HomeMy WebLinkAbout1418 SWEETBRIAR CIR | 1420 SWEETBRIAR CIR; ; 81-388-3; Permit.S--L
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D I hereb) }n that I am licensed under
provisions ~ vnapter 9 (commencing with
Section 70CA.'f of Division 3 of the Business
and Professions Code, and my license Is In
lull force and effect.
Lit No _______ Class
I hereby affirm that I am exempt from the Con· ~~a;·~~~;:;::~ ~t~~.~~~'9:~l~
couoty which requires a permI1 to construct alter, amp,ove, demolish. or repair any structure,
pnor to its issuance also requires the apphcant for such perm,t to fife a signed statement that he 1s
ltcensed pursuant to the prov1s1ons of the Con·
tractor's Ucense law (Chapter 9 commencing with Sectton 7QlO of D1v1s100 3 of the Business and Pro-
tess,ons Code) or that 1s exempt therefrom and the
basis for the alleged exemprion Any v1olahon of ~=~~~:: ~y~~, ~r ,:,rm:~~~~: ,
hundred doll0l1i iS500)
rri. 1, as owner of the praperty, or my employees ~ wages as the11 sole compensation, will do the
wo,k, and the structure 1s not intended or ottered fOf'
sale (Sec 7044, Business ,and Professions Code The Coruractor's Lteense Law does not apply to an
owner of p,operty who builds 01' impro.,es thereon
and who does such wOt1l himself°' thrOUQh his own
employees. provided thal such ,mproveme;its are not mtende"j or ortered for sale If. howe...er, the
=~~t~.'~~~=:u:f~1~•::;~ ~ ~:'~~ 1 of ptO'lln0 that he did not build or Impr0Ye tor the I
purpose ot sale). I
□ I, as owner of the property. am exclusively
contract1n~ with licensed contractors to construct the Pfoteci (Sec 70M, Business and Professions
Code· The Contractor's License Law does not apply
to an owner of property W'hO builds or improves ~-:::;i~ 7i~nc~~~!~~~ ~~~h~~~~~;~~-:
License Law).
□ I am exempt ul'\der Sec ___ ,8 &PC
fOf this reason __
ii.if: hereby affirm that I ha'le a cen1hcate ot consent lfo".self-msure. or a certIf1cate ot Workers'
Compensation Insurance. or a cer11f1ed copy thereof
!Sec 3800, Labo< Code) /
POLICY N~a_-_f~ @7 JJ -~-
COMPAN,&;,9.'7t:: /-,tJ. en r • (!..
li(' Copy IS hied wolh t~ coty µ
~r11f1ed copy Is hereby furnished
CERTIFICA.Tl OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE
(This secllon need not be completed ,t the permit ,s fOf one hundred dollars (S100} or less)
D I ceri,ly that ,n the per1ormance ot lhe wOB tor
which lhlS p,ermI1 IS issued. I shall nol employ any person in any manner so as to become subIecl to
the Wo111.ers· Compensation Uws of Cahforn,a
NOTICE TO APPLICANT It, after makinJ this Cet11
hcate of E•emphon you should beCome subJecl I?
lhe WMers' Compensatton pro.,1st0ns of I1'\e Ubor
Code. you musl forthwith comply with such
p,ov1s1ons or !his permit shall be deemed revoked
O I he,eby aft1,m thal there Is a cons1ruct1on 1end1ng agency to, the pertormance ot the wor1t lor
wtuch ttus permit •s issued (Sec 3097 C1v1I Code)
Lenoet s Name ___________ _
Lende(s Address __________ _
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USE BALL POINT PEN 0'1_'V & PRESS HARD
---.,.., CARLSBAD BUILDING DEPARTMENT ) ... ---APPLICATION & PERMIT ., .
APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA A QECLARATIONS.
'-.,Ii\ 1200 Elm, Carlsbad, California 92008 (714) 438-5525
JOB A.O0RESS f' J 4-~ ... ~·;,T·I DATE o~;PLICATIONI BUSINESS LICENSE# /1 VA~-i;.r / PERMIT NUMBER
11-/18 S .l'.-:Eerre>,fv,,4,rc, c£1,0c~~ 1t1s;t1 I ---;-Vl)½J
OWNER'S NAME I owNeR·s PHONE PRIME coNTRAcToR I I coNTRACTORs PHONE• zoy (1 ti .:2.
