HomeMy WebLinkAbout2598 STATE ST; ; 84-149; PermitCl) z 0 ~ cc ,c ... 0 w a
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-~ O I hereby affirm that I am licensed under
provlatone of Ctlapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Profeaalons Code, and my license is In
full f0<ce and effect.
lie No ______ Clm
I hereby afhrm 1ha1 I am exempt lrom the Contrac-tor's License law lor the following 1eason (Sec 7031 5
Business and Professions Code Any cuy Of county which re-
quires a perff'Nt to conslruct. ilter ,mprove, de~ish. Of
repair ~Y structure. prt0< 10 its issuance also reqmres !heap-ptteanl tor such penTttl to tile a S!gned statement lhat tie ,s
licensed pursuant to the provisions of the Coniracto( s LiCense law ( Chapter 9 commern:1ng with Sec Mn 7000 ot
Oiv~IOn 3 ot lhe Busmess and Profeswns Code} or lhat IS ex· empt therefrom and the baSis for the allege<! e,emphon Any ~!'~: :~~~t"1:~3c~j ~n~7;~~~~! itfn',: ~~~: oreo dollars ($500).
O I, as owner of the property, or my employees w,th wages
as their soJe compensation. wlll do the work. and 1he strut·
ture is not intended or offered to< sale (Sec. 7044. Business
and ProtessiOns Code: The Contractor's license Law does
not apply to an owner ol properly who builds or improves thereon and who does such wDl'k h1msel1 or through hts own employees. provided that such improvements are nol mlend-ed OJ offered tor sale. If, however. the bu1ld1ng or improve·
ment is sold within one year ol completion. the OY1ner-bu1lder will haVe the burden o1 proving that he did not build Of im-
prove tor the pu1pose of sale).
D 1,. as owner of the property, am exclusiyely contracting
with hcensed contractors 10 construct the protect (Sec, 7CM4. Business and Profess,ons Code: The ContractOf's Ucense
Law does not apply to an owner of property who builds°' im-proves thereon. and who contracts tor e.ach prqects with a
~ector(s) ltcense pursuant lo the Contractor's Uc:ense
D As a homeewner I am improving my home, and the follow·
mg conditions ex,st 1. The work is being pertormed prior lo sale. 2. I have lived in my home for twelve months 3. rr:v: :r~~~::c,o111:1~ :!ption during the last three years.
□ lamexemplunderSec. ______ ,S&P.C. fo, this reason ____________ _
0 I hereby afhrm lhat I ha"e a cert1hca1e of consenl
to self insure. or a cen1t1ca1e of Workers'
Compensation Insurance. or a cenit1ed copy thereof
!Sec 3800. Labo• COOe)
POLICYNO r
COMPANY
□ Copy IS hied Wllh lhe City
0 Cer1thed copy 15 hereby furn1s
CERTtFtCATL OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This sectton need not be completed ,t the permit
,s tor one hundred dollars IS 100) Of tess)
0 I cen,ty that 1n the performance or 1he work tor
which this permit 1s issued. I shall not employ any
person In any manner so as to become sut>1ec1 to
the Workers· Compensa11on Laws ol Cahlorn,a
NOTtCE TO APPLICANT II. afler makmJ lh1s Cert,
llcate of Exemption you should t>ecome sut>Je-ct M
the WC>Olers· Compensation provisions of the Lat>or
Cooe. you must l0f'1hw11h comply with such prov1s,9ns Of ttus permit shall t>e deemed ,e.,.oked
D I .nereby aUirm thal there ,s a con!Huct,on
lending agency to, lhe perto.-n1ance ol the work tor
which this perm,1 ,s issued (Sec 3097 Crv•I C00e)
Lenders Name ___________ _
Lenoe,·s AdOress __________ _
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USE BALL POINT PEN ONLY & PRESS HARD --• APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. ~-•' CARLSBAD BUILDING DEPARTMENT I APPLIC_A!,ION & PERMIT
1200 Elm. Carlsbad. California 92008-1989 (619) 438-5525
,OB A0ORESS AV ST.RO. NEAREST CROSS ST
1oA3 o~;P;L1:;,~1
rtNESS LICENSE • VALUATION PERMIT NUMBER
;259? ~rArc: s,-~;;.,o:i-· ''1/71 LOT I BLQCI( I SUBDIVISION I ASSESSOR PARCEL NO CONTRACTOR CONTRACTORS PHONE • ZONE -
OWNER'S NAME I OWNER'S PHONE At!? Se;;2..v, L~ 7~q 117p
1?1cJIAJ2.D BIPAN&'TD,J CONTRACTOR'S ADDRESS LICENSE NO. PLAN 1.0. # BLOG USE CODE
:lS--79 .SrllrE Sr .::2..?403-I OWNER'S MA LING ADDRESS
701,J. OWE.NS MDUTJ-1 AtE ".-' -A k. 'l1.5o¢ DESIGNER LICENSE tt STANDARD PLAN# BUILDING SO. FOOTAGE
0ESCR1PT•ON OF WORIC • 1..1NE 1Al<:-rA1, .AT"ION o,: ~ DESIGNER'S ADDRESS DESIGNER'S PHONE
--.__ ~· --~--------------------------F/P FLA ELEV. NO OCCGP EDU
