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Home My WebLink About1258 OAK AVE; ; 81-474_misc; Permiten z 0 ~ cc C .., (.) w C C I[ 0 0 cc w C .., 3 I w z ~ z 0 j:: C en z w Cl. :IE 0 0 en ic w ><: cc 0 3: O I h,.,_Jy anlrm that I am llcensed under provisions of Chapter 9 (commencing with Section 7000) of DIYlslon 3 of the Business and Professions Code, and my llcense Is In full force and effect. l ie No ____ Class I hereby afflnn tNt I am exempt from the Con ~~~·~~~~:;:: ~; ~,~:.~,~~'8t~,(~ county which requlfes a perrmt to construct alter, improve, demolish. or repair any structure. pnor to its issuance also requires the apphcant for such pemut to hie a signed statement that he ,s hcensed pursuant to the provisions of the Con· tractor's License Uw (Chapter 9 commencing with Section 7000 or 01v1s1on 3 of the Business and Pro, fess,ons Code) or that 1s exempt therefrom and the basis tor the alleged exemptt<>n Any v1olat1on of Sechon 7031 5 by an apphcant for a perrmt subjects tne applicant to a c,v,I penaJty of not more than five hundred dollars ($500) ~ i.S owner of the property, or my employees ages as their sole compensation. will do the and the structure ,snot intended or offered for (Sec 70U. Business and Profess1ohs Code The ContractOf's license uw does not apply to an owner of property who builds or improves thereon and who does such w0f1t himself or through hts own employees. provided that such 1mproveme;its are not 1ntende1 or offered for sale It, hOwever the building or improvement 1s sold within one year of completion, the owner builder will have the burden of provino thal he did not build or improve tor the ~ of sale) as owner of the propeny _ am exclusively tin; with hcensed contractors to construct Pf 1ect (Sec. 7044 Business and Professions Code The Contractor's License Law does not apply to an owner of property who builds or ,mproves thereon, and who contracts tor each proJects with a contractor(s) hcense pursuant 10 the Contractors License Law) D I am exempt under Sec for this reason .B & PC CJ I hereby affirm that I have a certificate of consent to self-insure, or a cert1f1cate of Wor1(ers· Compensa11on Insurance. or a certified copy thereot (Sec 3800. ut>Or Code) POLICY NO COMPANY 0 Copy ,s hied with the city 0 Certthed copy ,s hereby furnished CERTIFICATl OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed ,t the permit 1s for one hundred dollars (SlOO) or less) \JJ, certify that in the performance of lhe wot1( to, E£1.ch this permit ,s issued, I shall not employ any person ,n any manner so as to become subJect to the Workers· Compensation Laws of California NOTICE TO APPLICANT If, after mak,n~ th,s Cen, hcate of Exemption. you should t>ecome subJect t? the Workers· Compensation provisions of the Labor Code. ~u must torthw1th comply wtlh such or lh1s permit shall be deemed revoked {·~~!{~~~ 1•ndmg agency for the performance of the wor1t !or which this perm11 1s issued (Set 3097 C1v1I Code) ~ Lenders Name ____________ _ Lender 5 Address ------------ V" • & PRESS HARD APPLICANT FILL IN INFORMATION WITHIN SHADED AREA AN" OECLARATIONS -' CARLSBA-BUILDING DEPARTMENT ·u 1200 Elm, Carlsbad, California 92008 (714) 438-5525 APPLICATION & PERMIT - J08 ADDRESS r JA-JC s-.-A~·i.T·1,17i~p ir 0 NI BUSINESS LICENSE # ~47t/-PERMIT NUMBER 1-Z-S-fs Bt-47,t 0 ~YAA. A5AP-o l1i9:W;;-:;;E PRl~T~7o~ CONTRACTORS PHONE • ZONE / OWNER'S MAILING ADDRESS CONTRACTOR'S 4DORESS LICENSE NO. PL~ ,':.# ti-l l/-BLOG USE CODE Po. E:bx lb.fa LOT I BLOCK I SUBOI VISION I ASST~CR:.Elf~ ~ ~ DESIGNER STATE LICENSE" STANDARD PLAN # BUILDING SO. FOOTAGE .. // IA I DESCRIPTION OF WORK { }~-o .1/c.j/f:11~1 .. -L • ,.,., D DESIGNER'S AOORESS DESIGNER'S PHONE 00013465 / I JJ'\00~ SF~ II, I --, .. F/P F LR ELEV . NO 1:A EDU ' vO NO STOiS I r CENSUS TRACT I GP LANO USE 1 P:;,l<iG~ACE I RES rlTS 1 GRADING J".ERMIT ISSUEO I REDEVELOPMENT ffW DCC LOAD FIRE SPR AREA vO ND vO NO vO NI"!./ Not Valid Un~r Milchine ~rtifi«I , ~ QTY. ~ PLUMBING PERMIT -ISSUE QTY. MECHANICAL PERMIT -ISSUE SUMMARY/ACCOUNT NUMBER -. EAC1'!,,,f1XTURE TRAP / ~ ' INSTALL FURN DUCTS UP TO 100.000 BTU /. BUILDING PERMIT v"f'Z--- I EACH B~ING SEWER / '--1f-· ~ ., -7 -OVER 100,000 BTU SIGN PERMIT --- '/ EACH WATER~TER ANO/OR VEITT - ---~ -J<,(.C/ .. -r; I) BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK K'l'l I ~ -"v. ,~ ----:,."7 ----:; EA'"O,SSYm~ BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING ~ EACH GAS SYSTEM 5 0 R M METAL FIREPLACE ELECTRICAL --,, 7 . On I . 7=-r; ---------,, EACH INSTAl. ALTER. IA WA PIPE • VENT FAN SINGLE DUCT MECHANICAL ,.....EACHV~AKER -~-' -HOOD/DUCTS MOBILEHDME MECH EXHAUST 1--->---- WATERS NER RELOCATION Of EA FURNACE/HEATER MOBILEHOME PARK INSP EA~OF DRAIN (INSIDE) " SOLAR V -- -~ TOT/.L MECHANICAL ~I Tl --/ STRONG MOTION TOTAL PLUMBING ---, FIRE SPRINKLERS PUBLIC FACILITIES FEE QTY._ ELECTRICAL PERMIT -ISSUE v , --elTY. SOLAR -ISSUE BRIDGE FEE 1/'YJ -rJ -::;; - NEW CONST EA AMP'SWT BKR -COLLECTORS SCHOOL FEE -DISTRICT 1 PH 3 PH STORAGE TANKS Carlsbad EXIST BLOG EA AMP/SWT /BKR ROCK STORAGE Encinitas 1 PH 3 PH PUMP San D1egu1to --- REMODEL/ALTER PER CIRCUIT PLAN CHECK FEE San Marcos ----- TEMP POLE 200 AMPS -~~ -- OVER 200 AMPS - TEMP OCCUPANCY (30 OAYSI --------~ --I--,-------- --1-· ----->----· TOTAL ELECTRICAL ?-1. 1..--' TOTAL SOLAR / TOTAL FEES PAYABLE I 5lt,6 \ - I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION ANO PERMIT'' AND DO HEREBY Expj:~rm,t isaued by the Budding Off1c11I under the prov1s1onaofth11 * AN OSHA PERMIT IS REQUIAEO FOfl EXCAVA TI0NS OVEA CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall ex Y limitation and become null and void If the building or work s· O" DEEP AND DEMOUTION OR CONSTRUCTION OF DECLARATIONS ARE TRUE AND CORRECT ANO I FURTHER CERTIFY ANO AGREE IF A PERMIT IS authorized I permit II not commenced within 180 days from the date of such STRUCTURES OVER 3 STORIES IN HEIGHT ISSUED TO COMPLY WITH ALL CITY, COUNT'' ANO STATE LAWS GOVERNING BUILDING CON· :~~~ or f 1~y '::'~~1~e~~t!~r:~t:~~l~~~~ r:,~..'