hl D4-N J .N7'c~J~k..),t.~5'1~.v1 ,t/.3d, 33lc ~/)/;,IJhv-;;--.,.;:::-N.RhSS/tt<-1 #.-3{>-..331-,,,., f\_-/ -~ ol-3~b --.J
OWNER'S MAI.LING ADDRESS • CONTRACTOR'S AODRESS ,-LICENSE NO. P~N 1.0. # /1 BLOG USE CODE
?;,c . .Bx. ./.3qg {;4-,e~s.A~r. <!A a,~~R ~~~£"' //;z . .&:=,£. ~ ~ -~I· ~'ii~
L9-1'. l BLOCK I suBotv1s10N I ASSESSOR PAR·c· EL No. 1,;_, "' 0EsIGNER _ _ . STATE LICENSE,. sTANoARo PLAN# BUILDING so.~°(/GE
(7 ,;;; /,;) -f Pt'"•-~ *'O V I / -;> , J -J "
DESCRIPTION OF WORK ('/ ~ L / '5 X , /Vt N~ z V"(../ ?7,{,., /<("'77'-'. VC''7 /.2. .l); ,/>,<. ,e. x /6).;;) 0 ~; F-r-lf-o-'::E'='s1c:cG.,-:N-,;:ER~.-=-s-"Ac:"o:.,:CoR--E-"s'--s~)'-:;,.'1'9~;;S-=_=-;;,-=.o,,._ib...,,__,v,P.-.-(..,./,,g~+,;-//-JGJ-E-R'-S-PH-O-N-E-.....,_ _______ --1 ____ ~-!.,_----<
;)..G ~ ,,;.,</ ~ ... >.r-=CZ:13-J./d~~v ?4i.-=-.fie;<" 1
...c-=~ ~ · -------:~ NO FLR= s/f,iEs tG~ V .1,0{2V8,1,l,6!2 666,30
CENSUS TRACT I GP LAND use I PA?f':;..G y'f_e I R~ I GRADING ~EAMIT 1ssuEo I :~~;,.VELOPMENT J:JlTI occ LOAD FIRE SPR . ~ r, y D N D v□ Nhl. vro vkl NO Not v~lid Unless Machine Certified , '
QTY. PLUMBING PERMIT. ISSUE 7 c.c; () QTY. MECHANICAL PERMIT· ISSUE 3 . Q(""', SUMMARY/ACCOUNT NUMBER 1
EACH FIXTURE TRAP INSTALL FURN . DUCTS i.JP TO 100,000 BTU BUILDING PERMIT l.J-/ -J/ ,-
EACH BUI LO ING SEWER OVER 100,000 BTU SIGN PERMIT ~.
EACH WATER HEATER AND/DR VENT -BOILER/COMPRESSOR UP TD 3 HP PLAN CHECK -J.A~ ~ 'N
EACH GAS SYSTEM l TO 4 OUTLETS BOILER/COMPRESSOR 3·15 HP TOTAL PLUMBING /
EACH GAS SYSTEM 5 OR MORE ------+--+METAL FIREPLACE ELECTRICAL
EACH INSTA~ .. ALTER . REPAIR WATER PIPE VENT FAN SINGLE 0UCT MECHANICAL
EACH VACUUM BREAKER MECH EXHAUST -HOOD/DUCTS MOBILEHOME
WATER S0FTNER RELOCATION OF EA FURNACE/HEATER M0BILEH0ME PARK INSP
EACH ROOF DRAIN (INSIDE) SOLAR 1 ~
TQT,t:;L MECHANICAL STRONG MOTION /_ ,_ fl')
~ TOTAL PLUMBING -. --r-FIRE SPRINKLERS
PUBLIC FACILITIES FEE
QTY. ELECTRICAL PERMIT. ISSUE ~QO QTY. SOLAR . ISSUE BRIDGE FEE
NEW CONST EA AMP/SWT BKR COLLECTORS SCHOOL FEE· DISTRICT ---+-------f-------------------1----------1
1 PH 3 PH STORAGE TANKS Carlsbad
f_XIST BLOG EA AMP/SWT/BKR ROCK STORAGE Encinitas
1 PH 3 PH PUMP San D1egu1to
REMODEL/ALTER PER CIRCUIT PLAN CHECK FEE San Marcos
TE MP POLE 200 AMPS
OVER 200 AMPS
TEMP OCCUPANCY (30 DAYSI ---·-
TOTAL ELECTRICAL ,---TOTAL SOLAR TOTAL FEES PAYABLE I t, ff l, ~
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION ANO PERMIT" ANO DO HEREBY Exp,rat,on Every permit IUued by the Budding 011,c,al under the prov,s,ons olth'" * AN OSHA PERMIT IS REQUIRED FOfl EXCA\IATIONS OVEfl
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall expire by llm,tahon •nd become null "nd vo,d If the building or work ~· O" DEEP ANO OEMOLITION QA CONSTRUCTION OF authonzed by such permit ,s not commenced within , 80 days trom the date of such DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS permit. or ,f the building or work authorized by such permit II suspended or STRUCT\JR£S OVER 3 STORIES IN HEIGHT
ISSUED: TO COMPLY WITH ALL CITY. COUNTY AND STATE LAWS GOVERNING BUILDING CON• abandoned at anv time alter the work ,s commenced for a nanod of 180 dav• ,.
