HomeMy WebLinkAbout1088 LAGUNA DR; MULTI-PERMIT FILE; CB022279; PermitCity of Carlsbad
1635 Faraday Av Car1$bad,. CA 92008
08-07-2002 Plumbing Permit Permit No: CB022279
Job Address:
Permit Type:
Parcel No:
Reference #:
Project Title:
Building Inspection Request Line {760) 602-2725
1088 LAGUNA DR CBAD
PLUM
1552721900 Lot#: 0
Construct_ion Type: NEW
Status:
Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
ISSUED
08/07/2002
SB
08/07/2002
08/07/2002
"f.HE VILLAS REPLACE WATER HEART
AND REPLACE EXISTING GAS LINE 3248 08/07 /02 0002 01
Applicant
FLOYD AND HOWERTON PLUMBING
1269 GREENFIELD DR 92021
619-444-3040
Total Fe~s:
Plumbing Issue Fee
Fixture or Trap
Building Sewer
Roof Drain
$34.b0
Install/Repair Water Line
Water Heater and/or Vent
Gas Piping System
Vacuum Breaker
Other Plumbing Fees
Master Drainage Fee
Sewer Fee
Additional Fees
TOTAL.PERMIT FEES
lrispector: _s_.---~------
owner:
VILLAS DE CARLSBAD LTD
9619 CHESAPEAKE DR #103
SAN DIEGO CA 92123
Total Payments To Date: $0.00
0
0
0
0
1
1
0
.Balance Due:
$20.00
$0.00
$0.00
$0.00
$0.00
$7.00
$7.00
$0.00
$0.00
$0.00
$0.00
$0.00
$34.00
$34.00
FINAL APPROVAL
Date: <A I I b /O'd. Clearance: ------
NOTICE: Please take NOTICE that approval of your project includes the "lmposi\ion" of fees, dedications, reservations, or other exactions hereafter collectively
referred to as "fees/exactions." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must
follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for
pro<;essing.in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack,
r~view, set aside, void, or annul their imposition.
You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity
changes, nor planning, zoning, grading or otlier similar application processing or service.fees in connection with this project. NOR DOES IT APPLY to any
· · h' · i ·1 r whi h f Ii i i n h r vi I
02
PERMIT APPLICATION
CITY OF CARLSBAD BUll,.DING DEPARTMENT
_ 1635 Faraday Ave., Carlsbad, CA 92008
FOR OFFICE USE ONLY
PLAN CHECK ·No. e}o '2-2.Z. 7~
EST. VAL. _________ _
Plan·Ck. Deposit ___ _,,. ____ _
Validated By ¢
Date 8"-7-0 7
Address (inclu·de Bldg/Suite. #) Business Name (at thiii. address)
I0'-6$ !· Ps.Gall.NP. S:;?'P::s2£
Legal ·Description ' Lot No. 'Subdivision Name/Number · Unit No. Phase No. Total # of units
Assessor's Parcel # Existing Use Proposed Use
Name Address City State/Zip Telephone#
~a:Or,1JF.JA~i9efi:rtiYie'-nlffl'IA11~~~~~k~:;l~-;,1lli1~tt,r·~~~~~S2:1-!rk~~~~~~1¾~~~~i~~"lfil~~~~~~~1~~~
(Sec. 7031.6 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its
issuance, also requires the applicant for such permit to file a. signeg statement that he is -licensed pursuant to the provisions of the Contractor's License Law
[Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code] or that lie is exempt therefrom, and the basis for the alleged
exemption. Any violation of Section 7031.6 by any applicant for a permit subjects the applicant to·a.civil penalty of not more than five hundred dollars [$5001).
fL.o¥D A#/ )'O...)e:~ y0,n;~ 1a.,H C.~~~ \J-L ·€:L.tA:).::):r\ . CA: o/~\ '2[9-4y4-304D
Name · Address · City State/Zip Telephone#
State License·# &,:J L\ ~(p · License Class C ;:-,Co City Business License# ·sp 4,L.}co-7 L} \ )-
Designer Name
State license #
Address City State/Zip Telephone
·Ia?~it_WoaU:~MOUN$~T{4.t#tB#:;J.~r;;;;;,_7;[,f;J~)_:£i'~~'~:;·~~\h~~~2£~\~~~~:,t::;:1l~~f;j·&~~~Xt:~::~;~~~~~~~-~~:EZS~7Z'~~Tg~r.~~~ W~rke;;; C~~pens~tloh i:i;~,a;atlon: i hereby ~ffir~· und;r ·pen;;'ity-of p;rjury' o~;'of th·; foll;;;;;g declarati~ns: · ----· v, • " "· • • • .,,, ___ ,._ • .,--=· · .... ~ -"
0 I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance
of the work for which this permit is issued,
~ I have and will maintain workers' compensation, as required by S~ction 3700 of .the Labor Code, for the performance of the work for which this permit is
~ued. My worlcer's compensation insurance carrier and.policy number a~e: / J
lnsuranceCompariy S:t::A,""¼7 fU.'"-'t'> .. · PolicyNo. C>4U-O\QC(~7 ExpirationDate }D/1/0?-..
(THIS SECTION NEED NO'f BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOll.ARS [$100] OR LESS) ~,
0 CERTIFICATE OF EXEMPTION: !·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 Workersf Compensation Laws of California.
·WARNING: Failure to sec orkers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred
thousand dollars ($10 ,O addition to the cost of compensation, damages as.provided for in .Section 3706 of the La r de, interest and attorney's fees.
SIGNATURE . DATE 9-'. 7 0 r-.
W~liN,liitt(' ~Q.. ~igwl:~~~t$~~g!i:t~3:P?1:-~S:~~~~;t~:i~1f~~~1~~~;f~~~~t~i~~1:;Mt~~~~~~r~~s~~~S~!~~\¥~~fi51?:2;t!:~~~~1t~;~~::,~~~
I-hereby affirm that I am exempt from the Contractor's License Law for th11 following reason:
q I, as owner of the prop·erty or my employees with wages as their sole·compensation, wifi do the work and the structure is not-intended or offered for sale
(Sec. 7044, Business and Professions 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 suc.h·improverpnts·are.not intended or offered for sale. If, however, the building or improvement 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 safe).
0 ·1, as owner of the property, am exclusiveiy contracting with licensed contractors to construct the project (Sec, 7044, Business and Professions Code: The
Contractor's License Law does not apply to an owner of property who builds or ·improves thereon, and· contracts for such projects with contractor(s) licen$ed
pursuant to the Contractor's License Law). • ... · .... ,.~..,,, ·
D I am exempt under Section ______ Business and Professions Code for this reason:
1. I personally·plan to provide, the major labor and.materials for construction of the proposed property improvement. D YES-[]NO
2. Hhave./ have not) signed an application for a building permit for the proposed·w9rk.
3. I have conJ.racteo, with the following person (firm) to provide the proposed construction (include name I address / phone number / contractors license number):
4, l·plan to provide-portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (include name/ address/ phone
number/ contractors license number): ·
6, I will provide some of the work, but I have contracted (hired) the following persons to provide the VI/Ork indicated (include name / address / phone number / type
of work): . .,_.-------------'---------------'------------------------------
PROPERTY OWNER SIGNATURE _____ ~---,----.,----,---------PATE ________ _
~uf!r~1s~seF~t17.o~7l-lDriiDNfiA17'.nO)lVIN'al'eeRMl[j;§;W.~6~-1~0;;;~,;; $:tQ,s,s~,'17~?'.~':0".~c~{;ll,$,0;'.Jl~8~~;;/~~~~;w:;;:;~;i!.f;%':,,f;t;;?:'i'i.?f(*'-l''%~ L."'t"t?..t.!~~--"' ..... -t:.~J-...~ ... w .......... ~~~-------.. ,~~ ,v,,, .... --~,-~----~"*'-~"'~~-«-~ (,,~ ... ...._..,, ... -.w~r.-<"" ~ »-1.,,,.,~«-"'"'I".,_..,..,,....,,.~ ...... *"""'"'""~
Is the applicant or future building .occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention
program under Sections 26606, 26633 or 26634 of thi! Presley-Tanner Hlizardou~ Substance Account Act? 0 YES D NO·
Is the applicant or future building occupant required·to obtain a permit from the air pollution:controf district or air quality management district? D YES D NO
Is .the facility to .be constructed within 1,000 feet of the outer boundary of a school site? D YES O NO
IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE
REQUIREMENTS .OF THE OFFICE OF EMERGENCY SERVICES AND T!iE AIR POLLUTION CONTROL DISTRICT.
