The URL can be used to link to this page

Home My WebLink About2548 STATE ST; MULTI-PERMIT FILE; 85-238; Permit11[ 0 (.) UI z 0 ~ a: < .., (.) "' a a: "' a .., 5 • ii "' z 3 0 z 0 j:: < UI z "' G. :lE 0 (.) UI a: Ul >£ a: 0 3 ·1l 0 I hereby atllrm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. ltc No ____ _ Clm I hereby aflirm thal I am exempt from the Contrac- tor's license Law fOf the following reason (Sec 7031 5 Business and P,olesSJons Code Any c,ty or county wh,cn re-quires a perm11 to construcl, alter. improve, demohsh. or repair any structure, prior to tis issuance also requires ?heap-plicant for such perm11 lo hie a S1!lned statement that he 1s hcenseo pursuant 10 the prov1st00s of the Conrrac1o(s License Law {Chapter 9 commencing w11h Section 7000 ol Otwsion 3 of the Business and Professions Code) or thal 1s ex- empt lherelrom and the baslS tor lhe alleged exemphon, Any v1olat1on o1 Section 7031.5 by an applicant for a perm11 sub-Jects the applicant to a c1v11 penally ot not more than hve hun- dred dOl~rs ($500). 0 I. as owner ol lhe proPerty, or my employees with wages as lherr sole compensa1~n will do !he work'. and lhe struc· ture ,snot intended or oflered for sale {Sec 7044, Business and Proless~n!) Code The Contrac1or's License Law does not apply to an owner of property who builds or improves !hereon and who does such work himself or lhrough hiS own employees, provKled !hat such improvements are not intend· ed or offered tor sale 11, hOwever. the building Of improve- ment 1s sok1 w1th1n one year ol compfelt0f1. Ille owner-builder win have lhe burden ol proving !hat he did not buHd or im· prove tor the purpose ol sate) 0 I. as owner of the property, am exclusively contracting with lteensed contractors to construct !he protect (Sec. 7044, Business and ProtessNlns Code The Conlracto(s lteense Law does not apply 10 an owner ol property who bU1lds or Im· proves !hereon. and who contracts tor each proiec1s w,th a conlractor(s) license pursuant to the Conlractor's License Law) D As a homeowner I am improving my home, and the follow Ing cond1!1ons exist: 1 The work is being performed prior to sate 2 I have IJVed in my home lor twelve months pnor lo complehon of lhiS work 3 I have not claimed this exemphon during lhe last three years D I am exempt under Sec ______ , 8 & P C fof this reason ____________ _ D I hereby att,rm that I nave a cert1f1cate of consent to self-insure. or a cer11hca1e of Workers Compensa11on Insurance_ or a cer11hed copy thereol !Sec 3800. Labor Code) POLICY NO COMPANY □ Copy IS filed with the Cely 0 Certified copy Is hereby tum,shed CERTIFICATl OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be compIe1ed 11 the perm11 is. to, one hundred dollars (S 100) or less) 0 I certify that ,n the perlormance ol the woo. 101 which 1h1s permit ,s ,ssued. I shall no1 em.ploy any person ,n a.ny manner so as 10 become sub1ec1 to 1he Workers COmpensa11on U ws ol C-ahfom,a NOTICE TO APPLICANT It, alter makin3 this Cer11 hcate of Exemp11on you should become sut>1ect I'> the wooers Compensation prov,s,ons ol the Lat>or Cooe you must lorthy.11h compIy with sucn provisions. or 1h1s perm,1 shall be oeemed revokea 0 I hereby attum Iha! there •S a consiruc11on 1end1no agency for the pertormance of the wor1c. l01 wn,ch lh,s permI1 1s ,ssvect 1Sec .3097 C,v,I Cooe1 Lenders Name ___________ _ Lenders Ad(Jress __________ _ USE BALL POINT PEN ONLY & PRESS HAKU "rrLtVl"\1111 IV r11..1.. ••••••• ....,,,, .. ,,.,,,_, •••••••••• _,_,....., ___ ..... ,-·······-____ ............ _, .. _, CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT 1200 Elm, Carlsbad, California 92008-1989 (619) 438-5525 I JOB A0ORESS AV ST. RD. NEAREST CROSS ST. ::E;s~isNI Blr.lCENSE # VALUA TION (:?" p::;.., PERMIT NUMBER :z5'¥8' St?f,e e:Snea-:r L/1-€ i.,lA/ J4 ~ . /~o--~ ~~~~f LOT BLOCK I SUBOI VISION I ASSESSOR PARCEL NO CONTRACTOR C~NTRACTORS PHONE• ZON{ i't'~ 6 ti/// Bf2. OWNER'S NAME Hrt~T L 17:zc/~~-;;~s 'DoANIJ/f-T CONTRACTOR'S ADORESS LICENSE NO. PLAN 1.0 . ,t BLDG use CODE OWNER'S MAILING ADDRESS , -:z <, '8 I "11' ✓.-.. ~ov.sr &l/lJS131t.n OESIGNER LICENSE :t STANDARD PLAN # BUILDING SO. FOOTAGE I 0ESCRIPT,ON OF '(I/ORK .nPH A. .S/W° rt) E:)(1)-n N ~ J:riLP DESIGNER'S ADDRESS DESIGNER'S PHONE I : ~/6/J {M2fJUUHJe>IT OP S1~J -F/P FLA ELEV. NO DCC GP EDU STORIES 3/2b /t:;J.j37b-vO NO --•:., RES UNITS j nr, rt·i.::-,•ic •.J Jn':' -. i'. '· •. I CENSUS TRACT I GP LANO USE I PARK ING SPACE GRADING PERMIT ISSUED I REDEVELOPMENT TYPE DCC LOAD FIRESPR I AREA CONST I YO ND vO NO vO NO Not Valid Unlers M~chine Certified I --J 2-3-SUMMARY/ACCOUNT NUMBER ~----1 QTY. PLUMBING PERMIT -ISSUE QTY. MECHANICAL PERMIT -ISSUE ., - I EACH FIXTURE TRAP , INSTALL FURN. DUCTS uP TO 100,000 BTU BUILDING PERMIT 01-00-00-8220 /v'- I SIGN PERMIT EACH BUILDING SEWER OVER 100.000 BTU 01-00-00-8221 - EACH WATER HEATER AN0 10R VENT BOILER{COMPRESS0R UP TO 3 HP PLAN CHECK 01-00-00-8806 ✓-~ EACH GAS SYSTEM 1 TO 4 OUTLETS I B0ILER{C0MPRESS0R 3 15 HP TOTAL PLUMBING 01-00-00-8222 - EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE ELECTRICAL 01 ·00-00-8223 EACH INSTAl . ALTER. REPA IR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01 ·00-D0-8224 ·---· EACH VACUUM BREAKER MECH EXHAUST -HOOD 'DUCTS M0BILEHOME 01-00-00-8225 WATER SOFTNER RELOCATION Of EA FURNACE/HEATER MOBILEHOME PARK INSP EACH ROOF DRAIN /INSIDE) SOLAR 01,-0Q-nn.R??/; T0Tt.L MECHANICAL STRONG MOTION 80-92-33-D519 TOT AL PLUMBING I FIRE SPRINKLERS 01-00-00-8227 .r--QTY. SOLAR -ISSUE PUBLIC FACILITIES FEE 32-00-00-89ll QTY. ELECTRICAL PERMIT -ISSUE BRIDGE FEE NEW CONST EA AMP SWl BKR COLLECTORS SCHOOL FEE · DISTRICT I PH 3 PH STORAGE TANKS Carlsbad 80-92-21-0519 EXIST BLOG EA AMP,SWT BKR ROCK STORAGE EncInilas 80-92·22-0519 ) PH 3 PH PUMP San D1egu1to 80-92-23-0519 REMO0E L A L HR PER CIRCUIT PLAN CHECK FEE San Marcos 80-92-24-0519 I TEMP PO LE 200 AMPS OVER 200 AMPS LICENSE TAX 01-00-00-8162 TEMP OCCUPANCY !30 DAYS) MFF 80-92-57-0519 CREDIT DEPOSIT TOTAL ELEC1RICAL I TOTAL SOLAR TOTAL FEES PAYABLE r /6~ I a. I HAVE CAREFULLY EXAMINED THE COMPLETED •·APPLICATION AND PERMIT" AND DO HEREBY Exp♦rahon. Every perm,t issued by the Bu1ld1ng Of11c1a! under the prov1sIons of lh1s * AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall e,pire by hm11at1on and become null and void II the bu1lc!mg or work 5· o· DEEP AND DEMOUTION OR CONSTRUCTION OF authonzed by such perm,1 ,s nol commenced w,thm 180 days':~ dateol such ' STROCT\JR£S OVER 3 STORIES IN HEIGHT DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS permI1. or ,f the bu1ld,n~ or work authonzed by such perm11 suspended or ISSUED TO COMPLY WITH ALL CITY COUNl Y AND STATE LAWS GOVERNING BUILDING CON abandoned al anv time a er Iha work Is commenced In, a per, of 180 da•s J I STRUCTION, WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND ~URE 1f. f)cui ,-CONTRACTOR 0 APPROVED BY /~· 1D¥5P~ KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS, COSTS AND I EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE .....!) BY PHONE 0 I GRANTING OF THIS PERMIT. . . . I . ... -; DATE INSPECTOR BUILDING I \ A ' <f'.:.