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Home My WebLink About2804 SOMBROSA ST; ; 80-758; PermitLICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provi- sions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Profes- sions Code, and my license ls in full force and ef- fect. OWNER-BUILDER DECLARATION D I hereby affirm that I am exempt from the Con- tractor's License Law for the following reason (Sec. 7031.5,Business and Professions Code), Any city or county which requires a permit to con- struct, alter. improve, demolish, or repair any structure, prior to Its issuance also requires the applicant for such permit to file a signed state- ment that he ls 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 violation of Section 7031.5 by an ap- plicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($500). D I, 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 for sale (Sec. 7044, Business and Profes- sions 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). ".Jl1 as owner of the property, am exclusively con• tractlng 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 reaso,,.__ ___________ _ Date Owner WORKERS' COMPENSATION DECLARATION I hereby affirm that I have a certificate of con- sent to self-Insure, or a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Labor Code). POLICY NO ___________ _ COMPANY ___________ _ □Copy Is filed with the city. □Certified copy Is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed if the per- mit le for one hundred dollars ($100) or less). I certify that in the performance of the work for which this permit ls Issued, I shall not employ any person In any manner so as to become subject to the Workers' Compensation Laws of Cailfomla. NOTICE TO APPLICANT: If, after making this Cer- tificate of Exemption, you should become subject to the Workers' Compensation provisions of the Labor Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY I hereby affirm that th_ere ls a con_structlon 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. ~ o 9' / J Joi§ ADDREss AV. sT. IDATE OF" APPLICATION Bus. LICENSE PERMIT NUMBER '/1 ,._./7 ~ . ..1 .---RO O 4' Ir~, r4'1-·1-r·, ,.,. I I I I I I I I I I I I I I,-~-l"'-f-,flo IS-:i..3~ -v i, OWNER ' O:NER'S PHONE PRIME CONTRACTOR STATE LICENSE t O -7 0-~ l'-1 o <;.; A 1-1 R. S \?o ke v.:> 4 '"1= o ;J"'-L -1-,,; "" • r-r.1r VR cJ u s o ?o .t::~ .B '>" OWNER'S MAILING ADDRESS • CONTRACTOR'S ADDRESS CONTRACTOR'S ::l 8 ~41-~ i#f h L?c> s"' s -f. :;?7" 2 l-1#-./-e,0 'PL :1<~ .-v.dG a1 ~ 1J 1a□es:,4 r. ,, , LOT I BLOCK ISUBOIVISION f., ASSESSOR'S PARC:fL NO • .., _..9-ESIGNER STATE LICENSE ~ • :.i6.(,, ./1 C<i""" I I /1/":J ~ 101 £,.. r.::: . ,, ./S, ,A I DESCRIPTION OF" )!IOR.L-,? A ,_---i= ...,, , c.i~bt ee ~ _A,,-1 A~/_ ~ /~ ~-,,f/b c:; -. --,. 0-BIGNER'S ADDRESS DESIGNER'S PHONE A,/~/#N~ / ,c;, ~-~~~;~./~'11',llf i'M:l-L,~~4 cENsus TRACT GP LAND usE zoN1NG I REs. uN1Ts I PARKING SPACE sf I NUMBER of" sToRIEs # Not V•lid Unlt!ss MachiM Cartifild BLOG so. F"T. BLDG USE occ. GP I STANDARD PLAN II Ito' °;..7sJ> I TYPE CONST l occ. LOAD I QTY. PLUMBING PERMIT AMT. QTY. MECHANICAL PERMIT AMT. • EACH FIXTURE TRAP 4.")