~1·r=:i or STRUCTION, WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND~. :[ APPR~ lw/t; KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND A~PLI TS SIGNATURE .. ..;:::" 12.. OWNER CONTRACTOR 0 EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF TH~ ,m· BY PHONE 0 GRANTING OF THIS PERMIT ' Tl •-..:... d-,,' -A ,1_ , , , INSPECTION TYPE DATE INSPECTOR BUILDING FOUNDATION REINFORCED STEEL MASONRY I GUNITE OR GROUT FLOOR & CEILING SUB FRAME SHEATHING FRAME EXTERIOR LATH lNSULATION ' I INTERIOR LATH & DR YWALL I PLUMBING I I I /,'K-gz_ ~ SEWER AND BL/CO PLUMBING UNDERGROUND PLUMBING TOP OUT ; --TUB AND $HOWER PAN I 1 GAS TEST I ELECTRICAL • I TEMPORARY POWER I I ELECTRIC UNDERGROUND I ,- / ROUGH ELECTRIC I , I ELECTRIC SERVICE I ' ,; BONDING ~ I ' G. F. I. -SMOKE DETECTOR. MECHANICAL I ' DUCT & PLEM., REF. PIPING HEAT -AIR COND. -SOLAR SYSTEMS VENTILATING SYSTEMS CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE ITEMS ABOVE HA VE BEEN APPROVED. JOB SITE FINAL PLUMBING ELECTRICAL MECHANICAL GAS BUILDING SPECIAL CONDITIONS CERT OF ocr ':.i/1 ~1c_Y_IS_S_U_E_D ______ ~---~- - FIELD INSPECTION RECORD REQUIRED SPECIAL INSPECTIONS REQ IF INSPECTORS INSPECTION 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 . .... ! ".'- ' ' ... ... - -• ,_ . .. - fr . 1S"l ... t.f 71.f INSPECTOR'S NOTES L./f T .: .. r ' . DATE ·- I - ---., "· I . ...-\• ':'---.. t.' .• t----: -· Ii \ ... ~ ,. .......... -. . 1 / ' ' \ It : ' \ ,. "' • r ,· ... ~ .~ ... i . \ C -. ' f r..:-,-~ I ~ .. ; . -·---· ... I .... - (.) Ill z 0 ~ u: ~ ~ Q IE I[ 8 u: Ill Q ~ 5 ~ Ill z ~ z 0 .: ~ z Iii A. 2 0 0 en a: Iii :,,: a: 0 ~ O I hereb) .. r11nn thet I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Prolnalona Code, and my license Is In lull force and effect. Lie No -----Class I hereby 1ff1rm lhal I am exempt from the Con- ~/'f ~~j:':: ~~f~~.:~~~.~ county which requires a pemut to construct alter, unprove, demolish, Of' rep.au any structure. pnOf' to its issuance also requires the applicant tor such penmt to tile a signed statement that he 1s hcen59d pursuant 10 lhe pnwosoons of lhe Con· tractor's License Law tChapter 9 commenc,ng with Sectoon 7000 al O,v,slO<'I 3 ol lhe Business and Pro-fessoons Code) or thal ,s exempt lhe<efrom and the basos for lhe alleged exemploon Any voolatoon of Secloon 7031 5 by on "Pl>h<:anl for a perm,1 sub1ec1s 1ne apphcanl 10 a covol penally of nol more lhan love hundred dollars (S50()) 1,j. as owner al lhe property, or my employees wages as their SO,e compensation, will do the M , and the structure ,snot intended or offered for sale (Sec 70M, Business and Prolessoalls Code The Conlraclor's License Law does nol apply 10 an owner al property who builds or improves thereon and who does such wotk himself or through his own empk>yees, p,ovtded that such 1mproveme;its are not 1ntende1 o, offered for sale If, howeYer, the building or improvement 1s sok:J within one year of completion, the owner-builder will have the burden at provong lhal he dod not buold or improve lor lhe purpose al sale) CJ I, as owner of lhe praperty, am exclusively contrachni with licensed contractors to construct lhe prOjecl (Sec 7044. Business and Proless,ons Code The Contractor's License Law does not Ol)ply to an owner of property who builds or improves ~':~t;: ~:nc~n~~!~~~ ~~~t!'~~~:~!:·! License Law) D I aim exempt under Sec for this reason , B &PC 0 I hereby affirm that I ha~ a cert1t1cate of consent to self-insure, or a cer11t1caite of Workers' Compensation Insurance. or a cert1f1ed copy thereof (Sec 3800, Labor Code) POLICY NO COMPANY 0 Copy os hied wolh lhe Coly C] Certified copy 1s hereby furnished CERTIFICA Tl OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (Th,s sechon need not be completed 11 the perm11 1s for one hundred dollars ($1().)) or less) D I certify that 1n the performance of the work tor which this pemut 1s issued. I shall not employ any person m any manner so as to become sub1ec1 to the Wonc.ers' Compensation Laws of California NOTICE TO APPLICANT 11, aller ma1<1n1 lhos Certo-hcate ot Exemption, you shoukj become sub1ec1 t,:, the Wonc.ers' Compensation prov1s1ons of the Labof Code, you must forthwith comply with such provisions or this permit shall be deemed revoked r O I hereby affirm that there ,s a construction ffi tend1no agency tor lhe performance of the wor1t tor Q which this permit ,s ,ssued (5ec 3097, C1v1I Code) z ~ .. '-enders Name ___________ _ Lenders Address ----------- USE BALL POINT PEN ONLY O _PR...;..E...;SS...;..H_A...;..RD __________________ _ CARLSBAD BUILDING DEPARTMENT 1 1200 Elm, Carlsbad, Callfomla 92008 (714) 436-5525 APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS APPLICATION & PERMIT Cl) JOB AOORri se BUSINESS LICENSE # VALUATION 9;~·:;;:tt i Cl) -........ A~Tn~ii'.b't .HI ... CONTRACTOR. 0 ~ ~~~~~~+.·~·-----~---+PLANI.D.#~h=~ a4Jl ~ CONTRACTORS PHONE • ZONE I.OT I BLOCK 1 SUBDIVISION I ASSESSOR PARCEL NO. DESIGNER DESCRIPTION OF WORK 1 ............. . - ' F/P FLA ELEV. vO NO CENSUS TRACT I GP LAND use PARKING SPACE RES uN1Ts GRADING f'.ERMIT ISSUED I REDEVELOPMENT AREA YO ND vO NO QTY PLUMBING PERMIT -ISSUE I 1 ~OJ_ QTY. MECHANICAL PERMIT -ISSUE ..._\ I EACH FIXTURE TRAP I 1 '1/..J d5 I INSTALL FURN. DUCTS UP TO 100,000 BTU NO STORIES TYPE CONST LICENSE NO. STATE LICENSE # DESIGNER'S PHONE OCC GP EDU OCC LOAD I FIRE SPA vO NO PLAN 1.0. # BLOG USE CODE STANDARD PLAN# BUILDING SO. FOOTAGE !2!2~/81~~cc 00016288 12/21/Bi Not Valid Un~s .,.chine Certifil!d 31,:;,u S 1,60 SUMMARY/ACCOUNT NUMBER BUILDING PERMIT 01-000·4220 ,..,,.. .................. 01-000·4221 PLAN CHECK 01-000·4806 I f I EACH BUILDING SEWER I OVER 100,000 BTU ::.11JN ~tHMII ( EACH WATER HEATER ANO /OR VENT BOILER/COMPRESSOR UP TO 3 HP 7 1 EACH GAS SYSTEM 1 TO 4 OUTLETS _;.,~C-A, I BOILER/COMPRESSOR 3·15 HP LI QTY. EACH GAS SYSTEM 5 OR MORE ----I l. METAL Fl REPLACE EACH INSTA~ .. ALTER. REPAIR WATER PIPE VENT FAN SINGLE DUCT MECH EXHAUST -HOOD/DUCTS EACH VACUUM BREAKER ~~~~~~-1-~~--~~~~1-~- WATER SOFTNER EACH ROOF DRAIN (INSIDE) TOTAL PLUMBING I ELECTRICAL PERMIT· ISSUE ~~ "'I I . ....)