STRUCTI0N, WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND .J,PUCANT'S SIGN~E .. . . --'l.>I . C. O C O ."11'1 APPROVrD BY ~~ KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS. COSTS ANO . ~ C OWNEJV>1-NTRA T R,,..,__ f L 3'J
EXPENSES wH1cH MAY IN ANY WAY ACCRUE AGAINST sAI0 c1TY 1N coNSEOUENcE oF rtie, A. ,.. .-· "/;:__"!-,,1~,. /-./l< ... u,;.~,:c '"'' BY PHONE O 1 ~ I 1/
GRANTING oF THIS PERMIT. ~ .<-..... ,,.. .• (_:, \·<a,.!'d-· Y-A . ./ • J..,,, _ ... ~
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l DATE INSPECTOR 81-'?:i 'i(~ -.3 ' ' BUILDING I
I FIELD INSPECTION RECORD t FOUNDATION I
f
REINFORCED STEEL I REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
I INSPECTION REO. IF INSPECTOR'S DATE MASONRY I CHECKED APPR OVAL
GUNITE OR GROUT l SOILS COMPLIANCE
FLOOR & CEILING SUB FRAME I PRIOR TO
i FOUNDATION INSP
SHEATHING STRUCTURAL CONCRETE
FRAME I __., OVER 2000 PSI I
EXTERIOR LATH lNSULATION ~~ ,, ~ -'--PRESTRESSED
,1'S,..J~) CONCRETE
INTERIOR LATH & DRYWALL I ..:r;:-; tR--fa. L~ ~ POST TENSIONED
CONCRETE PLUMBING l FIELD WELDING
I SEWER AND BL/CO HIGH STRENGTH -:
PLUMBING UNDERGROUND r BOLTS -
PLUMBING TOP OUT I SPECIAL MASONRY I
TUB AND $HOWER PAN ' I
GAS TEST i PILES CAISSONS
ELECTRICAL i -! TEMPORARY POWER
ELECTRIC UNDERGROUND I .. . ROUGH ELECTRIC .,
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ELECTRIC SERVICE I ~ . BONDING A ,,
-' ·' ~ ... I -G. F. I. -SMOKE DETECTOR. I ,-I . I ❖ . I MECHANICAL I . .
' I I . DUCT & PLEM., REF. PIPING
' \ . -, --HEAT -AIR COND. -SOLAR SYSTE~S
VENTILATING SYSTEMS I .
'·
CALL FOR FINAL INSPECTION ~HEN ALL APPROPRIATE
•, ITEMS ABOVE HAVE !BEEN APPROVED. ,. o,./' V ' ' .. JOB SITE FINAL . ~\~.L'S -PLUMBIN.G ~ v.,,...x~ . -. '
If -7 <.e v · . .. ELECTRICAL •.. ,'\ ~/,.., r'-' ' MECHANICAL .. ) ' GAS ,Yn..• \ I
• , I t---V
\ ' ·' BUILDING
SPECIAL CON[YTIONS 1~~ CERT OF OCCUF ~YISSUED ' ,. , .. r i. L 1
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O I hereby , _ m that I am licensed under
provisions of t.napter 9 (commencing with
Section 7000) of Division 3 of the Business
and Professions Code, and my license Is In
full force and effect. I.JC No _____ Cliss
I hereby affirm that I am exempt from the Con-;.r:~o;·s~!~,:'; ~ ~,~~=,~~ . .r-:~~
county whteh requires a permn to eons1ruc1
a11er. 1mpr0¥e, demohsh, o, repatr any structure, pnor to its issuance also requ,res the appheant for
such penn,t to hie a sioned statement that he 1s
hcensed pursuant to the prov1s1ons of the Con· tractor's L«:ense Law (Chapter 9 commencing wirh
Sect.on 7tX.O of Otv1sion 3 of the Business and Pro-
tess.ons Code) Of that ,s exempt therefrom and tne ,
b&s•s fOf the aneged ••emphon Any vt<>&alton of
SecttOn 70315 by an aipphcant for a penn1t sut>tects
tne applicant 10 a c1v11 penalty of not more than hve
hundred cloU~ ($500)
□ I. as owner ol the property. o, my employees
,.,th wages as their sote compensaHon. will do the WOf'1il. and the stn.,cture Is not intended Of offered fOf
sate (Sec 7(),M, &s1ness and Professions Code
The Contractor's Lteense Uw does not appfy 10 an owner of Pfoperty who builds or lmp(oves !hereon
and who does such wonc himself o, through hts own employees. prov,ded that such improvements are
not 1ntendr.t or ottered for sale If. l'loWevel, lhe
building Ot 1mp,0¥ement 1s SOid w,ttun one year of
comptettOn, the owner-builder will have the buroen
of proving Iha.I he did not bulld or improve tor the
pyri:,ose ol salel.