I hereby affirm that there is a construction fending agency for the performance of the work for which this permit is issued (Sec. 3097(0 Civil Code).
I certify that I have read the application and state that the above information is correct and that the information on the plans is accurate. I agree to comply with all
City ordinances and State laws relating to building construction. I hereby authorize representatives of the Cit\' of C!irlsbad to enter upon the above mentioned
property for inspection purposes, I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES,
JUDGMENTS, COSTS AND·EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
OSHA: An OSHA permit is required for excavation~ over 5'0" deep and demolition or construction of structures over 3 stories in height.
EXPIRATION: Evlilry permit issued by he b · ing 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 comm nee · hin 180 days from the date of such permit o~ if the building or work authorized by such er ·1 is suspended or abandoned
at any·time after the work is·commen~~~~;D·d of 1~0 days (Section 106.4.4 Uniform Building Code}.
WHITE: File YELLOW: Applicant PINK: Finance
-. C•
UNSCHEDULED BUILDING INSPECTION
DATE 8 ... \S:-02
PERMIT# . 9 ~,~J °\
INSPECTOR ____ _
.. PLAN CHECK# ___ _
• ' t~ . 0 JOB ADD.RESS __ \~D~Ss.~n ......... \ • ..,c ...... ~ "'¥~u-_.....,.a,,,,_, """""""'c\,...._,_""""''------_,,_-----
DESCRIPTION _________________ _
CODE DESCRIPTION
c A.2cct:e::=, M,.9 a :lo::~
~~
ACT. COMMENTS.
F~
"' z 0 i= ,c cc 4( _,
(J w Q
I f
.I -. , .. J; . ., . . .... , C ';,';,a '·. . . . J· e L'. ci-·J.herel,>y•aiflrm that i am·llcensed under I'
<J 1 "1)rovlalon11 of Chapter. !l (<;ommencl11g with .f :i Section 7000) · of Dlvlsloh 3· of"the 'Buslne~s l ·
1-• and Professions Code, and mv, license Is in I
~-lull l,qrce and effect. · · 1.
u·r . : I hereby a!Jirm that I .am ·exempt ironi' the Contrac· I tqr's License. L~w for the toJlowjng reason (Sec. 7031.5 I Business and Protessions Code: Any city or.county which re· quires a permit lo construct, alter, improve. demolish, or I ' repair any structure, prior to its isSuance also requires the ap-f' -phcant for such permit to !11~ a.signed statement·that he is licensed ·pursuant to the provisions of the Contractor's I
Licens~ Laiv. (Chapter 9 commencing with Section 7000 of f Division 3. of th~-Business an~ Profession? yodeJ qr that is ex· I empt theref/011) and the basis for .the allegeo e~emplion. "ADY .• , violation. ot:SectIon. 7031.5 by a~ applicant for,a•perm1t .sub· 'j .jects.the apphcant.to a civil penalty of not;more than-hve hun· . dred' dollars ($500). f
USE BALL ·POINT PEN ONIJ & PRESS HARD· APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATION$.
•,
JOB ADDRESS
CARLSBAD BUILDING DEPARTMEN.T
2075 Las Palmas Dr., Carlsbad, CA 92009-4859 (619) 438-1 ~6'1 . . .
AV., ST.RO. NEAREST CflOSS ST.
l08_/2 L.Mv/\.lfi f:>f?.
'LOT .. ·--· -. . -·-., , CONTRACTOR .. SUBDt VISION \ ASSESSOR-PARCEL ,~o.
.APPLICATION &-P.ERMIT . . / . .
I DATE GF APPLtCAnO·N' ri/1ob3(; J --······· ~·-----,
VALUATION
-~
CONTRACTORS PHONE# Zo"NE ...... ·. • ·/d s-S--
Pe:RMIT NUMBER
_,. .-. , ;-'·····' BUILDING SQ. FOOT,'GE
:J:'"N~f!J/'111~ f'R..O.l""&~rr /£'r?aU/7 23 :l~~~~~~~~"~U....:!::_·~c-+,1~. ~J'\J~. o~A.J~-t-oe~~~~-+~---......._ __ -1._.,.,-----'--:--:~7 . . . . I= · DESIGNER$ PHONE · OWNER'S MAI UNG ADDRf?:S;l DESIGNER . .
~OS ~·e~ str: .S/Uw\,1-N .!( W'f mAN DES'CRIPTION OF WORK ,c, B. ":< ·DESIGNER'S ADDRESS StATE LICENSE NO.
Q)
u::
i::' 03 0 Cl. E -~ cc w 01· ..J. s:·
f'I 1, i'S.Ol'/ner·of the prpperty, or my empioyees w1ih wages 'f
as their sole compensation, \viii' do the work, and the struc· f lure is·not·lntended·or· offered-for safe (Sec:7044, ·Business 1 and Professions Code· The·Contractor's.License:Law does njlt J!PPIY to aii owner ·01 property.~who builds or improves .I, ..
j:e-.rr;: ~~-az-te-· -e/~ FiP F LR' ELEV,,. NO
STORIES
OCC GP EDU Ofi02 iOl i~1iu186~Kn1 30 .. Iii 61.
~ W•· z
thereon and who does such work himself or through his own· r I erii"Rloy'ees, prov1ded'lhat•such improvements are-not intend· 1. · vD NO •
i-
ed qr offered f~r~ale, ff, ho_wev_e\, Jh_e bmldmg'9'qmprove-· ! ! · l ! . . . . . . '·. · :·· . . . ·, '\ -m~nl'lssoldwithmoneyearofcomplello,n,theown~r-buil9er I· , _ PARKIN<;i-?PA,CE. RES UNITS GRADINGPERMIT.ISSL/ED .R_EDEVELOPMENT TYPE OCCLOAD· FIRE SP!'!,,;-·· •• ·,;
w1ll-~ayethe.b~rdenofprovmg,that.he,d1dnotbuildor1m-.1 . . . . ... . • . AREA ,CONST , •,v ,, .. ·~-,., -1_-~-1:--· -~ ----·""~ ..
provetorthepurposeotsale). . , ; · YO NO vD NO -,. ¥0 NC)·-• Not V1Jff{!UnJes~-~ach1neCerttfled
•. !';I I, as owner of the property; arii'exctusively contracting f :· . . . . ·. . . rtsa· . . . . ... · ·. . . > • ..;. ~ •
, ·,with licensed co_ntractors to construct the·project (Sec. 7044, I · · . · • · · 0 0. •, .. ,..;, · · · Business an.d Pratesslans cod_e. -Jhe contractar's:1:1cense r , QT'l.-: PLlJMBIN~ PERMIT· ISSUE·. . • .. . . QTY. MECHANICAL PERMIT· ISSUE . ~ • · ,, \ .. -SUMMA.R~/ACCOUNT NUMBER
•• La~ ~oes n.ot apply to:an o,l'/n.er qf'prop~rty who build.s or,i(ll· , , . , . . . . . Q . · •· .. -~ -· ··proves.thereon .. and·wh9_co~tractsfo_reacnpr91ectsw1th.a (. EACH FIXTURE TRAP . ·INST-A'LL FURN DUCTS up, TO 100 000 BTU , • BUILDING-PERMIT '-001-810·00·00·8220 c.ont(actor(s) license pursuant to lhe Contractor's License I ... . . . · . · · · · · • . · • · , · · •· : ·.· -.