/ R EL O CA Tl ON OF EA FURNACE/HEATER TOT/.L MECHANICAL QTY. I SOLAR -ISSUE NEW CONST EA AMP/SWT/BKR I I I COLLECTORS 1 PH 3 PH I I I STORAGE TANKS EXISTBLDGEAAMP/SWT /BKR I U IROCKSTORAGE 1 PH 3 PH I U I PUMP TOTAL PLUMBING ELECTRICAL MECHANICAL MOBILEHOME MOBILEHOME PARK INSP SOLAR STRONG MOTION FIRE SPRINKLERS PUBLIC FACILITIES FEE BRIDGE FEE SCHOOL FEE • DISTRICT Carlsbad Enclnllas San Dleguito San Marcos ~ REMODEL/ALTER PER CIRCUIT . I I I PLAN CHECK FEE I U--- TEMP POLE 200 AMPS OVER 200 AMPS TEMP OCCUPANCY (30 DAYS) 01-000-4222 01-000·4223 01-000-4224 01 ·000·4225 01-000-4226 65·640-0519 01-000-4227 25·000-4933 65-623-0519 65·624-0519 65-625-0519 65·626·0519 TOTAL ELECTRICAL I TOTAL SOLAR TOTAL FEES PAYABLE 1 ~/. ;ft) CERTIFY UNDER PENALTY OF PERJURY THAT AU. INFORMATION -. · 0 HAVECAREFUU.• EXAMONEOTH,OOMPUT£0"-.cA1'0N--:.:..-c DECLARATIONS ARE TRUE ANO CORRECT ANO I FURTHER CERTIFY . _ A l'Efliiitll. -· ·.i'i-lOIIIIIII * AN OSHA P£MtlT IS~ FOIi EXCAVATIONS OVER S' O" DEEP AND OEMCIU1lON OIi CONSTAUCl10N OF STIIJClUMS OVER 3 STOAIES IN HEIGHT ISSUED: TO COMPLY WITH ALL CITY. COUNTY ANO STATE LAWS -aHLDINGCCNt L~D!~~~~!~~~~i2~iis~~~~~~~~~; STRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGRE£~ MIO KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, . CCl81$ Ml) EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN 0,..;;;....---. GRANTING OF THIS PERMIT. . _ BY PHONE 0 APP~VEO BY 1~'2-1 /s, ~ ,.--I 7 I I-I 'O I~ i= .!l l < I .>< C a: 0 en en Cl) en en < I ~ !2 a5 >- Ill en Cl) 0 0 0:: (1) 1;j 0 @ Cl) 0 C (1) C u:: C Cl) Cl) C, 0 0 Cl) a. en C ~ .c 3 \ ' t ~ ' \ ' .,. BUILDING I FIELD IN SPECTION RECORD I. FOUNDATION I REINFORCED STEEL ! REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES -. '" REQ IF INSPECTOR'S ~ MASONRY l INSPECTION CHECKED APPROVAL DATE j GUNITE OR GROUT I SOILS COMPLIANCE FLOOR & CEILING SUB FRAME I PRIOR TO i FOUNDATION INSP SHEATHING STRUCTURAL CONCRETE FRAME ; OVER 2000 PSI I PRESTRESSED EXTERIOR LATH lNSULATION I CONCRETE INTERIOR LATH & DRYWALL ' POST TENSIONED CONCRETE PLUMBING ' I -FIELD WELDING -I /, 5 -ti},. ~ .. SEWER AND BL/CO t HIGH STRENGTH I 1• BOLTS ~. . . PLUMBING UNDERGROUND ---------·~· PLUMBING TOP OUT I SPECIAL MASONRY I TUB AND $HOWER PAN ! I GAS TEST i PILES CAISSONS ELECTRICAL i TEMPORARY POWER ' I I' .. ... ELECTRIC UNDERGROUND t ... I . .. ROUGH ELECTRIC I r ELECTRIC SERVICE i ' I ' ~ ·-· BONDING I ' G. F. I. -SMOKE DETECTOR j MECHANICAL j --------I ' DUCT & PLEM., REF. PIPING ,, HEAT -AIR COND. -SOLAR SYSTEMS '. .le \ :). -•a '\c~ . ,\ VENTILATING SYSTEMS '~ "\. .. \ CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE ~ .. ITEMS ABOVE HAVE BEEN APPROVED. - /, . JOB SITE FINAL I PLUMBING ' {4·("~ '~fl/)"(V I ELECTRICAL fi \ j \ ~ t· \ ' .. ,--. -' MECHANICAL ' ' ~ GAS ) ' . '· \ .. , .. " -..... I,.._ -.... ,... I ,-...... , I ·-,__ -·--BUILDING I ', .... -,-l, ' ••J ~. ,,,-11 I ., SPECIAL CONDITIONS I CERT OF OCCI ,-,NCY ISSUED . r--. __ c~ . \ 1 -) , II) z 0 j:: C CZ: C ..J 0 w C ~[ ~ ... z 8 CZ: w C ..J 5 ~ w z ~ 0 z 0 ~ II) z w ti. 2 0 0 II) a: w ..: CZ: 0 3 ' ![ 0 I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is In full force and effect. Lie No Class I hereby affirm that I am exempt from the Con· ~~a;·~~~~~;::~: ~,~:1:~1~~'~,t~, county which requires a permit to construct alter. improve. demolish, or repair any structure, p,ior to its issuance also requires the applicant for such perm,t to hie a signed statement tha.t he 1s licensed pursuant to the prov1s1ons of the Con· tractor's License Law (Chapter 9 commencing w,th Section 70CX> of Oiv,s,oo 3 of the Business and Pro- fessions Code) or that ,s exempt therefrom and the basis for the alleged exemption Any v1olahon of Section 7031 5 by an applicant tor a pemut subJects 1ne apphcanl to a c1v11 penalty of not mo,e than five hundred dolla~ ($500) C I, as owner of the property. or my employees -.1th wages as their sole compensat,on, will dO the work. and the slructure 1s not intended or offered tor 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 wot1t himself o, through his own employees. provided that such 1mproveme;its are not intende1 o, offered to, sale If, however the building or improvement 1s sold w1th1n one year of completion. the owner builder will have the burden of p<ov1ng that he did not build or improve lor the purpose ol sale) O I. as owner of the property. am e>cclus,vely contractin; with licensed contractors to construct the pro1ect (Sec 70.U_ Business and Professions Code The Contractor's Ltcense Law does not apply to an owner of property who builds or improves ~~~i~: 7.:nc~n~~!~~~ ~~c~h~r~~~;;:.: Ltcense Law) D I am exempt under Sec for this reason ,B &PC 0 I hereby afhrm that I ha;ie a certificate of consent to self.insure, or a cert,f,cate of Workers Compensa11on Insurance. or a certified copy lhereot (Sec J800, Labor Code) POLICY NO COMPANY 0 Copy IS hied with !he c,ty 0 Certified copy 1s hereby furnished CERTIFICATl OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need nol be completed 11 lhe permit 1s tor one hundred dOllars (SHX>> or less) D I ceri,ty that in the performance ot the woni. lor which this permit 1s issued. I shall nol employ any person m ~Y manner so as lo beeome subJeCI to the Workers· Compensation Ulws of Ga.lllorma NOTICE TO APPLICANT II. alter makin~ 1h15 Cert, f,cate ot Exemption. you should become sub1ec1 I? the Workers Compensation prov1s1ons of !he Labor Code you must forthwith comply with such provisions or this permit shall be cteemed revok.ed 0 I hereby affirm lhal !here 1s a cons1ruc11on 1end1no agency tor the performance of tne wot1c to, which ltl1s permit 1s issued tSec 3097, C1v11 Codel Lenders Name _______ ....:..---~ Lenders Address ----------- USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS //r.sr CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT 1200 Elm, Carlsbad, California 92008 (714) 438-5525 JOB ADORE'S ;;l~ ()\~ Av~, 0u2t~w. C.A. "'~T 1 °~: 16:e;rlONl BUSINESS LICENSE it VALUATION PERMIT NUMBER tJI -t/-0 fo OWNER'S NAME 'fOi /'(, IT....-r'!~ #-1"114 OWNER'S PHONE PRIME CONTRACTOR CONTRACTORS PHONE ~ ZONE l.CUA ~ 1'7~-22?7 , ~ OWNER'S MA,L•NG ADDRESS '#. p,0 itl40 CONTRACTOR'S ADDRESS LICENSE NO. PLAN 1.0. # BLOG USE CODE 12/JOl "'1eff~ 0C 't)Z ,1 G~~-!.";':'~ .. " ~ -~E ' (' r ' ~ --~ hwtc-i·tr~ 1 ASS[SST~E~ r2:yo-~ DESIGNER '· STATE LICENSE it STANDARD PLAN # BUILDING SQ. FOOTAGE ' ' DESCRIPTION OF WORK r:z€~~ OF '3Fl2-. _. /17 /B 19:;i: L, ·,0111 1111 DESIGNER'S ADDRESS DESIGNER'S PHONE ~ao 1.~2:6 "'J/171 81 3o;OC' /. ~),V~D ),.~ F/P F LR ELEV . NO OCCGP EDU 1-J.J /VJ O 7-A.