--&3~ " FOUNDATION I FIELD INSPECTION RECORD REINFORCED STEEL I MASONRY I I GUNITE OR GROUT I REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES INSPECTION REO IF INSPECTORS DATE . CHECKED APPROVAL ''- FLOOR & CEILING SUB FRAME 1 I SOILS COMPLIANCE SHEATHING D ROOF D SHBAR PAl,OA TO FRAME I I EXTERIOR LATH I FOU DA TION INSP STRUC1URAL CO CRETE - OVER 2000 PSI INSULATION I I INTERIOR LATH & DRYWALL I I PRESTRESSED CONCRETE . POST TENSIONED CONCAE1E ' -PLUMBING I FIELD WELDING SEWER AND BUCO DIPUCO I I UNDERGROUND D WASTE D WATER HIGH STRENGTH BOLTS TOP OUT D WASTE D W~TER SPECIAL ASO RV TUB AND SHOWER PAN l GAS TEST I I -- PILES CI\ISSONS D WATER HEATER D SOLAR WATER I I ' ELECTRICAL I D ELECTRIC UNDERGROUND D l}FFER ROUG~ ELECTRIC I : 11 I D ELECTRIC SERVICE D TEMPO~ARY -- D BONDING D POOL I I I MECHANICAL I D DUCT & PLEM., D REF. PIPINP HEAT -AIR COND. SYSTEMS I VENTILATING SYSTEMS I " I I CALL FOR FINAL INSPECT!~N WHEN ALL APPROPRIATE ITEMS ABOVE HAV BEEN APPROVED. FINAL I PLUMBING I ' ' ' ELECTRICAL I MECHANICAL I GAS I A/ ./ BUILDING I 1-,,\\·"-' x:T I -·;.,-' •ir-... ,...._ ... SPECIAL CONDITIONS I . / I / - I LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provi• sions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profes- sions Code, and my license is in full force and ef- fect. OWNER-BUILDER DECLARATION D I hereby affirm that I am exempt from the Con- tractor's License Law for the following reason (Sec. 7031.5,Business and Professions Code), Any city or county which requires a permit to con- struct, alter, improve, demolish, or repair any structure, prior to its issuance also requires the applicant for such permit to file a signed state- ment that he is licensed pursuant to the provi- sions of the Contractor's License Law (Chapter 9 commencing with Section 7000 of Division 3 of the Business and Professions Code) of that is ex- empt therefrom and the basis for the alleged ex- emption. Any violation of Section 7031.5 by an ap- plicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). D I, as owner of the property, or my employees with wages as their sole compensation, will do the work, and the structure is not intended or of- fered for sale (Sec. 7044, Business and Profes- sions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon and who does such work himself or through his own employees, provided that such Improvements are not Intended or of- fered for sale. If, however, the building or improve- ment is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve for the purpose of sale). '.JI, as owner of the property, am exclusively con· tractlng wit" licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not ap- ply to an owner of property ••ho builds or im• proves thereon, and who contracts for such pro- jects with a c~ntractor(s) license pursuant to t contractor's License Law). I am exempt under Sec. ____ B. & P.C. for this reason, ___________ _ Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of con· sent to self-insure, o, a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Labor Code). POLICY NO. ___________ _ COMPANY ____________ _ □Copy is flied with the city. □Certified copy Is hereby furnished. ..,_ CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed If the per- mit Is for one hundred dollars ($Hl0) or less). I certify that in the performance of the work for which this permit Is issued, I shall not.!!l!'ploy any person In any manner so as to become subject to the Workers' Compensation Laws of California NOTICE TO APPLICANT: If, after making this Cer· tlficate of Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction len• ding agency for the performance of the work for wMch this oermlt is Issued (Sec. 3097, Civil Code). USE BALL POINT PEN ONLY OWNER Walls LOT BLOCK I SUBDIVISION OESCR1PTI_Q._N~:-WORK 7 _\ it:.~{ CENSUS TRACT GP LAND USE At't'L ILA I IUN 0. t' t:KMI I 1200 ELM AVENUE (714) 438-5525 JOB ADDRESS I I I I I I I I I I I I OWNER'S PHONE R !:?4LTcJ~S 1-j-3'-f-Jll.-f7 PRIME CONTRACTOR ; / f) I ASSESSOR'S PARCEL NO. I I I I I I I I I I I DE~ER' S ADDRESS ""' 'I ~ I~ .. 4 -r Yt'f!'..f ft; .. lfr~ Z,,,NG C/tlti ,l MATION WITHIN RED LINES. eus. LICENSE STATE LICENSE CONTRACTOR'S PHONE STATE LICENSE DESIGNER'S PHONE PERMIT NUMBER I I I I II r o.c-~ t.S?-e> I RES. UNITS I #RKING sPAcE sf I NUMBER OF STORIES Not V•lid Unftlss MlchiM Cartifi«I BLOG SQ. FT. BLDG USE occ. GP I STANDARD PLAN# I PLAN ID II I TYPE CONST I occ. LOAD I QTY. PLUMBING PERMIT _/ EACH FIXTURE TRAP ./ EACH BUILDING SEWER / EACH WATER HEAT~NO/OR VENT EACH GAS SY~ 1 TO 4 OUTLETS EACH G~STEM 5 OR MORE EAOONSTAL., ALTER, REPAIR WATER PIPE J,,-fACH LAWN SPRINKLER SYSTEM V WATER SOFTNER Tcc,io TOTAL PLUMBING CONTRACTOR ELECTRICAL PERMIT ./...,. QTY. / NEW CONST EA AMP/SWT/BKR _/ 1 PH .25 _./ 3 PH EXIST BL!)G EA AMP~KR 1 PH .25 _/ 3 PH REMOOEL/A1,-'ER PER CIRCUIT TEMP P.o,rt 200 AMPS om200 AMPS /tEMP OCCUPANCY 130 OAYS) ---;,c Issue TOTAL ELECTRICAL CONTRACTOR AMT. AMT. 2 .• 00 QTY. MECHANICAL PERMIT A~ INSTALL FURN. DUCTS UP TO 100,000 BTU OVER 100,000 BTU/ .801 LER/COMPRESSOR UP TO 3 HP ./ BOILER/COMPRESSOR 3-15 HV BOILER/COMPRESSO'l.)81o HP VENT FAN SING.J.e'l)UCT VALUATI ON : MECH E)l:HJ!r11ST -HOOO/OUCTS REl.d<:'ATION OF EA FURNACE/HEATER __...,ri.urrlu ~C:.C:.1""' 1 . n n l SIGN PERMIT TOTAL MECHANICAL CONTRACTOR QTY. MOBILE HOME PERMIT AWNING PORCH SET-UP RAMADA, CABANA_/ FENCE OVERY TOTAL ~ILE HOME .,, /AMT. / ./ // V •AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER 5'-0" DEEP AND DEMOLITION OR CONSTRUCTION OF ST';J:U RES OVER 3 STORI ES IN HEIGH~~ .h/A 0,. /1 __ jJ ~ -~/V~ - PLAN CH ECK ALL INCLUSIVE PERMIT TOTAL PLUMBING ELECTRICAL MECHANICAL MOBILE HOME SOLAR MICO -FI LM TOTAL FEES PAYABLE SCHOOL FEES: - I I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT, ANO 00 HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED; TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER SPECIFIED HEREIN OR NOT. 1,ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM- LESS 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. APP I/T'S SIGNATURE' V {/ OWNER.Pf AGENT D CONTRACTOR□ I APP~ BYPHONEOJ..._.....-><,-• I I I I I I I I I I • w ~ ~ • I , I I I ~ I .a,;-I'-'"' i= , I ,~ .