HomeMy WebLinkAbout1278 Las Flores Dr; MULTI-PERMIT FILE; CB880982; Permit., z 0 ;:; .. a: .. ~ ~
g ['-Ji ! hereby ,mrm t. hat I am licensed under
(.J ~!•Ions al Chapter 9 (commencinQ wilt\
: S.Ctlon 7000) o! Oly\slon 3 ot the Business
..,_ and Pro, .. s/ons C~. and my license 1s in i full tore• and eflect
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1 hetetly atl1rm Illa! I am ~xempl lrom tile Canirac
w·s l,cense Law lor Irle to1lowmq reason (Sec 7i)Jl <;
Bus,ness aM Pr~tess1ons COile Any cJt'i 01 count•1 'l<n,cr, ie
qu,res a perm,1 to rnnstruc! a11e1 improve OemaJ1\/l o,
<eimr Jny Sf/LJC1ure i;r,or ID ils ,ssl/4nce also reqv,res i~ JP
p11c3n1 Jor such Derm,1 !D tile J s,oneD Sl;,temenr Illa! ~e ,s HCensM ou1su3n\ 10 me pJov,sions of tile lo~\qcior s
License la"' iChaole< '3 commencing v,11n SerMn 7000 ol aw,s,on 3 of Ille aus,ness and f'ro(essrons Cone, 011h~1 ,s e,
empt 1/lere!ram on<! the oas,s !or t!ie airegeo eHmpt,nn ~n~
,-ota!101t o( SecMn 7031 5 by an appl1canl W .i pe'rn1i sub
1ec!S Ille acp1,car!l lo a c,.,11 penal(y or not mace !Mn r,ve n~n
drer! cto11a,s 1$50Gi
es owne, 01 tile property or rny ~rnc1oye~s ,,,,,r, waq~s
i!S lhe,r sole compenSi!t,on w,11 do !M won, a~a IM ,true
1ure ,s ~o\ ,nieMed or o!1ered 1a, ~ale IS~c 70~4 6u~1nes~
i!nd f'ratessro~~ Cade Tile Comracior s L1ce11S€ low does
nm aopiy 10 on ow11e1 al oroperly w/lo ~ulitls or ,moroV€s
1ne,e1m ,,nC w/lo mies such wo11< h<"1sell or iMrough h,~ ow~
emoiov~s proy,ne<I 111a1 s<.Kh ,mprovemenls are nOI ,mend
e~ 01 Qlle\ed l'}r sale 11 M'llever. \l'le building o, ,mp,ove
rnenl •s sOJO w,1n,n Me year 111 c=p1e1,ori the owr,er-ouMer w,11 h<1ve \he l)u1~en ot pm;,ng \ha\ tie ct1d no\ nu,1~ or ,rn
PIDYe for lhe ,:mrDOse ol s;ile/
as ownei ol The prope!l~. am exnusNely conrras:,ng
w,1h licensed rnnHattors 1n conwur! the pro1ec1 (Ser 7044
6u~1ness and P10\es~•Ons Code The Contractors l<tense Law ctues nor aopl~ !a an crwner 01 property wM b~llds or ,rr, o,ove~ mereon ari<i wno contracls re, e~c/1 pro1ecro v«tn .J can1,actoris1 l,cense oursuanl io lne Cani:ac101·s License taw1
As a nomeowner ram ,rnprov,ng rnt home ano lhe !Dllow ,ng c0nd1t,an5 ex,,;t
1 ne 'l<Ork 1s oe,~g: pertarrneO pnm ta -;ale
2 I nave irveO 1n my home lor twelve rnanttis
prior \O cornplet1on Ol 1h1s 'l<O!K
1 na,e 1101 cla,me-0 lh>S exi:mo11on dun~g the 1as1 th,~e yeil's
I am exempr undet Ser _____ _ s&n 'or lh1s reason ____________ _
.XI nereby aft11rn that I h<!,se 3 cert,f1cate ot consent to
se1• ,r.sure or a ceit,1,cate of Wor~e,s C:ompensa11on In
su'~nce or a cer!,',ed Wp~ mereol 1Sec JBOO. Labrn Cede!