[aw).•; · · .. · • ·. · · . • I . EACH-BUILDING SEWER • OVER Hi0,000 BTU. • • SIGN PERf\1l1-'.~.::; ., • , 001-810·00-0Q.;82~1
D As a homeowner'! am.improving my ~ome and the•tollow-I · • I ,· '• ·i ·· · · · . ingconditions:exist: • ' ,· EACH WATER HEATER AND/OR VENT , • BOILER/COMP.RESSO.R UP TO 3 HP ;···. • PLAN:CH_ECK-. , '.'. OO~c8:Hl·00·00°8821'
-1. The work is ~eing perforined·prior to. sale. • · · · • · · I ' · · · · ,' '• • ·• ' . . . 2. I _havq live~ i~ my holl)e tor twelye months f EACH GAS SYSTEM' 1 TO 4 0 UTLETS • 801 LER/COMPR ESSO R 3-15 HP ~ ·.-1, { :: • . TOTAL PLUMBING 001 ·810·00-00-8222 ,rnor.to complet1on of this work~ ..... . . --3. ~ave not claimed this exemption during the f EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE '1 _!_ last three years. • f' · ·
• . EACH INST-A~ .. ALT~R, REPAIR WATER _PIPE VENT FAN SINGLE DlJCT D I am exej11pt under Sec.' • .-' , B &'P.C, ·f· . for this reason . ~ I
r I
. I q I hereby affirm !hat I ,hay~ .. a c~rtifl te of consent to f,
self-1nsure. or a certif!Cate qf'Wor~er~· Compensation In-,,·.
surance. or~ certlfled,copy ther~ f,(S , •. ~00. laborCode) t
.POLICY N9. I
z' COMPANY Q D . . . . I !c Copy is f,ted with t_he cl J
~ 0 Certified copy ,s hereby f
~ I :If · . , · , . I 0 CERTIFICATE·OF EXEMPTION FROM
<J W,ORKERS' COMPENSATION INSURANCE f• if> ,(This seCtron n~ed not be completed If the permit I
CC Is for one hundred dollars ($100)-or less) f· ~ ' ' D ,I certify,-that In th~ performance of tbe work for which f
~· this permit·is issued, I shaU-not employ any,person in any [
3_ .:~i::~~:~~r ~~fo~il=~~Ject to the Workers· Compen-l
· ~ 1·NOTICE TO APPLICANT:.!!, afler·makong this Certoflcate f
of Exemption. you•should become·subject to the Workers· l
ConlpenSalio'n provisions of ilie· Lab9r Code, ·_you ·m:u:Sl l
forthwith;Comply w1th.such,provls,ioris or.this Permit shall 1·
•• 15:e: deemed ·revok'ed~ . ·I
',·,., I
, . , •· . I
E_~CH VAG_lJUM BREAKER M~CH ~XHAU§T • HOD_[)/DUC,TS
WATER SOFT-NE-R. I II I RELOCATION OF EA FURN_~_CE/HEATER
EACH ROOF ORAIN {INSIDE) I II I DRYER VENT
TOT!<L MECHANICAL
TOTAL PLUMBING I
QTY. .ELECTRICAL PERMIT· ISSU~ s:o~ QTY. MOBILE HOME SETUP
· NEW CONST EA AMP/SWT 1BKR CAR PORT
1 PH 3 PH AWNING
E5<IST BLDG EA AMP/SWT/BKR 'MRAGE
1 PH 3 PH
REMODEL'ALTER PER CIRCUIT
!JMP PQ LE 200 AMPS
0\/ER 200 AMPS
TEMP OCCUPANCY (30 DAYS)
/'I 7esr-.Ht~r~~-zr~ ,
TOTAL ELECTR.ICAL.
·1 6(1__~ TOTAL
~-: 'E~~CJ,~ICAL/ '•, 001-810-00:00-8223
'\ MEG~AN1cA. 001-810·90·00·8224 '.
MOBILEHOME \ ,001·8.10·00-00-8225
·soLAR \'
\ • 0,a,1~a10-00-00-8226
,STRONG MOTION '"\ 88\J:5'19:92.33.
FIRE SPRINKLERS •, .90'1'-810·00·00-8227
PUBLIC FACILITIES FEE 320·810·00-00-87 40
BRIDGE FEE 360·810-00,00-87 40
PARK-IN-LIEU (AREA
TIF 134•810•00·00·8835
LA COSTA TIF 133-810-00·00·8835
FMF
LICENSE TAX -001-810·00-00-8162
MFF 880-519·92-57
CREDIT .DEPOSIT
TOTAL FEES. PAYABLE I
~.a..---
30--
Q ,Jmids,Jssued (Sec. 3097,.Civll Code) . • ,. • f
[
0 thereby. affirm that tliere. 'is a construction tending j ffi igrncy fort~e Performance of tt,e work for Which this per-t
C ND PE MIT" AND DO HEREBY · Expiration. Every permit issued by the Building Olftcial under the provIs10ns otth1s I HAVE CAREFULLY EXAMINED THE COMPLETED "APPL! ATION A R Code shall expire by limitation and become null and void If the building or work CERTIFY UNDER PENAL TY OF PERJURY THAT ALL INFORMATION HEREON INC,LUI;llNG THE authorized by such permi!·1s not commenced withm 180days from the date of such
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGJ:lEE IF .A PERMIT 15 permit, or if the. building or work authorized by such permit Is suspended or
* AN OSHA PERMIT IS REQUIRED FOR EX°"VATIONS O\IER
5' O" DEEP ANO DEMOLITION OR CONSTRUCTION OF
STRUCTIJRES OVER 3 STORIES IN HEIGHT
ffi Lender's Name t. · ~ l _, . ,,. -. . . . . . .. . .. -·(
Lender's. AddreSs. __ ~~...ca_._ _______ I
.,.·,~ •..• -· --·-· ·-···---. ·1
I
I
ISSUED: TO COMPLY WITH ALL CITY,'CbUNTY AND STATE LAWS GOVERNING BUILDING CON· [2a~b!!an~d!!:o~n!!ed~a!_t !!8n!!l.t\!!im!!_e~a!J_fte!!r:Jl!!Jh!8~W!!,O!!:_!rk~isJC:!10!!m!!!m[!!e!!:n!£C~ed!!_!!fo?!r__!a!..g!8!frtif'o!f!dJo!!IJ1§:802J!daioos!a... -c:; .... ~~~~~=-~r-.,--------,~:":'::"" ____ _,
STRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND -APPLICANT'S SIGNATURE 'I-OWNERD OONTRACTpR . A_PPRQVEQ BY
KEEP HARMLESS THE CITY ·OF CARLSBAD AGAINST ALL LlABILITIES, JUDGMENTS, COSTS AND e2· ~. . ·-·· .. . .·... ...... ,. ,i •. . < ,.. .,._ ,,...,.;, • ...> EXPENSES WHIOH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE ,,,-1./1 C: BY PfiONE O" ,_,.,. . --4
GRANTING OF THIS PERMIT. ,/ ~ __ . ~-.' , ., I
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~ . 5/{A-'(~,=>~ TYPE r DATE INSPECTOR .
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. ·.
BUILDING l . ..
FOUNDATION I FIELD INSPECTION RECORD ·-
REINFORCED STEE.L r ---REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES MASONRY l REQ. IF INSPECTOR'S INSPECTION . DATE GUNIT!= .OR GROUT ' CHECKED APPROVAL I ' SUB FRAMED FLOOR D CE(..ING .
-SOILS COMPLIANCE
SHEATHING 0 ROOF D SI !EAR PRIOR TO
FOUNDATION INSP FRAME
STRUCTURAL CONCRETE EXTERIOR LATH t OVER 2000 PSI • I
INSULATION 4 PRESTRESSED _, CONCRETE INTERIOR LATH & DRYWALL ' POST TENSIONED r
J CONCRETE -
~
PLUMBING .. -l FIELD WR.DING . .
D SEWER AND BUCO D ijUCO HIGH STRENGi'H ·;,
BOLTS UNDERGROUND D WASTE dWATER /}/ I
TOPOIJT D WASTE, D WATER SPECIAL MASONRY n ./
TUB AND SHOWER PAN l. l,4~
GAS TEST t· PILES CAISSONS () . t r If I A .0 WAT~R HEATER D SOLAR WATER ,.n 0 If IJ;:· ~ ' .