~' ~ I I V, I I ~ I I I I I I I I I I I I I I I I I I I I I I I I I : I I I I I • I I I I , SITE ADDRESS: - - INSPECTION DATE WOOD FLOOR FOUNDATION • FORMS• SET BACK • TOILET UNDER FLOOR PLUMBING UNDER FLOOR HEATING OK TO INSTALL SUB FLOOR SLAB FLOOR UNDER SLAB PLUMBING FOOTING • FORMS • SETBACK • TOILET OK TO POUR CONCRETE FRAME ROUGH ELECTRICAL ROUGH PLUMBING ROUGH HEATING/VENTILATING FRAME OK• PLACE INSULATION INSULATION OK • PLACE WALLBOARD WALLBOARD OK• PLACE TAPE EXTERIOR LATH 0 K • PLACE STUCCO -,.. FIREPLACE ...... DAMPER :11: STEEL PLATE Tl Es/HEIGHT OF CHIMNEY OTHER TEMP POWER (POLE) SEWER GAS TEST SWIM POOL• STEEL BONDING • PRE DECK • FENCE PREP LASTER SHOWN • FRAME • PAN FINAL INSP BY BLDG DEPT OTHER-DEPT'S REQ COMPLETED ELEC METER-PERM-TEMP GAS MET ER-PERM-TEMP CERT OF OCCUPANCY ISSUED OWNER: FIELD INSPECTION RECORD INSPECTOR INSPECTOR'S NOTES . •. '" ~ • "<C- . " ,j .. :.). • _j.\_ ... , . - ' . . ' PERMIT NO: - ' ~-""'· ~ . .... ·- RO ✓?--~% . \ ·- . .. -· . • LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provi- sions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profes- sions Code, and my license Is In lull force and af• feet. OWNER-BUILDER DECLARATION 0 1 hereby allirm that I am exempt from the Con· tractor's License Law for the following reason (Sac. 7031.5 Business and Professions Code), Any city or county which requires a permit to con- struct, alter, improve, demolish, or repair any structure, prior to Its Issuance also requires the applicant for such permit to Ille a signed state- ment that he is licensed pursuant to the provl• slons of the Contractor's License Law (Chapter 9 commencing with Section 7000 of Division 3 of the Business and Professions Code) or that Is ex• empt therefrom and the basis for the alleged ex• emption. Any violation of Section 7031.5 by an ap- plicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ). as owner of the property, or my employees wages as their sole compensation, will do the worl<, and the structure Is not Intended or of- fered for ,sale (Sec. 7~4. Business and Prof es• sions Code: The Contractor's License Law does not apply to an owner of property who builds or Improves thereon and who does such work himself or through his own employees, provided that such Improvements are not Intended or of• fered for sale. II, however, the building or Improve- ment is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or Improve for the purpose of sale). e roperty, am exclusively con- tracting wit licensed contractors to construct the project (Sec. 7~. Business and Professions Code: The Contractor's License Law does not ap- ply to an owner of property •.•ho builds or Im- proves thereon, and who contracts for such pro- jects with a contractor(s) license pursuant to the contractor's License Law). I am exempt under Sac _____ B. & P.C. for this raaso,,_ __________ _ Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of con- sent to sell-Insure, oi a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Labor Code). POLICY NO, ___________ _ COMPANY ___________ _ □Copy is filed with the city. □Certified copy Is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed If the per- mit Is for one hundred dollars ($100) or less). I certify that In the performance of the worl< for which this permit Is issued, I shall not employ any parson.In any manner so as to become subject to the wo:,ers' Compensation Laws of California. 