HomeMy WebLinkAbout2723 SPOKANE WAY; ; 84-758; PermitIll z 0 ;:
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O I hereby affirm that I am licensed under
provl1lon1 of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Profe11lon1 Cade, and my license is In
full force and effect.
Lie No ______ Class
X, I hereby afhtm that I am exempt from lhe Contrac-
r's License Law tor the lollowmg reason (Sec. 7031.5 Business and Professions Code· Any city or county which re·
quires a perrmt 10 construct. alter, tmprove, demolish. or repair any struc1ure. priOr 10 11s issuance also requires !heap-
pOcant !or such permit 10 hie a sI9ned statemenI thal he Is htensed pursuant 10 the prO'l~~s ol the con1ractor's
Ltcense Law (Chapter 9 eommenc1ng with Section 7000 of 0iv1s1on 3 ot 1he Business and Professions Code} Of !hat 1s ex-
empt therefrom and lhe basrs for the atlegeo exemptiOn Any v1otat1on of Section 7031.5 by an apphcant tor a perm11 sub· Iects the applicant to a CIVIi penalty of not more lhan hve hun-
dred dollars ($500)
r, 1 ::it nwn1>f n! thl> nrnnPrh, nr mv PmnlrNP.P-. wtth wanf"ir;
as their sole compensahon. W111 do the work. and the strUc-ture 1s not intended or ollered fOf sa!e (Sec 7044, Business
and Profession!> Code. The ContractOf·s license Law does
not apply to an owner ol property Who builds or improves thereon and who does such work tumself or through his own
employees, provided that such improvements are not mtend·
e<l or ollered tor sale. If. however. the building Of improve--
men! 1s sold within one year of completion. the owner-bu1kler w,11 have !he burden of prOV1ng 11\at he dtd no1 build or im-
prove lo, the purpose ol salel
D I. as owner m the property, am exclusively contractmg
with licensed contraciors 10 construct the protecl (Sec. 7044. Business and Professions Code: The ContractOf's License
Law does not apply lo an owner of property who builds Of 1m· proves !hereon, and who contracts for each prOjecls with a contractor(s) hcense pursuant to lhe Contractor's License
Law)
D As a homeowner I am improving my home. and !he lollow·
ing condItt0ns extsl: 1. The work is being performed prior lo sale 2. 1 have hved ln my home tor twetve months
pr.or 10 comptelion ol 1h1s work 3. I have not claimed lhis exemption during the last 1h1ee yea1s.
D I am exempt under Sec. ______ . B & P C
fOC' this reason
□ 1 hereby affirm thaI I ha-tea cert,t,cate of consenl
to self insure or a cer11f1cate of Workers
Compensa11on Insurance. or a cen,ftect copy thereol
(Sec 3800 l..lbO< Godel
POLICY NO
COMPANY
□ Copy IS ftled w,tri lhe city
D Cer11t1e0 copy 1s heret>y furnished
CERTIFICATl OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE
(This secllon need not t>e completed 11 the oerm11
Is tor one hun(!red dollars ($100) or less>
0 I cer11ty !hat ,n the pertormance ol lt'le work !or
wh,ct'I lt'lts permit ,s issued I shall noI employ any
person In any manner so as to become sut>IecI 10 lt'le Workers Compensation U ws of Cahtorn,a
NOTICE TO APPLICANT II. alter maktnJ this Cer,1
hcate of EKemptK>n )'OV sh<>okl t>eeome subIecI t?