□ I, as owner ot the propeny. am e.:clus1vety
contract.nv with hcensed contractors to construct
the pro,ect (Sec 70,,U Business and Professions Code· The Contracto(s License Law does not apply
10 an owner of property who builds or improves =i~ ~~c:'~~!~ ~~t!r~~~;;:.:
LJcense Law)
D lomexemplunde<Sec _ __ __8 &PC
tor lh1s reason
0 I hereby afhrm thal I nave a cert1t1cate ol consent
to self•1nsure. or a cen1hcate ot Worti.ers' CompenSiiltOn Insurance, Of a een1f1ed cc>py thereof
!Sec-3800. Labo< Code>
COMP~Y IA~
IS hied w11h tne c,,;;,, I""'
0 Cen1f1ed coc,y ,s hereby t·urn1sr.ec,
CERTIFICATl OF EXEMPTION FROM WORKERS" COMPENSATION INSURANCE
{Ttws sect'Of'I need not be completed 11 the ~•t 1s l<X one hundred dollars (S 100) or less)
0 I certify that in the perlormance ot lhe wOtk tor wh.ch this permit ,s issued, I shall not employ any
person in any manner so as to beeome sut>Iec t to
the Wontets· Compensatt0n Laws of C,111ornia
NOTICE TO APPLICANT 11. alter malun; 1n,s Cer,,
tote of Eaemphon. you shoo'<' beeome subject I? the Workers· Compensation prov,s,ons ot 11\e Labor
Code. you musl f<X1hw1lh comply w1lh such
prOY1sK>ns or this perm11 snau t>e oeemec revokec:J
O l hereby affirm 1nat there 1s a construc11on
1en<11ng agency tor th~ peri0'mance ot 1he wOfk f0'
whtCtl lh,s pe,mit IS tSSued tSec 3097 C,v,f Cooe1
Lenders Name ___________ _
Lenders Address __________ _
v ..... _..,,., .. 'v,, ......... \,Cf ... J " .. ..,.., ,,..,,"_ ------------------. ---·-·-----. ------------------------"".Ji -.:--------·---------
CARLSBAD BUILDING DEPARTMENT V APPLICATION & PERMIT -
1200 Elm, Carlsbad, Callfornla 92008 (714) 438-5525
JOB AODRESS AV.ST.,DATE OF ~ATIONI BUSINESS LICENSE • VALUATION PERMIT NUMBER
M13,J.o dOl.3:-13-r Be;~ c,~~ RD. //J ~ I
~;;;;~I 0~ /1'.S!lt>,{, ~'3;~;;;7cx PRIME CONTR"'-!.2.!!-, / ~ CONTRACTORS PHONE • ZONE <?f-:$-3/J_ ~ I _j_ ___ ~ •/'. ,. 7 v: 1/ ~.SnM
OWNEA"S MAILING ADDRESS CONTAACTo's "less LICENSE NO PLAN 1.0. II BLOG USE COOE
?CJ~ /.3.£/'8 (!_ #!,;LS -8 A-D
LOT I BLOCK I sueDI v1~10N I ASSESSOR PARCEL NO. DESIGNER l(Y STATE LICENSE# STANDARD PLAN# BUILDING SO. FOOTAGE
0ESCA!PTION OF WORK ) •-r-•-Ir,-,■ -----DESIGNER"s'"AI DRESS DESIGNER'S PHONE .~ ." , -'7 .. ,_.:. --' -.... ., .. _.
