 9i56rF<ifi CCC LOAD FIRE SPA vO NO Nor Valid Unlt!si AUchine Cerrifi«I SUMMARY/ACCOUNT NUMBER BUILDING PERMIT SIGN PERMIT PLAN CH.ECK TOTAL PLUMBING ELECTRICAL MECHANICAL MOBILEHDME SOLAR.-·•• •··- 001-810-00-00-8220 001-810-00-00-8221 001-810-00-00-8806 001 ·810-00-00-8222 001-810-00-00-8223 001-810·00-00-8224 001-810-00-0(!-8225 l.lGHR-00-00-8226 880-519-92-33 1-810-00·00·8227 PUBLIC FACILITIES FEE-320-810-00-00-8740 .Oiji~= 7. J~\l) PARK-IN-LIEU (AREA ) a,L}l¥ar:I31-810-00·00·8835 a 001-810-00-00-8162 MFF 880-519-92·5 7 CREDIT DEPOSIT TOTAL FEES PAYABLE l ss- 56- 55 .. I HAVE CAREFULLY EXAMINED THE COMPLETED ··APPLICATION ANO PERMIT"" ANO 00 HEREBY CERTIFY UNDER PENALTY OF PERJURY THAT All INFORMATION HEREON INCLUDING THE DECLARATIONS ARE TRUE ANO CORRECT AND I FURTHER CERTIFY ANO AGREE IF A PERMIT I~ ISSUED TO COMPLY WITH All CITY_ COUNlY ANO STATE LAWS GOVERNING BUILDING CON STRUCTION. WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS. COSTS ANO EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT EJ1P1re110f1. Ew,y permtt iNueclbytlle8u11dingOfllctalunder tne prov,s,ons of th,s Code allall exp,re by l1m1tat,on end become null and vt>td If the butld1ng or work authorized by 1uch permit 11 nol commenced within 180 days from the date or such :::c..:i ·~. ':y i:-:~:i~-=~:~'70:~ed-:c: ~r;:::., '!/=~ Of * AN 08tv. P£lllMfT 1$ l'IEQl#IED FOR EXCAVATIONS 0¥8' 5· O" DEEP ANO DblOUTl0N OR CONSTAUCTION OF STAUCl\lfllS OVER 3~ IN HEIGHT Z1cA ·s s10NATURE • . • /1/) /j , OWNER□ CONTRACTO~ ~,t) ~~, BY PHONE 0 APPR~~----;9-/~ a:, u: >-;;; 0 a. E a:, I- • I l1o 0 CD C: Ol .5:! a. a. <( I :,,:_ C: a: 0 rn rn Cl) rn rn <( I ~ 0 ai >- a:, 0 C: Ol C: u: :::::. C: Cl) ~ CD 0 ti a:, a. rn C: 21 .c. ~ "\ TYPE DATE INSPECTOR J I ' . ....... 'il<, ·-J!X) -/ I . -• -J BUILDING I FOUNDATION I FIELD INSPECTIO N RECORD -REINFORCED STEEL I REQUIRED SPEC IAL INSPEC TIONS INSPECTOR'S NOTES MASONRY I I REQ IF INSPECTOR'S GUNITE OR GROUT I INSPECTION CHECKED APPROVAL DATE SUB FRAME □ FLOOR □ CEIPNG .. SOILS COMPLIANCE SHEATHING D ROOF D SHEAR PRIOR TO FOUNDATION INSP FRAME I ' I STRUCTURAL CONCRETE EXTERIOR LATH I -OVER 2000 PSI INSULATION I PRES TRESSED I CONCRETE f!\ INTERIOR LATH & DRYWALL I POST TENSIONED r ,r•·t~.-. I .,. .. , ·r ,.-~ l I CONCRETE ' ~ ·~ "'!. ( ... . ... ... -.. J __ ., ...... " l PLUMBING I FIELD WELDING .. ' □ SEWER AND BUCO □ PJ_/CO HIGH STRENGTH ·•:--:t , BOLTS ' UNDERGROUND □ WASTE □'WATER I I TOP OUT □ WASTE □ WATER SPECIAL MASONRY (I l~t, _;., ,. #l .> ,r >, ~·-,.._ --....,, ~-."', . ?\':~~, ,•:!\tc.?. ·~~ ·_.! .. ... - TUB AND SHOWER PAN ' ~ IJt--,~,._,.;-j!f:r;" I GAS TEST I ~ PILES CAISSONS ' . □ WATER HEATER □ SOLAR WIATER . ., ' ' . ... ~ I . ELECTRICAL I I □ ELECTRIC UNDERGROUND D UFFER r ; ROUGH ELECTRIC ' l - □ ELECTRIC SERVICE □ TEM P<!>RARY -I ' -" □ BONDING □ POOL I ~ ~ ':'.t --.,; r -I ,, ' MECHANICAL I .. □ DUCT & PLEM., □ REF. PIP,NG r .,.._ :"\ ... ,.,. ,.. .... _._. -- I , .., ___ .;.;~ ·-·•-":.=-=--·=--:::-.. '-1 J HEAT -AIR COND. SYSTEMS I -I .-l ~ •• --. VENTILATING SYSTEMS I / ' •r . -I A ~ CALL FOR FINAL /NSPECl1/0N WHEN ALL APPROPI VATE " ITEMS ABOVE HA '(E BEEN APPROVED. f"\ J ~ ,(,: I /} . '.-~ ~i • ,· J, . • . FINAL V ' // fj '( ·~ (. '' I . . I ~ "i/Y "" ~- PLUMBING ' I ff, ' I --. ' ~ . I <"J\ 'f I '/I l,j ~ . ' -" ' ELECTRICAL --' ' .. MECHANICAL I q _J .! ,r .,. I . ;',.· 'ii,' . -'. '2 -. ~ GAS I -,../ I .., ,-;.... " I BUILDING I \I I ~ SPECIAL CONDITIONS .,. I I I . ,, I V J ) _I ,