HomeMy WebLinkAbout1080 Palm Ave; ; CB881425; Permit<II z 0 ~ C a:
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0 I heteby affirm lhat I am llcenaec:t under
ptO'ltalona of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Profaaalona Code, and my license Is In
full tore• and effect.
I hereby att1rm 1~1 I am exempt lram lhe Conrrac;. to, s Locon5'! L•w lo, the lollowmg 1 .. son (Sec; 7031 5
Business ano ProtesSK>ns Code Any city Of county whtC.r, re--quires a perm,t 10 construe! alter. improve. demoltsh or
re~u any s1ruc1ure, pr.o< 10 ,ts 1ssia,nce also requires the ap-
plant tor such perm,t to tile a StQnecl sta1emen1 !hat he 1s
heenseo pursUJnl to lhl p,ov,sions of the ~trK104' s Locon5'! Law (Ch>ptor 9 commencing with Sec;t,on 7000 of
Drv•slOn 3 of lhe Busmess and ProtesSJOOs CodtJ °' lh.11 IS ex empl therefrom and lhe DaslS tOJ the allegeo exemphon Any
v10lat10n ot Sec!IOO 7031 5 by an ipphcant 104' a permt1 sub
1ects !he aP()htant 10 a c1v11 penalty of not more lhan live hun
drod dollars ($500)
I. as CMner ol the property Of my employees w,tn wages
u lhe,r sole compensatoo. will do the work. and lhe slruc• ture ,s no1 1n1erided Of otle,ec, tor sale (Set 704c Business
and Prolesst0ns COde· The conuac1or·s license Law does nol appty 10 an owner ot p,operty who builds or improves
thereon and wno ooes such work ~umselt or lhrough his own
emok)yeeS provtded INII such mp,ovemen1s a,e not tntend·
ed or ottered lor sale 11. however the 1>urk11ng or M'Tlprove-ment 1s SCM0 w1th1n one year Cit complehon. the o.ner-bu11der wlll have lhe burden ol provmg that he did not build or im-
prove lor !he purpose ot sale!
I as owner of the property am exckmvety contrachng
w,tn ltcensec contrilCtors to consliucl the p,oitct (Sec 7044 Business ano ProtesSIOOs Code The Contractof·s lacense
Law dOes not apply 10 an owner ot property wtlO bu•lds or ,m--proves thereon, and who con1rac1s tor each protects wnh a contractor(s) hc:ense pursuant lo the Contracror's Ucense Uw)
As • hom!Ownor I am 1mprcMng my home and the tallow 1ng cooo,t.ons uis1
1 The work 1s being pertormed prlOf to sale 2 I have hved m my home for twelve monlhs
poor 10 cornplehon ol th,s work
3 I !\ave nol claimed lh1s exemphon during !he Last lhree years
r:) I am exempt undet" Sec _____ _ B&PC lor this reason ____________ _
= I hereby altum lhat I ha-.e a cert,ficale of consenl 10
sell-insure or a c:ert1hcate ot Workers· COC"npensation In-
surance or a cer11fled copy thereof tSec. 38CX) Labor Code)
POLICY NO
COMPANY
Copy IS hled w1lh the city
0 Ce<llfted cooy 1s hereby turmsheo
CERTIFICATE OF EXEMPTION FROM WORKERS. COMPENSATION INSURANCE
(This sec1lon need nol be completed if the permI1
,s tOf one hundred aonars tS 100) Of less)
~ I certify lhal 1n the pet>formance of lhe wcwk IOf whlcn
this permit 1s issued. I shall noc employ any person tn any
manner so H lo t>ecome sub1ect to the WOfkers Com pen.
sat.on Laws ot Cahlornia
NOTICE TO APPLICANT If. after making lhlS Cert1flca1e
ol Exemption. you should become sub1ect to the Workers
Compensat.on provisions of the Labcw Cooe you musl
tortnw11h comply w1lh such proYIsIons or this permit shall
be deemed revoked
0 I hereby alt.rm thal there 1s a cons1rucllon lending
agency fOf the performance of the work tor which this per-
mit Is issued !Sec. 3097. Cwil Code)
Lender s Name
Lender·s Address ___________ _
/
USE BALL POINT PEN ONLY & PRE~S HARO APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. ---
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT ,, 2075 Las Palmas Dr., Carlsbad, CA 92009-1915 (619) 438-1161
JOB ADDRESS AV ST.RO THOMAS BROS NO.
IOATi~P~
BUSINESS LICENSE • VALUATION PERMIT NUMBER
/OJ-O ~-~~-fi,~,. ~ JI I ~~/~'S,-LOT I BLOCK I SU80•VIStON I ASSESSOR PARCEL NO
CONTR//~~
CONTRACTORS PHONE • ZONE u:.
