HomeMy WebLinkAbout2832 STATE ST; ; 82-113; PermitCII z 0 ;::
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O I her', . '!firm 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. Lte No ______ Class _____ _
I hereby aftinn that I am exempt lrom the Con-
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county which requires a pennit to construct
alter, improve, demolish, or repair any structure,
pnor to its issuance also requires the c,phcant for such pem,I1 to hie a signed statement that he ,s
hcensed pursuant 10 the provisions of the Con-
tracto,'s License Law (Chapter 9 commencing with Section 700) of D1vis100 3 of the Business and Pro-
fessions Code) or that Is exempt therefrom and the
basis for the alleged e,cemptlOf"I. Any YK>tation of
Sectooo 7031.5 by an appllc..t for a pemut subjects
tne applicant to a civil penalty of not more than five
hu'.*.lld dollars ($500).
I, as owner of the propef1y, or my employees
wages as their sate compensation, will do the
l, and the structure 1s not mtended or offered for
sale (Sec roM, Business and Professiolls Code.
The Contractor's License Law does not appty to an
owner of property who builds or ImprOYeS thereon
and who does such wont himself Of' through his own
employees, proYtded thA1 such Impnweme.1ts are not intende1 or offered for sale If, howevef, the
building 0< improvement Is sold within one year ol
completoon, the~-t>u,ldef ~•II ~rtlen of proving that he 1d not build ~ ~
purpose of sale). t/'-"'~
□ I, as owner o the property, ;)fT1 exclusively
contractlni with lteensed contr~tors to construct the p,oiect ($«. 70,U, Busmess and Profess;ons Code: The Contractor's License Law does not apply
to a.n owner of property who builds or improves
thereon. and who contracts for each pmiects with a
contractor(s) license pursuant 10 lhe Conlr.cto(s
Lteense Law)
0 lamexemptunderSec _____ ,B &P.C.
f0<th1s reason ___________ _
□ I hereby affirm lhat I have a cert1t1cate of consent to self.insure. or a certihcate of Wortc;e-rs·
Compensation Insurance. or a cert1fte<J CoPy thereof
{Sec :llnl. uobor Code>
POLICYNO _
COMPANY
□ Copy IS filed With lhe Ctty
0 Cer11hed copy 1s hereby furnished
CERTIFICATl OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed 11 the perm,t
Is tor one hundred dollars {$100) or less)
O t certify that in the performance of the woo for
which this permit 1s issued, I shall not employ an~
person ,n any manner so as to become sub,ec.t to
the Wonters· Compensallon Laws ol Cahtom1a
NOTICE TO APPLICANT II. otter ma1<1n1 this Certi-
ficate ot Exempl1on. you should become subject t'J the wooers· Compensahon provIsIons of the Labor
Code. you must tor1hw1th comply with such
provIs,ons or this permit shall be deemed re\/Oked
0 I hereby affirm that there Is a conslruchon
lending agency tor !he pe<formance of !he work fo,
which ttus permit •s issued (Sec YS7. c,,.,11 Code)
Lenders Name ___________ _
Lender's AOOress __________ _
USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO Fl.LL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. -"-'
CARLSBAD'" LJILDING DEPARTMENT I
AP,-. JCATION & PERMIT 1200 Elm, Carlsbad, Callfomla 92008 (714) 438-5525
JOB ADORE% i' 4 ;1. ~ ~c/ AV.ST.
1~;/;;10NI
BUSINESS LICENSE # VALUATION PERMIT NUMBER RO. Q~//3
71R~~/(f,, L. ~ j ~ OWNER'SPHONE PRIME co7TRA7OR ~ ,,,r¥'. CONTRACTORS PHONE • ZONE
!4u -✓;,-,r,. ·r.. w ~N. ~·:l'?J'-7.!& ~ -
:;;:~INa;;:k . JA~/f)~p CONTRACTOR~ ADDRESS UCENSENO. PLAN I.O. # BLOG USE CODE ..
LOT I BLOCK I SUBDIVISION I ~ss~.7:E/b-L..8
DESIGNER . STATE LICENSE It STANDARD PLAN It BUILDING SO. FOOTAGE
DEL.: 'Y):&.,Z~RK L ~--, >'l'~ -t:7«?~ DESIGNER'S ADDRESS DESIGNER'S PHONE
/·_ £~ ~/~2/~2 8□7 7.01
-s--NO EDU □001 807 3/cuee 7~01 --F/P F LR ELEV. OCC GP f STORIES ...
vO NO --
CENSUS TRACT I GP LAND USE I PARKING SPACE I RES UNITS I GRADING f'.ERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRE SPR AREA CONST
YO ND vO NO vO NO Not Valid Unlt!Ss MJchine fArtifitd
QTY. PLUMBING PERMIT -ISSUE 7.50 QTY. MECHANICAL PERMIT -ISSUE 3.00 SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100,000 BTU BUILDING PERMIT 01-000-4220
EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT 01-000-4221 --
EACH WATER HEATER AND/OR VENT BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01-000-4806
EACH GAS SYSTEM I TO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING 01-000·4222 -EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE ELECTRICAL 01 ·000·4223 7 :::----
EACH INSTAl .. ALTER , REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01-000·4224 .
