HomeMy WebLinkAbout2012 SUBIDA TER; ; CB890034; Permit"' z 0 .:: C IC C _,
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O I hereby affirm that I am licensed under
provlalona of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and ProfH aiona Code, and my license is In
full tore• and ellect.
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I hereby athrm 1na1 I am exempl tram the Contrac-tor's l.Jcenst Law lor the tallowing reason 1sec 7031 5
Business and Protesst0ns COde Any c,!'y Of county whttli re-quires a permal 10 coostrucl, alter. ,mprove. demohsh or
repair any siructure, pnor 10 its issuance also requires !heap-phc~nt fOf such permtl lo hie a s19ned stalemenl !hat he ,s
1tcenset:S pursuanl 10 lhe prov1s10ns 01 the tonuactor·s I Lttense Law (Chapter 9 commencing w1lh Section 7000 ol
Oiv1s10n J ol the Busmess and Protesswos Code) or that 1s ex· \ empl therefrom and lhe basis Im lhe al!egeo exemphoo A.ny
't!OlahOf'I o1 SeclM>fl 7031 .5 by an apphcant for a permit sub·
ittts the apphcanl to a c1v1I penally ot not more than t,ve nun·
dred Oollars ($5001
t. as owner ot the property. or my employees with wages
as lhetr sole compensation wdl do the work. and !he struc-ture 1s noi intended cw otlered IOJ sate (set 7044, Bus.mess
and ProtesSU>ll~ CoOe The Con1tac10, s t,,cense law does 1
not apply 10 an owner ot property who builds or improves 1
thereon and who CIOeS sucn wo,-1( 11,mself or through his own
employees. provided lhat such unprovemenls are no1 intend·
ed or offered for safe II. however. 1he bu110ing or improve-
ment ,s sokl w11h1n one yea, of compIe1t0n the owner-bu11der will have !he burden ot proving t?\31 he drd no1 burld or 1m·
prove lor the purpose ol sa1e1
I _I 1. as owner ot 1ne property. am exclusively con1rac1Ing
with hcensed conuac1ors to construc1 the prOJecl (See 7044, Business and ProfesS!Ons Code The Contractor's License
Law does not apply to an owner ot property who bu1lds or im-=f:c:!t~)l,c;;~ ;:s:;,';a~5i:: ~~fr:Cti~15t~~~S: law)
n As a homeowner tam improving my home. and 1he follow mg cond1t1ons exist
1 The work is being pertormed PftOf to sale
• 2 I have hved in my home for twelve months prlOI' to comp~llon ot lhls work 3 I have not claimed tnIs exempoon during lhe tasl three years
0 tamexemptuncJerSec ______ ,B&PC. tor 1h1s reason ____________ _
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C I hereby affnm thal I ha"e a cert,hcate of consent to
sett-insure. or a cert1hcate of Workers· Compensation In-P
surance. or a cert1hed copy I hereof (Sec 3800. Labor Code}
POLICY NO
COMPANY = Copy IS hied w11h the c11y
D Ce1t1fied copy Is hereby furnished
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need nol be completed if the permit
is '°' one hundred dollars ($100) Of lessl
0 I certify lhat in the pe1formance ot the work for which
thtS permit Is issued. I shall not employ an-, person in any
manner so as to become subject to the Workers Compen-
sation Laws of CaJ1forn1a.
NOTICE TO APPLICANT: If. after making thts Certificate
ol Ek.emption. you should become subJect to the WOfkers·
COmpensa0on PfOV1sions of the Labor COde. you must
forthwith comply with such pro"1s1ons or this permit shall
be deemed revoked.