ELECTRICAL l ./~ (_ J, (2. __,,,,.--I 1
0 ELECTRIC UNDERGROUND I::il UFFER I *-I~ di ROUGH ELECTRIC r
t _jb I ~~/ Or
D ELECTRIC SERVICE 0 TEMPPRARY 'i --·-·~ \ ···: .. :·: :·, • -:-. ,. I /2.-,r' -0 BONDING 0 POOL t
j I If ------(/_0,, X ... -MECHANICAL I /__ '-" V
0 DUCT & PLEM., D REF. PIPjNG
HEAT -AIR CO.ND. SYSTEMS l !~]: ~D! T:\T~\~~~~~! 1t1 ~ tia L -· ' VENTILATING SYSTEMS I
1 -•' I" -. I ..
CALL FOR FINAL JNSPE~voN WH.EN AL_L APPROPRIATE '
ITEMS ABOVE HA. E BEEN APPROV.ED ..
FINAL j. ' -. ' •,.' . I, .. --. PLUMBING l
I '. 1 .,, -/J,.2 6 /'~.£. -' .:... .. ELECTRICAL ' MECHANICAL I 4 . . , ' . ' ... -
GAS , . \' .. ·-. . t
BU~DIN~ l
I
SPECIAL'SPNDITIONS . , .. I
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' ,. ii --=--;-=:: . '~·~·-Av, USE BALL POINT PEN ONLY & PRESS HARD APPLICANT to :~kFOR~ATION,Wff.t-ilN SH-:oe·o AREA AN~~;LAR,ATIONS:
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. .. APP~"J:ION ~j>ERPt1~~--... I. . .. .. --· -.•. CARL:SBAD' BUILDING -DEPARTMENT
ICO ·, -dC .. . . · . , ~ · • ._. · ,. ·1 · .. .. ; • · · · .. , : . , Carlsbad, Cailfornfa 92008'.4859 , • -· · 1-.t. ~ I _l!er!bY_!fflrm that~ am llcen_sed under 1, . _ . . · • • _ _____ ----~-_____ ~ __
(J_ ,• .prpvlalO!l,! of Chapte,r 9 (commencil]g with I JOB ADDRESS • AV.ST.AD. • NEARESTCROS$ST.1 !DATE OF APPLICATION! t BUSINESS LICENSE# ~-ALUATI0· ' = '-· Section 7000) of Division 3 Qf the Business · · . , • • • • • , • ,.... ~. , , _ . .. . .
t-'._ and ProfeaaloniiCode, and my llcense.·ls In· I 1088 l.:a.:.c:tUJ"lQ;..' :l:)r-t_yc::.,.-:Z:X,...VL,5 • . C) J f'I /8/..,e;, f 5050 · , Z full force and effect. 1· · -· I I ' 8r ,.:;-:. -,· .. _. . . . . . . ,, LOT BLOC!< ISUf!DIVIS19N · I ":'SSE$SORPARCELNO. I CONTRACTOR -• CONTRACTOA'S,PHONE# ·zoNE • -~ '" ,.
I hereby aff,rm:that I ,am exempt from the Contrac-i ' · f:5' ~ .. ?_71;:::a -j 7' · :
tQr's·LJc.en.se:L?W·f?rthefollowingrea.an-(Sec.7031.5 ... • . . . ' ' . '.. Co·--·~"r---.e:,.. .,,,._"· .A_~-=a.-17·~~--and'Protess,ons Code: Any1:1tyorcountywhich re• J OWNERS NAME . OWNER'S PHONE, 11....C,...,>r' i. -£-1' • .__... -• -..I ,
PE'AMIT NU EA
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repalfapysIructu_re,pr1orto1ts1ssuancealsoreqmrestheap-·t a.l•·••-.,.·. "'·--J...,,,, __ ,_i l...a....-" _..,.. ~•-•• .1-"'2."2......, .---r-··-~-, -· , '. · P,l1c;int,fors_uchpermittofi1e·a·signedstatementttiatheis r vt..• ,r._,~, nt'1'! · -~~ ··• ., ·re, ..::=t.~--,.,~H._..., '-V.;;;;;,._,,<-J, ..-....... ' ....,._.. ---:,.;,·...,~-· _ · · .... ·•.· , , -• ... • , •.• m.
.P~rmit ,to'c9~§.tr~~t.,,al!~r. i.'!lRrgy~._-~~[llqhsh, or , . ', • . ; CONTRACTOR'S ADDRESS ' · .-...... . ,, STATE LICENSE NO. ., 1 BUILDING SQ. FOOTAGE
···h,en_sed-pursuanhto,-the pro~Isl~ns ~f ,the ~ontractor's , 1• -0 wNEA'S M.AklNG A0DA<ESS • · · • ~ ".l"'l·'--r,. /'t.#0 , -~ '~., f"!~7--' = L1_cense taw (Chapt~r-9 CDJllmenqmg ·w,th Section 7000 of , · . . • • . . · • , . -. LI., • 01vls1on3'0ffheB~smessand·ProfessionsCode)orthatisex-f' _._..._ ' ; DESIGNER • •·· U · ·-· · DEStGNE.RSPHONE -~-. , .>, empt-therelromandthebasisfor-theallegeoexemptiafi. tiny,. I tOl'~r"\ ~ A-~ _,, __ .,,..._ -. .,...,_, -. . . . --· ... ~---.
ylolatiiln'ofS~qljon703_1,.!iby.~napp~c~n't'fora_'ijerimt·sub• ' . . ,. -1 ~ .:--1.lFl •• ~ .-. -... 1 ' • ..;_ ·V· ., .:.. -a-· ·-, \ . · ~ ·, fectsthe.apphcanltoac1vdpena1tyofnotmorettianftVeh4n-,I OESCAI.PTION QF WORK , .' -, , •. · · ... (..,I , • ·, -rra.l, \AC..1"'11 I "!"lhP.l. ;').r,, r ~ , ·--""7~ ·, · o
· dred dollars.($500). -· . --~ -·• ,·-l j I"\,-.-_ ; -,rv,a. ,l"\.nn: -.::. • : rv'\.J.-t'~ '. DESIGNER'S ADDRESS . STATE LICENSE NO. .. -~· . • . . . • . -. .. -·. E'
, n 1, as ow~er of.the.pr_operty1 or my.employees with wage.. f • • -· -._J • , ' 377'-t,, Fou.r-~ ~VC• · :1 · <D ffi -a~tli_elrsol~-~Ol)lpensa!t0n;w1ll:do,thework-;andthes1ruc-· 1 ----~ -.L..., ,....,_ i ~ ~· -•• ,. ,-.~ Q,~· tM~-· · • ·· --• . .... .. .. . . ..I;.
