HomeMy WebLinkAbout1642 James Dr; ; 80-600; 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 el•
feet.
OWNER-BUILDER DECLARATION
!:::11 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 reQuiras a permit to con•
slruct, alter, improve, demolish, or repair any
structure, prior to its issuance also reQuires the
applicant for such permit to fite a signed stale·
men! that he is licensed pursuant to the provi·
sions of the Contractor's License Law (Chapter 9
commencing wItn ~ec1Ion ,wu oT uIvIsIon ;j oT
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 ap-
plicant for a permit subjects the applicant to a
civil penalty of not more than five hundred dollars
($500).
, .. 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·
fared for 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 such work
himself or through his own employees, provided
that such improvements are not intended or of·
fered for sale. 11, 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 ;;,.nd 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. ____ ~ 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 (Sec. 3800, Labor Code).
POLICY NO.
COMPANY _____ _
_ 1Copy is filed with the city
c._, Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS" COMPENSATION INSURANCE
(This section need not be completed ii the per·
mil is for one hundred dollars ($100) or less)
I certify 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 Workers' Compensation Laws of California.
NOTICE TO APPLICANT: If, after making this Ger·
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
CONSTRUCTION LENDING AGENCY
CITY OF CARLSBAD-BUILDING DEPARTMENT
USE BALL POINT PEN ONLY APPLICATION & PERMIT
1200 ELM AVENUE (714) 438-5525 -/, ; 2J.,:,( ( I •• --) / / ~ ., --. JOB ADORESS tRr· 1;:~P~~!ON 161 I 1/71 I
-
I I I I I I I I I I I I I I I I I I I I I I w hv,r C •• OWNER'S PHONE PRI~ ~-·1-~ ~ 'J :U'9 :2 . .'/-.2 .
lf5ER'S ~ING ADDRESS ~~u'""t CONTRACTOR'S ADDRESS .q . ./."'g •' C)>c,r,_,? ,._.....
;::;-18L0CI( IJ?IBDlV"'''°r .L.. r k-; ASSESSOR'S PA~L .No. , DESIGNER ',/J ,/l101/ • --;1;;,::i..,_/, / ,O.t...--~ /I .
\:JESCRIPTION OF WORK [Jt:,~ ; JC)_ /L_. t \)-.. ' -. -;-• .. L..t.. IJ ,....,..,...,,_ '-::') ;/_ p ,-+-.,, .... .,~;;,.,;,;;::,.·::,;..i.,~jf
r1-r11-1 ' (ll) c -, .... ?...f'J,.13 c;..__ Ci't,.,.., ,
APPLICANT TO FILL IN INFOR -
MATION WITHIN RED LINES.
BUS. LICENSE PERMIT NUMBER
187gy
STATE LICENSE f?l--e:,tJO ;2.f33J/
CONTRACTOR'S
{_80 -~'o;-y t::"." .
STATE LICENSE ,__
1.n:.::,il>Nt:..,-'::, PHONE
~.1 -,~q LL1'ff
CENSUS TRACT GP LAND USE ZONING PARKING SPACE. Sf ' NUMBER OF STORIES /e. I I RES. /ITS #3 ,{,(,;, / Not Vah'd Unless M4china Cartifisd
BLDG SQ. FT. BLDG USE ;e,;; l"J>;;'_J;, I "'" '<:;,q I TYPJ;;) l0E~; -I I b¼) 3 2. _3C::I) , ~ ~~--QTY. PLUMBING PERMIT AMT. QTY. MECHANICAL PERMIT AMT. .,
) -----==-'4 c~
/I EACH FIXTURE TRAP -=,,,,_,:1,1 / INSTALL FURN. DUCTS UP TO 100,000 BTU ,n.-~' '/ EACH BUILDING SEWER "'· (11!) OVER 100,000 BTU '
EACH WATER HEATER AND/OR VENT BOILER/COMPRESSOR UPTO 3 HP
EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3·15 HP
EACH GAS SYSTEM 5 OR MORE BOILER/COMPRESSOR 16-30 HP
EACH lNSTAL., ALTER, REPAIR WATER PIPE ./ -~ VENT FAN SINGLE DUCT b, . (l'l,i / ii'S-0 _ef!..,. EACH LAWN SPRINKLER SYSTEM I MECH EXHAUST -HOOD/DUCTS VAllJATICN:
WATER SOFTNER -/. RELOCATION OF EA FURNACE/HEATER BUILDING PERMIT I .. ..::I 6T S'.' C I ¢
T~~,--\\ /'>. .(\(\ -".) _,,.,. ..... SIGN PERMIT I I I
TOTAL PLUMBING ' 13?'!:!-TOTAL MECHANICAL /3.~ PLAN CHECK /7, ·;_,,,., I .
CONTRACTOR CONTRACTOR ALL INCLUSIVE PERMIT I • I I TOTAL PLUMBING I QTY. ELECTRICAL PERMIT AMT. QTY. MOBILE HOME PERMIT AMT. ELECTRICAL ,~ .. , .,.., Z7 ' NEW CONST EA AMP/SWT/BKR .. I/ .l\ Zh.tv AWNING MECHANICAL 1./1-~ .........