POLICY NO
cos"" 1013568-88
--Ceo) ·5 ftSt'att~ c•Fund -x Cert,1,ed cooy ,~ hwetJ; lum,sneo
CERTIFICATE 0~ EXEMPTION FROM
WORKER$' COMPEIJ$-"1ION INS\.JRM.CE
1Th,s s~CtH:>n ne'l'd Ml ce completed 1f tne perm,:
1s Jo, one hcwdced j()lia's 1$100\ ()r ls>$S1
I cert•'} that,,, !he perlmmance ol t/'le ;\O<< foe wn,ch
m,s perm,\ ,s issued. I shall not employ any oerso~ ,~ any
'1'1;mne, so as !o become suDwct to !he wo,~ers· C0'1'1Den
sat,on Laws ot Cal1fr,rn1a
NOTICE TO APPLICANT il, .:,fie, m;,~,ng lh,s Cer1,t1c~1e
ol E~empt,on ~ou sho\Jld beccirne s11ti1ect \o lne Wm~ers
Com()ensa!,on oro,,s,ono of me Labor Code rou 'l'luSI
toclhwr!h comoly w,m sui:h o,o,,,s,ono o, rh1s 9erm1t sr,&JI
00 •j~emed cev,;J~ed
I hereby a11<,m \hat \he1e ,s a cons\run,on lep,q,ng
--..., ...,, th A '\'ora tor which 1h,s per
USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA ANU ucv•~---. CARLSBAD BUILDING DEPARTMENT
2075 Las Palmas Dr., Carlsbad, CA 92009-1915 (619) 438-1161 APPLICATION & PERMIT
JOB A.OORESS AV.ST,RO. THOMAS BROS NO. 0.ATE OF APPLICATION 8US!Ness LICENSE# VALUAT!ON PERMIT NUM8ER
1278 Las Flores Dr. Pio Pico Dr. 7-,;J1-Ji 19451
COT BLOCK I SUBO!V!SION ! ASSESSOR PARCEL NO. CONTRA.CTO~
Arlen Foster o,,_._, __
CONTRACTORS PHONE# ZONE ~ &f'at{:2--
OWNER'S NAME
Beth Vanderswag
OWNER'S MAILING ADDRESS
'\ ?7A. T .~q_ ?1,...,,..,.,,_.,.. T'\v
DESCR!PT!QN OF WORK _, . ~-----... -.
I CENSUS TRACT I""'"" s,ACc
QTY
'
QTY
PLUMBING PERMIT -ISSUE
f.t>.CH FIXTURE. TRAP
EACH 8U\Lll1NG SEWER
EACH WATER HEATER ANU OR VENT
EACH GAS SYSTEM l 10 ~ UUT LE TS
EACH GAS SYS HM~ OR MOR[
EACH INST AL All £R REPAIR WAHR PlPf
EACH VACUUM BREAKER
WATER SOFTNfR
f;\(".H R(\Ul f"")\-l,;,,','; ''i'.; ~:e ·,
TUlAl PlUMEINC l
ELECTRICAL PERMIT -ISSUE
NEW CONS! EA AMP SW! 8KR
I PH I PH
EXIST !:llUG EA AMP SWT 8KR _,/
1 PH J PH/
REMODft Al HR PER [IR-~
Tf",\PPOlf. JUOA\i\P'i/
O\IER lUU AMPS /
TtMP OCCU~lY .)0 OA.YSI
./
l /]TA l fl~ I. l'R Ii.A I l
/
l 729_;;N{t PHONE
697-4151
CONTRACTOR'S ADDRESS
2819 Central Ave.
STATE LICENSE NO.
4433_48
8U!LOING SQ FOOT AGE
RfS UNITS
r::_7 c:;,n
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OESrGNEA
OES!GNEA'S ADDRESS
' , FLA ELEV
,[; "□
REDEVELOPMENT
AR!'A
NO
STORIES
TYPE
CONST
DES!GNE A'S PHONE
STATE LICENSE NO.
