HomeMy WebLinkAbout2711 SOCORRO LN; ; 80-102; 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
0 1 hereby affirm that I am exempt from the Con•
tractor's License Law for the following reason
(Sec. 7031.5,Buslness and Professions Code), Any
city or county which requires a permit to con•
struct, alter, Improve, demolish, or repair any
structure, prior to it.s Issuance also requires the
applicant for such permit to file 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 vlolatlon of Section 7031.5 by an ap-
plicant tor a permit subjects the applicant to a
civil penalty of not more than five hundred dollars
($500).
DI, 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 tor sale (Sec. 70«, Business and Profes•
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-
fered for 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 ••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 reason, ____________ _
Date Owner
WORKERS' COMPENSATION DECLARATION
I hereby affirm that I have a certificate of con•
sent to self-insure, o, a certificate of Workers'
Compensation Insur~• o ~rtl!led copy thereof (Sec. r ).
POLI r.> I
~
PAN'
PY Is flied with the city.
D rtlfled copy Is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed If the per-
mit Is for one hundred dollars (S100) or less).
I certify that In the performance of the work for
which this permit Is Issued, I shall not employ any
person In any manner so as to become subject to
the Workers' Compensation Laws of Callfomla.
NOTICE TO APPLICANT: If, after making this Cer•
tlflcare of Exemption, you should become subject
to the Workers' Compensation provisions of the
LabOr ~• you must forthwith comply with such
provlsloN;; or this permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
I h•r•-hv affirm that there Is a construction len-
CITY OF CARLSBAD-BUILDING DEPARTMENT
USE BALL POINT PEN ONLY APPLICATION & PERMIT
1200 ELM AVENUE (714) 438-5525
APPLICANT TO FILL IN INFOR-
MATION WITHIN RED LINES.
NO, JOB ADDRESS AV. ST. bTE OF APPLICATION
~/oEtEr"'
PERMIT NUMBER
,_ I /1 / I/ I 15 101<:..1<=-tO I R.1l,)_1O r'f L~ 19' 10 ti 1"'71 I I I
RD
1l1AI M lli1 I I I I ct-b-80 io-1 o-,_,., OWNER OWNER'S PHONE PRIME CONTRACTOR ST ATE LICENSE
GJ.=cllc IA VAM {") ER.. I< I ('\t,l'I ,() -:;Gll.o I A V -c h. 0 em_ le'. /(..W'\ -~~7/,t:;'
OWNER'S MAILING ADDRESS V CONTRACTOR'S
,.....-
-~ ..
-" ~NTRSC~RC ~RJ~-t Co.,.st-. U OOJI~ 01~11 ~c :J.111 PHONE b S OC.C,Oll-1'? (I L,.. ..o. /\,1 l; ~J ";)... '" MA+~l'-11'1 L JLd ~·B-r-~U..-~9 00 , I i,ijc!b 0 I 1ii 111 '. LOT BLOCK tr:UBOIVISIOH I ASSE..:!JOR'S PARCEL NO • DESIGNER STATE LICENSE
").~ ivo<.lc. ,~-~c; .1.. 11~1 ~ 4',~1 0 14-i qo1 I C,'...\--.... DESCRIPTION OF WORKQ l k ts Oc.., l<..friAtJ..\ ;N. l,( J,1_ /\ DESIGNER:ls ADDRESS DESIGNER'S PHONE
Lio' .r' IJ-1 --...) C,\. ~f CAQ l.s h~..l.
CENSUS TRACT GP LAND USE ZONING I RES. UNITS -I PARKING SPACE I NUMBER OF STORIES
/.~-:19 Not V•lid Unlffl Machin, c.rtifi_,
BLDG SQ. rT. BLDG USE occ. GP I STANDARD PLAN# I PLAN ID # 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 ,A
EACH BUILDING SEWER .,,,, OVER 100,000 ~
EACH WATER HEATER ANO/OR VENT _/ BOILER/COMPRESSOR UPTO 3 ~
EACH GAS SYSTEM 1 TO 4 OUTLET.¥ BOILER/COMPRESSOR 3-1>-lff>
EACH GAS SYSTEM 5 0 R MOK BOILER/COMPRES~16-30 HP
EACH INSTAL., ALTER,Ba"AIR WATER PIPE VENT FAN S~LE DUCT
11~~ . .,,~ J / l, 00 EACH LAWN SPR~LER SYSTEM MECH EXA'AUST HODO/DUCTS
WATER SOFTNER .., . RELOCATION OF EA FURNACE/HEATER -BUILDING PERMIT I . 1/il,.e,1 ()
/.AA;,_,J -61 H) /,,,. ... ,1,, .""5-6, SIGN PERMIT I , f I I -TOTAL PLUMBING TOTAL MECHANICAL I l~ola PLAN CHECK I .