EACH VACUUM BREAKER MECH EXHAUST -HODO/DUCTS MOBILEH0ME 01-000·4225
WATER S0FTNER RELOCATION OF EA FURNACE/HEATER M0BILEH0ME PARK INSP
EACH ROOF DRAIN (INSIDE) SOLAR 01 ·000·4226
TOTJ.L MECHANICAL STRONG MOTION 65·640·0519 --TOTAL PLUMBING I FIRE SPRINKLERS 01 ·000·4227
PUBLIC FACILITIES FEE 25-000-4933 QTY. ELECTRICAL PERMIT · ISSUE QTY. SOLAR · ISSUE BRIDGE FEE ? on
NEW CONST EA AMP/SWT/BKR COLLECTORS SCHOOL FEE • DISTRICT
1 PH 3 PH STORAGE TANKS cartsbad 65·623-0519
EXIST BLOG EA AMP/SWT/BKR ROCK STORAGE Encinitas 65·624·0519
1 PH 3 PH -.-t!.. PUMP San Diegui1o 65·625·0519
/ REMODEL/ALTER PER CIRCUIT r5~ PLAN CHECK FEE San Marcos 65·626-0519
TEMP POLE 200 AMPS
OVER 200 AMPS
TEMP OCCUPANCY (30 DAYSI
TOTAL ELECTRICAL I ?~ I'""'" TOTAL SOLAR TOTAL FEES PAYABLE I 7~
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT" AND DO HEREBY El<pirat,on. E-,, pennll iuued by the llulldlng Official undartlle pn)'MiOnS of this 1r AN OSHA PERMIT IS IIE0UIAED FOfl UCAVATIOHS OYER CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall •ltlllre by M-lton and become null and VOid. If 1h11 building or work S' O" DEEP ANO 0£MOUTIOfl OR CONSTAUCTIOH Of'
DECLARATIONS ARE TRUE ANO CORRECT AND I FURTHER CERTIFY ANO AGREE IF A PERMIT IS authorized by euch permit Is not commenced within 180 deya from the date of such STIIUCTURES OYER 3 STORIES IN HEIGHT perm•~ or ,t the bu::::X.,or -'< authoriad by IUCII pe,l!llt is or ISSUED· TO COMPLY WITH ALL.CiTY, COUNTY AND STATE LAWS GOVERNING BUILDING CON aban-at_,. -the wor1' Is~ -a ~ ot 11111-
STRUCT10N. WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE To SAVE INDEMNIFY AND Zhs ~~ y ~ 1 CONTRACTOR 0 AP7~fol-DATE KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND .A f 1W_t Vr EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE / ~ ':ii::'"~ 8YPHONE 0 GRANTING OF THIS PERMIT. '/. , , _
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BUILDING '
FOUNDATION
REINFORCED STEEL
MASONRY
GUNITE OR GROUT
FLOOR & CEILING SUB FRAME
SHEATHING i.
I
FRAME !
EXTERIOR LATH lNSULATION ' ' INTERIOR LATH & DRYWALL I I
PLUMBING f
-.
SEWER A ND BL/CO I
PLUMBING UNDERGROUND l r
PLUMBING TOP OUT l
TUB AND $HOWER PAN I
GAS TEST I
I
ELECTRICAL I
TEMPORARY POWER I
ELECTRIC UNDERGROUND I I
ROUGH ELECTRIC I
ELECTRIC SERVICE I
BONDING . t' ..... ~ ·,
I
G. F. I. -SMOKE DETECTOR I
MECHANICAL I
DUCT & PLEM., REF. PIPING
HEAT -AIR COND. -SOLAR SYSTEMS C
V ENT! LATI NG SYSTEMS ~_;
CA LL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS A BOVE HA VE BEEN APPROVED.
JOB SITE FINAL
PLUMBING
ELECTRICAL
MECHANICAL
GAS
BUI LDING
SPECIAL CONDITIONS
CERT OF OCC' 11;,ANCY ISSUED r I 1
c--·
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS
INSPECTION REO IF INSPECTOR S
CHECKED APPROVAL
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRES TRESSED
CONCRETE
POST TENSIONED
CONCRETE
FIELD1WELDING
,11GH STRENGTH
BOLTS
SPECIAL MASONRY
PILES CAISSONS
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INSPECTOR'S NOTES
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