-{2._,, fZl) \ FF STORIES YO NO CENSUS TRACT I GP LANO USE ·1 PARKING SPACE I RES UNITS I GRAOING ~ERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRESPR AREA CONST YO ND vO NO vO NO Nor Valid Unlffs Machin~ urrtfi«J QTY. PLUMBING PERMIT· ISSUE 7.50 QTY. MECHANICAL PERMIT -ISSUE 3.00 SUMMARY/ACCOUNT NUMBER EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100,000 BTU BUILDING PERMIT . EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT EACH WATER HEATER ANO /OR VENT -~--t= --- BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK -..___ ---- EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING ---- EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE ELECTRICAL ------~ EACH INSTAl . ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL EACH VACUUM BREAKER MECH EXHAUST HODO/DUCTS MOBILEHOME -------- WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MDBILEHOME PARK INSP EACH ROOF DRAIN (INSIDE) SOLAR TOTJ;L MECHANICAL STRONG MOTION . -· ... -r--~-._ TOTAL PLUMBING FIRE SPRINKLERS PUBLIC FACILITIES FEE QTY. ELECTRICAL PERMIT · ISSUE 2.00 QTY. SOLAR · ISSUE BRIDGE FEE NEW CONST EA AMP/SWT 1BK A COLLECTORS SCHOOL FEE · DISTRICT I PH 3 PH STORAGE TANKS Carlsbad EXIST BLOG EA AMPISWT/BKR ROCK STORAGE Enc1n1tas 1 PH 3 PH PUMP San 01egu1to ./1 _._ REMODEL/ALTER PER CIRCUIT PLAN CHECK FEE 1 San Marcos ' I ~ ..,. ---- TEMP PO LE 200 AMPS I nf,/'{')f .J p,,,,.Jc f _ ,/t). fLIIL\./ 'Jn ,,_., -·-.. -"fl I . OVER 200 AMPS -· ------,-/ TEMP OCCUPANCY 130 DAYSI 1-r----------A")/1 --:_ -·1 ---~------. - TOTAL ELECTRICAL TOTAL SOLAR I :lD -TOTAL FEES PAYABLE I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION ANO PERMIT" AND DO HEREBY Expiration Every perm,t ,nued by the Bu1td1ng Ofhc,sl under the prov,s,ons of th,s * AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall expire by hm1t1hon and become null and void If the bu1ld1ng or work !>' O" DEEP ANO DEMOLITION OR CONSTRUCTION OF DECLARATIONS ARE TRUE AND CORRECT ANO I FURTHER CERTIFY AND AGREE IF A PERMIT IS authorized by such permit 1s not commenced within 180 days from the date of such STAOCT\JAES OVER 3 STORIES IN HEIGHT permit. or ,f the bu1ld1nff or work authorized by such permit 1s suspended or ISSUED TO COMPLY WITH ALL CITY. COUNlY ANO STATE LAWS GOVERNING BUILDING CON· abandoned at anv time a tee the work , -menced for a °""od of 180 davs STRUCTION. WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND APPLIC~IG(!J :~ERO CONTRACTOR 0 APPROV BY 1~7/f1 KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS. COSTS ANO EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE BYPHONE 0 . ~ .J._.l. GRANTING OF THIS PERMIT - \. 1 -·---------- INSPECTION TYPE DATE INSPECTOR ! .. BUILDING FOUNDATION RE~1\JFORCED STEEL MASONRY I GUNITE OR GROUT I FLOOR & CEILING SUB FRAME SHEATHING FRAME I EXTERIOR LATH lNSULATION . INTERIOR LATH & DRYWALL PLUMBING SEWER AND BL/CO I PLUMBING UNDERGROUND I PLUMBING TOP OUT I ! TUB AND ~HOWER PAN GAS TEST ELECTRICAL I TEMPORARY POWER I I ELECTRIC UNDERGROUND I ROUGH ELECTRIC I I ELECTRIC SERVICE I BONDING A G. F. I. -SMOKE DETECTOR'. I MECHANICAL ! DUCT & PLEM., REF. PIPING HEAT-AIR COND. -SOLAR SYSTEMS · ' VENTILATING SYSTEMS I ' ... CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE ITEMS ABOVE HA VE BEEN APPR@VED. . JOB SITE FINAL ..... ;,: ' i ..... PLUMBING ELECTRICAL u: -4-:~ '. \, ! :· MECHANICAL ' ·' . . ,/ ~ GAS BUILDING I SPECIAL CONDITIONS CERT OF OCCUPANCY ISSUED . '• . x/, l.fOb 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 I PILES CAISSONS - A . .. -. .. ' _._ > ~-.. ~· ' I } ·u --.. ., ... 'l S r'f::.. o2. ~ '2.., ff, 7/// .. • . .... ..... -I .. . -\,J I ;·! \ '•· ~ ..... . . ...... ·-.. ' ,' -· ~ ' ,. ' ·~ ' -. ., ·. . ' . ·--· ~-. \' . . . ' ' ' - City of. Carlsbad r 1200 ELM, CARLSBAD, CA 92008 • TEL. (714) 438-5525 ,,., < •: ,, t-------~-=--=-~~.:.:...!!=-.-==------------1 Owner J'.< Malling Address p c1iy-t__A Contractor Se- Address Clly Stale Lie. S. Classlt. Zip Tel. City Lie. No. COMPLETE FOR PLAN CHECK ONLY LEGAL DESCRIPTION ASSESSORS PARCEL NO DESCRIPTION OF WORK PLAN 10 NO. DESIGNER ADDRESS PHONE CONT ACT PERSON MISCELLA~ EOUS RECEIPT . ' I l/2 J/8 1346S GiJ7, 4 1J MISCELLANEOUS FEE RECEIPT D 0 • PLAN CHECK FEE_O_l_-_o_:o_:o_-_4_8_:0_:6 ___ -1------~ VALUATION ____________ -+-------i OEMOLITION _____ -:cc:_=-~----==---+---·----1 __ .. ---- o~~~~~~~~~~~~;..._~~-t-~~~~--t o~~~~~~~~~~~~~~~-t---:~~---r---i TOTALFEE $ 007, 'WARNING: PLAN CHECK FEES. WHERE NO ACTION IS TAKEN BY THE APPLICANT IN 180 DAYS AND NO BUILDING PERMIT IS ISSUED, FEE ARE FORFEITED TO THE CITY. ~ . COMMENTS:----------------------f Slgoat," of Ap~ Le6,1o /!, {2-'(j ------------------------f White -Applicant Yellow -FIie Pink -(1) Finance (2) Data Process Gold -Assessor INTERDEPARTMENTAL INFORMATION SHEET .. ELTLDING DEPARTMENT DAf_EECETVED BUILDING ADDRESS: NOV 13 1981 PLANNING DEPARTMENT ZONE (L -] LOT SIZE LOT WIDTH ~~~~~~~~--~~~~~~--- UNITS ALLOWED~~~~~~~~~~~UNITS PROVIDED~~~~~~~~~~~~- PARKING SPACES REQUIRED % COVERAGE ALLOWED BUILDING HEIGHT ALLOWED -----.6'-+-H-~~·'--· ___ PROVIDE D _ __,oc...+--4-~_...-~---- ~~~~~~~~~~~~-P RO VI DE D PROVIDED -~-----~~~ FRONT SETBACK: ALLOWED 11:::.. p RO VI DE D_--4,V~--- I NT RUSI ON S SIDE SETBACK: at 1 LANDSCAPE & IRRIGATION PLAN COMMENTS: ENVIRONMENTAL PROTECTION REQ: REAR SETBACK: OK TO ISSUE~;ATE 11li-;~/0K TO PI NAt ______ DATE ___ _ · n»$z/ ~ ENGINEERING DEPARTMENT~ - R.O.W. INDUSTRIAL WASTE -~~~~~IMPROVEMENTS_~~~---~~ SEWER CONNECTION GRADING PERMIT LEGAL DESCRIPTION_~~,W..-:1U------/-~-f,;;;.--~r-~~:__-"7~-:-:--;--.L.::z~,,_"'I:::~;;;;;;;;;;a;__.,c___ FIRE DEPARTMENT SPBit;KLING SYSTEM FIRE PROTECTION EQUIP ·---~~-~- FIRE ALARMS EXITS _______________ _ FIRE HYDRANTS _________ ~LOCATION __ ~----~~--~-~~--~ ADDITIONAL COMMENTS OK TO ISSUE: WATER DEPARTMENT .REQUIREMENTS OF APPROPRIATE DISTRICTS MET~---~~~~DATE~-~--~--- ''·"'" . -... • -APPLICATION FOR PERMIT TO CONNECT TO CITY SEWER SYSTEM . CITY OF CARLSBAD ENGINEERING DEPARTMENT 438-5541 FOR APPLICANT TO Fl LL IN BUILDING ADDRESS OWNER MAILING ADDRESS CONTRACTOR CONTRACTOR'S ADDRESS NEW BUILDING EXISTING BUILDING LEGAL DESCRIPTION REMARKS: LATERAL LOCATION i-: (I) .. ST. LATERAL NO. _______ INSTALLATION DATE------- VALIDATION LATERAL CHARGE COMPUTATION STANDARD 4" (Mex. H. 30', V. 10') __ ....,4_6-D------ OVER 30' H. @ FT. _________ _ OVER 10' V. @ FT. _________ _ STANDARD 6" (Mex. H. 30', V. 10') ________ _ OVER 30' H. ___ @. ___ FT. ________ _ OVER 10' V. @ FT.