CONTRACTOR CONTRACTOR ALL INCLUSIVE PERMIT I I I
ELECTRICAL PERMIT AMT. TOTAL PLUMBING I I I QTY. AMT. QTY. MOBILE HOME PERMIT ELECTRICAL I I I
NEW CONST EA AMP/SWT/BKR / AWNING MECHANICAL I I I
1 PH .25 3pr" PORCH / MOBILE HOME I I I
EXIST BLOG EA AMP/SWT/BKV SET-UP / SOLAR I I I I
1 PH .25 / 3 PH RAMADA, CABANA / ~ I , I I I
REMODEL/ALTER fiR CIRCUIT FENCE OVER 6' / A'l~~-J M~--.> I , I I I
TEMP POLE ¢°AMPS TOTAL MOBILE HO¥e" -MICO,,l"~lM I , I I I
OVER 200..AMPS / -I . I I ; I
TEMP OCCUPANCY 130 DAYSI ✓ I I I I
,I AA ,I, I J ;i... ". I . I I I
TOTAL ELECTRICAL TOTAL FEES PAYABLE I CONTRACTOR . I I r?,1¼1 /> .
I HAVE CA REF ULL Y EXAMINED THE COMPLETED "APPLICATION ANO PERMIT, ANO DD """ o'"" """" "a,ou,a,o ,oa "~"'"o"• om~~ HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I 5'-0" DEEP AND DEMOLITION OR CONSTRUCTION OF ½
FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED; TO COMPLY WITH ALL CITY, STRUCTURES OVER 3 STORIES IN HEIGHT /0 ~
COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER
SPECIFIED HEREIN OR NOT. l,ALSO AGREE TO SAVE INDEMNIFY ANO KEEP HARM-~-A~{)._,..,,/)~ ~ A~ ~ /. • • • .. , ,,So LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS, COSTS ANO
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE
OF THE GRANTING OF THIS PERMIT. ~ANT'SSIGNATURE· (f"' OWNER□ CONTRACTOR□ l~DBY /DATE
AGENT D BY PHONED ~1S~~ ~"'\.h I -
! ~ ~
~ j:::: ~ 0.. VI ~
SITE -ADDRESS: OWNER: PERMIT NO: 'S'0-10~ -FIELD INSPECTION RECORD . ' ' .... -
INSPECTION DATE INSPECTOR INSPECTOR'S NOTES ·
WOOD FL.OOR ..
FOUNDATION • FORMS• SET BACK • TOILET -.-
UNDER FLOOR PLUMBING ' ,J . _,. . -L • . . ~ . .. -' : C --
UNDER FLOOR HEATING I : • f 2 . --.
OK TO INSTALL SUB FLOOR
. f .' .. : --/ "'; ·~ ~ .. :'.! cc • '
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 . '· ...... ---.. -~ '1 .
FIREPLACE '. a ..,..
DAMPER &:STEEL
PLATE Tl Es/HEIGHT OF CHIMNEY
OTHER
TEMP POWER (POLE)
SEWER
' GAS TEST
SWIM POOL • STEEL BONDING ' -
• PRE DECK .
• FENCE PREP LASTER --
SHOWN • FRAME Ill I I •
• PAN l If ,,,). X A~
I" ('t I Iv' " ' +. ~ ~. FINAL INSP BY BLOG DEPT
OTHER DERT'S REQ COMPLETED
ELEC METER-PERM-TEMP .
GAS METER-PERM-TEMP -
-
oa
' ' . -·"' '':. CERT OF OCCUPANCY ISSUED . ... , i ' . '