/.....-, INSTALL FURN. DUCTS UP TO 100,000 BTU J t' • ... EACH BUILDING SEWER OVER 100.000 BTU • ,\<, • EACH WATER HEATER ANO/OR VENT BOILER/COMPRESSOR UP TO 3 HP EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP EACH GAS SYSTEM 5 OR MORE BOILER/COMPRESSOR 16-30 HP EACH INSTAL.,ALTER,REPAIRWATERPIPE J. ~ VENT FAN SINGLE DUCT L/.. ,,.__,__J - EACH LAWN SPRINKLER SYSTEM r MECH EXHAUST -HOOD/DUCTS VALAUTION: / v v · ..., ' ~, WATER SOFTNER RELOCATION OF EA FURNACE/HEATER BUILDING PERMIT I , I ~-1 ISSUE 3.0o issue j_.uu s1GNPERM1T , • 1 1-. 1 TOTAL PLUMBING 7 ~ _ TOTAL MECHANICAL PLAN CHECK 1 • 1 /~. 'P CONTRACTOR • CONTRACTOR ALL INCLUSIVE PERMIT .,. 1' ( 1 TOTAL PLUMBING I If• r. QTY. ELECTRICAL PERMIT AMT. QTY. MOBILE HOME PERMIT AMT. ELECTRICAL I 1-1. _.,_,. NEW CONST EA AMP/SWT/BKR AWNING MECHANICAL I I . I 1 PH .25 3 PH PORCH MOBILE HOME I I I EXIST BLDG EA AMP/SWT/BKR SET-UP SOLAR I , I I I 1 PH .25 3 PH • ,.A.. RAMADA. CABANA I , I I I REMODEL/ALTER PER CIRCUIT C . FENCE OVER 6' I , I I I TEMPPOLE 200AMPS "' TOTALMOBILEHOME MICO·FILM ! , I I I OVER200AMPS I , I I : I TEMP OCCUPANCY (30 DAYS) I , I I - T'"',.,.rr 2. 00 SfRONG M:ITTnN. 1 • 1 1 • . r, "" TOTAL-ELECTRICAL 7 ?-11---+----------------1------11 TOTAL FEES PAYABLE I . -......ii !I CONTRACTOR I I .~P,,. f;(I) / ... I HAVE CAREFULLY EXAMINED THE COMPLETED '"APPLICAT ION ANO PERMIT, ANO DO •AN OSHA PERMIT IS REQUIRED FOR EXCAVAT IONS OVER HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE ANO CORRECT AND I s·-o·· DEEP AND DEMOLITION OR CONSTRUCTION OF FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED; TO COMPLY WITH ALL CITY, STRUCTURES OVER 3 STORIES IN HEIGHT COUNTY ANO STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER SPECIFIED HEREIN OR NOT. 1 ALSO AGREE TO SAVE INDEMNIFY ANO KEEP HARM-sru,001 FEE · LESS THE CITY OF CARLSBA D AGAINST ALL LIABILITIES. JUDGMENTS, COST S ANO r ~ • EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE 11--r-------~-==-=>\-------------------....... -.------~----------l OF THE GRANTING OF THIS PERMIT. I ~j7J-1cANT'S SIGNA~~-/ OWNER□ CONTRACTO~ IAPP~OVEO BY" r; DATE ~Jn1'.J-A #( ~~ AGENT □ BY PHONE □ /J-!A<.r.U d•: 1 r.1, .. ! ~ ~ ~ i= ::rl 0. V) ~ Si SITE ADDRESS: . INSPECTION DATE WOOD FLOOR FOUNDATION• FORMS• SET BACK • TOILET UNDER FLOOR PLUMBING UNDER FLOOR HEATING OK TO INSTALL SUB FLOOR 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 FIREPl;.ACE DAMPER & STEEL PLATE TLES/HEIGHT OF CHIMNEY OTHER TEMP POWER (POLE) SEWER GAS TEST SWIM POOL • STEEL BONDING • PRE DECK • FENCE PREPLASTER SHOWN • FRAME • PAN FINAL.. INSP BY BLDG DEPT OTl-t£R 0EfT~S REQ COMPLETED ELEO METER-PERM-TEMP GAS METER-PERM-TEMP CERT OF OCCUPANCY ISSUED J -\ .... __ _, 4 ' -I •(l./c...,., Tf t.--f : ,T /1-4 / 1(/'/ . V/.w"/,.,, I/fr I INSPECTOR . D ,.,:.. 1.,/--' . .,.. ~I~ JA V ,-,-- I // - I OWNER: tl ._ · PERMIT.NO: '6'0-7S~ FIELD INSPECTION RECORD INSPECTOR'S NOTES . l f; .. .. ~ -•--=· -=-:.; ........ -l -. --. .,. ,: . - '· ' : .. : 0.: --,I,: ..... .:, •, A .. . ;;. .. ~ ; ~ ,, ... , ' 2: -- . ' - ·••"n " . . I L~ .. C -. i z~ • . - '~..-. ... '" ' (P,,, - <. -.;-..., r· \ . .. ,-