---------- TOTAL CONSTRUCTION COST---------- SERVICE CHARGE (REPAVING ETC.>--~--"'I.""'->+(...,.) ___ _ TOTALLATERALCHARGE--~t;:~~'i">-:'=!-:------ LINE COST DATA ASSESSMENT DIST. NO.-------------- FRONTAGE ____ cosT PER FT. ___ TOTAL __ _ OTHER-------------------- CONNECTION FEE NO. UNITS~--COST PER UNIT "'2l:o TOTAL--- PUMP STATION FEES NO. UNITS ___ COST PER UNIT ____ TOTAL __ _ TOTAL CHARGES (LATERAL ETC.I ~o ,'o,/ WHITE: Engineering GREEN: Finance YELLOW: Sanitation PINK: Building GOLDENROD: Perrnltter A'ITENTION POOPERI'Y OWNER: An "o\.;t1c:.e-builder" building pennit has been applied for in your name and bearing your · J~ture. _lease complete and return this infonnation in the envelope provided at your earliest opportunity to avoid unnecessary delay in processing and issuing your building pennit. No building pennit will be issued until this verification is received. 1. I personally plan to provide the roajor lal::or and materials for construction of the proposed property irrprovernent (yes or no) ----''{°--...,.6...._ ____ _ 2. I (have/have not) bo,\/L: signed the application for a building pennit. 3. I have contracted with the following person (finn) to provide the proposed construction. Contractors License No. ----- 4. I plan to provide portions of the \<.Ork, but I have hired the following person to coordinate, supervise and provide the major \<.Ork. Name ~-----------~ Phone Address ------------Contractors License No. City~-----------~ 5. I will provide some of the work but I have contracted (hired) the following persons to provide the work indicated: Name Signed: Address Phone Property <Mne{ Social Security Number 511 -?)l-,f~/ Date: //-~:3-2'/ Type of Work 1200 ELM AVENUE CARLSBAD, CALIFORNIA 92008 Dear Property Ovvner: <tCitp of QCarlsbab TELEPH,Ol'jE-f , 714-438-5525 An application for a building fennit has been sul::mitted in y01.rr P.arne listing yourself as the builder of the propert'i faprovements specified. i'or your protection you should be aware that as "owner-builde:c·: you are the responsible part:'.f of r er-....ord on such a pennit. Building pennits are not :.:-equired to be signed by the property owners unless they are personally perforrni..11g t.~eir own mrk. If your \..t>rk is being performed by sareone other than yourself, yol'. rnay protect yourself from p:::,ssible liability if that person applies for the proper pennit in his or her name. Contractors are required by law to be licensed and bonded by the State of california and to have a business license from the City of Carlsbad. They are also required by law to put their license number on all permits for which they apply. If you plan to do your own mrk, with the exception of various trades that you plan to subcontract, you should be aware of the following info:mation for your benefit and pro- tection. If you errploy or otherwise engage any persons other than your immediate family , and the work (including material and other costs) is $200 or rrore for the entire project, and such persons are not licensed as contractors or subcontractors, then you may be an em- ployer. If you are an errployer, you must register with the state and federal government as an errployer and you are subject to several obligations including state and federal incane withholding, federal social security taxes, mrkers' compensation insurance, dis- ability insurance costs, and unerrployrnent contributions. There may be financial risks for you if you do not carry out these obligations, and these risks are especially serious with respect to mrkers' corcpens,ation insurance. For specific info:rrnation al:out your obligations under federal law, contact the Internal Revenue Service (and, if you wish, the U. S. Small Business Administration). For rrore specific infonnation al:out your obligations under state law, contact the Department of Benefit Payments and the Division of Industrial Accidents. If the structure is intended for sale, property owners who are not licensed oontractors are allowed to perform their work personally or through their own errployees, without a licensed contractor or subcontractor, only under l.iroited conditions. A frequent practice of unlicensed persons professing to be contractors is to secure an "owner-builder" building permit, erroneously implying that the property owner is providing his or her own lal:or and material personally. Building permits are not required to be signed by property owners unless they are performing their own mrk personally. Infonra- tion al:out licensed contractors may be obtained by contacting the Contractors State License Board in your carmunity or at 1020 N Street, Sacramento, CA. 95814. PIBASE COMPLETE AND RETURN THE ENCIDSED OWNER-BUIIDER VERIFICATION FORM SO THAT WE CAN CONFIRM THAT YOU ARE AWARE OF THESE MATI'ERS . THE BUILDING PERMIT WILL Nor BE ISSUED UNTIL THE VERIFICATION IS RETURNED. Very truly yours, Building Departrrent City of carlsbad CITY OF CARLSBAD DATE: {ift} SJ BUILDING DEPARTMENT RELOCATION CORRECTION LIST 'O I\ . .,,,-ft;v PERMITTE E: &'1. H-SAeo ADDRESs:Uoi Af'F'lflZ-~N PHON~'j_-z..L-"! 7 BUILOING LOCATION :/..J.r )/)0 Z.A·(:?-r PROPOSED LOCATION: ti--e ([}IJ..JC-)/.ve:_ c.A(G.b I F-,:::--. -L~ 5' tel> This is a copy of the corrections and work to be accomplished to the bu il ding you have proposed to relocate. It will serve to inform you of the required work to be done before said building can be occupied at the new address . These corrections are the terms and condi tions of the Relocation Permit, and are required to be completed within 180 days from the date· the permit is issued . NOTE: This is not a permit. Do not move the building or start any work until you have posted the required bond, obtained the Relocation Permit and Planning Commission approval. ITEMS CHECKED ARE YOUR CORRECTIONS . BUI LDING : l Provide two(2) copies foundation and pro- posed site plans. 2 Provide underfloor ventilation, access and clearance as per code . · 3 Underfloor structure to be altered Code requirements as~follo~s: or ~4 Replace existing roof covering with fiTe ·retardant material. 