HomeMy WebLinkAbout1536 CHESTNUT AVE; ; 87-580; PermitDECLARATIONS
LENDER
1 1
1
§
Q.Q 1 hereby atfirm that there is a conagency (or the performance ot the work 1mit is issued (Sec. 3097, Civil Code)LRnrlpr's Namp0 s.
5 c
S 1'
?I
WORKER'S COMPENSATION
1
NOTICE TO APPLICANT: If. after makintof Exemption, you should become subjecCompensation provisions of the Laborforthwith comply with such provisions orbe deemed revoked.|?53
f _ ro o
1 ° |S
till 1 1 | certify that in the performance of ththis permit is issued. 1 shall not employ amanner so as to become subject to the Wsation Laws of California.5^ »
sil
^ o. 5:
?3&CERTIFICATE OF EXEMPTIONWORKERS' COMPENSATION INS(This section need not be completedis for one hundred dollars [$1009ri3
^ir POLICY NO.COMPANY12 Copy is tiled with the cityD Certified copy is hereby furnished1 1
CH 1 hereby affirm thaH have a certificself-insure, or a certificate of Workers' Csurance. or a certified copy thereof (Sec. 3Is
w o
0) D
5'S
? 5 D I amexfimpt unrlRrRprfor this reasonCD
e=
o 1 1 As a homeowner 1 am improving my horning conditions exist:1. The work is being performed pri2. I have lived in my home torprior to completion ot this work.3. 1 have not claimed this exemflast three years.I is |
| S| 3
J' l" S
f i I
OWNER/BUILDER
illillr P1!JPH|E Hilfslll|f!-_
1HII1
iplli
iMili ^I=!i°5ill i^!-is!i|;iHl&ll fisfsJi«a?i sssii^fsai:.-
- = s»l? "slislssi: Ss^ii-^'l3
oG^ ~ ^ 3 m 3 3. — ^ o. " j- — Hs^'"1 <"--;(»*«
-"•g-iSg "^-"Ig^gSSB oSSS g-5-f £2 = Is
S3-|^2j Jp<|||f|- gt||f "ilal"'!
l|f=|l t-^l?i"s|| i^ll^lllals
|if|ai sfl'il"i2sl l-lfs'll'lls-
2^1*1 fSIMill^ fa?^^?^
CONTRACTOR
1 1 1
Q 1 hereby affirm that 1 am Meprovisions of Chapter 9 (commSection 7000) of Division 3 of tand Professions Code, and myfull force and effect.s • " I
S §o c»s*a
3-S55
ISTRUCTION. WHETHER SPECIFIED HEREIN OR NOT. 1 ALSO AGREE TO SAVE INDEMhKEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS. CCEXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCGRANTING OF THIS PERMIT.111 M-
IZZrn o CJ
(/\
i '
^ \ 3r]i
frf
i Z
V 1
o"ooj z< -tII2 om Xa a
-o
rti
BJ
,~ a
C O 33 >s: r~ M *-E CAREFULLY EXAMINED THE COMPLETED "IFY UNDER PENALTY OF PERJURY THAT AARATIONS ARE TRUE AND CORRECT AND 1 FED' TO COMPLY WITH ALL CITY. COUNTY AIX5c r- >
2?!J5r
> m m o
TION AND PERMIT'RMATtON HEREONCERTIFY AND AGRI LAWS GOVERNINCD ™ Z 2
f~ "Cr *~~ n
z m 2 T
? cr m -<
B 13 fl> O
? 3 3 o. JJ1
jofli
X ^ Q. — f.n . Every permit issued by the BuMcexpire by limitation and becomeby such permit is not commence*if the buitding or work authonat any time after the work is conmg Ofticial under thenull and void If thewithin 180 days (romEed by such permitimenced for a periodsi lit
ions of thisng or workate of suchpended or0 days* AN OSHA PERMIT tS- 0" DEEP AND OESTRUCTURES OVEFS REQUIREDMOUTION OI1 3 STORIESFOR EXCAVATIONS OVER CONSTRUCTION OFN HEIGHT•a
m
W
1
o
TOTAL FEES PAYABLE\CREDIT DEPOSIT-,MP OCCUPANCY i30 DAYS)0
m
CD
o
S
CO
-.MPPOLE ?00 AMPS !3D
0
O
m
r-
3D
-am
X
m
cr
~n-n
CO
CO
o
t!n
tb
en
-
X
oo
-u
X
r-
Om
wm
H
X
CD
CO
CD
0
O
CD
0
CO
cn
rn
(1ST BLDG EA AMP/SWT BKR !cr>
1m
-
X
I
AWNINGoo
TI
OJ
CO
0
oo
0o
§s
CO
CJ1
\
2
O
C/l
m
S
CO
cc
^:
f
"\
O
o
—1
-n
CO
PO
CO
o
oo
o
0
OO
CO
COen
o
ELECTRICAL PERMIH
W
Cm
K
D
MOBILE HOME SETUPID
rn
CZ
3Dm
C
rn
Tlmm
CO
CO
o
o
0
o
CD
CO
-d.