OCC GP EDU
DCC LOAD F!RESPP GRADING PERMIT ISSUED l
10 N □ ,c:; ..... o ,,o "'□ Nat Valid Unlns M.1chine Certified
QTY. MECHANICAL PER!<)!-1\),SuE / SUMMARY/ACCOUNT NUMBER
81J·:J -00 0
OG 1-810·00·00-8221
801LER,toMflRE t,, PLAN CHECK 0QJ-810-00·00-6891
80IlER:CO TOTAL PLtJM8iNG oo:-s 10-oo-oo-s222 ..... ,-.
METAL f1Rf ,E /( ,... ..,f(Y~~""'f IJ ELECTRICl'lL OOH:l 10-00-00·8223
VENT ~AN SINGLE Dtit:'t :;;(j*r c&'-, f If MECHANICAL 001-8\Q-00-00-8224
'
MECH fXHAUST HO~io,s.c ~"t--J JI MOBILEHOME 001-81(?-(JQ-Q0-822~
RELOCATIONoi.,,ii:'~;si~"flf•rrn I II SOLAR co,s:oooocs22&
DRYER V~ -_ .. C)'<. } }\ STRONG M0110N 380-:,;9.92.33
...,-onTMrcH~~L 1 Jj r1Rt sPR1~r1Lrns ~ iJUBLrC FACILITIES FEE
00 1-B ', 8-Q!J-C0-822.7
320· 8 '0-00-00-S 7 --10
BRIDGE FEE 360-8 1G-00·00-8740
QTY I MOBILE HOME SETUP __, PARK-!IHJEU 14REA
CAR PORT / rn 312-810-00-00-8835
AWNING _,,,, LA COSTA TIF 3-; 1-a 1 o-oo-oo-8835
GARAGE / FMF _,, LICENSE TAX 001·8'0 C,]-,J('•3'.ii2
/ MFF 880-519·92-51
/
/
/
./ CAED!T DEPOS!T
~
fQTAt TOTAL FEES PAYABLE I ~ ·~ .
1 HAVE CAREFULLY EXAMINED THE COMPLETED ··APPLICATION AND PERMlT .. AND DO HEREBY
CERTJFY UNDER PENAL TY OF PERJURY THAT All lNFORMAT!ON HEREON !NCLUOING THE
DECLARATIONS ARE TRUE ANO CORRECT AND! FURTHER CfRT!FY AND AGREE !FA PERMIT J&
E:ct11rat1on E...ery permit !$Sued by tl'le81.1ildmg; Otl1cu11 undef !he prov1sK1ns of this * AN OSHA PERMIT IS REQUIAEO F"OA E;(CAVATtONS OVER
Code shall exp,re by Hm1ta11on and become nu1\ and ~o,d H the bu,ld,ng or work 5· O" DEEP 4NO OEMOlfTK)N OR CONSTROCflON Of autl'loru:e.:t bysucil permit rs no! commenced w,tn1n 160 days from the date ofsucn STRUCT\.IAES OYfA 3 $TORlES IN HEIGHT
perm,t. or 1f the bu1ld111g or work authorized by such perm,t •s $l.1Spended or -~~··en TO COMPLY WlTH ALL C!TY, COUNlY ANO STATE LAWS GOVERNING BUILDING CON· LJa~b!an~oo~n~ed!!!_a~lLJa~n~t~"!!!!'''Ja!/i!ft•~•~th~•Lw~m~k'.•~•1c:,o~m~m~&n!!,!<~•~•!.:•~00•1•ci;,tn~od!!1Jo~t~1~BO!Q.J!!i'----,,::;.J'':'":~~.,,,~~----':'------~~:-------,
~,.,c:,-.u::,"D HEAE!N DA NOT. J ALSO AGREE TO SAVE !NDEMN!FY AND l!;UCANT'S SIG~l-URE If-,.-.~NER(1 CONTR.t..CTOR ~ OATE -• ,.,,...,. All UAB!LIT!ES. JUDGMENTS. COSiS ANO 1:,,:.;··'\. _i ,,-... · '--~ -"? /
---. ,., ~nNSE.OUENCE OF THE. '( "V v~ BY PHONE f] ,,,.,. <..-..<7 j '/ j_ / rr.:r-,-,, ~ .--,""t-Lro 7
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-IN.: 'PECTOR ----·••"1 C& a-~ 'j ~ ;;i, t-OUNDATION FIELD INSPECTION RECORD REINFORCED STEEL REQUIRED SPECIAL INSPECTIONS
MASONRY INSPECTOR'S NOTES
GUNITE OR GROUT INSPECTION REO IF INSPECTORS DATE CHECKED APPROVAL
SUB FRAME D FLOOR D CEILING SOILS COMPUANCE
SHEATHING D ROOF D SHEAR PRIOR TO
FRAME FOUNDATION INSP
EXTERIOR LA TH STRUCTURAL CONCRETE
OVER 2000 PSI
INSULATION PRES TRESSED
INTERIOR LATH & DRYWALL CONCRETE
POST TENSIONED
cor~CRETE
PLUMBING l"IElD WELDING
D SEWER AND BUCO D PUCO --~
HIGH STRE1~GTJ-1
UNDERGROUND D WASTE D WATER soc.Ts
TOP OUT D WASTE D WATER 5µECIAl MASONRY
TtlB AND SHOWER PAN
GAS TEST Pl~ES CAISSON;:'
D WATER HEATER D SOLAR WATER ----------