11.i>TICE TO APPLICANT: II, after maklng this Cer- tificate of Exemption, you should become subject to the Worl<ers' Compensation provisions of the Labor 1~e, you must forthwith comply with such pro .. slo,. or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction len- ding agency for the performance of the work for which this oermlt Is Issued (Sec. 3097, Civil Code). USE BALL POINT PEN ONLY APPLICATION & PERMIT~ 0 1200 ELM AVENUE 7U) 438-5525 MATION WITHIN RED LINES. - NO. J08 ADDRESS -~\r 1 0A11 i1~TION aus. LICENSE PERMIT NUMBER I?. 1-" 4, 8'1 1.l1 tv4 111 /=i 1S 11'1 ,~. At R1 L 1 ~I/.,} Al), ,e,A, I I I I <J\/ bf OWNER OWNER'S PHONE PRIME CONTRACTOR ~ STATE LICENSE ':-TAMES I>. 1,,,/; LL 'ANf '7..2 q .st t,J,.JI" A,,.J-A~ .,.,, , , . OWNER'S MAILING AOORE"ss CONT"RACTOR'S ADDA/ CONTRACTOR'S .o .. (),, PioX./7/4-OCFA~1:.b£ ,6'A, t?~~4-. PHONE oq1~J.~5PJ u 8 , loT BLOCK I suao1v ISION ' I ASSESSOR'S PARCEL NO. DESIGNER STATE LICENSE 8a-~11 J I I I I I I I I I I I DESCRIPTION OF WORK ~ 5/~ .-,. ',J~ f_b ':1='/\f flJ"fJ+/J A. !(EE:. iJ. / Ll.;J_ Ir FLv.<:iJ DESIGNER'S ADDRESS DESIGNER'S PH,ONE .M11t1JE.l <; ~// ro 1t. A.PVlftfr:' .r/lit1 t?o<.. CENSUS TRACT GP LANO USE ZONING -.../ RES. UNITS I PARKING SPACE I NUMBER Of STORIES Not V•lid UnE MachiM c.rtifi«I &LOG SO. FT. BLOG USE occ. GP I ST AN OARD PLAN # I PLAN ID# I TYPE CONST I occ. LOAD I QTY. PLUMBING PERMIT AMT. QTY. MECHANICAL PERMIT AMT. EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100,000 BTU EACH BUILDING SEWER OVER 100,000 BTU EACH WATER HEATER ANO/OR VENT BOILER/COMPRESSOR UP TO 3 HP ~J..ol~ EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP EACH GAS SYSTEM 5 OR MORE BOILER/COMPRESSOR 16-30 HP EACH INSTAL., ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT EACH LAWN SPRINKLER SYSTEM MECH EXHAUST -HODO/DUCTS - WATER SOFTNER RELOCATION OF EA FURNACE/HEATER BUILDING PERMIT I I _1-{' :v 1..,, SIGN PERMIT I . I I I TOTAL PLUMBING TOTAL MECHANICAL PLAN CHECK I I 1...2~ . - CONTRACTOR CONTRACTOR ALL INCLUSIVE PERMIT I I I ELECTRICAL PERMIT AMT. QTY. MOBILE HOME PERMIT AMT. TOTAL PLUMBING I I I QTY. ELECTRICAL I I I NEW CONST EA AMP/SWT/BKR AWNING MECHANICAL I I I 1 PH .25 3 PH PORCH MOBILE HOME I I I EXIST BLOG EA AMP/SWT/BKR SET-UP SOLAR I I I I 1 PH .25 3 PH RAMADA, CABANA .// ,_ ..-J--', I I I I . REMODEL/ALTER PER CIRCUIT FENCE OVER 6' ,,#~h4f7D. _, , -v--I I I .Si (,,J TEMP POLE 200 AMPS TOTAL MOBILE HOME , M-ft <f-'F IL M I I I I OVER 200 AMPS I I I : I TEMP OCCUPANCY (30 DAYS) I . I I I I ' I I I TOTAL ELECTRICAL TOTAL FEES PAYABLE I I~ :,.... CONTRACTOR . I I . ' V I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT, AND DO 'AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I 5'-0" DEEP AND DEMOLITION OR CONSTRUCTION OF FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED; TO COMPLY WITH ALL CITY, STRUCTURES OVER 3 STORIES IN HEIGHT COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER SPECIFIED HEREIN OR NOT. l,ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM- LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND .l'i ~ EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE .,, OF THE GRANTING OF THIS PERMIT. ~ns:9Yu~PI~ OWNE~ CONTRACTOR□ 'APPROVED BY ~ !