HomeMy WebLinkAbout2012 SUBIDA TER; ; CB881559; Permit"' z 0 ;:::
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I USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. ----·-·-. -··-· . -·--·--· ---·-----·--·-·--. . ·-·-· -.. -·-----···-·--·· ..
'llii. I hereby affirm thal I am licensed under
iJ«;,111001 of Chapter 9 (commencing with
Section 7000) of Division 3 of lhe Business
and Profq1lon1 Code, and my license Is In
lull force and effect.
I hereby alflrm !hat I am uempt from lhe Conlrac· tor's lteense law tor !ht lollow1ng reason (Sec 7031 5
8usu1ess and Protesst00s Code Any c1ly or county whteli re-quires a permil to construe!. aller. improve c,emohsh or repair any struclure, pr,o, to its issuance also requues !heap-
phcanl tor such pernv1 to ti~ a S1SJned statement that he 1s licensed pursuanl to lhe piov1sl()Os ot lhe Contractor s
License Law (Chapter 9 convnencmg with Section 7000 of
OMsK>n 3 ol lhe Business and Pfotessioos Code) or lh.at 1s ex-
empt therelrom and lhe basts for the anegea exempl!on Any v1ofalioo ot SectlOn 7031.5 by an applicant tor a permit sub· ,eels lhe appllcanl to a CMI penalty of not moJe lhan l1•1e hun-
dred dollars ($500}
1 I as owner of !he properly, or my employees w!lh wages
as their sole compensalion. will do the wOfk and the suuc·
ture rs no! mtencted or ottered lor sale (Sec 7044 Bus,oess
and Protesssons. COde The Con1rac1or·s lttense Law does nol .1pply lo an owner of properly who builds 01' improves
thereon and who ctoe:s such work htmsel1 or lhrough his OW'R employees, prowtded lhat such wnprovemenIs are not intend-
ed or ottered lor sate 11. however. Ihe bu1ld1ng or ,mprove-menI ,s sold wtlhm one year ot complellon the owner-bu11der
Wtll have lhe burden 0, proving Iha! he dld not bu11(1 0, wn-prove for rt,e purpose ot sale)
l I. as owner ot the property. am exclusively conlracltng • wilh hcensed conlractors 10 construcl lhe proiecI (Sec 7044.
Business and Professt0ns Code The ContractOf''s License Law does not apply to an owner of property who butlds o, im-
proves thereon. and who contrJCIS tor each prOfects wnh a co~~lor(s) hcense pursuant to the Con1rac1or·s License Law}
I J As a homeowner I am 1fflP(oving my home. and the lollow
mg condiUons exist: 1 The work 1s being perto,med pllOr to sate
., 2 ~,::~~ ~::le;'!m ~~ 1~~worft lwetve months J
3 I have not claimed this exemphon during the I last lhree years
D I am exempl under Sec ______ , B & P C for this reason ____________ _
0 I l\eret>y affirm that I have a certificate of consen110
self-insure. Of a cer11hcate of Workers Compensation In-
surance or a cert1lled copy 11\ereot tSec 3800. Lat>cK Code} •
POLICY NO
COMPANY
Copy IS hied With the c,ty
0 Ce1t1f1ed copy 1s l\ereby furnished
CERTIFICATE OF EXEMPTION FROM WORKERS" COMPENSATION INSURANCE