STORIES
vO NO --3/l9/fj,.71bC.. I o • ._l
CENSUS TRACT I GP LANO USE I PARKING SPACE I RES UNITS I GRADING PERMIT ISSUED I RE DEVELOPMENT TYPE OCC LOAD Fl RE SPA ' 0 •' lt • AREA CONST ;
YO N □ vO NO vO NO Not Valid Un~s Machine Certified
QTY. PLUMBING PERMIT· ISSUE 1-!!-QTY. MECHANICAL PERMIT -ISSUE 3-SUMMARVACCOUNTNUMBER
EACH FIXTURE TRAP INSTALL FURN. DUCTS i.JP TO 100.000 BTU BUILDING PERMIT 01 ·00·00-8220
EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT 01-00-00·8221
EACH WATER HEATER ANO/OR VENT ,,..,n 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 .4'~
I
EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE ELECTRICAL 01·00·00·8223
EACH INSTA~ .. ALTER. REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01-00·00·8224
EACH VACUUM BREAKER MECH EXHAUST -H000/OUCTS M0BILEHOME 01 ·00·00·8225
WATER S0FTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP
EACH ROOF DRAIN !INSIDE) SOLAR n1 .nn.nn.aooo
,r,'O TOTAL MECHANICAL STRONG MOTION 80·92·33·0519
TOT AL PLUMBING I /C) ,-/ FIRE SPRINKLERS 01·00·00·8227
~-fl QTY. SO~E
PUBLIC FACILITIES FEE 32-00·00·8933
QTY. ELECTRICAL PERMIT • ISSUE BRIDGE FEE
NEW CONST EA AMP'SWT BKR I I COLLEC-SCHOOL FEE • DISTRICT
1 PH 3 PH II /. l~AGE TANKS ---.. Carlsbad 80·92·21-0519
EXIST BLOG EA AMP/SWT/BKR J' I/ ROCK STORAGE 1 ' Encinitas 80·92-22·0519
t PH 3 PH 71 I' .v i... lfiUMP 'P \ I San Dieguito 80·92·23·0519
REM0OEL'ALTER PER CIRCUIT/7 )~/-( // .Jl(ANCI ~K FEE r y 'i ., San Marcos 80·92·24-0519
TEMP POLE 200 AMPS I /\../ V ' ·1 ./ I ,v ,I J
OVER 200 AMPS ,Y./ ~1•) VJ \\ 'V ,'l / LICENSE TAX 01-00-00-8162
TEMP OCCUPANCY 130 0AYS) z-r Jr' f / ,v I tr, ,r I n r /).., / -A?.e:=
./"\I IY V ., /UV ,v ,;7 CREDIT DEPOSIT I
TO~CAL
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TOTAL SO~ I ~ ~ TOTAL FEES PAYABLE /0
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION ANO PERMIT" AN~i 0( HEREBY Ex1>1ration Every permtt ,ssued by the ButlcMo Qffw:,at under the prov1s,on1 0ltl11s * AN OSHA PEI .. IT IS REQUIAEO FOfl EXCAVATIONS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON tNCLUI NG THE Code sllalt exp,re by 1tm11at1on and become nutt and VOid 11 the bu1tdmg or worll s· O" DEEP 4NO 0£MOLITION OR CONSTRUCTION OF authorrzed by such permit 11 not commenced w1th1n 180 days from the date"' sue.,, DECLARATIONS ARE TRUE AND CORRECT ANO I FURTHER CERTIFY ANO AGREE IF A I l!RMIT IS permrt, Of 1f the bulld1::ff.,Of wortl au1ho11zed by such permit •s su•~~o STRUCl\JRES OYER 3 STORIES IN HEIGHT
ISSUED TO COMPLY WITH ALL CITY COUNlY ANO STATE LAWS GOVERNING BUILDING CON --al anv time a the work ,s commenced for a nenod of I 80 "•-•
STRUCTION, WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY ANO . :~ APPROVED BY DATE
KEEP HARMLESS THE CITY OF.CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO A2NT S SIGNATURE • ~ OWNER O CONTRACT
I ,9/lf EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE # 12_ m l ~ BY PHO E 0 ~ p GRANTING OF THIS PERMIT " :: ·• _ ,
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TYPE I DATE INSPECTOR
BUILDING I
. .>UNDATION I
I
REINFORCED STEEL I
MASONRY i
GUNITE OR GROUT I
FLOOR & CEILING SUB FRAME I
SHEATHING D ROOF D SHE~R
FRAME I
I
EXTERIOR LATH I
INSULATION I
INTERIOR LATH & DRYWALL I .
I
PLUMBING :
SEWER AND BUCO D IPUCO I
UNDERGROUND 0 WASTE □~TEA
TOP OUT D WASTE D Wl>,TER
TUB AND SHOWER PAN I
GAS TEST I
D WATER HEATER □ SOLAR WA,:ER
I
ELECTRICAL I -
□ ELECTRIC UNDERGROUND □ L(FFER
ROUGH ELECTRIC I
D ELECTRIC SERVICE □ TEMPORARY
D BONDING D POOL I
I
I
MECHANICAL I
D DUCT & PLEM., □ REF. PIPIN~
HEAT -AIR COND. SYSTEMS I
VENTILATING SYSTEMS I
I
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CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVEIBEEN APPROVED.
FINAL
PLUMBING
ELECTRICAL
MECHANICAL
GAS
BUILDING
SPECIAL CONDITIONS
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flf--14<;
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR"S NOTES
INSPECTION REO IF INSPECTORS DATE CHECKED APPROVAL
SOILS COMPLIANCE . ' ~--PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRES TRESSED ' CONCRETE
POST TENSIONED
CONCRETE
FIELD WELDING
HIGH STRENGTH
BOLTS
SPECIAL MASONRY
PILES CAISSONS
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