,Q ture Is not Intentied or offered.for sale;(Sec,.7044, Business , ., ,::--Tl: r-.. l A, I"'\. ~~ I ' I
..1. ··and-Professions-Code: TheContractor'slicenselawdoes (.. _,,,, . F/P Ff!-Fl'ELEV. ! .. NO '·occGP' EDU • , 5 _,· not ?PPly,\o an owner of,prdperty who-bmlds,or-iniproves ·r · . l · · · s • -• · .-ST.ORIE$ , . ·--···-. • .• . , · 'o Ill . . fhe.reon ;md'who does such work himself or. tli'rough_his own, . · · • " · '· .. • · .. · .. ·--· ii!-· employees, provided that.such improvements areJlot Intend,-I' · . "'<D NO -·-·-, , , • 0
,w ed a/, olfered'for sale, Jf. •. however, the buitdm1f-9r:1mpfove: • I ·• ,. ·1 I· · · .. · · · I · ' .. · · · · 1 . · · · ., .... -· ... ·· .. .. .. · ·.. . .. "·, 6 ·· . · ·· . .. • · •· , · ... . • CJ z ' .. ment-issoldwlthmoneyearof,completion theowner.-builder .. ,, . • PARKING ~PACE AES l:JNITS GRADING PERMIT IS!lUED AEDEVE·LOPMENT TYPE occ L AD FIRE SPA . •. ' • .. . .•. '' .... ~ · will have th~ b,urifen ol.pioving·tt,at h~.ci'id _notibuiJd or ,in-• i · • • · · • '· • · • • · ··· · . . AREA ·, · c6N_ST ·
0 ·, provefor.t!le_pwposeof,~ale). .. • _.___ • I · _ . · · ·. ,· · y O ',NO--.. -vO ·ND--. , .. .. .. .. ~ . vd .. [)1O.... . J'!ot Valid Unl(!SsMachine·Cl!rtifit?d _
0 'I, as.owner of the property, am.exclus1\iely,contrJct1ng I • • ' .. ..... • • ~ · , ' , · · , • · '· · ,, • ' • .,_ .. ... . · • -· -~ •
··wu~i,censedcont,r?ptor•laconstrilctihep'rol~ct.($ec. o44, • J· QTY • PLUMBl'NG PERMIT 'ISS"'E · 7 v~ QTY iMEOHAN.ICA'· PERMIT 1ss· u·E · ~ SUMMARY/ACCOUNT NUMBE. R . '~ . '(-· ,Bu~mess and Professions code· The·C~ntrac!~r'.s. L e~se : · , -. u · , . · . . LC • •• • , • • • , _.... ,_ .... • • .• • •• • • •• .. •• _ • • • .• __ ci., . ----Law does not.apply to.an owner:.of property-who bmld c 111i-• I · · ·' , --· • · · , ' ·
•pr9ve~·!her~on,_a~dwh9contra~ts.torea~hpro1~cts 11h.~-I, .. EA .. CHFIXTURE°TRAP . ·--..... . • • INSTALlFUBN.OUCTSUPT01000008,TU . , BUILDINGPERMIT 00.1·810·00·00-8220. ... i
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contractor(s} hcense pursuant to the Contrador s 1cense . · 1 ,i ~ • , , , • , ~. ·• . -1, ---•• , ~ -• _.... • • _
-L~w): ., ·1· · E/1:GHBUILDING'SEWER• •• .. . • . OVER100,000BTU ' • SIGNP.ERMIT ,00-1-810·00-0b:8221 .. ·-.. '· . --1·
'D 'As·a homeowner,l·aljl improving my home and tti ,I • . . .. ' . ' . ' ' ' . . ' ' .ing.conditionsex,st: · . · ·'· 1· -· EACHWATERHEATER.AND/O'RVENT. • BOILER/COMPRESSORUPT03HP' " 1 ·• • .. ·PlANCHECK -· 001,810·.00•00,8806 ... , .. _ •. _ .. .,1 .. ) ... .Tlie·worK is being' performed· prior to sal • · . . · . . , · . .. , . --. . ..
2. -1 have rived in, my holne .. for..twelve L, · -EACH GAS SYSTEM·l TO 4 OUTLETS • 80{LBR/COMPRESSOR 3-15 HP • TOTAL PLUMBING 001-810-00-00-8222 //?. prior to completion of this :work. r . . .. . ' . . . . .. . • ' ' ' . .
3. ,I· h_ay<t oat _cl_aimed· th,s exemption d · f EACH GAS SYSTEM 5 OR MORE . 1 METAL FIREPLACE ELECTRICAL 001-810-00·00·8223 • ... last three years. .. · .. • ' • · • ·
0 tamexemptunder-Sec,_____ f • EACH INSTA~ .. ALTE~. REPAIR WATER PIPE . _.....,, VENTFAN SINGtE DUCT • • · -MECHANICAL· 001-8.10-00·00·8224 •
'fQr~hisreason '· · •• : , 1. EA~!-! V.A,CUUM BREAKER, !l.,_ ~....:----MECH EXHAUST· HOOD/DUCTS • MOBILEHOME 001·810-00-00-8225
-J .. WATER SOFTNER " , RELOCATION OF EA FURNACE/HEATER _. . SOLAFI •• • 001-810-·00·00·8226 '
. .. ; . ·I •. f EACH ROOF DRAIN (INSIDE) • DRYER VENT . • .STRONG MOT.ION • 880·519·92-33 )d lherebyafllrmJhatlhaveacertlflcateotconsentto I . . . ' · _ · TOH,L MECHANICAL FIRE SPRINKLERS ·001·810·00-00-8227 self-insure. or a cert1f1cafe o{,Work~rs' Compensation In-f ~ , ~-, , _
surance,oracertifiedcopyther_eof(sec.3800.LaborCode) J' . TOTAL P_LUMBING \ , £<,I_ . " · . PUBLIC'FA:CILITIES FEE -320'810,Q0-00·8740 .. ..
PO~!CYNO.~ s1aq~ -~.I .. _ -, . · D · • · · 1
COMPANY~~--• I QTY: . ELECTRICAL PERMIT• ISSUE ~ ,--_ QTY. MOBILE HOME SETUP ' . . . BR! GE FEE 0 co_py is fifed with the city · : I · , ~ ' PARK,IN-LIEU (AREA -)
)Ci certlf1edcopyi~her~b;·f~;ni;hed . \ NEW CONST EAAMP/SWT•BKR.. • _ ' CAR PORT • · TIF --oot,810-00-00-8835 ,1
i 1 PH . . -.• 3 PH' . AWNING · . • LICENSE TAX 001-810-0Q-00-8162
~ERTIFICATE9F.~XEMPTION:FROM I · EXIST'BLOG·EAAMP/SWT/BKR ' ,. · GARAGl: . , MFF 880-519·92·57 WORKERS: COMPENSATION INSURANCE· I . ' ' •
(Th,s·,wctlon"need not be·completed If the permit 1 PH--3 PH .
' 'Is for on<t hundred dollars ($100) or less) I ,
D lcertifythatinthepeflormanceofthework·forwhlch f REMOOEL'ALJE.R; . .PER CIRCUIT_ ,, , . ,.
this permit ls issued,"! shall not employ any person in any f -· ~ -• -~
:r;na~~ersoastobecomesubJectlotheWorkers'Compen-. I . T6MP _PO ~E 2QO·AMPS , • ..
sat,on.Laws of California. OVE'R 200. AMPS · -.11 "
,N.OTICE TO >IPPLICANT,lf,.after maklng·thls Certificate I ' . -
of.Exeruptlon,youshotJl~becomesubfecttotheWork,ers' I·· TEMP OCCUPANCY !30 DAYS)
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Com~nsatlon•provlslons of the Labbr Code. you musL 'f , ._ _ ' . ,, r"'""'\ _ _,
forthw)th.'c6niP,ly.wlt~ spcli_pro~islons·otthis permit,sha!I . I . : . , _ • . · CREDlT' DEPOSIT · • .. .. .. · , , • 0
:~teeme~-;e~oked. --;-:_: . : ,. • , · · ,. f · · TOTAL ELECTRICAL · 1· , ' ·_' · .· TOTAL · ' • , · · · · • -· · TOTA'L FEES PAYABLE I· ./(} ..-,-~
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: · ., : ,._ · · er_e,, ~>a firm !toat \ ere-s ~,construction lending ! H Code shall expire by limitation and become null and vo,d. 1f the budding or work. • .. ""' · --· · -· a:: . .agency.for.the perfonnance..o/thewor~ forwhich_thls_per-I CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATlO ~ HEREON INCI..UD!NG T E authorized by iuch permit is not commenced within iso days from the·date of such 5 0 DEEP ,\ND DEMOLITION OR CQtlSTRUCTION OF '
:[ .J I h .. _ b ·r·· • ._ · h--.-1 -· • · .... : • · I · 1 HAVE CAREFULlY•EXAMINED THE COMPLETED "APPLICATION AND PERMIT'' AND-DO-HEREBY Expiration. Everypermi\issuedbylheBuildlng0ffic1atundertheprov1s1onsofth1s * AN OSHA PERMIT .IS REQOIRED FOR EXCAVAT"'NS OVER -1
-~: ._-'l'Jt is lssue~•(Sec, 3097, Civll,Code) , . f DECLA~ATIONS'-A-RE TRUE AND CORRECT,AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS permit, or if the building or..work authorize·a by such permit is suspended·or _ STRUCTVRES OVER 3 STQRll;S_IN HEIGHT _ _ , . ~'.