(This secUon need not be compteted If the perrmt
rs for one hundred dollars tS 100) or less)
l I
0 I certity that 1n the performance of the work for which t ::~=~~t ~: i1~s=~~:h:~lb~=~~~~\~:k:;~ro:;p:n: {
sa11on Laws ol CahfOJma t
NOTICE TO APPLICANT. It. after making !his Cer1iflcate f
ol E11:emption. you should become subject to the Workers· 1
Compensation provisions of the LabOf Code. you must
foohwtlh comply with such provisions or this permit shall
be deemed revoked
D I hereby aff1rm that there ,s a construction lend1no 1
agency for the performance of the work tor which this per-I
m•t is issued (Sec, 3097. C1V1I Code) I
~nder's Name _____________ I
l ender's Address ____________ I
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT ,-, 2075 Las Palmas Dr., Carlsbad, CA 92009-1915 (619) 438-1161 . ~
J08 ADDRESS AV. ST.RO. THOMAS BROS NO. I DATE OF APPLICATIO~I BUSINESS LICENSE • ~UATIONf'-PE~T NUMBER
~o,~ ~"' 1,;dA 7 ~£# ~ j /-C::, ,-~ ~6be)
LOT l 8LOCK I sueD>v1s10N I ASSESSOR PARCEL NO . COK.ACTOR CONTRACTORS PHONE • ZONE (!£> i~t6S-? .J t~ y,g I Dg'C() () \ -.~c..t 'e. .·,\A,~v.. t2.L-C~')Q OWNf A'S NAME ' ,~ c_t ~:E; ~O;E< <:.:,APILL'-
CONTRACTOR'S ADDRESS STATE LICENSE NO. BUILDING SO. FOOTAGE
\ c;-Q R (":\ . ·,.at-ll. \ \c._ 't\, ~~, 1-r\4 -070 OWNER"S MAit .. lNG AOOAESS
') r"\ \ '}_ C . \ ...... \A ~ T,d " ~""' DESIGNER OESIGNER•S PHONE
oes7l,' ,o)l~" ~erlt:! Al. a .,.__ ~A .A .,.. • ..... .,
3218 W21/88 0001 01 02
DESIGNER'S ADDRESS STATE LICENSE NO. EldP11t 120-0< , V ~ -v
FIP F LR ELEV. NO OCC GP EDU
STORIES
vO NO I CENSUS TRACT I PARK I NG SPACE I RES UNITS I GRADING PERMIT ISSUED I REDEVELOPMENT TYPE ;c,t" Fl RE SPR
-AREA CONST
vO ND vO NO vO NO Not Valid Un!n, fthchine Certditd
15-~t'G:lt
\,---....
QTY. PLUMBING PERMIT · ISSUE 7. 6l) QTY. MECHANICAL PERMIT · ISSUE ~ ·"Q..~ SU~MARY/ACCOUNT NUMBER
EACH FIXTURE TRAP INSTALL FURN DUCTS iJP TO 100.000 BTU ,r'.V.' c§.Ul~~ _ .. -.i ;>'Vul·~ lU·UU·00·~au /, -
EACH BUI LO ING SEWER OVER 100,000 BTU '-' . \, SlGN P •· ,t. -.,-.-001·810·00·00·8221
EACH WATER HEATER ANO,OR VENT BOILER/COMPRESSOR UP TO 3 HP . \Y.. P.'_':"'""~~w,. 001·810·00·00·8891 ll7 -
EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3 IS HP ...,\TOTA~BING 001 ·810·00·00·8222
EACH GAS SYSTEM S OR MORE METAL FIREPLACE -~ -.. ~1uicTRICAL 001·810·00·00·8223
EACH INSTAL. ALTER. REPAIR WAT ER PIPE VENT FAN SINGLE DUCT ~.(' ►\"~ MECHANICAL 001·810·00·00·8224
EACH VACUUM BREAKER MECH EXHAUST HOOO!OUCTS -~.., MOBILEHOME 001·810·00·00·8225
WATER SOHNER RELOCATION Of EA FURNACE/HE ATER y SOLAR 001 ·810·00·00·8226
EACH ROOF DRAIN PNSIDEJ DRYER VENT STRONG MOTION 880·519·92·33 I -
TOT!;L MECHANICAL FIRE SPRINi<LERS 001·810·00·00·8227
TOTAL PlUMBINu I PUBLIC FACILITIES FEE 320·810·00·00·87 40
BRIDGE FEE 360·810·00·00·8740
