HomeMy WebLinkAbout2446 TORREJON PL; ; 80-891; 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 Is In lull 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 is licensed pursuant to the provl•
slons 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 live 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•
lered 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. II, 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 end 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 pu~uant to the
contractor's License Law).
I am exempt under Sec. • , ~
for this reason , /\ ~ 1
Date OwnfirN )} ~K,l
WORKERS' COMPENSATIOM' DECLARJI.TitlN
I hereby affirm that I have a certificate of con-
sent to self-insure, oi 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 II the per-
mit is for one hundred dollars ($100) or less).
I certify that in the performance of the work for
which this permit Is issu~I shall not employ any
per59n in any manner so as to become subject to
tt,,, Workers' ~mpensatlon Laws of Calllomla.
NOTIC!i TO APPLICANT: II, after making this Cer-
tificate of Exemp\\on, you should become subject
to the Workers' Compensation provisions of the
Labo, Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
•
CO~TRUCTION LENDING AGENCY
I hArAhV Affirm thAt thAro It:: A l"-nntttr11t"tlnn IAn.
CITY OF CARLSBAD-BUILDING DEPARTMENT
USE BALL POINT PEN ONLY APPLICATION & PERMIT
1200 ELM AV ENUE (7 14) 438-5525
APPLICANT TO FILL IN INFOR-
MATION WITHIN RED LINES.
NO. JOB ADDRESS
1/~I tRr • 1D;~o: i,~;; SUS. L ICENSE rlT NUM8ER
~Af'tt-1 iro,~~.I! ... ,,e Ni .~ ~~~,,A. I I I I :2..o79~
OWH::z?ttTII ~ OWNER'S PHONE Mle:;;;;~ 4Y,J?~.s STATE LICENSE ~-fr; W J N ff /VS /,J/£/~91
OWNER'S MAILING ADDRESS
e#~~#ot
CONTRACTOR'S ADDRESS CONTRACTOR'S .. -::y:-~ ¾S"J ~u-sn-~ '2.~~ I _ ~r/9?'"" tF .!j'z:4-7qt </
LOT BLOCK llc1~~~j I ~ASSESSOR!i,'ttPA,SEL NfO._:)-,r-q DESIGNER STATE L ICENSE J).,j I t "'· I -, I ~ ffi.lLU~ -D,EfCRIPTIO'rjF WORK ~ Lt.,._ L. .rr1 /\.. l_ ,,.-• ~•. A.A "'Al ~ '~.#!L ~J .... ~ 4:Zf :;.0A~t'' ~JK,
DESIGNER'S P HONE
/fS-tJ?a R,t!>L-
6 i-t'G -C.'l!fl
CENSUS TRACT GP LANO USE ZONING
..,.,_,n .. , ...
l/,J '/ -· ½ ..
I RES. UNITS I PARKlkG PAh .:u ..J?, , I NUMBER OF STORIES
Not Valid Unwss Machin• CllrtifiMI
BLDG SQ. n. BLDG USE occ. GP I STANDARD PLAN# lw:Y91 y _I TYPE CONST I occ. LOAD I ::,.., ,/"• -•...:
I A.;·.
QTY. PLUMBING PERMIT AMT. QTY. MECHANICAL PERMIT I • AMT.
EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100,000 BTU
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 7~ BOILER/COMPRESSOR 3-15 HP
EACH GAS SYSTEM 5 OR MORE BOILER/COMPRESSOR 16-30 HP
/ EACH INSTAL., ALTER, REPAIR WATER PIPE ~ VENT FAN Sl~iGLE DUCT
Ut1a»~ z 1./~.J---' -
EACH LAWN SPRINKLER SYSTEM MECH EXHAUST -HOOO/OUCTS ~
WATER SOFTNER ; . RELOCATION OF EA FURNACE/HEATER ~-BUILDING PERMIT I . 1JJ~V
./.A.,.,,.~ ( ~ d7} /_A./1 i, 1 -, -J rfV SIGN PERM!~. l;--...J 'I'. I
TOTAL PLUMBING 9~ TOTAL MECHANICAL PLAN CH¥°Cf:'.Pcf' ~ .f',u11-,,I 1 --:J',0,-? -~ ,,1 I "J I
CONTRACTOR CONTRACTOR ALL INCLIJ!N.E..PERMIT -. -,. YI I
