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0 I hereby affirm that I am licensed under
prO'ilalona of Chapter 9 (commencing with
Section 7000) of OIYlslon 3 of the Business
and Profnalons Code. and my license Is In
full force and effect.
I hereby attum 111<1 I am exempt tram lhe Contrac-I
l0<'s License uw 10< the tonow,ng reason (Sec 7031 5 I :~~:s: :~~o~:s~:;:,~ al:~ ~:pr01'~80tJ~~n:i~~ r~ I
repi1r any structute. prlOf 10 ,rs issuance also requires !heap-l =~!J°'p~~~\': i~'~!J~rie;' ~"\:e°JO:,~~\':.': I L,c,nso Law (Cllopter 9 cornrnenong w,th Sec1oon 7000 ol I =f,,;:,~ ,~Slt':•~~ :~:•a~O:~:p:~.:: ,s :~y I •""'''°" ol Sec!JOO 7031.5 by 1n 1ppl1C1nl 10< • permit sub I itets the appliunt 10 a c,v~ pen,lly ot not mo<e tllon love hun I
dred dollars ($500) I
I I, as ""ner ol the p,operty, 0< my employees with wages as their so6e compensation ri do lht work, ano tt,e s1,uc-
lur1 1s not ,n1ended or olfered lor Qle (Sec 7044. Busmns
and ProlesS<Ons Code The COntractor's License Law ooes
not appty 10 an owner ot propeny who builds or improves
thereon and who does such work ntfnsen or through n1s own employoes. p,ovtded 111<1 such vnprovements 110 not ,nteno
ed or ottered tor sale It. hOwever. the bu•tchng 0t smprove
ment Is sold wIlh1n one year of ca,nplehon. lhe owne, bu1kler will tlavt !he burden o1 proving thal he did nol burld or 1m·
p,ove 10< the purpose ol Sllel
l I, ilS owner ot the property aim exclusIvety contraic11ng with loce...O contractors to construct the pro,ect (Sec 70<4
Business ind ProtnStOns Code the Contractor's license Law ooes nor appty to ain owne.-of property wtlO builds Of im-
proves !hereon. and who contracts for each proiects .,1th a contr,ctor(s) hcense pursuant 10 the Coniractor's license UWI
lJ As a homeowner I ,m I1111)f0Ying my hOme, and the toltow
Ing Cond1tt0nS !XIS!
1 The -k Is being performed pr,or to sale 2 I ll<ve IMd ,n my l1ame 10< twelve monlhs
3. r':v~ ~Pc1~::g' 11~,': =~phon during the 1.u1 three years
□ I am exempt under Sec ______ B& P C
lor lh,s reason
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C I hereby attum that I have a certificate of consent to
selt-,nsure or a c1rt1hcate of Worklt's· Compensation In• I
aura.net. or a certified copy thereof (Sec. 3800. Labor Code) I
POLICV NO I
COMPANV J
~ Copy 11 filed WIU'I the e1ty
0 Cemf,ed copy 1s nereby furnished
CERTIFICATE OF EXEMPTION FROM
WORKERS COMPENSATION INSUFV.NCE
(Th11 sec11on Med not be completed if the permit
ii for one hundred dOllars ($100, or less)
0 I certify tna1 ln the performance of the work tor wh1Ct1 I
th,s pe<m1t 11 ,ssued. I shalt not empfoy any pMson ,n any I :~:L::•~r ~~=1:ubJect lo the Workers Com pen. I
NOTICE TO APPLICANT. It, after making thls Certificate f
of Exempt10n. you shOukl beeome sub,ect to the Workers I
Compensation PfOV1sion1 of the LabOf Code. you must I
:~w~:~c::i:!th such provisions or this permit shall I
D I hereby affirm that there Is a construction lending :
agency tor the performance of lht work tor which this p11
m,t 11 issued (Sec. 3097, Civil Code) I
t --~--1 lender's Name ____ _
Lenders Address ____________ t
u;,t DALL l'OINT PEN ONLY & PRESS HARO APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. ----··-----· -··-. ----CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT 2075 Las Palmas Dr., Carlsbad, CA 92009-4859 (619) 438-1161
J08 ADOAESS AV ST.AO. NEAREST CROSS ST I DATE OF APPLICATION I BUSINESS LICENSE • /qJTI,°/ PERMIT NUMBER
2 7 ,'\ s-~c.iC: () < '( 0 l'('\. CC)" i -n-\ 1 tt ~-, ~ -~, &ttjt't LOT 8LOCK I sueD1~1s10N I ASSES,R PARCEL NO OU
r;C;;_R~ 0
CONTRACTORS PHONE • ZONE 1 I 15 5"4~07 ~(2__ o w ... £ A'S r,,AME I~,~ .. ;;~.\p~:~ M..-'+ \.4'{~• ~)... f"A .., ~ ~A "1' CONTAA~'S ADDRESS STATE LICENSE NO. BUILDING SO FOOTAGE
OWNE R'S MA .I ... G ADDRESS
D, 0 . Rr-. x 4 ~ rt \ \( \ I l'V\, ,-r-1"\ q")I_J/,._ D(SIGNE A DESIGNE A'S PHONE
~CAPll'.;"'<tWOA~ ,.l \.,' \. --._........... .l..f'o ,.._ -...... \. -.l_ ~ -t t'~. -OESIGN£R'S ADDRESS STATE LICENSE NO.