QTY. ELECTRICAL PERMIT · ISSUE ,'>. /Y) QTY. MOBILE HOME SETUP PARK·IN·LIEU (AREA )
NEW CONST EA AMP SWl 8KR CAR PORT TIF 312·810·00·00·8835
1 PH 3 PH AWNING LA COSTA TIF 311·810·00·00·8835
EXIST BLOG EA AMPISWT BKR GARAGE FMF
I PH 3 PH LICENSE TAX 001 ·810·00·00·8162
REMODEL ALHR PER CIRCUIT MFF 880·519·92·57
TEMP POLE 700 AMPS
OVER 200 AMPS -
TEMP OCCUPANCY 130 DAYSI
' CREDIT DEPOSIT
TOTAL ELECTRICAL I TOTAl TOTAL FEES PAYABLE l IAJ--
1 HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION AND PERMIT · AND DO HEREBY Eap,rat,on E-,o perm,l 11suedbytl!e8ulldtng0N,c1lllundertheprov,s1onsotth11 * AN OSHA P£AM:T IS REQUIREO FOR EXCAVATIONS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code Shall ••11t•• by hmitat,on and become null ano VOtd II Ille budding OI work S' O" DEEP 4NO Df.MOUTIOtl OR CONSTAUCTIQt,I OF
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT I!> aulhor,zed by euch perm,t 15 not commenced wilnm t80 days from Ille date ol sucn STRUCTURES OVER :, STORIES IN HEIGHT permit o, ,t Ille llu11dajl or work authonzed by ouch perm,t 11 -pended or
ISSUED TO COMPLY WITH ALL CITY. COUNlY AND STATE LAWS GOVERNING BUILDING CON abandoned at anv bme a ., the work ,, commenced to,. -nod of tlln "'·-· . .
STRUCTION WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND 0::CTURE • OWNER□ CONTRACTO~ APPROVED BY /J iDAtju/t3 KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS, COSTS AND
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE /t -av ""°"'E O GRANTING OF THIS PERMIT \\ • _ "\
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TYPE : DATE INSPECTOR I
BUILDING I
FOUNDATION I ~ ,Al 11 ,,/,
REINFORCED STEEL I LI,•£."'·-, rv-'-I
MASONRY I
GUNITE OR GROUT I
SUB FRAME D FLOOR D CEl~ING
SHEATHING D ROOF □ S..,EAR
FRAME I
EXTERIOR LATH ' I
INSULATION I
INTERIOR LATH & DRYWALL I
' I
PLUMBING I
D SEWER AND BUCO D PL/CO
UNDERGROUND □ WASTE □:WATER
TOP OUT □ WASTE D WATER
TUB AND SHOWER PAN .
GAS TEST I
D WATER HEATER □ SOLAR W'(!. TEA
f . ELECTRICAL ' I
D ELECTRIC UNDERGROUND □! UFFER
ROUG!i ELECTRIC I
□ ELECTRIC SERVICE D TEMPQRARY
□ BONDING □ POOL I .
I
MECHANICAL I
I
□ DUCT & PLEM., □ REF. PIPlt,IG
HEAT -AIR COND. SYSTEMS I
VENTILATING SYSTEMS I
I
I -
CALL FOR FINAL INSPECTiON WHEN ALL APPROPRIATE
ITEMS ABOVE HA ~E BEEN APPROVED.
FINAL I . " PLUMBING I / "1 :,.'14 v, ./._
ELECTRICAL . I' 17'D I I '{; ~ I
MECHANICAL I
I
GAS j
BUILDING .
I
SPECIAL CONDITIONS I .
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(!,8 B'<is' I S.!l7 \ I
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES .
INSPECTION REQ_ IF INSPECTOR'S DATE CHECKED APPROVAL
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRESTRESSED
CONCRETE
POST TENSIONED
CONCRETE
FIELD WELDING -.,
HIGH STRENGTH
BOLTS
SPECIAL MASONRY
PILES CAISSONS ~~:.. .. ,., ...........
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