HomeMy WebLinkAbout1623 JAMES DR; ; 80-611; PermitLICENSED CONTRACTOR'S DECLARATION
I hereby affirm that I am licensed under provi-
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
0 1 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 Ille 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 3 of
the Business and Professions Code) or that Is ex-
empt therefrom and the basis for the alleged ex-
emption. Any violation of Section 7031.5 by an BJ>-
plicant for a permit subjects the applicant to a
civil penalty of not more than five hundred dollars
(S500).
D I, 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 for sale (Sec. 7044, Business and Profes-
sions Code: The Contractor's Ucense Law does
not apply to an owner of property who builds or
Improves thereon and who does such 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).
'.JI, as owner of the property, am exclusively con-
tracting with licensed contractors to construct
the project (Sec. 7044, Business end Professions
Code: The Contractor's License Law does not aJ>-
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 Ucense LaW).
I am exempt under Sec _____ B. & P.C. for this reason, ____________ _
Date Owner
WORKERS' COMPENSATION DECLARATION
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 (Se:! Labor Code)l"1 '1
POLICY NO , /-7
COMPANvetc £ $( ;g 4 r;Ci 5
□Copy Is flied with the city.
~rtlfled copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS" COMPENSATION INSURANCE
(This section need not be completed If the per-
mit ,s ,_...,ne hundred dollars ($100) or less).
I certllf that In the performance of the work for
which this permit Is Issued, I shall not employ any
person In any manner so as to become subject to
the Wo.'t,jjrs' Compensation Laws of California.
NOTICE nl APPLICANT: If, after making this Cer-
tificate of Exemption, you should become subject
to the Workers' Compensation provisions of the
Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked.
l""'t"\1t.1C!Tc, 11""T1"" 1 c~ntN('! At;ENCY
CITY OF CARLSBAD-BUI LDING DEPARTMENT
USE BALL POINT PEN ONLY APPLICATION & PERMIT
1200 ELM AVENUE (714) 438-5525
/I
APPLICANT TO FILL IN INFOR -
MATION WITHIN RED LINES.
1,6 N0.3 ~ ~
I ;<, I d1 ·; I I I I I I I
JOB ADDRESS
I I I I I I I I I I I _L_J I I tRr·lDiZ ,;tgp~;;IONI 7r/1~ PERMIT NUMBER
ft,tl/ ow~
l'-A~f,A IJ.:. i ~~ID
OWNER'S PHONE
7 :L.CJt/'~C,C,2-w-0· :r;t;;;ooe,'S-~-} ~c.R
L ACTOR PRI ME
-..,.-..!'___ .,,--~
CONTRACTOR'~SS
STATE LICENSE !;z;f _; 3 J-?
~CTOR'S
,.,..,.J, , ('5;-<cfi)
~ STATVSE 11, BLOCK
7/0:3/ 5 ~Jj':..: PHONE
Cr "J 7--~~~___,,2....::::..D.._~~::.....:.....---~~~11&..-~~!....L ';>, 9-'1-11/,,K
\IIGP LAND USE 20N1NG ~ / j REs. uN1Ts / I P;RK3 sPACE s~.,, NUMB/OF sToR1Es CENSUS TRACT
Not V•lid Unlffl MachiM lMt.ili-1
IILDG SQ. FT.
~3Y IILDGU~£> ~3GJ ST~~; rAN Sl-e rYPE v;v I 0~ Do;; -I I ,
QTY. PLUMBING PERMIT
1/S"i EACH FIXTURE TRAP
,/' I EACH BUILDING SEWER
EACH WATER HEATER AND/DR VENT
EACH GAS SYSTEM 1 TO 4 OUTLETS
EACH GAS SYST~M 5 OR MORE
EACH INSTAL., ALTER, REPAIR WATER PIPE
EACH LAWN SPRINKLER SYSTEM
WATER SOFTNER
T!=:!=:11P
TOTAL PLUMBING
CONTRACTOR
QTY. ELECTRICAL PERMIT
NEW CONST EA AMPISWT/BKR
1 PH .25
EXIST BLOG EA AMP/SWT/BKR
1 PH .25
REMODEL/ALTER PER CIRCUIT
TEMP POLE 200 AMPS
OVER 200 AMPS
TEMP OCCUPANCY (30 DAYS)
Issue
TOTAL ELECTRICAL
CONTRACTOR
3 PH
3 PH
AMT. QTY. MECHANICAL PERMIT
~~ 7 INSTALL FURN. DUCTS UP TO 100,000 BTU
~~ -, OVER 100,000 BTU
BO I LE R/CDMPRESSO R UP TO 3 HP
BOILER/COMPRESSOR 3-15 HP
BOILER/COMPRESSOR 16-30 HP
~ VENT FAN SINGLE DUCT
MECH EXHAUST -HOOD/DUCTS
RELOCATION OF EA FURNACE/HEATER
3.._00 Issue
~?.~ CONTRACTOR
TOTAL MECHANICAL
AMT. QTY. MOBILE HOME PERMIT
_..2,S:',t? AWNING
PORCH / '
SET-UP / (\/
RAMADA, CABANA L ..ff._ /
FENCE OVER 6~7 n • JY (j/q \ /
TOTAL MOBIL,E HO~kl: 1/',,t , / v;· / 2~00 II lz
~ 7 !!-11 I '----'
AMT.