/~It __,. -AGENT D BY PHONED 'E-' -✓ ~ . I ' - SITE '\. . ADDRESS: OWNER: •-,. PERMIT NO: '. ...... , FIELD INSPECTION RECORD ·, INSPECTION DATE INSPECTOR INSPECTOR'S NOTES WOOD FLOOR .. FOUNDATION• FORMS • SET BACK• T OILET UNDER FLOOR PLUMBING UNDER FLOOR HEATING C OK TO INSTALL SUB FLOOR . \~ ·, SLAB FLOOR UNDER SLAB PLUMBING FOOTING • FORMS• SETBACK• TOILET . OK TO POUR CONCRETE I . - FRAME ROUGH ELECTRICAL ROUGH PLUMBING - ROUGH HEATING/VENTILATING FRAME OK• PLACE INSULATION l ,., INSULATION OK • PLACE WALLBOARD ' ' . WALLBOARD OK• PLACE TAPE I -. EXTERIOR LATH OK • PLACE STUCco· FIREPLACE DAMPER &STEEL PLATE TIES/HEIGHT OF CHIMNEY I OTHER TEMP POWER (POLE) . SEWER GAS TEST SWIM POOL• STEEL BONDING .... • PRE DECK • FENCE PREPLASTER SHOWN • FRAME . PAN FINAL I_NSP BY BLOG DEPT ../ ,,, . OTHER-DEPT'S REQ COMPLETED ,,,~ /4'/ ,_ - ELEC METER~PERM-TEMP I 1/W ti! r GAS METER-PERM-TEMP I'! I 't/--.. l CERT OF OC,CUPANCY ISSUED ' LICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provi- sions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profes- sions Code, and my license Is In lull force and ef- fect. OWNER-BUILDER DECLARATION 0 1 hereby affirm that I am exempt from the Con• tractor's License Law for the following reason (Sec. 7031.5,Buslness and Professions Code), Any city or county which requires a permit to con· struct, alter, Improve, demolish, or repair any structure, prior to Its Issuance also requires the applicant for such permit to Ille a signed state- ment that he Is licensed pursuant to the provi- sions of the Contractor's License Law (Chapter 9 commencing with Section 7000 of Division 3 of the Busltiess and Professions Code) or that Is ex- empt therefrom and the basis for the alleged ex- emption. Any violation of Section 7031.5 by an ap- plicant for a permit subjects the applicant to a civil penalty of not more than live hundred dollars ($500). D I, as owner qt"the property, or my employees with wages a5Jhelr sole compensation, will do the work, and ttj,e structure Is not Intended or of- fered for sale W,ec. 7044, Business and Profes- sions Code: Th#Contractor's License Law does not apply to an owner of property who builds or Improves thereon and who does such work himself or through his own employees, provided that such Improvements are not Intended or of- fered for sale. If, however, the building or improve- ment Is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or Improve for the purpose of sale). ':11, as owner of the property, am exclusively con- tracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not ap- ply to an owner of property \•ho builds or Im- proves thereon, and who contracts for such pro- jects with a contractor(s) license pursuant to the contractor's License Law). I am exempt under Sec _____ B. & P.C. for this reason ____________ _ Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of con- sent to self-Insure, or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Labor Code). ~~~!:.;>·------------ □Copy Is flied with the city. D Certified copy is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the per- mit is for one hundred dollars (StOO) or less). I certify that in the performance of the work for which this permit Is Issued, I shall not employ any person In any manner so as to become subject to the Workers' Compensation Laws of Califomla. NOTICE TO APPLICANT: If, after making this Cer• llflcate of Exemption, you should become subfect to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that there Is a construction len- ding agency for the performance of the work for which this oermlt Is Issued (Sec. 3097, Civil Code). C IT Y O F C ARLSBAD-BUI LDING DEPAR TMENT -'~ / ~.nlf -~~ ~ J~B ADDRE~S /itRr· ,DA7lis;cvON BUS. LICENSE PERMIT NUMBER I I .A_, ./ -:1 i I I I I I I I I I I I I too/ OWNER OWNER'S PHONE PR71:ACTOR STATE LICENSE WA LLS-/vtAGU/Rb:-R l=A-L TOR. ..r ,n1 • ...... -... p(nso:lt~~~R:S 2-S't t u-k.Jc Jf-( ~3~-3/YJ) lrNTRACTO~:S CONTRACTOR'S ...... -:l 11-.