D I hereby affirm thal there is a construction lending
agency for the pe,tormance of tile work fo, which this per•
m1t is issued (Sec 3097. C1vU Code)
Lender's Name ____________ _
Lender"s Address ___________ _
USE BALL POINT PEN ONLY & PRESS HARD -.... --------·-. ·--··-··-· -·-···--·-------------APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT
I 2075 Las Palmas Dr., Carlsbad, CA 92009-1915 (619) 438-1161
JOB ADDRESS <; .. \...:\c A
AV. ST.RO, THOMAS BROS NO.
lo{~E ;~P:1BTRNI
BUSINESS LICENSE ft 'VALUATION PERMIT NUMBER
~,~ 7°epp. 2 4?:.8\ /\n 9,928{ LOT BLOCK I SUBOl'VISION ASSESSOR PARCEL NO
~~..-rt-.
CONTRACTOFIIS PHONE• ZONE lk
t 2...(..-L, ~'2... Q
OWN~k'"' ~ ·'"' 14~::;;:;~~ CONTRACTOR'S AOORESS o\,,.• ~ A STATE LICENSE NO. BUILDING SO. FOOT AGE
,sa~ n-1: .. + u: \\ ... rv. s-:s,~cq OWNER"$ MAILING ~OORESS
c.O \L ~b-\ cl.A \ eee.. DESIGNER DESIGNER'S PHONE
DESCA>PTIO"' Of WORK
OESIG"'ER'S ADDRESS STATE LICENSE NO.
\ \~ 10 \ o .... ~, ;.. .r._.\ '~ "~l ~-'-' ,:..,:" F/P FLA ELEV. NO OCCGP EDU 4050 01/10/89 0001 01 02
-\-,o A'°.,.. v STORIES
vO NO BldPmt 15-0• l CENSUS TRACT PARK IN G SPACE I AES UNITS l GRADING PERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRE SPR
AREA CONST
I YO N D vO "□ vO NO Not Valid Un~s Machine Cmified .
<t ~~MARY/ACCOUNT NUMBER QTY. PLUMBING PERMIT · ISSUE 7-oO QTY. MECHANICAL PERMIT -ISSUE JS.~
EACH FIXTURE TRAP INSTALL FURN. DUCTS uP TO 100 000 BTU ~ u~•-•tHMI I 001·810·00-uu-oau
EACH BUILDING SEWER OVER 100.000 BTU r"\ \:,t!;ffiN PERMIT ,...{'\ 001 ·810·00·00·8221
EACH WATER HEATER ANO OR VENT BOILE A/COMPRESSOR UP TO 3 HP y -PLA~ CQ!:l,1\-;.I..JV __ 001-810-00-00-8891
EACH GAS SYSTEM I TO 4 OUTLETS BOILER/COMPRESSOR 3 15 HP \ l\~A~PLUMBING <l'!..~_....-Ol.l.~~0-00-00-8222
EACH GAS SYSTEM ~ OR MORE MET AL FIREPLACE 1--> ELEC...,_;..:: .,,-.\Cs '>Mi-810-oo-oo-8223 k<:'.~-
EACH INST AL . ALT ER, REPAIR WAT EA PIPE VENT FAN SINGLE DUCT • 0/!CH ;; .. -r 'C .,. 001 ·810·00·00·8224
EACH VACUUM BREAKER MECH EXHAUST HOOD DUCTS • ~•., .~l.EliOME 001 ·810·00·00-8225
WATER SOFTNER RELOCATION Of EA FURNACE/HEATER .. A! ~\)~OLAR 001-810·00·00·8226
EACH ROOF DRAIN !INSIDE I DRYER VENT yr STRONG MOTION 880·519-92·33
TOT.C.L MECHANICAL FIRE SPRINi<LERS 001 ·810·00-00-8227
TO I Al PLUMBINl, I PUBLIC FACILITIES FEE 320-810·00-00·8740
BRIDGE FEE 360-810·00-00-87 40
QTY. ELECTRICAL PERMIT -ISSUE ..S:00 QTY. MOBILE HOME SETUP PARK-IN-LIEU (AREA )
NEW CONST EA AMP SW! 8KR CAR PORT TIF 312-810-00-00-8835
I PH 3 PH AWNING LA COSTA TIF 311-810-00-00-8835
EXIST BLOG EA AMP!SWT SKA GARAGE FMF
1 PH 3 PH LICENSE TAX 001·810·00·00·8162
REMODEL ALTtR PEA CIRCUIT /(} MFF 880-519·92·57 .