-PHI
/. ·'4
VAilJATioo = J?.3~Bs ,t,
~
BUILDING PERMIT "7' l ~~~
3 . 00 II SIGN PERMIT • I 1 , 1 I • 1
~ PLAN CHECK /,;?"7 5'"' /3 · ✓ ALL INCLUSIVE PERMIT I I I
AMT.
~
)
VI z
I I,
TOTAL PLUMBING I i:2J.S-d\:P
ELECTRICAL I ~ I J>.' llr1f'
MECHANICAL I T.M.""f'tt
MOBILE HOME I l j • I
SOLAR I I , Vi2~ II'>
MICO-FI LM :J3~_,, ~
✓---7
TOTAL FEES PAYABLE 1 I
I I I . I
.1 1 I · I
! I I . I
1 · I I · 'J, I 1S-1"i I '
I , I I . I
1 • 31"Pt:.-4,
I HAVE CAREFULLY EXAMINED THE COMPLETED '"APPLICATION AND PERMIT, AND DO
HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I
FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED; TO COMPLY WITH ALL CITY,
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 AND
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE
•AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER
5'-0'" DEEP AND DEMOLITION OR CONSTRUCTION OF
SCHOOL FEES:_b_
OF THE GRANTING OF THIS PERMIT.
~~S:1;::;:GHT
I t(,,P-LICANT'S SIG14'A~ OWNE~ CONTRACTOR~ lAPPROVED BY DATE
! < 0
~ >
~ ;:: ~ Q ~
... .. ----------... -... -
•
• --.. ...
...
---
• ---.... .. ---
j:P
BUILD NG
FOOTINGS
FOUNDATION
REINFORCED STEEL
MASONRY
GUNITE OR GROUT
SHEATHING 1-f i.. '
FRAME ~, C
INSULATION
EXTERIOR LATH
INTERIOR LATH & DRYWALL
PLUMBING ---:i.,. / ~"--{ 0-Cf~
SEWER AND PL/Cog~R
COPPER
TOP OUT
TUB AND SHO?7=
ELECe.L
UNDERGROUND~
ROUGH {~ ( C.
CEILING HEAT
BONDING
MECHANICAL
DUCT & PLEM, REF.
IIEAT--AIR
PIPING~
VENTILATING SYSTEMS
FINAL: .5r C 5',,-. JbJ'it.
-
COMPLETE IN DUPLICATE AND POST WITH THE INSPECTION RECORD CARD
THIS IS TO CERTIFY THAT INSULATION HAS BEEN INSTALLED IN CONFORMANCE WITH THE
CURRENT ENERGY REGULATIONS, CALIFORNIA ADMINISTRATIVE CODE, TITLE 25, STATE
OF CALIFORNIA, IN THE BUILDING LOCATED AT:
SITE ADDRESS
Number Street City
EXTERIOR WALLS
Manufacturer __ O""W=EN=-S~C:.,:Oc.:;R"'N"-'IN"-'G"---Thickness/Type __ ,::.3½,.,_,'_'_ R Value-~!~! __
CEILINGS
Batts: Manufacturer _....c;;O..cW.;::E::cN-=-S--=C:.:OccR::.N:.;:IN:.;.G-=--._ Thickness/Type __ 6.:..'_' _ R Value __ 19_
Blown: Manufacturer _________ Thickness/Type ____ No. Bags
Wt./Bag ________ Sq. Ft. Covered ______ R Value __ _
FLOORS
Manufacturer _________ Thickness/Type ____ R Value ___ _
SLAB ON GRADE
Manufacturer _________ Thickness/Type _____ R Value ___ _
Width of Insulation ____ Inches
FOUNDATION WALLS
Manufacturer _________ Thickness/Type _____ R Value ___ _
GENERAL CONTRACTOR ______________ LICENSE NUMBER ____ _
BY ___________ TITLE _________ DATE ______ _
306493 INSU~Ti'.ON CONTRACTOR ..cD.:..ANc.:...:A"'-"J.:..O.:..H.:..N.:..SO.:..N;.;...:IN:.;..:..SU.:..L::.A.:..TccIO.:..N:.;.:.;:,IN:.:.C.:..· __ LICENSE NUMBER
BY-"~=-----------TITLE Authorized Representative DATE ..5/12-/&/
Bl Form #121
22175
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) CITY OF CARLSB/\D ;J:{;~,., f
J This Certificate issued pursuant to the requirements of Section 306 .,,,,,,,-;:!·,ts, ~
1 of the Uniform Building Code certifies that at the time of issuance t
4 this structure complies with applicable ordinances of the City ?> 3 regulating building construction use. ~~=~--~
1 Use Classilicalion SINGLE FAMILY DWELLING Bldg. Permil No. 80-611 ;?
Group B3 Type Construction VN Fire Zone_.~----U~e Zone______ t
.... Occupanl Load_________________ -·~·-·---·· ... _ _______ ~;_:,.
~ Owner of Buildin~fZcu:.lsbacLDev Corp, : Addreu .l' .• 0 ,_ . .lJoXJL ... Cru:J.sbad,-.Ca__ ,.
4 Building Addreu"-162:3,· ;James i°)iV!'; • f. Locolity_~_~rlsbad, CA 92008 ;
~ ' ·t~t:Ti ... -·, •• •·.~--·---·-:' . ·::'. ~ ./! .• .,.•~~---;;
◄ . By-,,C:...:1../6~~....!:::::..U::).~~-----~
/4 _________________ Oate;:::_~=.....u..::;,<>--1--+--------,-,
◄ )· 4 ~~
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