ELECTRICAL
D ELECTRIC UNDERGROUND DUFFER
ROUGH ELECTRIC
D ELECTRIC SERVICE D TEMPORARY --,-..-~-
D BONDING D POOL '
MECHANICAL --~ --
D DUCT & PLEM., D REF. PIPING
HEAT -AIR COND. SYSTEMS
VENTILATING SYSTEMS
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE BEEN APPROVED.
FINAL
PLUMBING
ELECTRICAL '""" 1 ~
MECHANICAL ;V/ GAS .1T l
BUILDING r._')'/•IJ l1,r l I-"'/
SPECIAL CONDITIONS I I /
/
LICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provi-t
sions of Chapter 9 (commencing with Section
7000) of Division 3 of the Business and Profes-
sions Code, and my license is in full force and ef-
fect.
OWNER-BUILDER DECLARATION
C'I hereby affirm that I am exempt from the Con·
tractor's License Law for the following reason
(Sec. 7031.5.Business and Professions Code), Any
city or county which requires a permit to con-
struct, alter, improve, demolish, or repair any
structure, prior to its issuance also requires the
applicant for such permit to file a signed state-
ment that he is licensed pursuant to the provi-
sions of the Contractor's license Law (Chapter 9
commencing with Section 7000 of Division J of
the Business and Professions Code) or that is ex-
empt therefrom and the basis tor the alleged ex-
emption. Any violation of Section 7031.5 by an ap-
plicant for a permit subjects the applicant to a
civil penalty of not more than five hundred dollars
($500)
:·· l, as owner of the property, or my employees
with wages as their sole compensation, will do
the work, and the structure is not intended or of-
fered tor sale {Sec. 7044, Business and Profes-
sions Code: The Contractor's License Law does
not apply to an owner of property who builds or
improves thereon and who does sucn work
himself or through his own employees, provided
that such improvements are not intended or of-
fered for sale. If, however, the building or improve-
ment 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
sale).
=.1, as owner of the property. am exclusively con-
tracting with licensed contractors to construct
the project (Sec. 7044. Business and Professions
Code: The Contractor's License Law does not ap-
ply to an owner of property ·•ho builds or im-
proves thereon, and who contracts for such pro-
jects with a contractor(s) license pursuant to the
contractor's license Law). ,
I am exempt under Sec. ___ 7 y. ~ P.C.
lor this reason )
Date ____ Owner -rtt'--'IH---
WORKERS' COMPENSATION O~CLARATION
I hereby affirm that I have a certificate of con-
sent to self-insure, or a certificate of Workers'
Compensation Insurance, or a certified copy
thereof (Sec. 3800, Labor Code).
Poucv NoPW<" C! 1 1'1S,'1 10 </-
coMPANY ~E-.N-A---------
-;,4Jcopy is liled with the city.
LJCertIfied copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
{This section need not be completed ii the per·
mil is for one 11undred dollars ($100) or less).
\ certify that in the performance of the work for
whicl1 this permit is issued, I s11all not employ any
person in any manner so as to become subject to
the Workers' Compensation Laws of California.
