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Home My WebLink About2562 STATE ST; A; 80-248; PermitLICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provl• slons 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 el• feet. OWNER-BUILDER DECLARATION D I hereby affirm that I am exempl 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 appllcant for such permit to file a signed state- ment that he Is llcensed pursuant 10 the provi• sions 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 live hundred dollars (S500). 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• lered for sale (Sec. 7044, Business and Proles• slons 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• lered 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). ".JI, as owner of the property, am exclusively con• tractlng 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 1•ho builds or Im• proves thereon, and who contracts for such pro• jects with a contractorjs) 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 sell-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· mil Is for one hundred dollars (S100) or less). I certify that in the performance of the work for which itils permit Is issued, I shall not employ any person In any manner so as to become subject to the Workers' Compensation Laws of California. NOTICE TO APPLICANT: If, alter making this Cer• tlficate c,I Exemption, you should become subject to the Workers' C~m n~atl p lslons of the Labor Code, you ~ rt ply with such provisions or thll .Ii II eemed revoked. I hereby affirm that tliere Is a construction len• ding agency for the performance of the work for which this permit ls Issued (Sec. 3097, Civil Code). I . CITY OF CARLSBAD-BUILDING DEPARTMENT USE BALL POINT PEN ONLY APPLICATION & PERMIT 1200 ELM AVENUE (71 4) 438-5525 I I NO;~ ~I bi..J I /}I Ji JOB~ I iT~ '1 I I I I I I I • I I I tRr-~_: J]~joN OWNER b L A,~ II ,.i"i,.,. /J~!" ~o NER's PHONE PRIME CONTRACTOR !J'An-!" ~ · _ .Z:-~"'· .. , ,.~ 1.+ g $Heer /YleTAL OWNER'S MAIL~ 1~6~7T,:; AMAe, ttrJPA LOT BLOCK ASSESSOR'S PARCEL NO. DESIGNER APPLICANT TO FILL IN INFOR - MATION WITHIN RED LINES. ;;;?23 PERMIT NUMBER to---~~g STATE LICENSE 3.11~-~ CONTRACTOR'S 'r!rJ°-5 () I I I STATE LICENSE I SUBDIVISION I I I I I I I I I I I I 3/IJ/804135 DESCRIPTION OF WORK .Jke,,... Vi:1l rf'A-,vw€ 0OJl4135 3/13/80 J,AI< ~.JJ/J.L1 C> DESIGNER'S ADDRESS OESIG MER' S PHONE 0t1Cl413S 02 CENSUS TRACT GP LANO USE ZONING I RES. UNITS I #RKING SPACE sf I NUMBER OF STORIES Not V1/id Unless MachiM C«tifi«J BLOG SQ. FT. BLOG USE occ. GP I STANDARD PLAN II I PLAN ID II I TYPE CONST I occ. LOAD I llTY . ~UMBING PERMIT AMT. llTY. MECHANICAL PERMIT AMT. EACH FIXTUR~ INSTALL FURN . DUCTS UP TO 100,000 BTU EACH BUILDING SEWER ............... OVER 100,000 BTU EACH WATER HEATER ANO/OR~ BOILER/COMPRESSOR UP TO 3 HP 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 OUCT Jl.ildi1tJ1!:TI~ :~ _ EACH LAWN SPRINKLER SYSTEM ;"'-,.... /-MECH EXHAUST -HOOD/DUCTS 4..dO WATER SOFTNER RELOCATION OF EA FURNACE/HEATER a"rt-eTNG PERIVII I ... I . I I T,..,.. •• -i nr Tc:: c::,,.,. i .nn 818N l'el!Mlf ,, I ' I I TOTAL PLUMBING TOTAL MECHANICAL 7---() PLAN CHECK I I I ' CONTRACTOR CONTRACTOR ALL INCLUSIVE PERMIT I I ~ ELECTRICAL PERMIT AMT. TOTAL PLUMBING I I AMT. MOBILE HOME PERMIT El crT01r"L I I 7'.0. 7 .fl, 3/ ,~i' I I I I I I ll~ 1h;w CONST EA AMP/SWT/BKR ~ING V'lii:ruA&Ut'A ' I 171e>bl ,I lPH ~ 3 PH PORC~ MUnJLt: nuME I I I EXIST BLD~AMP/SWT/BKR SET-UP ............... SOLAR I I I I 1 PH .25 .......... 