0 [ TOI At PLUMBINGc
X
2
o
-n
0
m
CO
Tl
m
COro
0
CO
CD
CD
0
Oo
CO
-vl
0 IRE SPRINKLERS 001-80
ocp
CD
O
COI\Jrv>
-v)
m
IE
O
O
3D
—
•in
3
m
a
m
m
— i
VTRONG MOTIONCOo
en
tbro
CO
CO WATER SOFTNER |RELOCATION OF EA FURNACE/HEATERi —
oo
OO
0
o
0
oo
00roro01 EACH VACUUM BREAKERMECH EXHAUST HOOD/OUCTSo
CD
m
O
m
o
0
CO
o
0o
8
COf\3roen EACH INSTAL.. ALTER. REPAIR WATER Pm
m
Z
-r,
CO
Z
m
O
C
0
m
O
O
f—
CD
CD
CO
0
o
0o
CO
ro
ro
X
O
co
CO
GO
m
0
0
X
m
•n
Om
mi —m
o
o
CD
CO
0
oCD
0o
00
ro
ro
CO
\IEACH GAS SYSTEM 1 TO 4 OUTLETSBOILER/COMPRESSOR 3 15 HP— H
1 —
d
03
8
CO
O
0
CD
CD
0
CO
roro EACH WATER HEATER AND 'OR VENTBOILER/COMPRESSOR UPTO 3 HPi
inmO
S
rin
CD
0
O
CO
CO
(£)EACH BUILDING SEWEROVER 100,000 BTUCD
-om
3D
8
CO
o
0o
CO
ro EACH FIXTURE TRAP2
CO
f—
1 —
-n
C
33
0
C
-H
OO
c:
-o
-H
O
0
CD
o
0a
CD
— 4
cr
cz
o
rr
3C
CD
0
CO
O
0o
8
CO
ro
ro
O
O
PLUMBING PERMIT - ISSUE\J
fc
D
MECHANICAL PERMIT • ISSUESUMMARY/ACCOUNT NUMBERt'CENSUS TRACTPARK ING SPACEI
C
Z
-t
Ul
GRADING PERMIT 1Y D N CCm
o
REDE VE LOPMENTAREAvQ NDTYPECONST1 OCC LOAD-< _
O J
z w
D 5
"*
-c 71
n ^
za
r
D
m
r
NUSTORIESOnn
O
T)
mDc
/Vof l/a//rf Unless Machine Certified3
r.
rv
•^^•i
^IA
h
1r
1 DESIGNER'S ADDRESS1 STATE LICENSE NO.IDESCRIPTo
O'
o
»
V
I
n ^ O
H §
fTF m
«•""" 3)
J £
0 \z
Jf ">
C
'J'
r'
7
W
3D
3y
1 DESIGNER1 DESIGNER'S PHONEoo
1
oI-*
i
o
^ °
? =» U*
\
>0
s
J
P-
1
*•"—*•
W**1 CONTRACTOR'S ADDRESSSTATE LICENSE NO. |BUILDING SO. FOOTAGEOWNER'S PHONEi
1
e
1
r
O-t
BLOCKSUBDIVISIONASSESSOR PARCEL NO.1CONTRACTORS* « -CONTRACTORS PHONE *m
(
• — o
v T" i ^V 1 >
(T' i
CP
^T <
"" w
ID
3J
O
en
z
p
DATE OI/F APPLICATIONiJs'^BUSINESS LICENSE *y
V
^!CARLSBAD BUILDING DEPARTMENT ADD. irATION A PFF2075 Las Palmas Dr., Carlsbad, CA 92009-1915 (619) 438-1161 f%rrui\*f»i iv»ii w rs.rH
>!