Z: ,_ : .. . · : t.t.,, '·O ~ I(_ . f ISSUED. TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING !3UIL_DING CON· abandoned at an~lme ati .. ,-.111,e work Is commenced for a oeriod of 180 davs. . · .c• ~ Lender's Name' ' L;_e/1 .. ': .:. f\ . · · STRl:ICTION. WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY ANO · , · . . > . .;., ,. -~ tlll':5''' St::, I KEEP HARMLESS THE CITY OF CARLSBAD AGAINST All LIABILITIES, JUDGMENT.$, COSTS AND APPLIC~NT IG T. E >I-~ • • OWNER.0 CONTRACTOR. _,A,PPROV!=~ B~ .•. ···w·· . . . . ,{ ·~:/(Jg >: ' •. ,Lender,s-Addr~ss . , .. · · · . • I EXPENSES WHICH MAY IN ANY WAY-ACCRUE AGAINST SAJD CITY IN CONSEQUENCE OF THJ:; _ '-) ·•-~ , '· ··, ,.., " . -·_.--,. -•. ·--• ... , . . ' ... .. ~ ~o, ~ ' . f GRANTING OF THIs:PERMIT. . -. -/ -. .. -BY PHONE O • )., ' "''<i; ~~-:~ . :1 // ' [.._..---. . ... -. ... . . ·qc.J<='I' I. ' . . . . -, .
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TYPE DATE INSPECTOR . . . . i ,-·. ·. -, . " , ._._JIUU .. Q N§.~ ·-I
·..,_ ~---tlbtf ~\
FOUNPATION ~ _ : FIELD INSPECTION RECORD ).~-,
REINFORCED STEEL' 1 REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
MASONRY .. , · I REQ. IF ;I INSPECTOR'S 1· . OUT I ·· · INSPECTION CHECKED APPROVAL · DATE 1--------,-------~:-----c---;-'-----...,._--,-,;-;-GUNl't,E OR GR ' . I , -~-' I
sus FRAME o FLOOR· o···cEmtNG. ··"" .. · soJi:.s coMP.LIANCE
\
SHEATHING · D ·ROOF DStiEAR' _ · . . . . ~~~:O:~ION INSP -· • .... J .
FRAME ; . , • ' 1 . . • . ' . Sl"R!JCTURAL GONCRETE
EXTERIOR. lA TH: , • ! ' . . " -· 'OVER 2000 PSll ,
-·. · . ,.· · • , PRESTRESSED
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INSUl,ATl9N · . · -.. .. J . .. . • · · CQNCRE:TE
INTERIOR LA-il:i.& DRYWA~t. · '. ·i · · · · · _ · _1-c·-=-Po.:..:s..:,:r::.:,.T,;E.:..,..Ns::-..,.1-=-oN'""'·E::=D:----+.,_:_--t------r-~--,
• . -. • ' ' 'CONCRETE
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, .-PLUMBING ~-1
D P[/CO D SEWER A~D.suco·
UNDERG80.UN0:. ;·0-y,IASTF;.. _ D~WATER
TOP OlJT D WASTE D .'tATER
TUB-: AND SHOWER -PAN ·1
GAS TEST _ t
D WATER HEATER p ~O!,.:AR W,ATER
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ELECTRICAL i
D ELECTRIC UNDERGROU~D_ Q_ UFFER
ROUGH ELECTRIC l
p ELECTRIC SERVICE D TEMPORARY ·
ci BONDING d PQQL I
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MECHANICAL J
0 DUCT & PLEM,, D REF. PIA.ING
.·: HEAT -AIR.COND. SYSTEMS l
VENTl~JING SYSTEMS I l -:i-+ -' • -
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CALL FOR FINAL INSPECT/ON WHEN ALL APPROPRIATE
ITEMS ABOVE HAWE; BEEN APP_l:l.QVED.·,· ·· . -· · -
FINAL I .
-
PLUMBING l ... ",i; :~.::----/;.'2-lf,'l~ ·.f{/---~,
' . . (J EU;:CTRICAL I
MECHANICAL I i
GA$ I 1 .. -. :_ '.: t,". 'i. ·, .. .• .
BUILDING ' I I
SPECIAL CONDITIONS I
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FIELD WELDING
HIGH STRENGTH
BOLTS
SPECIAL MASONRY
PILES CAISSONS
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!) . 1: .USE BALL POINT PEN ONL~ & -P~ESS HARD · . APPLICANT TO FILL IN !NFO~MATION V/ITHlfl! ~HADE!;> Af'~A ANQ.DECLARATIONS,
f CARLSBAD BUILD.ING DEPARTMENT . . . . . __ , . ··-··
{ . ., c,arlsbad, California 92008-1989 (61~438-5525 ___ _ _____ --~A~PLl~ATION_,~ ~~~IT
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.0 I .hereby ·af_flrm that I .am licensed. under
, pro~lslons of Chaptl!r 9 ·(commencing witl,l
Sectlpn 7000) 'bf Dlvjsl9n ~ of the B.uslness.
arid Professions Code, and my license Is In
f\JII fbrc::e anp e_ffect.
Lie No ______ Class
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I hereby affirm that I am exempt from the Contrac-tor's License Law for the following reason (Sec. 7031.5
Business.and Professions Code: Any city or county which re-quires a permit to construct, alter, improve, demolish, or
re-pair_any s,ructure, prior to 11s issuance also requires lhe ap· phcant for such permit to Ille a signed statement that he ,s
IJcerisea. pucsuan) to the provismns of the. Contractor'$ License Law (Chapter 9 cqmmenc19g•.with Section 7000 of
Division 3 of the-Business and Professions Code) or that ,sex-empt therefrom and the'bas,s for'the'allegea·exen'fption. Any Violat,ori of Section 7031.5 .by-.an'.apphcant for a.permit sub·-
1ects \he applicant to a civil penalty of not more than five hun-dred aollars ($500).
O J, as owner of th~ property, or my, employee~ l)'lth wag~s as ·their sole compensation; -will do·the work, ·and·lhe struc-" ture is not,intended or offered for•sale (Sec. 7044, Business
and Professions Code· The,Contractor:s License· Law does not apply to an owner of 'property 'who ·builds or improves thereon and who does such,wdrk h1mselt or,througlrh1s own
employees, provided'that such improvements.are not intend, ed <Jr offered for sale. If, however,.th.e building' or improve· ment·,s sold within one year ol completion,_ the owner-builder
will have·the burden of proving !hat' he did: not bui)B or Im.-prove for the P,U(pose of ~ale).. · • _ · •
O I, as owner of the,pr,operty, am exclusively contracting with licensed contractors to construct \he project (Sec. 7044,
Business and Professions Code: The-Contractor's license Law does not apply to:an owner of.property wh·o builds·or im-proves thereon, and who contracts for each projects wilh' a
.f~W;~ctor(s) licens_e ii_tiisuant lo the Contractor's License
D As a homeowner I am improving my home, and the follow· iog ,cond1ticins exist; . •
,1. The·woik is being_performed prjor 16 sale., 2. J· have lived in my home for .twelve months
pnono completion,Qf this work. . 3. I have not clafmed· tliis exempl,on during the last'three years.
D i am exempt under Sec.~--,'------, B & P.C. for thls:reason -----------~-
I hereby affirm that I have a certificate of-consent to
elf-insure. or a certificate of Workers' Compensation In·
urance. or a certified copy thereof (Sec. 3800~ Labor Code)
OLiCY'NOc
CO'MPANY
D Copy is flied with 'the city
0 Certified copy is hereby furnished
CERTIFICATE OF EXEMPTiON FROM
WORKERS' COMPENSATION INSUBANCE
(This section need not be corri.pleted If the, permit
' 1~ ,for one hundred dollars ($100) or less)
[J I certify tpat io th'3 performance of the work for which
this,perm1t Is issued, I-shall not employ any person in any
manrler so as to bec_ome subject to the Workers' Compen-
sation Laws of California.