3 PH RAMADA, CABANA .............. I . I I I REMODEL/ALTER PER°NCUIT FENCE OVER 6' ............. I I I I TEMP POLE 200 AMPS ........... TOTAL MOBILE HOME ............ MICO ·FILM I . I I I OVER 200 AMPS ........... ' I . I I : I TEMP OCCUPANCY (30 OAYS) ......... '-..... I . I I I Tc::c:::11""' ""'-. ?· nn " ~'T''R()N~ M()'T'T()N • I . I I I TOTAL ELECTRICAL TOTAL FEES PAYABLE I II~ CONTRACTOR ' I I . I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION ANO PERMIT, ANO 00 "AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER SCHOOL FEES: HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE ANO CORRECT ANO I 5'·0" DEEP ANO DEMOLITION OR CONSTRUCTION OF F URTHER CERTIFY ANO AGREE IF A PERMIT IS ISSUEO;TO COMPLY WITH ALL CITY, STRUCTURES OVER 3 STORIES IN HEIGHT COUNTY ANO STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER -/ SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY ANO KEEP HARM· "' LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS. COSTS ANO A .... --..L /? E XPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. ~T,~S:;U~✓-~ERO CONTRAC~rc Tr'~~.;'~//:-DATE .,,,~ / ~ . ---_,.. ~ AGENT D BYPHO E0 ·,;, I -'-~ , ! < 0 ~ ~ i= ~ Q. V, ~ SITE PERMIT NO:· xo .... .;v..w: ADDRESS: OWNER: FIELD INSPECTION RECORD '. INSPECTION DATE INSPECTOR INSPECTOR'S NOTES WOOD FLOOR • FOUNDATION• FORMS• SET BACK• TOILET . UNDER FLOOR PLUMB/NG ' 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 OK • PLACE STUCCO ... . ~ -FIREPLACE DAMPER 8: STEEL .. . ~ PLATE Tl Es/HEIGHT OF CHIMNEY OTHER ,- TEMP POWER (POLE) SEWER ' GAS TEST -SWIM POOL• STEEL BONDING - • PRE DECK ~ • FENCE PREPLASTER . SHOWN • FRAME - • PAN I I I\ J FINAL INSP BY BLDG DEPT ' "1\1~\~ l\'!ft' t -. OTHER DEP,'S REQ COMPLETED \' I ' ELEC METER-PERM-TEMP GAS METER-PERM-TEMP CERT OF OCCUPANCY 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 full force and ef- fect. OWNER-BUILDER DECLARATION 01 hereby affirm that I am e><empt from the Con- tractor's License Law tor the following reason (Sec. 703t.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 ftle 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) 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 subfects the applicant to a clvll penalty of not more than live 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 tor 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• 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 I•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 reaso ._ __________ _ Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of con- sent to sell-Insure, o• a certificate of Workers' mpensation Insurance, or a certified copy t ereof (Sec. 3800, Labor Code). LICY NO~------------OMPANY ___________ _ NQTICE TO APPLICANT: II, after making this Cer- t1t!cate,of Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such pllvlslons 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 tor which this permit Is Issued (Sec. 3097, Clvll Code). C CITY OF CARLSBAD-BUILDING DEPARTMENT APPLICATION & PERMIT USE BALL POINT PEN ONLY 1200 ELM AVENUE (714) 438-5525 NO. JOB ADDRESS tRr 1DAT.:r ~ir ATION 1.. ,Ki t:,;J , 1A1 t5 1T1A17 1£ 1S11r I I I I I I I I I I I I I I OWNER 1 ft~~8dz; 3 ~M~dT~~ 25 I_. cJ. fe . 