HomeMy WebLinkAbout1192 LAGUNA DR; ; 84-218; Permitq[
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D I hereby affirm that I am licensed under
provl1lon1 of Chapter 9 (commencing with
S.CUon 7000) of Division 3 of the Business
and Professions Code, and my license is In
lull force and effect.
Lie No ______ Class
I hefeby affirm that I am exempt from lhe COnlrac· tor's License Law tor the lollowing reason (Set. 7031.5
Business and Profess10ns Code· Any city or county which re-
quires a permII to construe!, alter. improve, demolish, or repair any structure, pnor to its issuance also requires !heap--
plicant lor such permit to file a s,gned statement lhat he 1s
licensed pursuant to the provisions of the Contrac1or's
License Law (Chapter 9 commencing w1tll Settion 7000 ol Division 3 ol tlle Bus,ness and Prolesslons COdeJ or that Is ex-
empt theretrom and the basis tor tlle alleged exemption Any
viotahon of Setlton 7031 .5 by an apphcant tor a permit sub· jects the appUcant 10 a C1V1I penalty of not moce than five hun·
dred dollars (SSOOJ.
O I, as owner ot Ille property. Of my employ,<s wtlll wages
as their sofe compensation, will do the work, and the strut· ture 1s not intended or offered fDf" sale (Sec. 7044, Busmess
and Professions Code; The Contractor's lteense Law does
not apply to an owner of property who builds or improves 1hereon and who does such work rumself or through his own
employees. provided 1hat such improvements are not intend·
ed or o1fered for sale. If, however, the buildmg or improve-
ment is sold within one yur of completk:ln, the owner-bu1kfer
will have the burden Of proving that he dkt not build o, im-
prove tortlle purpose or sale).
0 I. as owner of the praperty, am exclusive,y contract mg
witll llcensed contractors lo construct the project (Sec. 7044,
Business and Profess10ns Code: The Contracto,'s Ucense Law does not apply to an owner at property who builds or iffl· proves lhereon. and who contracts ror each projects with a contractor(s) license pursuanl to the ContJactor's license L.awJ.
D As a nomeowner I am Improving my llome, and the lollow· ing conditions exist 1. The work is being perfDfmed prior to sale. 2. I have lived In my home for twetve months prior to completion of tllis work.
3. I have not claimed this exemption during the
last three years.
D I am exempt under Set. ------· 8 & P.C. tor this reason -------------
0 I hereby affirm that I haYe a cen1t1caIe ol consent
to self-insure. or a certIhcate ol Workers· Compensat♦on Insurance. Of a cen1t1ed copy thereof
(Sec 3800. Labor Code)
POLICY NO
COMPANY
□ Copy IS hied w,th the city
O Cert1hed copy Is hereby furnished
CERTIFICATl OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This secIIon need not be compleled 11 the permit
Is fOf one hundred dollars (Sl()QJ or less)
0 I certify lha1 In the performance of the wor1( tor
which this permll Is issued. I shall not employ any
person In any manner so ,15 to become subIect to
the Wofiters· Compe-nsat1on Laws of Ga1tforn1a
NOTICE TO APPLICANT 11, after mak1n~ lfHS Cert,
ftcate of Exemphon, you shOuld t>ecome subIecI I?
the W0t1ters • Compensation provIsIons ol the Labor
Code. you musl forthwith comply with such
provisions or this permit shall be deemed re\/Oke<l
O I hereby affirm lhal there ,s a cons1tuct1on Ient1I0Q agency tor the pertQfmance of lhe -Nor11 lor
which lh1S permit IS issue<' tSec n,. C,v!I CO<Je•
Lenders Name ___________ _
lender"S AC)dress ---,--------
..,.<A ____ _
USE BALL POINT PEN ONLY & PRESS HARD t. ..,~MATION WITHIN SHADED AREA AND DECLARATIONS.