~ IV'7~1NG-
J
--FI P FLA ELEV. NO OCC GP EDU
STORIES
vO NO --
CENSUS TRACT I GP LAND USE I PARKING SPACE I RES UNITS I GRADING f'.EAMIT ISSUED I REOEVELOPMENT TYPE OCC LOAD FIRE SPR AREA CONST
TO N 0 v O NO vO NO Nor Valid Unlffs Machin~ ~rtifi«I
QTY. PLUMBING PERMIT · ISSUE 7~ QTY. MECHANICAL PERMIT -ISSUE Jf\ , '~ SUMMARY/ACCOUNT NUMBER
/'I EACH FIXTURE TRAP ~~~ INSTALL FURN. DUCTS UP TO 100,000 Q.TU ·" J ' \. Bt!I LDING PERMIT
j EACH BUI LO ING SEWER _(.P~ !\'tER 100.000 B\1,1. t,.J"" \\ .r'-nilGN PERMIT --v EACH WATER HEATER ANO/OR VENT -·~· BOILER/COMPRESSOR UP\N) 3 HP 1 \" :,r. ,1 PLAN CHECK ~ v-_,r .... -
,..1 EACH GAS SYSTEM I TO 4 OUTLETS <n..-BOILER/COMPRESSOR 3-15,P t\ '\}J \ .. ) ,. ~ TOTAL PLUMBING .57:-------
EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE i\ l-' " ~ ~ } ~ ELECTRICAL --
EACH INSTA~ .. ALTER. REPAIR WATER PIPE VENT FAN SINGLE DUCT ...x I\ \.. lY " MECHANICAL
EACH VACUUM BREAKER MECH EXHAUST -HOOD/OU TS /)?' \JI. MOBILEHOME --
WATER S0FTNER RELOCATION OF EA FURNA E/HEAT~ ry MDBILEHOME PARK INSP
EACH ROOF DRAIN (INSIDE) \ SOLAR
~~~ TQT.t;L MECHANICAL STRONG MOTION
~ I TOTAL PLUMBING FIRE SPRINKLERS
PUBLIC FACILITIES FEE
Q TY. ELECTRICAL PERMIT -ISSUE QTY. SOLAR -ISSUE BRIDGE FEE
NEW CONST EA AMP'SWT BKR COLLECTORS SCHOOL FEE · DISTRICT
1 PH 3 PH STORAGE TANKS Carlsbad
EXIST BLOG EA AMP/SWT/BKR ROCK STORAGE Encinitas
1 PH 3 PH PUMP San 01egu110
REMODEL/ALTER PER CIRCUIT PLAN CHECK FEE San Marcos
TEMP POLE 200 AMPS
OVER 200 AMPS
TEMP OCCUPANCY (30 DAYS) ---. I -
TOTAL ELECTRICAL TOTAL SOLAR TOTAL FEES PAYABLE I ~~
I HAVE CAREFULLY EXAMINED THE COMPLETED '·APPLICATION ANO PERMIT"" ANO 00 HEREBY Exp,ra1,on. Every permit osaued by the Bu1ld1ng 011,c,al under the prov,aIona ofth1a * AN 06HA P£RMIT t$ AEQUlflEO FOR EXCAVATIONS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall e•p11e by hm1ta11on and become null and void If the buIldIng or work s· 0 .. DEEP ANO 0EMOUTlON OR CONSTRUCTION OF
DECLARATIONS ARE TRUE ANO CORRECT ANO I FURTHER CERTIFY ANO AGREE IF A PERMIT IS 1uthor1zed by such permtt 11 not commenced within 180 days from lhe date of such STRUCl\JAES OVER 3 STORIES IN HEIGHT perm,1. or ,t the butld<::X.,or wort< authorlled by such permol 11 -pended or ISSUED TO COMPLY WITH ALL CITY. COUNTY ANO STATE LAWS GOVERNING BUILDING CON• abandoned at any 1,me a the work is commenced for a D8nod of t llil "•u• STRUCTION. WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY ANO APPLICANT'S SIGNATURE • OWNER □ CONTRACTOR 0 APPROVED BY
I OA~/
KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS. COSTS ANO ~ EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE BY PHONE 0 GRANTING OF THIS PERMIT
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BUILDING I FIELD INSPECTION RECORD
FOUNDATION
REINFORCED STEEL REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTION REQ IF INSPECTOR'S DATE MASONRY CHECKED APPROVAL
GUNITE OR GROUT SOILS COMPLIANCE
FLOOR & CEILING SUB FRAME PRIOR TO
FOUNDATION INSP
SHEATHING t STRUCTURAL CONCRETE I
FRAME I ' OVER 2000 PSI
I PAESTRESSED EXTERIOR LATH lNSULATION I CONCRETE
INTERIOR LATH & DRYWALL POST TENSIONED
CONCRETE
PLUMBING I FIELD WELDING --15,n.i~ I/~ SEWER AND BL/CO HIGH STRENGTH
PLUMBING UNDERGROUND BOLTS -I
PLUMBING TOP OUT i SPECIAL MASONRY
I
TUB AND ~HOWER PAN I
GAS TEST PILES CAISSONS -
ELECTRICAL I )·
TEMPORARY POWER t r ,
' , ·-.. ELECTRIC UNDERGROUND -· -) -
ROUGH ELECTRIC • ' -ELECTRIC SERVICE . -•c.