5 Ceiling joists, rafters and other structural members to be altered to meet code as follows : ---- 6 Exterior surfaces to be repaired, painted, restuccoed, or otherwise corrected as follows to provide /. ,1 ,.Y..dequate· weather pro~tion: __ _ tJlt _} ~ UttC -K::_ I I tJ,U.L:'S R-,t:/ ce,u~ 7 Rerooting required to provide /"' weather protection. /,I' 8 All broken doors , windows and screens to be repaired , replaced, /" and/or repainted as required. L/' 9 Fireplace, chimney and/or other masonry un to be correctecl as fo 11 0 WS : C. C:.. I "<'1?.J- 10 One hour fire resistive construc- tion to be provided _____ _ . 11 Repair or replace f loors, walls and/or ceilings to match existi ng as fo 110\-JS: ---------- 12 Inadequate room size in ---- ' 13 Inadequate ceiling height in __ 14 Inadequate light and ventilation in -,--,----------~~---15 Provide access to attic. --16 Correct dampnes s in --17 Provi'de landings and...,./o_r_s_t-ep_s_a_s_ follows: ---------~- PLUMBING : ~Separate plumbing and sewer pennits ~ required . ~9 All abandoned sewers, cesspools, and septic tanks to be filled and/ or capped. 20 Connect hous·e drain to sewer . --21 Drain and vent lines to be altered to meet code as fo llows: ---- ~Install backflow device on all hos e --bibs. -----------~- 23 Pro vi de water. test on drainage and vent system to roof. 24 Water lines to be corrected as follows: ------------ 25 Following plumbing fixture(s) to be corrected as noted: ----- 26 Repair shower compartment to pro- ~ vide waterproofing. _._t/2._7 7 Correct gas systeq1 as follows: __ I c :,.-r--(2.,c:, &..J)"f'Ff> QE:-V'{[( Et.JAL;. ~~E\2 0~ -Provide gas test. -0.-9 Heating corrections to be made as --fol lows: L----FLE>o'2... FtJIZ-N A-q;.S ~~ tt:.~(2~b fij .00 Provide new water heater o~ µsting .llilit anfollows: T1. ,12., I .P r ,v Ot.JT'51~!£. I RELOCATION CORRECT ION LIST PAGE TWG. ~: -~_311 S SPeparate el ~ctri ca 1 permit required . __ 32 Completely rewire structure to ~ meet code. V33 New .service rewired: ' --. Amps I 00 I±_ ·M 1,J Circuits --------. Size Conduit e Wire ------ 34 C on-conforming wiring as f 35 1. Any damage done to the building as result of relocation work must be repaired in complia11ce with ~'Bu~ldi'ng, Electrical and Plumbing Codes. 2. Provide a termite inspection of the existing structure. t· (A 11 require- 2. Deed restrictions are not enforced by this Division; they .may prohibi t this relocation. Check your deed and other reco rds before moving this structure to proposed site. 3. Oc cupancy of this building shall not be permitted until the co rrections listed hereon and all City ordinances and State Laws regulating building construction have been complied with. 4. Post hous e numb ers. 5. Street improvements required (curb, gutter and sidewalks). Inspection of buildin Proposed Site: Approved Denied ---- "I. By: ~---....... ;;,,gc;;,"'-1--~,-.a'f,"-=---~'-L-',~~~- for relocation: By: ments of this inspection must be ----------------completed prior to occupancy). Name Date ADDI Estimate of total work $ ------- I g.,, t?LAN::r£..l2. .$tfl~ LA)#Jef2£t).E:I< ~1"-'b-' o ttr: a8"5>c rv1 e:,Jr vJ , N..hG w-s 10% $ ______ _ Amount of Bond $ ___ _ ~A:::C<.. • I hereby ackno\'11 edge that I ha ve read ~ · this correction list. ~fl.//Mf::.tJ..b tlAlE1f-.lL ~~ agree to comply with the correct·ions {:;f J3C-, g Al ~LA<;. e::;'b listed· hereon and with all City Ordinances ' -r.:?""" and State Laws regulating buildi ng L,t.-:1"1'""7,4:= u ~ construction. Signature of Permittee: Name Address II) z 0 ~ a:: C ..J 0 ... 0 ~[ ~ ... z 8 a:: ... 0 ..J 3 I ... z ~ z 0 ;::: ~ z ... 0. :IE 0 0 II) ic ... "' a:: 0 3 r: O I hereby affirm that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is In lull force and effect. lie No Cl•ss I hereby all,rm that I am exempt from the COntrac· lor s License Law for lhe lollow,ng reason (Sec 7031.5 Business and Professions Code Any city or county which re-qu11es a permit to construct, alter. improve, demolish. or repair any structure, poor to ,ts issuance a1so requires the ap--plicanl for such pe,m<I to Me • s,gnecl stalemenl that he ,s licensed pursuant the prov,sions of the Contractor's License Law ha e 9 commencing with Sec11on 7000 of Div,s1on 3 of I B and Professions Code) or that is ex· empt lherefr and sis for the alleged exemphon Ally =·: ~ " ~."to Cl~~ ~7;~~~ tr:.•,~;~~ dred dolla 00). D I, as the property, or my employees with wages as the,r -cor-sat,on, wtll do the work. and the struc· ture 1s not intended or ottered for sale (Sec 7044 Bus,ness and Proless,ons Code: The Contractor's License Law doe$ not apply to an owner of property who builds or Improves thereon and who does such work himself or through h,s own employees. provoded that such mprovemenls are not intend· ed or ol1ered for sale, u. however. the bulld+ng or iffll)fOYe-ment ,s sold w1th,n one year of completion. the owner·bu1klef will have the burden of proving that he dod not build or Im-prove for the purpose of sale) D I, as owner of the property, am uctuSMly conlractJng wilh licensed contr,ctors lo construct the proiect (Sec 7044, Business and Professions Code The Contractor's License Law does not apply 10 an owner of property who builds or im· proves thereon. and who contracts for each pro,ecls w1lh a contr•clor(s) lieense pursuant lo the Contractor's License Law) D As a homeowner I am 1mprov,ng my home, and the follow· Ing cond11lons exist 1 The work 1s being performed prior lo sale 2 I have lived In my home f0< 1Wtlve months r:v: :;'P!:::.i"' ,t: =Pilon dunng the last three years, D I am exempt under Sec. , B & P C for th,s reason ____________ _ 0 I hereby affirm lhal I ha"9: a cer11hcaite or consen1 10 self.insure or a cen,t,cate of Workers Compensai11on Insurance. Of a cert,t1ed t oPy thereof (Sec 3800. LabOr Code) POLICY NO COMPANY 0 Cooy ,s filed with the Clly 0 Cen,hed copy ,s hereby furnished CERTIFICATl OF EXEMPTION FROM WORKERS COMPENSATION INSURANCE (This section need not be completed 11 the permit 1s to, one hundred dollars rs 100) °' iess) 0 I cer11ty thal ,n the performance ol rhe work for wtucn this perm11 1s issued I shall not ~ploy any person in any manner so ~ to become sub1ect to