~ r I PHONE orr.1 i 2oc ·:,1,i11~0 'l LOT 8LOCK I .I SUBDIVISION I ASSESSOR'S PARCEL NO. I DESIGNER STATE LICENSE I t I I I I I I I I DESCRIPTION OF WO, (.. • ) / //l'vl~I I 1r ..,,, "I 7' Sl<>"lf , I ·--_.,, --r J -1 DESIGNER'S ADDRESS DESIGNER'S PHONE I-'-1/x, I tI,vJ,lf n;c-eJ h--et.-fk.,,ci., 241/1/ CENSUS TRACT GP L ANO USE .nlNG J {Jr;'/ it-I RES. UNITS I P~RKING SPACE s f J NUMBER OF STORIES ~ ~-/ftJ Not Valid Unlffl Machin• Cartifi«J BLDG SQ. FT. BLOG USE occ. GP I S'l'ANDARD PLAN II I PLAN ID II I TYPE CONST I occ. LOAD I ~ QTY. ~NG PERMIT AMT. QTY. ~CHANICAL PERMIT AMT. EACH FIXTURE TRA"" INSTALL Fulm.,DUCTS UP TD 100,000 BTU EACH BUILDING SEWER_:---... .............. OVER 100,000 BTU EACH WATER HEATER ANO/O~NT BOILER/COMPRESSOR UP 1'84,.HP EACH GAS SYSTEM 1 TO 4 OUTLETS--..., BOILER/COMPRESSOR 3-15 HP .......... EACH GAS SYSTEM 5 0 R MO RE ' BOILER/COMPRESSOR 16-30 HP .......... EACH INSTAL., ALTER, REPAIR WATER PIPE " VENT FAN SINGLE DUCT . Valuation : J,5(5 -EACH LAWN SPRINKLER SYSTEM ~ MECH EXHAUST -HOOD/DUCTS WATER SOFTNER RELOCATION OF EA FURNACE/HEATER " UT I I I I ·-... ._ Issue 3.00 Issue .j.uu SIGN PERMIT _, I , I ,15 r TOTAL PLUMBING TOTAL MECHANICAL -· I I 11 .5!0 u ... u .. . CONTRACTOR CONTRACTOR ALL INCLUSIVE PERMIT I I I ~ECTRICAL PERMIT "" AMT. TOTAL PLUMBING I I I QTY. AMT. QTY. MOBILE HOME PERMIT ELECTRICAL I I I NEW CONS~A AMP/SWT/BKR AWN~ MECHANICAL I I I 1 PH .25 ' 3 PH PORCH " MOBILE HOME I I I EXIST BLDG EA A~/BKR SET-UP ' SOLAR I . I I I 1 PH .25 "' 3 PH RAMADA, CABANA'-I . I I I REMO DE UAL TEA PER C~IT FENCE OVER 6' ' I I I I TEMP POLE 200 AMPS ' TOTAL MOBILE HOME ' MICO-FI LM I . I I I OVER 200 AMPS " " I I I ; I TEMP OCCUPANCY (30 DAYS) " ' I . I I . I T,-.-••-"' 2 .nn "-I . I I I TOTAL ELECTRICAL TOTAL FEES PAYABLE I I rJ _qO CONTRACTOR . I I . ., I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT, ANO DO •AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT ANO I 5'-0" DEEP ANO DEMOLITION OR CONSTRUCTION OF SClfOOL FEES: FURTHER CERTIFY ANO AGREE IF A PERMIT IS ISSUED;TO COMPLY WITH A LL CITY, ~RES OVER 3 STORIES IN HEIGHT Q__ COUNTY ANO STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER tJd SPECIFIED HEREIN OR NOT. !,ALSO AGREE T O SAVE INDEMNIFY AND KEEP H ARM- AA_, ,O11/?_A../1~.-t_ _,/ LESS 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. r PLIC1'S SIGNATURE• () ;/ OWNER~ CONTRACTOR□ r~ Q.-~~ AGENT D BY PHONED / - • ~ a ~ ~ i= ~ ~ V) ~ SITE ADDRESS: ' :-~ • OWNER: ! PERMIT NO: . . 4 FIELD INSPECTION.RECORD INSPECTION DATE INSPECTOR INSPECTOR'S NOTES WQOD FLOOR FOUNDATION • FORMS• SET BACK • TOILET . -. UNDER FLOOR PLUMBING UNDER FLOOR HEATING . \ OK TO INST ALL SUB FLOOR • SLAB FLOOR UNDER SLAB PLUMBING . FOOTING• FORMS• SETBACK • TOILET OK TO POUR CONCRETE .• FRAME .~ - ROUGH ELECTRICAL - ROUGH PLUMBING I •' ROUGH HEATING/VENTILATING - FRAME OK• PLACE INSULATION -/ INSULATION OK • PLACE WALLBOARD WALLBOARD OK• PLACE TAPE EXTERIOR LATH OK • PLACE STUCCO .. FIREPLACE DAMPER 8:.STEEL ~ PLATE TIES/HEIGHT OF CHIMNEY 1· OTHER ' TEMP POWER (POLE) ~ SEWER ;I GAS TEST SWIM POOL• STEEL BONDING • PRE DECK .. • FENCE PREPLASTER SHOWN • FRAME ,# • PAN FINAL INSP BY BLDG DEPT .. OTHER OEPT'S REQ COMPLETED ELEC METER-PERM-TEMP GAS METER-PERM-TEMP CERT OF OCCUPANCY ISSUED