AMT. TOTAL PLUMBING I ~oro QTY. ELECTRICAL PERMIT AMT. QTY. MOBILE HOME PERMIT ELECTRICAL I ("T. ~ ~
/ NEW CONST EA AMP/SWT/BKR c5_v.., AWNING MECHANICAL I 1I . I
1 PH .25 3 PH PORCH MOBILE HOME I I I
EXIST BLOG EA AMP/SWT/BKR SET-UP SOLAR -. I I I I
1 PH .25 3 PH RAMADA, CABANA ,,,,.,.,. ~-A h1 ,J,. -} I I I 61Y
REMODEL/ALTER PER CIRCUIT FENCE OVER 6' C/ I . I I I
TEMP POLE 200 AMPS TOTAL MOBILE HOME MICO-FILM I I I I
OVER 200 AMPS I . I I : I
TEMP OCCUPANCY (30 OAYS) I ' I I I
/'..AA/ I -,:)--~, I I I I
TOTAL ELECTRICAL 7~ TOTAL FEES PAYABLE I .~oi J)? CONTRACTOR ,, . A I I
t-.-4.J .,LI tJ l /~.1 ~
• w ~ ~ a j:::
l:d
C. V') ~
"AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVE~ --. )7 -,,i•H r I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT, AND DO
HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I 5'-0" 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 AND STATE LAWS GOVERNING BUILDING CONSTRUCTION. WHETHER
SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM-
LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAIC CITY IN CONSEQUENCE
OF THE GRANTING OF THIS PERMIT. A~r"ff'.ANT'S SIGNA??_' OWNER□ CONTRACTORR~PPROVE~B DATE
I -A' 1_/_ --.,,,.--?' ~Y/ ./ I /A,,_,,, d
c;so-'fs'Ofl
SITE ' .c -
ADDRESS: .
__ , &-• '":" OWNER: . t ...... -:.. •. I PERMIT NO: ..-n, --.. ~ .
FIELD INSPECTION RECORD
INSPECTION DATE INSPECTOR INSPECTOR'S NOTES
WOOD FLOOR
FOUNDATION• FORMS• SET BACK • TOILET .,
UNDER FLOOR PLUMBING . "-'-,-•~1 " ' ~ ~ -.I,.._ JI ," l' ... ~-~ . .
UNDER FLOOR HEATING -' •-'/ I J.,J.,/' • I ' _ _r..~;--.!..{-.°':'I('!)·.;.· ~-o; -. ,a , ... ~ •• , ....... ,
OK TO INSTALL SUB FLOOR ' • :, ~~ l, • .... \ 'l--... ~-•f" l ·i. • _ ",\.-.~~ --. , . ,.. !· .. -.. ........ ·,~
;_
•. ' ,.. ·~ \ ':J~Ji ~ ,.: ~
'-C 1 ..... ...__: _; .... ·.:·1
SLAB FLOOR ' UNDER SLAB PLUMBING .. .
FOOTING• FORMS• SETBACK • TOILET t
OK TO POUR CONCRETE
FRAME
ROUGH ELECTRICAL "<
ROUGH PLUMBING
ROUGH HEATING/VENTILATING
FRAME OK • PLACE INSULATION
INSULATION OK • PLACE WALLBOARD
WALLBOARD OK• PL;ACE TAPE
EXTERIOR LATH OK • PLACE STUCCO
' ' . FIREPLACE ..
DAMPER &STEEL .
PLATE Tl Es/HEIGHT OF CHIMNEY -
OTHER ' .
TEMP POWER (POLE)
SEWER .
GAS TEST
SWIM POOL • STEEL BONDING ' .
• PRE DECK
• FENCE PREPLASTER
SHOWN • FRAME
• PAN I
FINAL INSP BY BLDG DEPT ' I /, J '·
OTHER DEPT'S REQ COMPLETED Iii /1 r1 ! I JIYY / •.
ELEC METER-PERM-TEMP f '. if /
GAS METER-PERM-TEMP ./ , .
CERT OF OCC UPANCY ISSUED rt
..... u:ut:~ r FOR, INSPECTION TIMEc..· __ __,_ __ _
INSPECTOR. ;t;;.; G:: PERMIT NO, b-t'V DATE:_/J,__½-e,Jl.....,_@~1-7 )
OWNER ________ -::::--:c---------------------
0 FOUNDATION
□ REINFORCING STEEL
0 MASONRY
□ GROUT· GUNITE
□ FLOOR AND CEILING FRAME
□ SHEATHING
0 FRAME
0 EXTERIOR LATH
0 INSULATION
□ INTERIOR LATH OR DRY
FINAL
PLUMBING
0 UNDERGROUND PLUMBING
0 UNDERGROUND WATER
□ ROUGH PLUMBING
□ TOP OUT PLUMBING
0 SEWER AND PL/CO
□ TUB OR SHOWER PAN
0 GAS TEST
0 WATER HEATER
D FINAL
ELECTRICAL
□ TEMPORARY SERVICE
0 ELECTRIC UNDERGROUND
□ ROUGH ELECTRIC
0 ING HEAT
G.F ..