lhe Wot1t.ers· Compens.ahon Laws of Gahfom~ NOTICE TO APPLICANT II, after mak,n~ ,n,s Cer1, hcate ot E•empt,on, you should become sut>1ec1 l'J the Wo'""ers· Compensation provisions of lhe Labor Cooe you musl forthw1lh comply w,trl such provisions o, ttus perm,1 shah t>e deemed ,e ... oked .,,..,eby affirm 1na1 there ,s II cons1ruc1tQn t()f the petiormance ol !he wort,,. to, ..... ,c;ec 3097 C+v1t Code) USE BALL POINT PEN ONLY & PRESS HARD CARLSBAD BUILDING DEPARTMENT 1200 Elm, Carlsbad, California 92008-1989 (619) 438-5525 JOB ADDRESS AV.ST. RD. DESIGNER 6'~~e~ CENSUS TRACT GP LAND USE PARKING SPACE RES UNITS QTY. PLUMBING PERMIT · ISSUE ---- GRADING f'.ERMIT ISSUED YO N D QTY. M F/P FLR ELEV. vO NO REDEVELOPMENT A REA vO NO APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS. APPLICATION & PERMIT VALUA TION ir~R~IT NUMBER ZONE ;)1 PLAN 1.0. # STANDARD PLAN # BUILDING SO. FOOTAGE DESIGNER'S PHONE NO I occ GP I EDU STORIES TYPE I occ LOAD I FIRE SPR CONST vO NO I Not Valid Unlffr Machin, Ctrtifitd 3-SUMMARY/AC~~~~. BUILDING PERMIT 01·00·00-8220 --------SIGN PERM IT 01 ·00·00·8221 PLAN CHECK 01·00·00·8-8-06-11----------i1 ----~-------t--+. TOTALPLUMBING 01-00-00·8222 ..., METAL FIREPLACE ELECTRICAL 01-00-00·8223 VENTFANSINGLE DUCT , ----01-00·00·8224 01·00·00-=-·-=-82=2-=-5-1--------~ MECH EXHAUST HOOD 'DUCTS WATER SOFTNER RELOCATION OF EA FU RNACE/HEATER EACH ROOF DRAIN (INSIDE) -----TOTAL ME CHANICAL TOT AL PLUMBING --- 01 ·00·l!l!.:8lli 80·92·33·0519 01 ·00·00·8227 -+----------1 QTY. I ELECTRICAL PERMIT · ISSUE PUBLIC FACILITIES FEE__ 32·00·00·8923-+----------1 ,.j'-! QTY., ~"'"-:___ \~ \I . ;iD A I BRIDGE FEE NEW CONST EA AMPISWT SKA COLLECTORS 1 PH 3 PH STORAGE TANKS ---------- EXIST BLOG EA AMPISWT/BKR ROCK STORAGE 1 PH 3 PH 1---+-R-EMOOEL AL TEA _PER Cl~~ TEMP PO LE 200 AMPS -6V-"-0- PUMP C) 1 ~j_ ~N CHECK i'EE ~ 0VER 200 AMPS f-,~~=-+u-T-EMP OCCUPANCY (30 DAYS) TOTAL ELECTRICAL TOTAL SOLAR SCHOOL FEE -DISTRICT Carlsbad _ __ 80·92·_21_-_05_1_9-t----------1 Encinitas 80·92· 22·0519 San D1egu1to 80·92·23·0519 San Marcos 80-92·i4-0519 I I c__ TOTAL FEES PAYABLE 5S',- * AN OIHA PEAMIT IS IIEQUIIIED FOIi EXCAVATIONS OVSI 5• er DEEP ANO DblOUTION OIi CONSTIIUCTION OF STIIUC1\IRES OVER 3 STORIES IN HEIGHT I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT" AND DO HEREBY CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE DECLARATIONS ARE TRUE ANO CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED TO COMPLY WITH ALL CITY COUNTY AND STATE LAWS GOVERNING BUILDING CON· ! jjf~ ... _ --* --w,---, --·· ,.... ...... ·---...... ·--· l ~ STRUCTION. WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY ANO _ ~ ~n~ '1 Ille•,~~ tor 8 ~gd of llO dfYI _ • ft--.. --'.l..<'.JA _. 1°"t~t ,J __ KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO _XPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE .G OF THIS PERMIT. BY PHONE 0 .!!? u:: >, <U 0 a. E ~ I "O 0 (.!) ~ (1) -~ a. a. <( I -"' C: a: ti "' Q) "' "' <( I :it .2 Q) >- <Ji "' Q) 0 0 ct (1) iii 0 @ Q) 0 C: (1) C: u::: !:- C: Q) ~ (.!) 0 0 Q) a. "' C: f ' ,,E DATE INSPECTOR .11 G - ~ ,..,-\ rt ON REINFORCED STEEL -. MASONRY .. GUNITE OR GROUT FLOOR & CEILING SUB FRAME SHEATHING FRAME EXTERIOR LATH lNSULATION INTERIOR LATH & DRYWALL PLUMBING SEWER AND B LICO PLUMBING UNDERGROUND PLUMBING TOP OUT TUB AND ~HOWER PAN GAS TEST ELECTRICAL TEMPORARY POWER ' . ELECTRIC UNDERGROUND ROUGH ELECTRIC ~ I ELECTRIC SERVICE ; BONDING G. F. I. -SMOKE DETECTOR MECHANICAL t DUCT & PLEM .• REF. PIPING HEAT -AIR COND. -SOLAR SYSTEMS VENTILATING SYSTEMS CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE ITEMS ABOVE HAVE BEEN APPROVED. JOB SITE FINAL PLUMBING ELECTRICAL MECHANICAL GAS BUILDING SPECIAL CONDITIONS CERT OF OCCUPANCY ISSUED ' FIELD INSPECTION RECORD REQUIRED SPECIAL INSPECTIONS INSPECTION REO IF INSPECTORS CHECKED APPROVAL SOILS COMPLIANCE PRIOR TO FOUNDATION INSP STRUCTURAL CONCRETE OVER 2000 PSI PRESTRESSED CONCRETE POST TENSIONED CONCRETE FIELD WELDING HIGH STRENGTH BOLTS SPECIAL MASONRY PILES CAISSONS ' - _, ~-. .... . - 1 -J < j :,,. ~ I . ,___ .. .. ' 4 , ' -" INSPECTOR'S NOTES DATE ' r -· "' . ' ,, .. I .. " '· .. - ,' -· ,, -~ -.. - r ·~-= r -i::-)r:·a, . -j · .. _._ C\·;.'~; •~-r;~'.!1__,' . • . - . - ... - : --I· . ,'. ------,, .-. ' "°' ' ' -. 1 II) z 0 ~ ac C _, u w 0 ~[ 0 C C ~ 8 C Ill 0 _, :i ~ w z ~ z 0 j:: ~ z w A. :IE 0 u II) ii: w ><: ac 0 ~ ll 0 I hereby 11, .. ,m that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my llcense Is In full force and effect. Lie No _____ Cl•ss __ __ I hereby all,rm that I ..., exempt from the Con- ~~~·~~~~:; ~~t=.:~~'~.~ county which requues a pemut to constrvc1 alter improve, demolish. or repair any structure, pnor to ,ts issuance also requires the apphcant tor such perm,t to file a s,gned statement that he os ltcensed pursuant to the provos,ons of the Con- tractor's License Law (Chapter 9 commencing with Section 7000 of 01v1st0n 3 of the Business and Pro-less,ons Code) or lhat ,s exempt therefrom and tile basis tor the alleged exemptton. Any v1olat1on of Sectton 7031 5 by an appltcant lor a perm,1 subjects tne applicant to a c,vll penalty of not more than five hundred dollars ($5()0). 0 I, as owner of tile property, or my employees '*•th wages as their soie compensalton, will do the work, and the structure 1s not intended or offered tor ..ie (Sec J'04.4, Business and Professions Code The Contractor's Ltcense Law does not apply to an owner of property who builds or improves thereon and who does such WOf'k himself or through his own employees. provtded that such ,mprovemeilts are not 1ntende1 or offered for sale It, however, the bu1ld1ng or improvement ,s sotd w,tr-:m one year of complehon, the owner·bt.11lder will have the burden of proving that he dtd not build or improve for the purpose of sale) 0 I, as owner ot the pre>perty, am exclusively contractmi with licensed contractors to construct the Pfotect (Sec TOU. Business and Professions Code The Contractor's License Law does not apply to an owner of property who builds or improves ~:'=i~ ~~~nc:'~~!