BONDING A ' ' ' I I
G. F. I. -SMOKE DETECTOR. I
MECHANICAL
DUCT & PLEM., REF. PIPING
HEAT -AIR COND. -SOLAR SYSTEMS
VENTILATING SYSTEMS
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE ...
ITEMS ABOVE HA VE BEEN APPROVED . -
./""I-~
JOB SITE FINAL ... ~7
PLUMBING 6 ,,,,~ _,,q"\
ELECTRICAL .A'\L, ,.,. ~
MECHANICAL 1 _,_T r,r .
GAS I II ~n V
BUILDING -~ .... , .. -
SPECIAL CONDITIONS u
CERT OF OCCUPA-:Y ISSUED ....--_
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O I hereby , •• rm that I am licensed under
p,ovlelone o1 Chapter 9 (commencing with
S.C:tlon 7000) of Division 3 of the Business
and Professions Code, and my license Is In
full force and effect. Loe No _______ Class _____ _
1 hereby att,rm lhat I am exempl from lhe Con-~:•n~;~,::: ~ ~,~r:.~~~ ~~
county wh.ch requires a permit 10 construct alter. unp,,ove, demohsh. °' repair any structure.
prK>f to Its issuance also requires the applicant fOf such pemut to hie a signed statement that he ,s
hcensed pursuant to the Pf'OYISIOfls ot the Con
tractOf"s Lteense Uw (Chapter 9 commencing wnh Secteon 7000 ot 01v1st00 3 of the Business and Pro '"'tOOS Code} Of that 1s exempt therefrom and the
bas•S '°' the alleged exempttOn Any VK>llhon of Seehon 7031 ~ by an applicant fOf a permit SUbjeelS
tne appHcant 10 • c,v,1 penalty of not more than hve
hundred dotla,s iS500I
□ I, .. owne, ol lhe property, o, my employees
w.,1th w,ages as their sote compensation, will do the
wont. and the structure 1s not intended Of offered '°' safe (Sec 7044. Busmess and Professions Code The Contractor's License Law does nol aoply lo an
owner of property who builds or improves thereon
and who does such wOfk himself or throuon his own
employees. proYtded thal such 1mpr0Yef1"'M!;its are
not mtende"J or ottered tor sale II. however. !he
bu1ld1ng or ,mprovement 1s sold w1thm one year of
comptetion, the owner-builder will have lhe burden
of prov1~ lhat he did not butld or improve fOf the purpose of sale)
C I. as owner ol the property, am e,cclus,vely
contract•n~ with licensed contraclors to construct
the pr0t9Ct (Sec 70U, Business and Pl'ofess.ons
Code The Contractor s Lteense Uw does not ac>()ty to an owner of property who builds or improves
~';::;:i!t~ 7.~r,c;'~!~ ~~~r!'~~~~:!-!
License uwf
0 I am uempl under Sec _.
for this reason
.B &PC
□ I hereby affirm th.at I Ni,,-e a cen.1t1cate of consent
10 self-insure, or a cert1t1cate of Workers
Compensation Insurance. or a ce1111ted copy thereof
(Sec 3800. Lat,or Code)
0 Cet11hed copy 1s hereby furnished
CERTIFICATl OF EXEMPTION FFIOM WOAKERS' COMPENSATION INSURANCE (This section need not be completed 1f the permit
IS tor one hundred dOllars ($100) Of ~SS)
O I cert1ty that ,n the performance ol the w0'1t tor
11111tuch this permit 1s issued, I shall not employ any person in any tn¥iner so as 10 become sub}e'Ct to
the WM ers· Compensation Laws of Calltorn,a
NOTICE TO APPLICANT If. atter makm:;1 th1s Cert•
hcate of b.emptt00. you should t>ecome sub1ect t?