NOTICE TO APPLICANT; 11, a~er making this Cer-
tificate of Exemption, you should become subject
to the Workers' Compensation provisions of the
Labor Code, you must forthwith comply wit11 such
provisions or this permit shall be deemed revoked
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction len·
• •L ----•-•------1 tho a,r,rk lnr
CITY OF CARLSBAD-BUILDING DEPARTMENT
USE BALL POINT PEN ONLY
APPLICATION & PERMIT
1200 ELM AVENUE (714) 438-5525
"· J06 AOORESS AV.ST. IDA~/F APPLICATION
1/ 1,<.1 71 :J, I j_,,'j, ,S I ,F,L ,o ,R,C ,<e I ,7,,;2,c;,._,,,1,;,,,' Ro // / I • ' I , ;d fo
OWNER OWNER'S PHONE PRIME CONTRACTOR
BErN //A ,',·.:..0 ,-:;-,e.,,-, v✓A-G flc,t? '.S /) L./f1 I>/ ;V 6
OWNER'S MAIL\NG ADDRESS CONTRACTOR'S ADDRESS
/,"> 7! ,L_ A--"> ;=:.,1_c;;(-'€.S :2So/ _<,/,4-TE -r
'" BLOCK I SU80]VISION I ASSESSOR'S PARCEL NO, DESIGNER
' ' ' ' ' ' ' ' ' ' '
DESCRIPTION OF WORK
J,v ,4 r~ AC' /-f£frrE,P ;._~;:: . .,,, Ac c ,.,,;:-,.,._. ~-OESlGNER'S ADDRESS
CENSUS TRACT GP LAND USE ZONING
APPLICANT TO FILL IN INFOR-
MATION WITHIN RED LINES.
SUS. LICENSE ;?(; ;.ERMIT NUM8ER
/;?{ 11
STATE LICENSE /C: >--,,, :./.5 ,7., 7
CONTRACTOR'S
PHONE
7,<.,:J_~ t>S':.
STATE LICENSE
DES\GNER'S PHONE
I RES. UNITS ! PARKING SPACE I NUM6ER OF STORIES
Not Valid Unless Machin8 CartifitJd
BLOG SQ, FT. BLOG USE occ. GP l STANDARD PLAN ti !PLANJD# ! TYPE CONST ! OCC. LOAD I
OTY. PLUMBING PERMIT AMT. OTY. MECHANICAL PERMIT AMT.
EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100,000 BTU ,_
EACH BUILDING SEWER OVER 100,00Jl,M\1
J EACH WATER HEATER ANO/OR VENT __ .., .ri.,.., BOILER/COMPRESSOR UP TO.Kf:fP
EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESS0"""15 HP
EACH GAS SYSTEM 5 0 R MORE BOILER/COMP~SOR 16-30 HP
EACH INST AL, ALTER, REPAIR WATER PIPE VENT Fi\K'SltlGLE DUCT ()~ EACH LAWN SPRINKLER SYSTEM ME.Rf! EXHAUST -HOOO/OUCTS '
WATER SOFTNER A'iELOCATION OF EA FURNACE/HEATER BUILDING PERMIT I I I I
,/--~,o / r""i 00 \ / ..... , .. ,-, .d,:J SIGN PERMIT I I I I ,
TOTAL PLUMBING TOTAL MECHANICAL PLAN CHECK I I I I
CONTRACTOR ~" ,oo CONTRACTOR ALL INCLUSIVE PERMIT I I I
ELECTRICAL PERMIT AMT. AMT. TOT Al PLUMBING I 1<' . .,-,o
OTY. OTY. MOBILE HOME PERMIT ELECTRICAL I I . I
NEW CONST EA AMP/SWT/BKR AWNING -MECHANICAL I I I
1 PH .25 3 PH PORCH -MOBILE HOME I I I
EXIST BLOG EA AMP/SWT/BKR I/ SET-UP / SOLAR .-' I I I I
1 PH .25 3 PH ,/ RAMADA, CABANA / -111 A./, ,n.,,, _/ I I I . I
REMODEL/ALTER PER CIRCUIT /. FENCE OVER 6' ./ 0 I I I . I
TEMP POLE 200 AMPS / TOTAL MnM'f E HOME MICO-FILM I I I I
OVER 200 AMPS I/ / I I I I
TEMP OCCUPANCY (30 DAYS) / / I I I , I
/ -• • d / ./ oZ_ . (} Cl / I I I I
TOTAL ELECTRICAL V ___,/ TOTAL FEES PAYABLE I .
