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HomeMy WebLinkAbout1175 CAPE AIRE LN; ; 80-183; PermitCONSTRUCTION LENDING AGENCY1 hereby affirm that there Is a construction len-ding agency for the performance of the work forCERTIFICATE OF EXEMPTION FROMWORKERS' COMPENSATION INSURANCE(This section need not be completed if the per-mit is for one hundred dollars (S10Q) or less).I certify that in the performance of the work forwhich this permit is issued, I shall not employ anyperson in any manner so as to become subject tothe Workers' Compensation Laws of California.NOTICE TO APPLICANT: If, after making this Cer-tificate of Exemption, you should become subjectto the Workers' Compensation provisions of theLabor Code, you must forthwith comply with suchprovisions or this permit shall be deemed revoked.1 HAVE CAREFULLY EXAMINED THE COMPLETED "APHEREBY CERTIFY THAT ALL INFORMATION HEREONFURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUECOUNTY AND STATE LAWS GOVERNING BUILDING CCSPECIFIED HEREIN OH NOT. 1, ALSO AGREE TO SAVELESS THE CITY OF CARLSBAD AGAINST ALL LIABILEXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINSOF THE GRANTING OF THIS PERMIT.C: i ( *ti irCCr r APPLICANT'S SIGNATURE' OvjNERQ CONTRACTORn^— ' AGENT D BY PHONE O>•v-a310<m <^° ^ D>-tm 3 •" S 3 O I >jjjjjjj 3 w -K I - 31 -0 - ' m m H 31 m n M > 3 r > ."' '. > 3) 0 Z J> n o ? 1 - °OO •AN OSHA PERMIT IS REQU5'-0" DEEP AND DEMOLITISTRUCTURES OVER 3 STOf '- '\^J JUU2**t<y-**r ?°5 \ SoS •=- , *o3 J m03rr 5lsR M5M o<I H J* LI 52^••r— . z u h. oSK 2 ER SCHOOL FEES:J^kV CONTRACTOR- -TOTAL ELECTRICALTOTAL FEES PAYABLE"A * 1 — i in (/> (D N 01—) -TEMP OCCUPANCY!3o -<w (/ ^JC S CT S »— ^ 1—cS DCopy is filed with the city.D Certified copy is hereby furnished.SdHV 002 H3AOTEMP POLE 200 AMPSTOTAL MOEr-m o Sm S Oo -n r~ S 8 I U PWORKERS' COMPENSATION ptciARA||ON1 hereby affirm that 1 have^&rtifipate df con-sent to self-insure, or a cerffncate W[ Workers'Compensation Insurance, oma cernlied copythereof (Sec. 3800, Labor CoderPOLICY NO.REMODEL/ALTER PER CIRCUITFENCE OVER 6'-oI rsaCJ! CO•oX RAMADA, CABANAEXIST BLOG EA AMP/SWT/BKRCOm•H (=-o COoI—> •33 -oX foen -oZ t>O9r?X So r-m XoZm NEW CONST EA AMP/SWT/BKRz MECHANICALoID5T Of i-= < 1* 9 : ti ? a- - ^ •^: V o ELECTRICAL PERMITH H MOBILE HOME PERMIT> S ELECTRICALTOTAL PLUMBING\hV :il-is£|!s ^iMlfllf^ff's IliffliHlIIfKiJ |lln?tJi i|Ii!!:Ji!!li Ii>I|ll!|!iilcfi tliyisfi flifiiiliHH ftiHiljiiiiHilm sal S fl^lll olflo||ol?^i !^??o|i.|?lllls nozH RACTOR ;S <TOTAL PLUMBING0z-H >30JO 1 >f—r— Z c=CA <m-am31 S H TOTAL MECHANICAL-Dr~>Z o o7* —issueo (/Ito (D O- Cc:SIGN PERMIT-WATER SOFTNERRELOCATION OF EA FURNACE/HEATERBUILDING PERMIT-EACH LAWN SPRINKLER SYSTEMMECH EXHAUST - HOOD/DUCTSEACH INSTAL, ALTER, REPAIR WATER PIPEVENT FAN SINGLE DUCTEACH GAS SYSTEM 5 OR MOREBOILER/COMPRESSOR 16-30 HPEACH GAS SYSTEM 1 TO 4 OUTLETSBOILER/COMPRESSOR 3-15 HP—EACH WATER HEATER AND/OR VENTt\> K V BOILER/COMPRESSOR UP TO 3 HPEACH BUILDING SEWEROVER 100 ,000 BTUv-/ '!tVALUATIONEACH FIXTURE TRAPINSTALL FURN. DUCTS UP TO 100,000 BTU-<PLUMBING PERMITI 3 MECHANICAL PERMIT> ~~"> ^**ai«***' tv*' X..,^ c TT ^j. .. _«»«• %. ^ ^ ^*V; X "O ^ JPV~-'" '" C:.«^^ S t<'V S ^w 0)ro (A O •q-1 D)rD0 C(Am STANDARD PLAN #TI Z D TYPE CONSTOno i-o>o n. K" Sr CENSUS TRACTo zD Cen m ZONINGRES. UNITS* 5yj JC. z<n in TJ>nm W Hh NUMBER OF STORIES1 <:;• J5 P ^ r ^-•^ r~^* *T- t O 3} S- H OZ o-n «o ^ Sr- l 1 "P Dm u>GNER'S PHONEA'or Vstid Unless Machine CertifiedI- OH BLOCKSUBDIVISION~ > z— o DmU) zm 33' U)r>,>> m Mr s ofz ER'S MAILING1DDRESSSs^-meL— — -Os 0 1 en l^i 8-C Smt/> "Yiftjr~^Ik CONTRACTOR'S 'PHONE^^ ^r>aoo r -+- k__->5 x o5zm </i TJ Xozm ^=S- TJ F!^- si^i 19 •r •i \. N ^ £«£^5? 3 (T "1LICENSED CONTRACTOR'S DECLARATION1 hereby affirm that 1 am licensed under provi-sions of Chapter 9 (commencing with Section7000) of Division 3 of the Business and Profes-sions Code, and my license Is in full force and ef-fect.[r\B ADDRESS-iAii\)u-i i i i i— ><aj-- 05 o V\ 5?~%TJ ?1oz BUS. LICENSE•om ^ iA iLA> 3 CITY OF CARLSBADAPPLICATUSE BALL POINT PEN ONLY 1200 ELM-BUILDING CION & PERMAVENUE(EPARTMENTT APP(714) 438-5525 MA1fi |25/1 oxit INSPECTION VALIDATE*