;;~R;~-; ✓-' ----Q I ~~ JJ ./1;4 17.2;~7;;,;_ CONT RACT0"'8"°AOORESS STATE LICENSE NO. BUILDING SO. FOOTAGE
o;;;_~·-~z //ALL t°n A /1,i 1 Jo d DESIGNER DESIGNER'S PHONE
Q~1PT1QN,cnORK ./,N'//./ L,.,.,h~ /.#_,H 2685 10/25/88 0001 01 02
I 'n /_/7 •.r. ,_.,,. OESIGNER0S ADDRESS STATE LICENSE NO. BldPat 24-oi
~~-/__~J Ju/;~,,, -,./).-, ,I .d :I';:_ .A
NO I FI P FLA ELEV DCC GP EDU STORIES
vO NO --
I CENSUS TRACT I PARK ING SPACE AES UNITS I GRADING PERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRE SPR AREA CONST
y D N 0 ,o NO vO NO Not Valid Unlffs Machine Ctrt//i«J
QTY. PLUMBING PERMIT · ISSUE 7~ QTY. MECHANICAL PERMIT -ISSUE /~~ SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP I INSTALL FURN DUCTS UP TO 100.000 BTU 9'.tfl:/ ~UILUINl> crnmll UUl•ij IU·UU·UU·ouu
EACH BUI LUING SEWER I OVE.~.~O)TU SIGN PERMIT 00 l-810·00-00-8221
EACH WATER HEATER ANO OR VENT BOILER/COMPR~fN.P ~ Jlf"' -PLAN CHECK 001 ·810-00-00-8891
EACH GAS SYSTEM I 10 4 OUTLETS BOILER~~Rt-,...Jl 5 HP TOTAL PLUMBING 001 ·8 I 0·00·00·8222
EACH GAS SYSTE M ~ OR MORE METAL fW.t°CE n \O..~~ ELECTRICAL 001 -810·00·00·8223
EACH INSTAL ALTER, REPAIR WATER PIPE VENT FAN SIN(jl,.fr,(JiQ.CT v -"'-n MECHANICAL 001·810-00-00-8224 _2t;/ UV
EACH VACUUM BREAKER ME CH EX HAUS 1·'''Hooo 'OU/;..Teta.\.., ... _ .. t.U' :-:>• MOBILEHOME 001 ·8 I 0-00-00-8225
WATER SOFTNER RELOCATION OF EA llffil~E..L: . -SOLAR 001-810·00·00-8226 ·-EACH ROOF DRAIN I ,NS•OE I DRYER VENTC\"' .. ,.\1 \)~" STRONG MOTION 880-519·92·33
T;~~~('lOIYH,AL
~~U"-
FIRE SPRIN~LERS 001-810·00-00-8227
TO I Al PLUMBINl, I PUBLIC FACILITIES FEE 320-810·00-00-87 40
~~ BRIDGE FEE 360-810-00-00-87 40 QTY. ELECTRICAL PERMIT -ISSUE QTY. MOBILE HOME SETUP PARK-IN-LIEU (AREA )
NEW CONSTEAAMP SWI HKR CAR PORT TIF 312·810·00-00-8835
I PH 3 PH AWNING LA COSTA TIF 3i 1·810-00-00-8835
EXIST BLOG EA AMP SWT BKR GARAGE FMF
I PH 3 PH LICENSE TAX 001 ·810-00-00·8162
REMODEL Al HR PER CIRCUIT MFF 880-519-92·57
lEMP POLE 700 AMPS
OVER 200 AMPS
TEMP OCCUPANCY 130 OAYSJ
CREDIT DEPOSIT
lOlAL ELELTRICAL I TOTAL TOTAL FEES PAYABLE I ;?f/ (1d
I HA\IE CAREFULLY EXAMINED THE COMPLETED APPLICATION AND PERMIT AND DO HEREBY E•p1rat1on EYery perrntt ,s,ueo by the 8u1ldtng Ott1c1a1 undet the pro..,,s,ons of 1h11 * AN 06HA P£AM:T IS MOUIAEO FOIi UCAVATIONS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall exp1re by 1tm1taflon and become null and vo10 If the bu1td1ng or work s· O" DEEP ANO OEMOUTION OR CONSTRUCTION Of
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT I~ authorized by sucf'I perm,, 11 not commenced l!lr1th1n 180 days from the date or such STIIUCTUAES OVER 3 STORIES tN HEIGHT
ISSUED TO COMPLY WITH ALL CITY COUNlY AND STATE LAWS GOVERNING BUILDING CON :=::a,:,·~. ':v ':!'.:-:X.it~~~:~!n~::::.:~~~ r~~~·~ts~~~ or
STRUCTION WHETHER SPECIFIED HEREIN OR NOT 1 ALSO AGREE TO SAVE INDEMNIFY AND APPLICANTS SIGNATURE • t OWNER £ CONTRACTOR 0
APPR~ ~ a D~~~ KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS. COSTS AND
{,/)/ ~J/40,: # ~_d---~BY HONE n EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE /,_ ,,,. ... _ I/ ~ GRANTING OF THIS PERMIT V -..,I/ "/ 1
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TYPE DATE INSPECTOR
BUILDING
FOUNDATION
REINFORCED STEEL
MASONRY
GUNITE OR GROUT
SUB FRAME D FLOOR D CEILING
SHEATHING D ROOF □ SHEAR
FRAME
EXTERIOR LATH
INSULATION
INTERIOR LATH & DRYWALL
PLUMBING
D SEWER AND BUCO D PUCO
UNDERGROUND □ WASTE □ WATER
TOP OUT D WASTE □ WATER
"lUB AND SHOWER PAN
GAS TEST
□ WATER HEATER □ SOLAR WATER
ELECTRICAL
□ ELECTRIC UNDERGROUND □ UFFER
ROUGH ELECTRIC
□ ELECTRIC SERVICE □ TEMPORARY
□ BONDING □ POOL
MECHANICAL
□ DUCT & PLEM., □ REF. PIPING
HEAT -AIR COND. SYSTEMS
VENTILATING SYSTEMS
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HA VE BEEN APPROVED.
FINAL
PLUMBING
ELECTRICAL
MECHANICAL
GAS
BUILDING
SPECIAL CONDITIONS
~ ~g 14: .?--~
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTION REQ IF INSPECTOR S DATE CHECKED APPROVAL
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRES TRESSED
CONCRETE
POST TENSIONED
CONCRETE
FIELD WELDING
HIGH STRENGTH
BOLTS
SPECIAL MASONRY
PILES CAISSONS
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