NOTICE TO APPLICANT: If, after making this Certificate
of Exemption, yqu should become subject to the Vl{orkers·
co·mpenSation provisions of the Labor C9de, you must
forthwith com pl}' With such provisions or this permit shall
be deemed re~oked. "
ffi ' agency t'or ttie performB.nce of.the work for which this per-l D I llereby 8fflrm that there IS a construction, lending
,~ mit'is Issued (9ec.,3097,Clvil,Cgde)
~ Lender's Name _______ ~-~
Lender's Addr~ss~-------~-~~--
VALUATION "
4ooz::>
I ... ·--~-~----------. --.-.---------~-·-.-. ----1·.Jos,AooRE;SS .. ·-.... _ AV.ST.RO, NEARESTCROSSST. , · ,~' _:'-'\i::)5[5 ,+t~u~~ :t::12.l'lt: UqUJJA .', ~eF~ S04. ' ' ' . . ' -
~USINESS. LICENSE~
CONTRACTORS PHONE # ZONE
PERMIT N'UMBER.
j LPlf s·LOCK •. SUBDiVISION ·CONTR-~CTOR .
: OWNER'S NAME , OWNER'S p'l-fDNE __ \4_A:~·\"2ft-,-_..,._tz.. __ C,CjJ ___ ~_·'t_· ~~--~· _. _x_.lO_l'-l __ -t--:----0:-:--:::..,..,..,.---...,...--------,---,-+-----,---,-,-----; l V\U.,A? ce CAf!L.$~D ~ 1:,4. 4~1·0 ·cosR,f!<bS (~lA~ CAM~ w LICENSE NO. PLAN 1.0, # BUILDING so. FOOTAGE
'4=1;'.c,&::t:) 51{p
:I OWNER'S MAI LING ADDRESS t------· _......, ____ · -~--------+----,-------+---;__-'-----'--,ai;;.;.;..,_'---"'-----,-..,--'1 I ........ ______ __.-.________ DESIGNER -DESIGNER'S Pl-fONE
I i . rr I DESIGNER'S ADDRESS
!. f 1----------------------------------F/P FLA ELEV.
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I vO -NO --
NO
STORIES
LICENSE: NO.
. OCC·GP EDU·
i_ ; GENS.US T•RACT ot_L_Al'!P USE P-Al'1KING SPACE .RES UNITS. .GRADING .PERMIT ISSUED REQEVELOPMENT TYPE DCC LOi>;D FlflE SPA
j _ ,!>-RE.A CONST
i Y'O N D vD NO vO ·N[J
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Not Valid Unless Machine Certified
1 ,QTY. PlllMBING PERMIT-ISSUE QTY. MECHANICAL PERMIT-ISSUE .2o~
' o.), '
SUMMARY/ACCOUNT NUMBER
I. 'EAGH FIXTURE TRAP INS-TALL FURN. DUCTS UP TO 100·,000 BTU _,,,,_,.,n ____ .,_ -nn• n•n nn tlUILUll~lJ rtt1MI I uu , -o I u-yu-00-8220
rse~sa
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: ·EACH BUILDING SEWER · · · ·· ovER ioo,ooo B~u
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~ACHWATER HEATER AND/OR·VEN_T BOILER/COMPRESSOR UP TO 3 HP . .
BOILER:/~0"11'_1l_~OR 3-15 HP
S'IGN PERMIT 001-810-00-00-8221 I · ~= PLAN CHECK 001-810-00·00-8806
I EA(:H GAS.SYSTEM 1 T0.4 OUTLETS TOTAL PLUMBING 001-81 Q-00-00-8222
I E.A.CHGASSYSTEMS OR MORE METAL FIREPLACE EL~CTRICAL 001-.~ 10-00-00-8223 ---~
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.EACH INSTA~ .. ALTER, REPAIR WATER PIPE VENT !'.AN SINGLE OUCT
E-ACH VACUUM BREAKER MECH EX·HAUST • HOpDIO UCTS
MECHANICAL 001-810-00-00-8224
MOBILE.HOME 001-81 o,oo,o~-822s
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WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP
EACH ROOF DRAIN (INSIDE) SOLAR _ 001-810-00-00-8226
TOTi;L MECHANICAL STRONG MOTION { ~ f , Ji' A!o-D-~1,,_ -~"'>n I
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TOTAL PLUMBING. I FIRE SPRINKLERS oo\'.s1tot\J-~.IV
I 1 IQTY.
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ELECTRICAL PERMIT -ISSUE Q~QTY. SOLAR -ISSUE PUBLIC FACILITIES FEE FL-tS3,!-810;00-00-8930 -· ' ·• .> r:n., 19:87
NEW C·ONST EA AMP/SWTIBKR COLLECTORS SCHOOL F,EE -DjliiW.,T, _ ., _
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1 PH 3 PH 'STORAGE TANKS ~-·vrtL.~s· ·-a· A Garlsba"1i::11..,, ,.,. •~--_ ,,.,.~._.__ ft
EXIST BLDG EAAMP/SWT!BKR I II '!ROCK STORAGE
1 PH 3 PH I II I PUMP I II San Dieguito
. . ~u;z.vlm~~\II PROCESSING tcnu~ Encinitas ~-_.:..· ----'-~-
: REMODEL/ALTER PER CIRCUIT I PLAN CHECK FEE I San Marcos j I
I, TEMP POLE 20p AMPS
I OVER 200 AMPS OCENSE TAX 001-810-00-00-8162
: TEMP OCCUPANCY (30 DAYS) MFF 880·519·92-57
I CREDIT DEPOSIT
;-: TOTAL EHGl'RICAL TOTAL SOLAR TOTAL FEES PAYABLE / ·
1
1
• I HAVE CAREFULLY EXAM1NED THE COMPLETED ''APPLlCATION AND PERMIT" AND DO HEREBY Expiration. El(ery per_m,_t i~sued bythe Building Official '!nderthe provi~ionsof this * -1'N OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER
'' CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON lNCLUDJNG THE Code ~hall expire by hmital,on 8nd become null 8nd void. If the building or work 5' O" DEEP A+ID DEMOLITION OR CONSTRUCTION OF 1. authorized by such permit Is not commenced wIthm 180 days from the date of such DECLARATIONS ARETRUE AND CORRECT ANQ I FURTHER CERTIFY AND AG8EE IF.A PERMIT IS . permit, or if the building or work authonzed by such permit is suspended or STRUCTURES OVER 3 STORIES IN HEIGHT I ISSUED: TO COMPLY WITH ALL CITY, COl)NTY AND STATE LAWS GOVERNING !3UILDING CON-L~a:::::b;::an.:.::d:::o:.;.ned=:a:::t~a:.:,:n~ti:.;.m:;::e..:a:.:,:ft~er~t:.:,:h~e~w~o:.;.rk~i~s..:::c:::;om:!!!:.m~e!!!nc:<!:e:!:!d..!f:::or~a~e:!!.r!!:io~d_;o~f'.1182.!0!.:d~a=s·~--r....,"""'~~~,,_-'""'! _______________ ...,. i STRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGRE:E TO SAVI: INDEMNlr'Y AND · , ·
j KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LlABILITIES, JUDGMENTS. COSTS AND APPLICANTS SIGNATURE .'If. OWNER O CONTRACTOR 0
·I EXPENSES WHICH f111AY IN AN)( WAY ACCRUE AGAINST SAJD CITY IN CONSEQUENCE OF THE BY PHONE 0
i GRANTING OF THIS PERMIT .
DATE
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, TYPE I DATE INSPECTOR , ... ---,
-r BUILDING !
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FOUNDATION I FIELD INSPECTION RECORD
" . --' ' REINFQRCED_STEEL f,
MASONRY r
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GUNltE QR GROUT i
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTION REQ. IF INSPECTOR'S DATE CHECKED APPROVAL
..
SUB FRAM!; D FLOOR D CEl41NG SOILS COMPLIANCE
SHEATHING D ROOF D SH~AR
FRAME '
PRIOR TO
FOUNDATION INSP
EXTERIOR LATH ·,
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STRUCTURAL CONCRETE
OVER 2000 PSI
INSULATION !
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INTERIOR LATH & DRYWALL !
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PRESTRESSED
CONCRETE
POST TENSIONED . .. . ..