... a.fie J. \4,-~ -gu:~ :~ el)E.~ ~ Re..u.J I d2-, F1P FLA ELEV NO OCC GP EDU
-'<),---HJ Q O~t-.. \.c-r ~ -:;:. -~l., STORIES
vO r,,0
PARKING SPACE I AES UNITS GRADING PERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRE SPA AREA CONST
y D ND vO NO vO NO Nor Valid Un~s Machine Ctrtrfi«t
QTY. PLUMBING PERMIT · ISSUE 1 -~ QTY. MECHANICAL PERMIT· ISSUE /~O' SUMMARY/ACCOUNT NUMBER
-----,I ·---_ _. --. ~ '.()(.
EACH FIXTURE TRAP INSTALL FURN DUCTS i.JP TO 100 000 BTU BUILOING PERMIT !llJ'l'lnO·lllMIO'!l!'l0-· .,_ v ... "' "'
EACH BUI LO ING SEWER OVER 100,000 BTU SIGN PERMIT 001·810-00-00 8221 V
~ ----------Z../ EACH WATER HEATER ANO OR VENT BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 001-810·00·00-8821 -
EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3 15 HP TOTAL PLUMBING 001·810·00·00·8222 ----~ 1-.r--EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE ELECTRICAL 001-810·00·00·8223 -
_EACH INST~ ALTER, REPAIR \'!ATER PIPE VENT FAN SINGLE DUCT MECHANICAL 001-810·00·00·8224 --------
EACH VACUUM BREAKER MECH EXHAUST HOOD OUCTS MOBILEHOME 001-810-00·00-8225
WATER SOFTNER RELOCATION OF EA FURNACE HEATER SOLAR 001-810·00·00-8226
fACH ROOF DRAIN ONSIDE) DRYER VENT STRONG MOTION 880-519-92_13 --TOT J;L MECHANICAL FIRE SPRIN~LERS 001·810·00·00·8227 --I --fOl AL PLUMBING PUBLIC FACILITIES FEE 320-810·00·00-87 40
__ <;""•t:)d BRIDGE FEE 360-810·00·00-87 40
QTY. ELECTRICAL PERMIT -ISSUE QTY. MOBILE HOME SETUP PARK-IN-LIEU (AREA )
NEW CONST EA AMP SWl BK R CAR POAT TIF 134-810·00·00-8835 -~
I PH 3 PH AWNING LA COSTA TIF 133-810·00-00-8835
FXIST BLOG EA AMP,SWT BKR GARAGE FMF
1 PH 3 PH LICENSE TAX 001·810·00·00-8162
REMO OE L ALI t R PER CIRCUIT /V) ·-MFF 880·519-92-57
TEMP POLE 200 AMPS
OVER 200 AMPS
TEMP OCCUPANCY (30 DAYSI -CREDIT DEPOSIT (Fr7 ~
TOTAL ELEURILAL l 1-.r-T01Al TOTAL FEES PAYABLE I h<1.,,
I HAVE CAREFULLY EXAM1NED THE COMPLETED APPLICATIUN AND Pl ·<MIT• ANO DO HEREBY Expiration Every perm,t issued by lhe Bu,td,ng O fftc1et undet tl'te p,ovt,10f"l1 ot this ••• -~ -'"" ""-'~"""" o, .. CEATlFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING TH!: Code shall expire by hm,tat,on and become null and vo,d If tt,~ bu1td1ng or ~ork s· o· DEEP NO MOllTION OR CONSTRUCTION OF
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY ANO AGREE IF A PERMIT I'> au1horized by such pe~~Si: commenced w,1hin 180 days from the date o• such STAUCTVRES ER 3 STORIES IN HEIGHT perm11. or 11 the bu1tdin o *Ork 1uthor•zed by suet-permit ,, sv,Pftnded a, ISSUED iO COMPLY WITH ALL CITY COUNlV ANO STATE LAWS GOVERNING BUILDING COi, 1band0ned 1t 1ny 1,me a t t WOfk ,, ,: tor a oer,od of 180 divs .