~~ ~~~,!r~~~;::,,;.: License Law) 0 1 am exempt unde< sec tor this reason ,B & PC D I hereby affirm that I have a cert1hcate ot consent to self.insure, or a cert1flc.ate of Workers· Compensation Insurance. or a cert1f1ed copy thereof (Sec 3800, Labor Code) POLICY NO CERTIFICATE. OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be completed 11 the permit 1s for one hundred dollars ($100) or less, D I certify that 1n the pertormance ot the work tor which this permit 1s issued. I shall not employ any person in any manner so as to become sub1eet to the WMers· Compensation Laws of ca11torn1a NOTICE TO APPLICANT II, after mak,n~ 1h15 Cert, hcate ot Exemption. yoo should become sub1ect t') the Workers· Compensation prov,s,ons of the Labor Ccx:te. you must forthwith comply with such provisions or this permit shall be deemed revoked 0 I hereby attum that there ,s a conslruchon 1end10Q agency tor the perlormance ot lhe work lor wh,ch ttus permit ,s issued (Sec 3097, C1v1\ Code) LenoersName ____________ _ Lenders Address----------- USE BALL POINT PEN Oflll l & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA A'" !)ECLARATIONS. ~ CARLSBAD BUILDING DEPARTMENT ; / APPLICATION & PERMIT ~ 1200 Elm, Carlsbad, California 92008 (714) 438-5525 l JOB ADDRESS i A~-~-T-1;~ 2 :6~10NI BUSINESS LICENS~ ~ALUATION PERMIT NUMBER l'JJJIJ (». A\~ ot-~.,(_l '??-'/ ~· OWNEitN A ' .. ,.,.._.~ ln,ioiiONE PRtME CONTRACT~'i CONTRACTORS PHONE I ZONE ')-'V.P ·• I._,,,... N:lfl~, '1$lj. 71Jl'f!63 OWNER'S MAf LtNG AODRESS CONTRACTOR'S ADDRESS UCENSENO. PLAN 1.0. # BLDG USE CODE .,~,~ M,~ ftXE 12-1b ...... u:- LOT I BLOCK I SUBDIVISION I ASSESSOR PARCEL NO. DESIGNER STATE LICENSE # STANDARD PLAN# BUILDING SQ. FOOTAGE £ -'QZO ---__ ... DESCRtPTIDN OF WORK Tt"'A .,,, -DESIGNER'S ADDRESS DESIGNER'S PHONE ---~~~-M~€ffll~ ·-€/OVGr._iol ;7 27,u. ---. F/P FLRELEV. NO OCC GP EDU OOOIEij!n 6/CJ2/ 82 27."' • aw. aJtJ~ @. ~TZ1EN STORIES bOtHo99i -03"' vD NO . ..._. -,. 6/: CENSUS TRACT GP LANO USE PARKING SPACE l RES UNITS I GRADING f'.ERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRE SPA AREA CONST vO ND vD NO vD NO Not Valid Unlt!ss Machint ~rtifit!d QTY. PLUMBING PERMIT -ISSUE ?,.S-o QTY. MECHANICAL PERMIT -ISSUE 9,ar) SUMMARY/ACCOUNT NUMBER EACH FIXTURE TRAP \ INSTALL FURN. DUCTS UP TO 100,000 BTU BUILDING PERMIT 01-000-4220 EACH BUILDING SEWER ~-OVER 100,000 BTU SIGN PERMIT 01 ·000-4221 EACH WATER HEATER AND/OR VENT "' ~~-BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK 01-000·4806 EACH GAS SYSTEM 1 TO 4 OUTLETS "' ~ BD>LER/COMPRESSOR 3-15 HP TOTAL PLUMBING 01-000-4222 EACH GAS SYSTEM 5 DR MORE '\: \. ~ ~ -~ ~-METAL FIREPLACE ELECTRICAL 01-000-4223 '7_"'1.,~ EACH INSTAL .. ALTER, REPAIR WATER PIPE ~\~' VENT FAN SINGLE DUCT MECHANICAL 01-000-4224 . EACH VACUUM BREAKER '--~ ~ MECH EXHAUST -HOOD/DUCTS MOBILEHDME 01-000-4225 WATER SOFTNER \.. I '7\ RELOCATION OF EA FURNACE/HEATER MOBILEHDME PARK INSP EACH ROOF DRAIN ( INSIDE) -~ SOLAR 01-000-4226 TOTl<L MECHANICAL STRONG MOTION 65·640-0519 -T --- TOTAL PLUMBING FIRE SPRINKLERS 01-000-4227 QTY. ELECTRICAL PERMIT -ISSUE .J./1, QTY. SOLAR -ISSUE PUBLIC FACILITIES FEE 25·000-4933 BRIDGE FEE I NEW CONST EA AMP/SWT/BKR U .JJ COLLECTORS SCHOOL FEE -DISTRICT 1 PH 3 PH STORAGE TAN KS Carlsbad 65·623-0519 EXIST BLDG EA AMP/SWT/BKR ROCK STORAGE Encinitas 65-624-0519 l PH 3 PH PUMP San Dieguito 65·625-0519 REMODEL/ALTER PER CIRCUIT PLAN CHECK FEE San Marcos 65·626-0519 ------ TEMP POLE 200 AMPS --·---~----- OVER 200 AMPS TEMP OCCUPANCY 130 DAYSI ------T--- TOTAL ELECTRICAL /}~ .!lb TOTAL SOLAR TOTAL FEES PAYABLE I 1-1,vt> I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT" AND 00 HEREBY Expiration. Every l)llrmtt iaauecl by the Building OffiCi9I under the provilionl ol'lhll * AN OSHA IIEMIIT IS AEQUIAED FOR EXCAVATIONS OVER CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code ~re ~ and become null and void. If the build!:. o, wottt 5' er DEEP AND DEIIOUTION OR CONSTAUCTlON OF author euch i1 ii ot:~ln 180 daY9 from the ot auct, DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS -m·. or · the I di~ w uth by auch permit ii or STAUClUIIES OY£A 3 STOAIES IN HEIGHT ISSUED: TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING BUILDING CON-aban on at anv me a the k ,, mencecl for a ""riOd of 1110 "-·. STRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND APPi ~~t::f .~OWN,VI.,!' CONTAACTORD APPROVED BY DATE 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 -16rZ.·~?,-GRANTING OF THIS PERMIT. , BY PHONE 0 ,--... . - -- ~ LL >, ~ 0 a. E ~ I ,:, 0 (!) c <ti _g a. C!l. <( I .;it! C: a: 0 rJ) rJ) Q) rJ) rJ) <( I 3: .2 Q) >- rJ) rJ) Q) 0 0 ct <ti <ii 0 §: Q) 0 C: nl C: LL C: Q) Q) C, 0 0 Q) a. rJ) C ~ .c 3 INSPECTION TYPE BUILDING FOUNDATIOJ'J. REJNFORCED STEEL MASONRY GUNITE OR GROUT FLOOR & CEILING SUB FRAME SHEATHING FRAME EXTERIOR LATH 1NSULATION INTERIOR LATH & DRYWALL PLUMBING SEWER AND BL/CO PLUMBING UNDERGROUND PLUMBING TOP OUT TUB AND ~HOWER PAN GAS TEST ELECTRICAL TEMPORARY POWER ELECTRIC UNDERGROUND ROUGH ELECTRIC ELECTRIC SERVICE BONDING G. F. I. -SMOKE DETECTOR MECHANICAL DUCT & PLEM., REF. PIPING HEAT -AIR COND. -SOLAR SYSTEMS VENTILATING SYSTEMS DATE INSPECTOR .. I CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE ITEMS ABOVE HAVE BEEN APPROVED. JOB SITE FINAL PLUMBING ELECTRICAL MECHANICAL GAS BUILDING SPECIAL CONDITIONS CERT OF occup -'1CY ISSUED I I j ) I ' ' l' ';_ ~ I \ • · , t, -' \ ' . ' -FIELD INSPECTION RECORD ' -~ -REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES -l=============~~~======~c======~~~~~~~~~~~~~~~~~,==;;==~~==1 REQ IF INSPECTORS 11 ._r _ INSPECTION CHECKED APPROVAL DATE -SOILS COMPLIANCE PRIOR TO -FOUNDATION INSP -STRUCTURAL CONCRETE OVER 2000 PSI -PRESTRESSED CONCRETE POST TENSIONED -CONCRETE -FIELD WELDING : ··------< _ HIGH STRENGTH BOLTS _ ------------, SPECIAL MASONRY -I PILES CAISSONS -" ~. ,.... ... 'j .!.I . -' • i - ~:.' -. t. ! f .c..... l ..... -; . 4 -- --__ .., ..... J ' ... -.. _ t ................ ., • :L, ·.-~ .. ---..!\. .J r· .... ;. \ •' r I 'J.•~,,...,~f",. l------------+----;-------1..,,... _. -f-1>-' _··.,..-...._--1 ' ,, ""~~-·-· -~ •• .'I i,..._.,.:•!..._~---~'··~--=:._ ___ ~:_c:;'•:.._~l ~:',._.::;_· _________________________ _ -"' .. :•· \ ~· . ... t_ ~ ' ~ j ~ .. -• e j ~ T • • -._.,-..."...--....... ~ ~. f ~, • · ... . "t;,.. _ !'""" I I • -• J-' " • ' ' "-~ ' ' ' • ' . \. 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