lhe Worlters· Compens.alton ptO'IISIOnS of the ubof
Code. you musl fortl'lwtlh comply w,th sucl'I
pro-Y1s1ons or this perm11 sh.all be deemed ,evOkeo
0 I hereby affirm that tne,e 1s a cons11uc11on
1end1nQ agency fl)( the performance ol tne w()f11; tor
wl'ucn this permit 1s issued tSec y;s7 C,v11 Godel
L~ sName ___________ _
Let'IOer s Address __________ _
USE BALL POINT PEN ;"l,i_y & PRESS HARD u • CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT ~
1200 Elm, Carlsbad, California 92008 (714) 438-5525
APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA P DECLARATIONS
JOB ADDRESS AV. ST. I DATE OF APPLICATION I BUSINESS LICENSE • VALUATION PERMIT NUMBER
IHI 1-itlt:lo £.;c-1:=,"A-e/~~. Q/,ee,14,~ RO.
OWNER'S NAME OWNER'S PHONE PRIME CONTRACTOR CONTRACTORS PHONE• ZONE fl(-3/>fE" --:-?
/ ,L:>.0 ~ <",-,.J. ~P-3dbD ..S,Z::M~ q ✓ 'r>J:Z .A./ /. ~ o;;;;,~R~, :r,oRe; ~~ 2
CONTRACTOR'S AO0RESS LICENSE NO. PLAN 1.0. # BLDG USE CODE
8) 'JC0pUJi..✓ALS,£ --/~,8 ~
LOT I BLOCK I suao,v,s,oN I ASSESSOR PARCEL NO. DESIGNER STATE LICENSE• STANOARD PLAN,; BUILDING SO. FOOTAGE
OESCRIPTION OF WORK
OESIGNER"S ADORESS DESIGNER'S PHONE
.__ -~ -~C-r'/(!/C.4 G, F/P FLR ELEV. NO OCCGP EDU
STORIES 111!218!281_1 b7.0( vO NO --
CENSUS TRACT I GP LANO USE I PARKING SPACE I RES UNITS I GAAOING f'.ERMIT ISSUEO I REDEVELOPMENT TYPE OCC LOAD FIRE SPR AREA CONST
YO ND vO NO vO NO Not V•lid Unwss ~chine wrtifi«I
QTY. PLUMBING PERMIT· ISSUE ?/;-() QTY. MECHANICAL PERMIT -ISSUE 3 . ()() SUMMARYMCCOUNTNUMBER
EACH FIXTURE TRAP INSTALL FURN. DUCTS iJP TD 100,000 BTU BUILDING PERMIT
EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT
EACH WATER HEATER ANO/OR VENT BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK I .. \
EACH GAS SYSTEM I TO 4 0 UTLETS BOILER/COMPRESSOR 3-15 HP TOTALPLUMBING ~ f 0/...4/,P-/ ( ---~ -J
EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE ELECTRICAL ff I 'I"'' -----~~,:_ ----
EACH iNSTAl-. ALTER. REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL
EACH VACUUM BREAKER MECH EXHAUST -HOOD/DUCTS MOBILEHOME
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP -EACH ROOF DRAIN (INSIDE) SOLAR
TOT I.L MECHANICAL STRONG MOTION --------,-· ---~
TOTAL PLUMBING FIRE SPRINKLERS
dnn PUBLIC FACILITIES FEE
QTY. ELECTRICAL PERMIT -ISSUE QTY. SOLAR -ISSUE BRIDGE FEE
I NEW CONST EA AMP/SWT/BKR / trfJ ,4-~ .;--o COLLECTORS SCHOOL FEE · DISTRICT ,
I PH 3 PH STORAGE TANKS Carlsbad
EXIST BLDG EA AMP/SWT/BKR ROCK STORAGE Enc1nt1as
1 PH 3 PH PUMP San D1egu110
REMODEL/ALTER PEA CIRCUIT PLAN CHECK FEE San Marcos
TEMP POLE 200 AMPS
OVER 200 AMPS
TEMP OCCUPANCY 130 DAYSI ----------
TOTAL ELHTRICAL --1 ~rJ-? TOTAL SOLAR TOTAL FEES PAYABLE I ~1~-
I HAVE CAREFULLY EXAMINED THE COMPLETED APPLICATION AND PERMIT" AND DO HEREBY bp,ra1100 E .. ry perrmt -by the Bu~dlng Offic,al un-tl>e prov,sion1 ofth11 * AN OSHA P£AMIT IS AEOl#IED FOR EXCAVATIONS OYEfl
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall expere by hm1tat1on and become null and void If the butld,ng or work s· o-DEEP ANO DEMOUTl0N OR CONSTI!UCTION OF