STRUCTION WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AN': "~ '.W::-OWNER[] CONTRACTOR[' APPROVED BY ~
I~~-,
KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND APPL! S SIGNATURE •
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THi BY PHONE f1 , . cf GRANTING OF THIS PERMIT "-.,/ -'
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. ,, < ~ 1-1..f ~ TYPE I DATE INSPECTOR ✓ -, -
I ' BUILDING l / I
FOUNDATION 1 FIELD INSPECTION RECORD
REINFORCED STEEL I
MASONRY l ,.REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
I
GUNITE OR GROUT t INSPECTION REQ IF INSPECTORS DATE I CHECKED APPROVAL
SUB FRAME D FLOOR D CEILING '
SOILS COMPLIANCE
SHEATHING D ROOF D S~EAR PRIOR TO
FRAME ! FOUNDATION INSP
EXTERIOR LATH I STRUCTURAL CONCRETE
OVER 2000 PSI
INSULATION I PRES TRESSED t
INTERIOR LATH & DRYWALL ! CONCRETE
POST TENSIONED
I CONCRETE
PLUMBING ' I FIELD WELDING
D SEWER AND BUCO D IJUCO HIGH STRENGTH
UNDERGROUND D WASTE 0 WATER BOLTS
TOP OUT D WASTE D WATER SPECIAL MASONRY
TUB AND SHOWER PAN I
GAS TEST I PILES CAISSONS
D WATER HEATER D SOLAR 'MATER
I ' , ~
ELECTRICAL 1
D ELECTRIC UNDERGROUND Cl UFFER
~
ROUGH ELECTRIC !
D ELECTRIC SERVICE D TEMPORARY ~ . OOSS •~\O:i Ol"OT 10:if;l~f 'to"OO -
D BONDING D POOL 1 ~ \i. 1"",
l
MECHANICAL I
D DUCT & PLEM., D REF. PIP.ING .. ~ , -.;_, \, ' :
HEAT -AIR COND. SYSTEMS I . ' . " I ~.---".:,._ ... :;-... '
VENTILATING SYSTEMS I >< I\ ./ ..
1 ·-) 0 -n
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE 'J ' I' ,-r .
ITEMS ABOVE HAVE BEEN APPROVED. -, J
FINAL : ITV
PLUMBING ! I ,(\ tJ . I
ELECTRICAL 1\/V I I I . \ . \ .-.~ .
MECHANICAL I J~ \ \
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GAS ' ' ' '
BUILDING I -\ -. . .
SPECIAL CONDITIONS ; I
I .
2075 LAS PALMAS DRIVE
CARLSBAD, CA g~g
Date: 10-4-88
To: Mr. Srariat
2705 Socorro Ln
Carlsbad, CA 92008
'11:'.itp of ~arlsbab
DEVELOPMENT PROCESSING
SERVICES DIVISION
PC# 484 Date: 6-2-87
Last Inspection: none
deck
PLEASE CALL FOR A FINAL INSPECTION
IF WORK DONE
BUILDING PERMIT EXPIRATION
Our records indicate that
12-2-87
your building permit will expire by limitation of time on
19
The prov1s1ons of USC, Section 303(d) state: "(d) Expiration. Every permit Issued
by the Building Official under the provisions of this code shall expire by limitation and
become null and void if the building or work authorized by such permit is not commenced
within 180 days from the date of such permit, or If the building or work authorized by
such permit is suspended or abandoned at any time after the work Is commenced for
a period of 180 days. Before such work can be recommenced, a new permit shall be
first obtained so to do, and the fee therefor shall be one-half the amount required for
a new permit for such work, provided no changes have been made or will be made In
the original plans and specifications for such work; and provided further that such
suspension or abandonment has not exceeded one (1) year. Any permittee holding an
unexpired permit may apply for an extension of the time within which he may com·,,,ence
work under that permit when he is unable to commence work within the time required by
this section for good and satisfactory reasons. The Building Official may extend the time
for action by the permittee for a period not exceeding 180 days upon written request by
the permittee showing that circumstances beyond the control of the permittee have
prevented action from being taken. No permit shall be extended more than once. In
order to renew action on a permit after expiration, the permittee shall pay a new full
permit fee."
Please check below Indicating your intentions and return this letter to us.
Project abandoned. New permit will be obtained prior to commencing work.
Maximum 180-day time extension requested. NOTE: Separate letter for an
extension request and reason for such must accompany this form.
If you have questions, please contact this department at 438-1161.
Building Official
11 / 8 6