' .. CONCRETE -;--..-
I PLUMBING ! . -
D SEWER AND BUCO D P~/CO
UNDERGROUND D WASTE D :WATER
TOP OUT D WASTE D V!fATER
FIELD WELDING ..
-
HIGH STRENGTH
BOLTS --
SPECIAL MASONRY ' . .. ,
•l TUB AND SHOWER.PAN j •• <
GAS TEST I ..
.PILES CArSSONS
D WATER HEATER D SOLAR W(ffER
!
ELECTRICAL I
D ELECTRIC UNDERGROUND D! UFFER
ROUGH ELECTRIC -!
D ELECTRIC SERVICE D TEMPG)RARY .
D BONDING 0 POOL ! ..
·. -. . ~\ ...... . . ~-. '-
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MECHANICAL ' D DUCT & PLEM., D REF. PIPtNG
HEAT -AIR COND. SYSTEMS i 1 ·., ' I '.
VENTILATING SYSTEMS !
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CALL FOR FINAL JNSPECT,WN WHEN ALL APPROPRIATE
· ITEMS ABOVE HAVE BEEN.APPROVED.
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FINAL ! ..
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PLUMBING I -.
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MECHANICAL I
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GAS l ./h . ' ' . .
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SPECIAL CONDITIONS
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. CITY OF CARLSBA •.
, · BUILDING DEPARTME .
729~1 I Sf -Ex.t. 36
8358
... F A 1· t t F0II I or. ,pp 1c·an 0 I n
Own~r's Na~e~•---3' g ~~~x
M~11 Address\ C) 8:&' ~~\J N /o-\') ~
Contractos:2~5,,. -~• N\) ~r-.l,\)_91'-)
Go~~r. A~dress <1~%:S 1?~ rt~\.~\~
:r~ Con~t.Jd To Add 0 To Alter 0.· Convert D
To Move From
'"r~~ Type· of Const.
Frame, Masonry; etc.
F;r · S \Gr}-,. To ~e Used -. ,--; ' ..
:;Kind· of :Foundation · No. of Storie•
Floor Space {Sq. F-t.) ~O-e> ~g.~\ . ~ --Attach!lrl .. ·,.
$arage Fl_oor Space (Sq. Ft.) '··
Detac;he..1 -
· Lega; D~scription\oS&s::~ M~ ~ ~ .
· . Lot Blocli :
· Subdivision . . CJr
. Section Townsliip Range ;
· No: of Existing Building -
Will this consfruction include any plumbing installation or alter-
atioD? Yes tJ No J)!(
Signature
of~~~---·
I ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION·
~~~l1.-rt:r.:1Jt:AI1,.IH~,¢:~~~
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i-rA~~Rfi1:N~~~sr~¥,Jg
ljlUILDING,·
I CERTIFY THAT I AM PR.Of'ERLY REG!STEREC> AND:/OR
·l!.leENSED AS .REQUIRED BY CITY OF CARLSBAD AND
S:rATE OF CALIFORNIA. OR THAT I AM, THE. LEGAL OWNER
OF THE ABOVE _OESCRIB~Slp~
SIGNATURE ~-·_Q~ . · . OF PERMITTE . . . · ..
Applimt~o-r· :BlJILDl'NG :PerJnil -
:e~ilding .Permit ·F,e
1£'9-~ .. -..
·. ·_ .. ·. ··JUN .15-65 ~P;~04601.J***1"***9
Bu-Jlding PePt~ U~e Onlv . · · . . ' . -
.00 .
.. .
Buifding Address /6/.f;X~~ -
St. Near .. .. ... ..
' .· ,-;' .. . .. .. ... -· ~ -
Set Bae~· '/.' . . f,rl
.. .. Bld_q • Valuatton / -!2 S·c/ -
')_ ' .
Front. P;l.. .. M.ain· Bfdq, · ..
--~· ..
Side P.L. --~ , .. _$arage-
--~-Rear r.L. .. Other .
<;;roup ··. Zone Approved ,by ... ,,
,.
·• ., .. . '" .. ,' .
•. Contrac;toi City 'Bl1s. l;ic. No ... ..,' .. . . .
" .. ' ---Water. Meter· l Sew!lge · Disposal ~ys.f-E!in
· __ ·-. ,.
'•
lnsp·ection R,ecord
.
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-~-
~----~ ..
.;,I· ... .. . --.. -..
.. '
. ..
. ., .· . .. .. .. ..
...
'. ,.
Utility C9mpany Notified .'..:.. Oat~ :BY
Pinal I .. · .. .. .. ..
If a ch~ck -is tenc:le;ed fcir-paymenf fo; ·the· \lb6ve· f~e ~nd· the ' check is nqt honored when _presentecl for payment; your ·
building· permit will -be-immediately revoked .. · .
· City of Carlsbad Buildi,ng Dept.
.. ,. ·, . .. ' . ' P.erm,t vo,1d 1f work 1s not commenced· within bO dan. sf >!f:SVHGe~ ' ' . , . . ' . ~ ''. . .
ApplicafioWor BOltD'l1NG .Permit CITY OF CARLSBA~
BUILDING DEPARTM-
729-1181 -·Ext. 36
licant to Fill In 3500 Building Permit Fee
·Owner's
. Mail Address fL!.!!:....lL.J~;-t::.=~==~J.\::~L--,'--=e:;=:.¥
Cqntractor --1.YYJ..!..'_!_L.l~~.£..:'-!..~:..:=::~=~~~L-cJ...§o=.!i
C~n~r, AQdress 2~ £),, ,e. JY p. ,/
To, Const. J(' To Add 0 To Alter D . Conver.t 0
Move From ---~----~~----,----,----,.
. Type o-F Const. ---'-· W!!!e!,=-·_,a.,""'-(!.)-.,c__,,d_=----------.,.......,..
Frame, Masonry, etc. l r,
For. t!) et-,rdc,or £,7 ,y'\, To Be Used
Kind o·f Foundation::·-----"-----'---No. of Storie,._ __ -'--~-
~ Spac_e (Sq. Ft.) E CH2 L£ e> J( 3 o)
· · Garage Floor Space (Sq. Ft.) Attached---~-------
Detache0-..c---'------
·,Legal Descdption --"--------''-----.'---------'---Lot :Block
Subdivisio~J# /~~ -I 'Cf -Q I or
Section, Township Range
No. of Existing Building----'---,----~--'-------------'"
Will this construction· include any plumbing installation or alter-
" -•'.
Set Back Bldg. Valuation /~~/)~
Front P.l. Main Bldg.
Side P.L. <3,arage
Rear -P.L. Other " Group -~t Ap rove .:( Or
Contra<;tor City Bµs. Lie. t:,lo. --,--'--------"--'-~------"-'---.;..,
Water Meter . /-Sewage Disposal Sysorero
Inspection Record
ation? Yes D No ')!I.. .
. . ~s~ .... ~ @~~ • <.:~-"-,-~-~-----'--,-~-'--------signature ,~f Applicant 111'7//;. k . (' .
. ~~~ .--~ .
·I ACKNOWLEDGE THAT I HAVE READ THIS 2:LICATION ·,
AND STATE THAT· THE ABOVE IS CORRECT AND AGREE TO
COMJ:'LY WITH ALL CITY AN[? STATE LAWS REGULATING
BUILDING.
I' CERTIFY THAT I AM PROPERLY REGISTERED AND/OR
LiCENSED AS REQUIRED BY CITY OF CARLSBAD. AND STATE OF CALIFORNIA OR THAT I AM THE LE.GAL OWNER qF THE P,BOVE OES_CRIBED RES.IDENTIAL PROPERTY. .
SIGNAT.URE
OF: PERlvJITTEE ~-----'-------~~~---
Utility Company Notified -.Date,_~-~'--~ By·--~---'--
Final
If a checli is rendered f9r· payme~t for ·the above fee and the .
.check · is ·not horiored: ·when -presented -for p,ayment, your-
:building p~rmit v:ill be.· immed_iafely revoke,d ..
City of C.ar!sba.d, Building Dept.
Permit-void .if work is not commenc11d w'i!hiri 60 days· ·of. ·issti\l_nce. :