CARLSBAD BUILDING DEPARTMENT Aa-, --~ATION & PERMIT
I 1200 Elm, Carlsbad, California 92008-1989 (619) 438-5525
JOB AODRESS
JI cq-,_, L..~-
AV. ST.RO.
c.>,._, .4.--
NEAREST CROSS ST. I OATE OF APPLICATIONI
LOT fe(OCK CONTRACTOR l SUBDIVISION I ASSE/~4,RC.:,t t/-z, 7
OWNER'S NAME OWNER'S PHONE /d1:;-,;: (!bT ~0fdfJEVN6(o.
CONTRACTOR'S ADDRESS MIii b~/fMtJT '139-J>ltlf
OWNER'S MAILING ADDRESS 3"?.r ST7f7l 5T. C ~
I/. tJ, .&ox 7 .3 C ~( ~~ 9_z,:;p~ DESIGNER rz o, -:-·· • t"'"····· .. oo•m -~~,, ..F,£e.. ~I\-(;. F/P F LR ELEV. "TT "'V
I vO NO
CENSUS TRACT GP LANO USE PARKING SPACE RES UNITS GRADING PERMIT ISSUED
YO ND I REDEVELOPMENT
AREA
vO NO
QTY. PLUMBING PERMIT · ISSUE ~ E;.---QTY. MECHANICAL PERMIT -ISSUE
EACH FIXTURE TRAP / 7 INSTALL FURN. DUCTS i.JP TO 100.000 BTU
EACH BUILDING SEWER / OVER 100,000 BT~
EACH WATER HEATER-~/OR VENT BOILER/COMPRESSOR UP TO 3 HP_./
EACH GAS SYSTEMftO 4 OUTLETS BOILER/COMPRESSOR 3-15 y°
EACH GAS svs;(M ~ OR MORE METAL FIREPLACE /
EACH INS~ ALTER, REPAIR 1/\'ATER PIPE VENT FAN SIN~UCT
EACHfiCUUM BREAKER MECH E~ST -HOOD/DUCTS
wj;7ER SOFTNEA REIAATION OF EA FURNACE/HEATER
!'EACH ROOF DRAIN (INSIDE) 7 V TOTJ;L MECHANICAL
TOTAL PLUMBING 7
QTY. I ELECTRICAL PERr,Art · ISSUE ~ II QTY.I SOLAR -ISSUE
NEW CONST EA AMP/SWT 1B R -COLLECTORS
l PH STORAGE TANKS
/ PUMP / l r I.I "'" "°""' ~ --I
PLAN CHE9<FEE /) ,J,,ef;.:;; J I
NO
STORIES
TYPE
CONST
3--
I 7-6~ifJJ~"f/!}~
() J'\ ,.,,;"~ 7 I I /' Qt" 'O
\ -v 7
V
~-~ TOTAL SOLAR 7
~
VALUATION PERMIT NUMBER 1'-1--
CONTR ZONE --;,,,.1 '6
72..tj-/7/i
LICENSE NO. PLAN 1.0. # BLOG USE COOE
37ZJt/f
LICENSE• STANDARD PLAN # BUILDING SO. FOOTAGE
DESIGNER'S PHONE
OCC GP EDU
OCC LOAD FIRE SPA
vO NO
4/17 /&
0OlJt9S36 4/1
Not V~lid Unless M#chine Certified
.:::
SUMMARY/ACCOUNT NUMBER
BUILDING PERMIT 01 ·00·00·B220
SIGN PERMIT 01 ·00·00·B221
PLAN CHECK 01 ·00·00·8806
TOTAL PLUMBING 01 ·00·00·8222
ELECTRICAL 01 ·00·00·8223 --MECHANICAL 01·00·00·8224
MOBILEHOME 01 ·00·0_Q·8225
MOBJLEHOME PARK JNSP
_SOLAR n,.nn.nn.ooo~
STRONG MOTION 80-92·33·0519
FIRE SPRINKLERS 01 ·00·00·8227
PUBLIC FACILITIES FEE 32·00·00·8933
BRIDGE FEE
SCHOOL FEE • DISTRICT
Carlsbad 80·92·21 ·0519
Encinitas 80-92·22·0519
San Dieguilo 80·92· 23·0519
San Marcos 80·92· 24·0519
LICENSE TAX 01-00-00-8162 ~
m-PP --CREDIT 6EPOSIT --TOTAL FEES PAYABLE T 212.~ff"
p .