the Wof1iters Compensation provisions ol lhe Ubot
COde. you musl lor1h-A1lh compty with such
prov1s1ons or this permII shall be oeemea revokeo
il O I hereby attum thal mere Is a consIrucIIon 1end1ng agency t0t the perto,mance 01 lhe woa IOI
which this perm11 Is issued tSec 3097 C1v1I CooeI
Lender s Name ___________ _
Lender .s .t.ooress __________ _
USE BALL POINT PEN ONLY & PRE_!S HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT
1200 Elm. Carlsbad, California 92008-1989 (619) 438-5525
JOB ADORES$ ~ / AV.ST.RD. NEAREST CROSS ST. I ~~;;;y~~IONI
BUSINESS LICENSE # VALUATION PERMIT NUMBER
;;J7;:i.3 _A---~ I, :lD 0 ~~---~ 7S-[/ LOT I BLOCK I suBDI vil10N I ASSESSOR PARCEL NO CONTRACTOR CONTRACTORS PHONE • ZONE
,,,, l.~~3. ~c;., 6) ()\J..J\'\ <UL
OWNER'S NAME OWNER'S PHONE
0'0'<'-V'I R . \'Q..O\. ~<2--7 d--'\,-CfbY-t CONTRACTOR'S ADDRESS LICENSE NO PLAN I.D. # BLDG use COOE ._
OWNER'S MAIL NG ADDRESS
"'d-' ?-~ ~~o~~"'-e..... \J...)o/, (_~\s'oc:.,,dJ~ DESIGNER LICENSE • STANOARD PLAN# BUILDING SO. FOOTAGE
~
DESCRIPTION OF WORK q_d--~ DESIGNER'S ADDRESS 0ESIGNE R'S PHONE
' I\. ' n ,.. ,... h7-~ v-.'C.(!_ ,~'r-,v '-..9V"-''-------~ ---
.___ ~r ~A~--
-F/P F LR ELEV. NO OCC GP EDU
~ STORIES
YO NO
-
CENSUS T RACl I GP LAND ~SE rPAR~G SPACE RES UNITS I GRADING PERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRESPP
AREA CONST I , I 33~
y D ND vO NO vO NO (to( yatid l(pless M•~,ir~ Certi(ied
1 QTY. PLUMBING PERMIT -ISSUE --1~ QTY. MECHANICAL PERMIT -ISSUE 3-SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP
, INSTALL FURN. DUCTS UP TO 100,000 BTU BUILDING PERMIT 01-00-00·8220 -,0 ,~-"
EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT 01·00-00-8221
EACH WATER HEATER ANO/OR VENT BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01 ·00-00-8806 J '1'. ~ ,,--
EACH GAS SYSTEM ) TO 4 OUT LETS BOI LER /COMPRESSOR 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, REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL 01-00·00·8224 --EACH VACUUM BREAKER MECH EXHAUST HOOD'DUCTS MOBILEH0ME 01-00·00·8225
WATER S0FTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP
EACH ROOF DRAIN (INSIDE) SOLAR n1-no-nn.oooo
TOTJ;L MECHANICAL STRONG MOTION 80·92-33-0519 ~
I TOfAL PLUMBING l FIRE SPRINKLERS 01-00·00·8227
s----QTY. SOLAR -ISSUE
PUBLIC FACILITIES FEE 32·00·00·89ll
QTY. ELECTRICAL PERMIT -ISSUE BRIDGE FEE
NEW CONST EA AMP SWT BKR COLLECTORS SCHOOL FEE · DISTRICT
1 PH 3 PH STORAGE TAN KS Carlsbad 80·92·21 ·0519
EXIST BLOG EA AMP/SWT SKA ROCK STORAGE Encinitas 80-92-22-0519
1 PH 3 PH PUMP San Dieguilo 80·92· 23-0519
REMODEL AL TtR PE R CIRCUIT PLAN CHECK FEE San Marcos 80·92-24-0519
TEMP POLE 200 AMPS
OVER 200 AMPS LICENSE TAX 01-00-00-8162
TEMP OCCUPANCY 130 DAYS) MFF B0-92-57-0519
CREDIT DEPOSIT
TOTAL ELECTRICAL 1 TOTAL SOLAR TOTAL FEES PAYABLE I 31.YS-
I I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION AND PERMIT" AND DO HEREBY Exp,rahon. Every permit issued by the Budding Offic1al under the prov1s1ons of this * AN OSHA PERMIT IS REQUIRED FOA EXCAVATl()fjS OVER
I CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall expire by hmttat,on and become null and vo1d II the building or work 5· o· DEEP ANO DEMOl.lTl()fj OR CONSTRUCTION OF
I DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS authonzed by such permit ,snot commenced w1th1n 180days trom the date of such STRUCT\JAf.S OVER 3 STORIES IN HEIGHT permit or 1f the bu1ld1nft or work authonzed by such permit Is suspended or
I ISSUED TO COMPLY WITH ALL CITY COUNTY ANO STATE LAWS GOVERNING BUILDING CON abandoned al anv 11me a er the work is commenced for a CMtrtod of 180 da0 "
STRUCTION WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND p 1 . &OVEDBY DATE
I KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS. COSTS ANO AP L CANTS SIGNATURE Jf-O'(:'NER f!I""' CONTRACTOR 0
I EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEOUENCE OF THE \ ~ Q_ ~ '""l.._ ~ BY p 0 ~~~/ d, .6/. I I.J -~/-,/'J~
I GRANTING OF THIS PERMIT '-~ · HONE --..ill'
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TYPE I I DATE INSPECTOR
BUILDING I
FOUNDATION I r/
REINFORCED STEEL I I/
MASONRY I V
GUNITE OR GROUT I
FLOOR & CEILING SUB FRAME I
SHEATHING □ ROOF □ SHeAR
FRAME I
EXTERIOR LA TH I
INSULATION I
INTERIOR LATH & DRYWALL I
I
PLUMBING I
SEWER AND BUCO D IPUCO I
UNDERGROUND □ WASTE D WATER
TOP OUT □ WASTE □ WI.TEA
TUB AND SHOWER PAN I
GAS TEST I
□ WATER HEATER □ SOLAR WATER
I
ELECTRICAL I
□ ELECTRIC UNDERGROUND □ WFFER
ROUGH ELECTRIC I
I
□ ELECTRIC SERVICE □ TEMPO!i!ARY
□ BONDING □ POOL I
I
MECHANICAL I
□ DUCT & PLEM., □ REF. PIPING .. -__ ,, -. ~-:-
HEAT -AIR COND. SYSTEMS I .. :, ~ .... ----... .... . ~-· VENTILATING SYSTEMS i . I
I /
CALL FOR FINAL INSPECTION WHENJ,LL APPR1 PR/ATE
ITEMS ABOVE HA VEi BEEN A PROJI.E.[}.