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS authorized by such permit 11 not commenced within 180 days from the date of such STRUCTUAES OVER 3 STORIES IN HEIGHT permit. or 11 the build•~ork authorized by such permit is suspended or ISSUED TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING BUILDING CON, •ban-al any tune a work II co,.._,ced for a oenod of IIIO "•u•
STRUCTION, WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND ~ :,>: T~ .\. __ .C'J 0 APPROVED BY 1.J#-ID7f~t;
KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS. COSTS AND -NT SIGNATU LL} _,:__ _ R .-CON!RACTOR
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE ,, 7 \. -~. --~ ' ---BY PHONE 0
GRANTING OF THIS PERMIT. -O ~ 1 J
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. 81-~ g-g ~ {:;; .. ,.> INSPECTION TYPE ' DATE INSPECTOR j
BUILDING
FIELD INSPECTION RECORD
FOUNDATION
REINFORCED STEEL l REQUIRED SPECIAL INSP ECTIONS INSPECTOR'S NOTES
INSPECTION REQ IF IN SPECTOR'S DATE MASONRY j CHECKED APPROVAL
GUNITE OR GROUT SOILS COMPLIANCE
FLOOR & CEILING SUB FRAME PRIOR TO
FOUNDATION INSP
SHEATHING STRUCTURAL CONCRETE
FRAME OVER 2000 PSI -
EXTERIOR LATH lNSULATION PRES TRESSED
CONCRETE
INTERIOR LATH & DRYWALL POST TENSIONED
CONCRETE
PLUMBING FIELD WELDING
SEWER AND BL/CO HIGH STRENGTH
PLUMBING UNDERGROUND BOLTS
PLUMBING TOP OUT SPECIAL MASONRY
I TUB AND $HOWER PAN I
GAS TEST PILES CAISSONS ,
ELECTRICAL
TEMPORARY POWER I . '
ELECTRIC UNDERGROUND ' . .
ROUGH ELECTRIC i
ELECTRIC SERVICE -BONDING A f \ -
G. F. I. -SMOKE DETECTOR'. I .
MECHANICAL .
DUCT & PLEM., REF. PIPING l I \ "--.!. ~ -
HEAT -AIR COND. -SOLAR SYSTEMS .. .. .
VENTILATING SYSTEMS .
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIA TE
ITEMS ABOVE HAVE BEEN APPROVED. .. ./ ~
JOB SITE FINAL ,~./7 . ' ----
PLUMBING C.I.. \ ~ _,.;' ✓ii'J
ELECTRICAL AT~ r--/Y"" { ..; ..... ,c.v MECHANICAL I _,. "'1/'
~ GAS ~ ~ .r1 -. ~ . -BUILDING .!J,' (',.. '\ .
SPECIAL CONDITIONS V
CERT OF OCCUP, CY ISSUED
~,( ~ -C ..
;! At.,~AJ..,A,U/4\~ ... A/~At\A~..A!Ah .. t...\t-./MAA!h.AAtv~AP:v~~/;:M~,AA/AA~M.,~ ).( ~ _, ► 3 CC rd tf i rat r u f OJ rru uu 11 n1 ,.,;:;;;'<~. ~ ~ r ZJ ... ~
~ CITY OF CARLSBliD ~ ~ ~ ~ This Certificate issued pursuant to the re quirements of Section 306 ~
1 of the Uniform Building Code certifies that at the time of issuance ~
~ this structure complies with applicable ordinances of the City ~
1 regulating building construction use. ~ ~ Duplex 81-388-3 ~ <[E Use Classification _________________ Bldg. Permit No._______ ~ j Group _____ Type Construation _____ Fire Zone ______ Use Zone______ ~
~ Occupant Load_..,..--:------------------------------~ ~ OwnerofBuilding 5.udan Interior Missio~d'd,ess P. o. B9x 13~8, Carlsbad ~ ~ . . t :J..4·18~&--1420 Sweetbriar C 1 b d CA 92008 ~ ~ Building Address · , , e. l . :-Locality ar S a , • ~ ~ t · f.\ . ~ • II-C e . /,.. ~ ~. :· I • ,,, t .. r ~ ______ B4 h~ ~~ ~
/2-'8~ ~ ~-~ ---::, _________________ Date________________ ~
~ NOTE: Alterations, changes, additions or changes of occupancy nullifies this certificate. ~ ~ (Past in conspicuous place) ~
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