I HAVE CAREFULLY EXAMINED THE COMPLETEO ~APPLICATION AND P.ERMIT" AND 00 HEREBY Expo-E"8fV permtt -by lhe8u11ding Oftocoet under !he prov1s1ons ofthos CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code lhall expire by trmotatoon and become nun and vo,<I II !he bu1t<1,ng or work * AN OSHA P£AMIT IS AEOUIREO FOR EXCAVATIONS OVER
!5' o•· DEEP ANO OEMOUTION OR CONSTflUCTION OF
STIIUCl\JAES OVER 3 STORIES IN HEIGHT DECLARATIONS ARE TRUE ANO CORRECT ANO t FURTHER CERTIFY ANO AGREE IF A PERMIT IS eulllonzed by such _m,t 15 not commenced Within 180 days from the date ol such
ISSUEOc TO COMPLY WITH All CITY. C6UNTY AND STATE LAWS GOVERNING BUILDING CON· =.:a•~ Ille i::,,:•::x.,or work luthonze<I by Suell -m11 11 suspended or
STRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY ANO ~=~==• :-==~..:!•=c.;tlle!!!!__?W~or~k!..,;IS!!_!:CJ!;Offl!!!!!;mence<l!!!!!:!!!!c.!12or~a~~•,!f•od!2.50!!,l.!180!!!!..:!WL-,,.,-.-~---------------------J
KEEP HARMLESS THE CfTV. OF GARt.S8AOA811'1"'6T All LIABILITIES. JUDGMENTS. COSTS AND ~PPll TS SIGNATURE •
EXPENSES WHICH MAY~ ANY,WAY:ACClllJE AGAINST SAIO CITY lk CONSEQUENCE OF THE A /1,,/ _
GRAMTING OF THIS P£Allllt. • · · •· ~, ~ ;...,..£.,,L...,_,_.,.__,, .o •
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TYPE I DATE INSPECTOR '
BUILDING I 'frt}--.;> I rt
FOUNDATION I FIELD INSPECTION RECORD
REINFORCED STEEL I
I REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
MASONRY I
GUNITE OR GROUT I INSPEC-TION REQ IF INSPECTORS DATE CHECKED APPROVAL
FLOOR & CEILING SUB FRAME I
'
.
SOILS COMP!. IANCE
SHEATHING □ ROOF □ SHEAR PR!OR TO .
FRAME ' I
FOUNDATION INSP . -
EXTERIOR LATH I
I
STRUCTURAL CONCRETE
OVER 200(kPSI
INSULATION I
INTERIOR LATH & DRYWALL I
PRESTRESSED
CONQRETE
POST TENSIONED I CONCRETE
' PLUMBING/ I FIELD WELDING
SEWER AND BUCO [FLJCO ' j / I .A
UNDERGROUND Q'WASTE □ WATER !)II r -, "· .J
-HIGH STRENGTH
BOl Ts
TOP OUT □ WASTE □ WATER .. I SPECIAL MASONRY
TUB AND SHOWER PAN I
I
GAS TEST I i, •• ........ PIL.ES CAISSONS
□ WATER HEATER □ SOLAR WATER " I
ELECTRICAL I
□ ELECTRIC UNDERGROUND 01UFFER I ,; ~
' ROUGH ELECTRIC I
I C,7/ ¥ ;v,-
□ ELECTRIC SERVICE □ TEMPORARY I -, .. ----
□ BONDING □ POOL I
I
I
MECHANICAL I , ' j
□ DUCT & PLEM., □ REF. PIPING o, r r,,-
HEAT -AIR COND. SYSTEMS I -: ,-.
I ' . -
VENTILATING SYSTEMS I
I
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITl;_MS ABOVE HA'lE BEEN APPROVED. ..
FINAL I
PLUMBING I
ELECTRICAL I
I
MECHANICAL I
GAS . .
I
. -
BUILDING I .
SPECIAL CONDITIONS
' I