5 T -A-T E. s7 ~wj~: ~~AkDa~ i;n;AC7R'~A;DD~ ~~•It llLoT BLOCK u I SUBOIV ISIO N I ASSESSOR'S PARCEL NO. DESIGNER I I I I I I I I I I I ~~T;r1t. /YJAk.f-UP A,rJ .:S.YST&'/'1 DESIGNER'S ADDRESS CENSUS TRACT GP LANO USE ZONING APPLICANT TO FILL IN INFOR - MATION WITHIN RED LINES, BUS, LICENSE PERM IT NUMBER c2~S:-8 3 fo~J.YK A-STATE LICENSE dJ-13J-'3 CONTRACTOR'S i;Jjo;E~ /J'ftf -STATE LICENSE DESIGNER'S PHONE I RES. UNITS l:ARKING SPACE# .rr -ft. I NUMBER or sToR I Es Not Vllid Unless Machin, !Mtifi,d ~! BLDG SO. FT. BLDG USE OCC. GP I STANDARD PLAN II I PLAN ID II -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 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 ;z.,.=.u-11 EACH LAWN SPRINKLER SYSTEM ~ MECH EXHAUST -HOOD/DUCTS VALUATION WATER SOFTNER RELOCATION OF EA FURNACE/HEATER BUILDING PERMIT I . I I I ISSTrn 3 .. 00 ISSUE 3.00 SIGN PERMIT I . I I I TOTAL PLUMBING TOTAL MECHANICAL f-o--o PLAN CHECK I I I I . CONTRACTOR CONTRACTOR ALL INCLUSIVE PERMIT I I I ELECTRICAL PERMIT AMT. AMT. TOTAL PLUMBING I I I QTY. QTY. MOBILE HOME PERMIT ELECTRICAL I I . -L NEW CONST EA AMP/SWT/BKR AWNING MECHANICAL I 1/'5 ~id'i 1 PH .25 3 PH POACH MOBILE HOME I I I EXIST BLOG EA AMP/SWT/BKR SET-UP SOLAR I . I I I I PH .25 3 PH RAMADA, CABANA Strono Motion I . I I I REMODEL/ALTER PER CIRCUIT FENCE OVER 6' I . I I I TEMP POLE 200 AMPS TOTAL MOBILE HOME MICO -FILM ! . I I I OVER 200 AMPS I . I I : I TEMP OCCUPANCY (30 DAYS) I . I I I T!::::!::::TTR I 2 .-00 ISSTTE I . I I I TOTAL ELECTRICAL TOTAL FEES PAYABLE I Sv.'fV CONTRACTOR . I I . I I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION ANO PERMIT, ANO 00 0 AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER SCHOOL FEES HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE ANO CORRECT ANO I 5'-0" DEEP AND DEMOLITION OR CONSTRUCTION OF FURTHER CERTIFY ANO AGREE If A PERMIT IS ISSUED;TO COMPLY WITH ALL CITY, STRUCTURES OVER 3 STORIES IN HEIGHT ~~~/a COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I.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 ~ t,/ / OF THE GRANTING OF THIS PERMIT. APPLICANT'S SIGNATURE" OWNER□ CONTRA~!! APPROVED BY OAP. AGENT 0 BY PH E 0 I . ~ I--c( 0 ~ > 5 j::= ~ a. V) ~ ~ W' SITE ' ' ADDRESS: ,,. ~·' OWNER: PERMIT NO: - FIELD INSPECTION RECORD ... INSPECTION DATE INSPECTOR INSPECTOR'S NOTES ' WOOD FLOOR FOUNDATION• FORMS • SET BACK• TOILET UNDER FLOOR PLUMBING . -· ., -·~-~ ~ -' -~ UNDER FLOOR HEAT1NG OK TO INSTALL SUB F LOOR ' .. 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 INSULATION OK • PLACE WALLBOARD -~ . WALLBOARD OK• PLACE TAPE .... EXTERIOR LATH OK• PLACE STUCCO . FIREPLACE DAMPER & STEEL PLATE Tl Es/HEIGHT OF CHIMNEY OTHER TEMP POWER (POLE) SEWER > GAS TEST SWIM POOL• STEEL BONDING • PRE DECK • FENCE PREPLASTER SHOWN • FRAME -. PAN FINAL INSP BY BLDG DEPT OTHER DEPT'S REQ COMPLET ED ELEC METER-PERM-TEMP , GAS METER-PERM-TEMP 3/4//pd ,f,l.,,..#1 I I (/ CERt' OF OCCUPANCY ISSUED • )(JMr~~~MAA~~/A/A&M/4./4.,~~.A.il~n: ~ Qh>rttfiratr nf ®rntl1u 1. rtJ ::;;:/._. E 3 ~ ~ j /C TY OF CP LS AD ~ 3 This Certificate issued pursuant to the requirements of Section 306 ~i~~--~t':1' ~ j of the Uniform Building Code certifies that at the time of issuance t ~ this structure complies with applicable ordinances of the City ~ j regulating building construction use. t ~ Fran~fort Station ~ ~ UseClassification Retail Store Bldg.PcrmitNo. 80-248 ~ ~ Group _____ Type Construction _____ Fire Zone ______ Use Zone______ t ~ Occupant Load_______________________________ ~ j OwnerofBuild inr-?·e taldin~,A~uriene ·Mdress 2562 A State St. ~ <%; Building Addre ss <,.1~5'~'2 ... ':A~:..~~·ateF, S~/ ;,-1.__Locolity Car lsbad , CA .2.?Q08 ~ ~ ,-_,_, -~ -:~~ ~ ~ ~ ~ NOTE: Altorations, chan9es, additions or changos of occupancy nullifies !his certificate. t (Pos! In conspicuous ploce) ~ i ""~ ~~WVVV/~WWWWWW ~~1W":f'~•"V'WWW"'r!f'rt'W'" ~~ I I. I I