TEMP POLE 200 AMPS
OVER 200 AMPS
TEMP OCCUPANCY 130 DAYSI
CREDIT DEPOSIT
" TOTAL ElE(IRICAl I 15"-TOTAi TOT AL FEES PAYABLE I Jt)-C
1 HAVE CAREFULL y EXAMINED THE COMPLETED 'APPLICATION ANO PERMIT' AND 00 HEREBY Exp,ration E-y permit •ssu«I by Ille Butldtng Oll1c1al uncle< lhe provrs1on1olth11 * AN 06HA P£Mt:T IS AEOUIN:D FOIi EXCAVATIONS O'IEA
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code lhllll •xp,re by trm,t•t,on ana become null Ind vord If the building or work 5 O" DEEP ANO DEMOLITION 01! CONSTRUCTION OF
DECLARATIONS ARE TRUE AND CORRECT ANO I FURTHER CERTIFY ANO AGREE IF A PERMIT I~ aull'lorlled by auch permit '1 not commenced will'lin !BO days from Ille date OI such STRUCTURES O'IEII 3 STORIES IN HEIGHT • permit. 0t 1f the buddt:ft or work authonzed by 1uch pe(mit 1s suspeneled or ISSUED TO COMPLY WITH ALL CITY COUNlY ANO STATE LAWS GOVERNING BUILDING CON abandoned at anv t,rne a er,,,. work ,, commenced tor a Dtlflod ot ,1111 .......
STRUCTION WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND IGNATURE • OWNER□ CONTRACTO,JS. APPROVED BY r 1/ loi//cfn KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS. COSTS ANO ('ICAN
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE 'AAA •
GRANTING OF THIS PERMIT ---" BY PHONE n
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TYPE ' DATE INSPECTOR I
\1'i.. \,... ' ' . .... -
BUILDING i
FOUNDATION I
. \_ C!.6s~oo.a4
FIELD INSPECTION RECORD
REINFORCED STEEL I
I
MASONRY j REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
GUNITE OR GROUT I INSPECTION REQ. IF INSPECTOR'S DATE CHECKED APPROVAL
SUB FRAME □ FLOOR □ CEl~ING
SHEATHING D ROOF D SHEAR SOILS COMPLIANCE
PRIOR TO
FRAME I FOUNDATION INSP -
EXTERIOR LATH I
I
STRUCTURAL CONCRETE
OVER 2000 PSI
INSULATION I PRES TRESSED
INTERIOR LATH & DRYWALL I
I
I
CONCRETE
POST TENSIONED
CONCRETE
PLUMBING I FIELD WELDING
□ SEWER AND BUCO □ PI-/CO
UNDERGROUND □ WASTE □:WATER
HIGH STRENGTH
BOLTS
TOP OUT □ WASTE □ WATER SPECIAL MASONRY
TUB AND SHOWER PAN I
GAS TEST I
□ WATER HEATER D SOLAR WATER
-,,,,~.
""'!'°'r r -
PILES CAISSONS .... · •'-.5;;/.
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ELECTRICAL ' .
□ ELECTRIC UNDERGROUND D UFFER
ROUGH ELECTRIC ' I □ EL~CTRIC SERVICE D TEMPQRARY
'/· ~•.t~•-:-,.._ ,:°' rl --,,
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D BONDING D POOL I
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MECHANICAL I
D DUCT & PLEM., D REF. PIPING
HEAT -AIR COND. SYSTEMS I
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f'":Cit-.lP: ni
,20 or,ro\eo ooor or ,~
VENTILATING SYSTEMS I
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CALL FOR FINAL INSPEc,uoN WHEN ALL APPROPRIATE
ITEMS ABOVE HA E BEEN APPROVED.
FINAL I I
PLUMBING I '
ELECTRICAL I a'\. I
MECHANICAL I CL \"'--
GAS I \ " -~ \ \
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BUILDING I l"' ~ I
SPECIAL CONDITIONS I --•
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