SM KE DETECTOR
FINAL
MISCELLANEOUS
□ PLENUM AND DUCTS □ COMBUSTION AIR /;,,/ i,.
D PATIO p/ ~;-. L □ SIGN ;-K1 ,1,~J !
□ GRADING •• •
0 DRIVEWAY
□ CONDITIONED AIR SYSTEMS
0 REFER PIPING
□ FINAL
READY FOR INSPECTION: ¼NDAY □TUESDAY □WEDNESDAY □THURSDAY □FRIDAY r b;.~_
DP.M,
SPECIAL INSTRUCTIONS _________________________ _
REQUESTED BY-,,,,~~~-~~~-•-~~------'PHONE No,/"rf-?f'£(
PERSON TAKING REPORT_,,~,i,e:::ur/..-=~---
REQUEST FOR INSPECTION TIME--_____ _
-' • I',/ J __ / -11\iSPECTOR_--,,J'""-""?,,-,,~=------PERMIT NO, _______ DATE: ______ ~r~.--r-.. __
OWNE,._ ______________________________ _
&UILDIN(j,
0 FOUNDAT-1-0N . ('
1':ii(REINFORCING STEEL J ,,.,...,.._~ ' ' ! 0 MASONRY
0 GROUT -GUN I TE
0 FLOOR AND CEILING FRAME
0 SHEATHING
0 FRAME
0 EXTERIOR LATH
0 INSULATION
_CjJ_ INTERIOR LATH OR DRYWALL
_ -FINAL
, PLUMBINtJ
0 UNDERGROUND PLUMBING
0 UNDERGROUND WATER
~ROUGH PLUMBING
0 TOP OUT PLUMBING
0 SEWER AND PL/CO
0 TUB OR SHOWER PAN
0 GAS TEST
0 WATER HEATER
D FINAL
I"
ELECTRICAL
0 TEMPORARY SERVICE
0 ELECTRIC UNDERGROUND
0 ROUGH ELECTRIC
_):8(POOL BONDING
0 ELECTRIC SERVICE
0 CEILING HEAT
0 G,F,i,
0 SMOKE DETECTOR
D FINAL
MISCELLANEOUS
0 PLENUM AND DUCTS
0 COMBUSTION AIR
0 PATIO
D SIGN
0 GRADING
D DRIVEWAY
D CONDITIONED AIR SYSTEMS
0 REFER PIPING
D FINAL
',,-• ' ---'·"\
READY FOR INSPECTION: □MONDAY
DA,M,
DP,M,
□TUESDAY,, □WEDNESDAY, □THURSDAY □FRIDAY "·
SPECIAL INSTRUCTIONS _________________________ _
REQUESTED BY----1,/i~~:A/£:..c· ,,....,,._.,,_,..,_ .. __ i:P::·o...~1.-1.~,~•':!•:,e~;;t ____ IPHONE NO./ J l • >({! I'
PER~ON TAKING REPORT t?::1
1200 ELM AVENUE
CARLSBAD, CALIFORNIA 92008
TELEPHONE,
(714) 729-1181
Tl1is document will certify that I am aware of the provisions of the
California Administrative Coue, Title 24, Section T20-1406(c),
"Swimming Pool Heating", as shown on form DPL #297. I understand
that neither a swimming pool buildir!g perrn:H: using a fossil-fueled
heater nor a plumbing/electrical permit for a new or replacement
fossil-fueled heater will be issuea ~nli.l this certification is
executed.
For the swimming pool located at __ .2._4.!lt JO~lG [ 4,J ( s i. te address ) I certify that a 11 o .t the f o 1·"1'"'o~w=i-=-nkg'-J1'-'r=e'--q-u·-i~r-e_m_e_n_t,-s---,f~o-r-
f o s s i l-fueled (or electric) swimming pool heaters will be met:
1. Outdoor pools shall be equipped with a pool cover.
2. ON-OFF switch on outside of heater to allow shutdown without
adjusting thermostat and start-up without relighting pilot light.
3. 36" minimum length of plumbing provided between filter and
heater to allow future solar installation.
4. After January 1, 1982, new heaters installed must have 75%
thermal efficiency.
S. Time clocks installed to allow pump operation during off-peak
demand periods (unless pump used for active solar).
6. Directional water inlets in pool for good mixing.
Print Owners Name:
Owners Signature: Date:
Print Contractors Name: HERMOSA HOUSING CORPORATION, 2551 State St. , Carlsba<;l CA
Contractors Signature: ~~/4 .• Date: 10/22/80
tTly R Rodgers Construction Vice President
Address: 2551 State Street, Carlsbad, CA 92008