CONTRACTOR I I I 1<:. 1-
./4W, ~~ I HAVE CAREFULLY EXAMINED THE COMPLETED "'APPLICATION AND PERMIT. AND DO •AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER
HEREBY CERTIFY THAT ALL \NFORMATION HEREON IS TRUE ANO CORRECT AND I 5"-0'" DEEP ANO DEMOLITION OR CONSTRUCTION OF
FURTHER CERTIFY ANO AGREE IF A PERMIT IS ISSUED; TO COMPLY WITH ALL CITY. STRUCTURES OVER JSTORIES IN HEIGHT
COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER
SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM
LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS. COSTS ANO
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE
OF THE GRANTING OF THIS PERMIT. APPLICANT'S SIGNATURE" C OWNER □ CONTRACTOA)'l !APPROVED BY 01viv o,V,E r: jJ ,;-. -AGENT 0 BY PHONED 11'.,y<
'
L---
• w ~ ;t >
5 r= u w a,
V) ~
SITE 80-/~;).__ ADDRESS: .. OWNER: . PERMIT NO:
FIELD INSPECTION RECORD
INSPECTION DATE INSPECTOR INSPECTOR'S NOTES
WOOD FLOOR
FOUNDAT!ON • FORMS• SET BACK• TOILET
UNDER FLOOR PLUMBING
UNDER FLOOR HEATING
OK TO INST ALL SUB FLOOR
SLAB FLOOR
UNDER SLAB PLUMBING
FOOTING• FORMS• SETBACK • TOILET
OK TO POUR CONCRETE
FRAME
ROUGH ELECTRICAL
ROUGH PLUMBING
ROUGH HEATING/VENTILATING
FRAME OK• PLACE INSULATION
INSULATION OK • PLACE WALLBOARD
WALLBOARD OK• PLACE TAPE
EXTERIOR LATH OK• PLACE STUCCO
. FIREPLACE
DAMPER 8:STEEL
PLATE TIES/HEIGHT OF CHIMNEY
OTHER
TEMP POWER (POLE)
SEWER
GAS TEST
SWlM POOL • STEEL BONDING
• PRE DECK •
• FENCE PREPLASTER
SHOWN • FRAME \ ., ,
• PAN I IV
FINAL INSP BY BLDG DEPT II\ " \
OTHER DEPT'S REQ COMPLETED ~ \l ~ \) I ELEC METER-PERM-TEMP
: GAS METER-PERM-TEMP
i ,----
i
i I ' l. CERT OF OCCUPANCY ISSUED
0 ( I
PLUMBING PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA
Applicant to complete numbered spaces only. Permit No.
JO& ADDA £55
1
LE GAL l 1 DtSC~.
LOT NO.
OWN£."
2 I.
I TOACT
MAIL AD0"l$5 ,. ,, .. _ 12 , c· --~ -, .•
., ..
MA IL ADDR ESS PHONE
';,-' ~
LICE.NS£ NO, STATE CONTl'IAC TOR
3 3:' :)'
ARCHITECT QA OtSIGNCA
4
EHC.INEtl'I
5
COMPENSATION fNS. CARRIER
6 ,.:'J.4 i&'PT'nll •
use. OF 8Ulr..OING
7
l AT
MAIL AODAE55
~AIL ADDl'IESS
MAIL ACOIH,55
CIAM_C!\'.ll"\ ••
• ' ---' D
,.... (
PHOM t LICENSE NO,
PHONE LICltMSt HO,
BJll:AHCH
• CA -·~ -
8 Class of work: □NEW 0 ADD ITION 0 ALTERATION 0 REPAIR
q Describe work:
....
:-
SPECIAL CONDITIONS:
APPUCA TION ACCEPTED eY PLANS CHECKED BY APPROVED ~OR ISSUANCE BY
/2 I. DATE
J' ., NOTI CE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC·
TION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM•
MENCED.