1PH .15 ,JI r1 ·' PORCH 7-7 MOBILE HOME I I . I
EXIST BLOG EA AMP/SWT/BKR V . \ SET·UP l./'" SOLAR I I f.J,;r-,
1 PH .25 .131 ,"\ .. RAMADA, CABANA .,,,,, I I I • I
REMODEL/ALTER PER CIRCUIT I ''\' ~ FENCE OVER 6' .,,,,, I I • I
TEMP POLE 200 AMPS I ' l"\t;\ TOTAL MOBILE HOME .,,,,, MICD-FILM I I I . I
OVER 200 AMPS I ' \ ./ ."//~ I/. -I I I . I
TEMP OCCUPANCY (30 DAYS) / G ' / .£/':./ ~ --•. /'t.t'lvz.::_~r I I I "', .::f'i l;
Issue I 2.nn ./ /I I I I • I
TOTAL ELECTRICAL I ,:2 7 !.f!--.,, TOTAL FEES PAYABLE
I .' ,✓,p£; CONTRACTOR I I .
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT, AND DO •AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER SCHOOL FEES: ---. 0 -HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I ~E> AND DEMOUTION OR CONSTRUCTION OF FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED;TO COMPLY WITH ALL CITY. µRES OVER 3 STORIES IN HEIGHT
COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION. WHETHER //.,,{_ -./4 , .,, -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 1/1/AY ACCRUE AGAINST SAID CITY IN CONSEQUENCE
OF THE GRANTING OF THIS PERMIT. ,<Wl'PLiCANrS SIGNATUAE"F ~ OWNEMVJ CONTRACTORn !APPROVED BY DATE
i,.-,
! ~
~
~ >= ::d Q.
V) ~
SITE
ADDRESS: OWNER: PERMIT NO: ..
FIELD INSPECTION RECORD
INSPECTION DATE INSPECTOR l NSPECTOR'S NOTES
WOOD FLOOR
FOUNDATION• FORMS• SET BACK• TOILET
UNDER FLOOR PLUMBING
UNDER FLOOR HEATING
OK TO INSTALL 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'. T AP.E
EXTERIOR LATH OK• PLACE STUCCO
FIREPLACE
DAMPER & STEEL
PLATE T\ES/HE!GHT OF CHIMNEY
OTHER
TEMP POWER (POLE)
SEWER
GAS TEST
SWIM POOL • STEEL BONDING
• PRE DECK
• FENCE PREPLASTER
SHOWN • FRAME
• PAN
FINAL INSP BY BLDG DEPT
OTHER DEPT'S REQ COMPLETED
~ ELEC METER-PERM-TEMP
: 3AS METER-PERM~TE',1P
~---~
' --
i I _CERT OF OCCUPAf'<CY IS:>UED
••
••
••
••
FOOTINGS ••
•• FOUNDATION
•• REINFORCED S'rEEL
••
••
·-
•
..
• -...
-...
-...
-...
' .. -..
• ----
MASONRY
GUNITE OR GROUT
SHEA'l'!UNG
INSULATION
EXTERIOR LATH
INTERIOR LATH & DRYWALL
PLUMBING 7 y ✓ "'-{QJ.
SEWER AND PL/CO~ WATE_R,/>r'--'
PLUMBING UNDERGROUND -£
COPPER
TOP OUT
TUB
GAS
AND· SHO~.~E
TEST
ELECTRICAL
UNDERGROU}~
ROUGH
CEILING HEAT
BONDING
MECHANICAL
DUCT & PLEM, REF. PIPING/2. 7:-/2.-
HEAT--AIR
VENTILA'I'ING SYSTEMS
FINAL, ~
' I
' i l
··;
<~
~ ..:1
Ci1'i Of
,. .,
;
~ This Certificate issued pursuant to the requirements of Section 306 ~ of the Uniform Building Code certifies that at the time of issuance
<~ -<1 this structure complies with applicable ordinances of the City ;j regulating building construction use.
·<i Use Clossifaotion ___ S_i_n_,gc:_l_e_F_anu __ • l-'y,_Dw __ e_l_l_i_n_,g,_ _____ Bldg. Pe,mit No. __ s_o_-_6_0_0 ___ _
-r.,, G __ R3 _____ Type Construation __ VN'-'-'. ___ Fire Zone _ __:3:.._ ____ Use Zone _ __;Rl=----<1 roup < Occupant Load __________________________________ _
<{ Owne, 01 Buildin7 ~C_a_r_.l_s_b_a_d_D_ev_e_l_opme=-_n_t ___ . Add,e,s _P_._O_._B_o_x_B __________ _
j Bui Id in 9 Add ,055 _1_6_4_;_2:c· _il:;_am:.:" ... e;;_s:c...· Dr::_c..1::.· V._ec.-.--~-Loco I ily --=~==:.L...;:::..:.:._.:c9.=2.:c0.:;0;;.8.,..., ____ _ ,, --.,, <g
<\
~ ... <