d
i
m
Z
o
BO
•o
JO
m
3D
O
TJ
TJ
f-
o
z
o
"ILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.White — Inspector Green — (1) Finance Yellow — Assessor Pink — Applicant Gold — Temporary File
f SPECIAL CONDITIONSBUILDINGQ
CO MECHANICALELECTRICALPLUMBING•n
Z
r-
2r-r~
-n
^Si
^°s
^o
mo
rn^
?m
l£
al
30o
31s
n VENTILATING SYSTEMS'HEAT — AIR COND. SYSTEMCO
n
oco
-o1—m
n
m
*T3
^Q
z MECHANICAIi D BONDING D POOLD ELECTRIC SERVICE D Tm
•VLT
DD
DO
-<ROUGH ELECTRICD ELECTRIC UNDERGROUNO
n
c-n-nm
DO ELECTRICALD WATER HEATER D SOLj>
DO
g
Hm•n
O
CO
Hm TUB AND SHOWER PANOc
D
5
m
>
m
DO UNDERGROUND D WASTIHI
a
$
5m
DO D SEWER AND BL/COC1
TIp.
O~~~
O PLUMBINGINTERIOR LATH & DRYWALLINSULATIONEXTERIOR LATHFRAMESHEATHING D ROOFn
CO
Tm
DO
COc
CO
-n
30>sm
a
-n
5o
3
n
0m
-7
O GUNITE OR GROUTMASONRYREINFORCED STEELFOUNDATIONBUILDINGTJm
a
m
_
COum
3O
33
GP
T"^
$PILES CAISSON'SSPECIAL MASONRYHIGH STRENGTHBOLTSFIELD WELDING •POST TENSIONEDCONCRETEPRESTRESSEDCONCRETESTRUCTURAL CONCREOVER 2000 PSIHm SOILS COMPLIANCEPRIOR TOFOUNDATION INSPINSPECTION •O
133
m m
00
m TIa ^
2
TJ W
'ECTOR1=ROVALCO
D
H
m 1 REQUIREO
SPECIALZ
CO
m
O
|
6z
j'.1
iv
z
CO
TJ
m
O
— Ho
33
LO
Zo
m
CO FIELD INSPECTION33
ECORD
City of Cartebab
REQUEST FOR INSPECTION RECORD
ADDRESS
REQUESTED BY PHONE NO.
BUILDING
D FOUNDATION D FOOTING D SLAB
D REINFORCING STEEL
D 'MASONRY
D GROUT-GUNITE
D FLOOR AND CEILING SUB FRAME
D SHEATHING D ROOF D SHEAR
a FRAME
D EXTERIOR LATH
D INSULATION
D INTERIOR LATH OR DRYWALL'
D FINAL
ELECTRICAL
D TEMPORARY SERVICE
D UFFER GROUND
D ELECTRIC UNDERGROUND
O ROUGH ELECTRIC
D POOL BONDING '
ELECTRIC
D FINAL
PLUMBING
D UNDERGROUND PLUMBING
D SEWER AND PL/CO
D TOP OUT PLUMBING --
D TUB OR SHOWER PAN
D GAS TEST
D WATER HEATER
D SOLAR WATER
D FINAL
MISCELLANEOUS
D CONDITIONED AIR SYSTEMS
SOLAR HEAT
D PATIO
D POOL n SPA
D SIGN
D GRADING
D DRIVEWAY
D FINAL
SPECIAL INSTRUCTIONS
Ready For. Inspection: D Monday
D A.M. P.M.
D Tuesda1 D Thursday D Friday
*•*»-«-«-*''
«/
•y #f*
/m
ATTENTION PROPERTY OWNER:
An "owner-builder" building permit has been applied for in your name and bearing your
signature.
Please complete and return this information in the envelope provided at your earliest
opportunity to avoid unnecessary delay in processing and issuing your building permit.
No building permit will be issued until this verification is received.
1. I personally plan to provide the major labor and materials for construction of
the proposed property improvement (yes or no) i» Q S>
2. I (have/have not) YM^-— _ signed the application for a building permit.
3. I have contracted with the following person (firm) to provide the proposed construction.
Name kj ftr Phone
Address _ Contractors License No. _
City _
4. I plan to provide portions of the work, but I have hired the following person to
coordinate, supervise and provide the major work.
M\frName NjVtT" 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:
NameAddressPhone Type of Work
Signed: Property Owner
Social Security Number
Date: ^ 1 \r> A ^
EACH SUBCONTRACTOR WILL BE INSTRUCTED TO OBTAIN A CITY OF CARLSBAD BUSINESS LICENSE
AND FURNISH A CERTIFICATE OF WORKMAN'S COMPENSATION TO THE CITY OF CARLSBAD.
Initials