I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS
APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT,
ALL PROVISIONS OF LAWS AND O .lDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING
CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
' I.. I ,.
SIGNATUJU. OF CONT .. ACTOIII 0" AUTHOIIIIZ[D AGf.NT (DAT[)
No.
..
--.. -. PERMIT FEES ----
Type of Fixture or Item
WATE R CLOSET (TOILET}
BATHTUB
LAVATORY (WASH BASIN)
SHOWER
KITCHEN SINK & DISP.
DISHWASHER
LAUNDRY TRAY
CLOTHES WASHER
WATER HEATER
URINAL
DRINKING FOUNTAIN
FLOOR SINK OR ORAIN
SLOP SINK
GASSYSTEMS:NO.OUTLETS
WATER PIPING & TREATING EQUIP.
WASTE INTl:'.RCEPTOR
VACUUM BREAKERS ·-
LAWN SPRINKLER SYSTEM
SEWER
CESSPOOL
SEPTIC TANK & PIT
ROOF ORAINS
PERMIT
DATE) TOTAL FEE
SICiNAT "r 01'" OWN[,. 1,-OWNEIII SU ILDtfl)
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O.
INSPECTOR
•• 9
CITY
3
Fee
$
,-,,
-
$
$ ~· -
CASH
RLUMBING PERMIT APPLICATION 111//')
0 ~ :e 0 ..
/1,,,, t·, z
City of CARLSBAD, CALIFORNIA ,., ► » " . " " ,.,
Applicant to complete numbered spaces only. .. IA
JOB ADOR ES5
1 .. > .. -lores, • l ~:. :.:;
LOT NO. I 8LK I u•cT
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LEGAL I Qst.£ ATTACHED SHltET) ~ 1 DESC~.
OWNER MAIL ADDRESS ZIP PHONE. i~ 2 "~ndortn:n..'i J.l'>S l< l'Vd ( :, l ~' t ~vv,;1 ·, ..... -~ .. j l • I
CONTRACTOR MAIL ADDRESS PHONlt LICENSE. NO,
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ARCHITECT OR DESIGN£.R MAIL ADDfllES!I PHONE LICENSE NO,
4
£NGINEER MAIL AODfU.55 PHONE LICENS[ NO, '
5
LENDER ' MAIL ADDRESS I -If: IUIANCH I
6 . I
1-....
USE Ofl' BUILDING 11 7
Class of work: □NEW 0 ADDITION 0 AL TE RATION El REPAIR -"' 8
,,. h \ 9 Describe work: f'~y.11, ,,,.,..,,..,,+_ nf' •-~--h~t""""' !:
1-......:
PERMIT FEES
No. Type of Fixture or Item Fee I-
SPECIAL CONDITIONS: WATER CLOSET (TOILET) -$
BATHTUB
LAVATORY (WASH BASIN)
SHOWER
K ITCHEN SINK & DISP.
DISHWASHER
APPLICATION ACCEPTED BY PLANS CHECKED BY APPROVED FOR ISSUANCE BY: LAUNDRY TRAY
CLOTHES WASHER
/ 1, . l.1 '( . WATER HEATER .. ,\.'
NOTICE URINAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-DRINKING FOUNTAIN
TION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF FLOOR-SINK OR DRAIN CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A ,I
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM, SLOP SINK
MENCEO. GASSYSTEMS:NO.OUTLETS
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. WATER PIPING & TREATING EQUIP.
ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED WASTE INTERCEPTOR HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT
PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE VACUUM BREAKERS PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING
CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. LAWN SPRINKLER SYSTEM
# SEWER ~r.o;~ CESSPOOL
8/ SEPTIC TANK & PIT -•
SIGNATURE 0,-COHTRACTOl'lt 0,. AUTHORIZED AGENT {DATEJ
PERMIT $
SIGNATURE 0,-OWNEl'lt ,,-OWNER BUILDER) CATE) TOTAL FEE $
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
A UDIT
s=,,,.,._, nn., a~ Q 1:u·nRn,-R J'ROM: INTERNATIONAL CONFERENCE OF BUILDING OFFICIALS e '50 50, LOS ROBLES e PASADENA. CALll"ORNIA 01101