FINAL I l /~
PLUMBING \ • l
' (j I
ELECTRICAL I I ~r, ~
! ' MECHANICAL I \.. '\ \ IR'"'
GAS I j\ "\ \--rt>~:::~ ... ~.'
BUILDING ,\ J ·, ',
SPECIAL CONDITIONS I . ·, I
!
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·:----:~·,\ ~
~ -~ .... , "· -
C ' ~4 .... 75~ -
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS l=====~IN,;S=P=E=C=T=O=R='="=S=N=O=T=E=S=======--====-cs;;;...,-=z======-i
REO IF INSPECTOR S •' • • INSPECTION CHECKED APPROVAL DATE •
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRES TRESSED
CONCRETE
POST TENSIONED
CONCRETE
~IELD WELDING
HIGH STRENGTH
BOLTS
SPECIAL MASONRY
PILES CAISSONS
' ·-
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• 1.;-...... • ' .J ~-
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--'
PLAN CHECK NUMBER 2:J J/ ADDRESS ,;; / ,P ~_, Received
PLANNING: TYPE OF STRUCTURE __ ~r.....=~o::~"""-· -~~->=:;;.-=·...:.,· =--O£e:211984
SCHOOL FEES: SAN DIEGUITO --------
CARLSBAD --------
% COVERAGE ------------
BUILDING HEIGHT ----------FENCES/WALLS __________ _
ENC IM ITAtlIY 05 CARLSBAD
SAN tJ.ARCOS --------
RE Q U 1 RED SETBACKS -----
:;::_T~~-z=:,-,-41~_-_·1=:~=======
· Tv!O CAR GARAGE ------------REA~ ex:
u.J 3 u..J
----------
5 ~ COMMENTS: __________________________ _
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REDEVEL0~1ENT A?PROVAL REQUIRED: ---------
LANDSCAPE PLAN CO~.M ENTS: -----------------------
ENV rner:~iENTAL REQUIREQ-'-: ----------------------
ADDITIONAL COMi'-1ENTS: -'--------------------------'
OK TO ISSUE: ~ DA_TE: /2,/40/4;yOK TO FINAL: __ DATE: _____ _
ENG I NEEfU NG LEGAL DESCRIPTION VERIFIED? ____ A.P.N. CHECKED? __
P. F .F • _______ PARK IN LIEU _________________ _
R.0.1~: _______ IMPROVEMENTS: ________________ _
_______________ E.D.U: ____________ _
SEWER: ___________________________ _
LATERAL: DRIVEWAY: ------------
~ GRADING PERMIT: ________________________ _
-u..J > I-~ ~ DRAINAGE: ____________________________ _
~ □
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C::=> □ 0::0' 0 u..J u c:::
EASEMENTS: __ _.!2""--.... K--.-.------ADDITIONAL COMM:NTS: --------
OK TO ISSUE: -.,,c.,ei......:::~:c:~------===-,:::;;;.__ __ DATE: /2-/2,/ h tz' 7 7 7 * ENGINEERING INSPECTION REQUIRED: __________________ _
PUBLIC r!ORKS INSPECTOR: _____________________ _
FINAL OK: __________ _ DATE: _______ -:--------
✓
* IF THIS ITEM IS NOT CHECKED, BUILDING DEPARTMENT WILL MAKE Alt INSPECTIONS
(DRIVEWAYS, CURB CUT, DRAINAGE, ETC.)