HomeMy WebLinkAbout1665 James Dr; ; 80-614; 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 lull force and ef-
fect.
OWNER-BUILDER DECLARATION
,:::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 a!so 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 for the alleged ex-
empflon. 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)
r_· 1. 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 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. 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).
-~.I.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,_Jl;IQOt' Lagor_-,ode~ --~-
POLICY No."",A-. I ~~y/ __
COMPANY ~ -v _-;.,r ,(I·~-..-~ ::~crlt °i"?'j ~-'-:
:.JCopy is filed With the city.
-~ertdied copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
_{T_his section ~eed not be completed ii the per·
m1t 1s for one r,!!'\-idred 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 m._i;ier so as to become subject to
the Workers' Co:inpensation Laws of California
NOTICE TO 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.
CITY OF CARLSBAD-BUILDING DEPARTMENT
APPLICATION & PERMIT USE BALL POINT PEN ONLY 1200 ELM AVENUE (714) 438-5525
APPLICANT TO FILL IN INFOR-
MATION WITHIN RED LINES.
f ,/ NO. \ }_.,,,,/ , _/~ JOB ADDRESS AV.ST, DATE OF APPLICATION BUS, LICENSE PERMIT NUMBER /~,t,S, K7-r t, ,,~~ , , , , , , , , , , , , , , , , , 1 ·~ /--~-'i-<JV l/?7f'?
ow~ 4....,-(IA-, 7;;•:;;';:;, pe,Ms 'j7RAno~ ~ ;;{;'33"?1 frJ-(; ;'f
ow~•s MAIL.P'I> ADDRESS l'J n n I C--;:, CONT~ACTOR'S ADDRESS CONTRACTOR'S l :;', '-' -o K. -.r::, ~· _._A, t-:J...eoa ..,.-,,o, ~o-"1'1J
)~ BLOCK ~BDIVl,11,Y • .. O /__,ASSESSOR'S PAR~_}O, l...,,,-" DE.SIGNER STATE LICENSE
~'Ct'7~===...Jlk~~.bl:!:?;~~4LJl~ZJ.71tJ~i'.JQ,l).LJ;,{/tL.1 LJL'.l.'~'' .... L:.1..~/[.11LJ f,f)!::..t'"'~ '',J JL, •.• , -------~ E SCRIPT ION OF ,-QR K {/ .-. /!::J _ ---r-7 C) ' Q ~c.~~~~•:,,,l•~c1c~~~~~2'.'.:=:"___....jkc===c--c=--l """:t' ff<. ·i ---.;::, ' ',. .. DESIGNER'S Ar::;__Ess_u iJ/l OESIGNER'S PHONE
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4
ENsus TRACT \J GP LANo usE zoNING # I RES. UNITS ,, PARKING spAcE 'sf I NUM_!ER oF sTOR'.Es
(f--17-"7 /C..,/ / ., r !I, ~ '1/:Jo, -/ NotVa#dUnlessMacJ,;nec.rt;fied
BLDG/~ BLDG;~~ R; ! STAND;/4L;N # I PLAN~!'~-'~ TYPE y~ ! :e-t>"~-/ I
QTY. PLUMBING PERMIT AMT. QTY. MECHANICAL PERMIT AMT.
/;;t EACH FIXTURE TRAP ~ . -/ INSTALL FURN. DUCTS UP TO 100,000 BTU .LJ. -
/" EACH BUILDING SEWER _r: -' OVER 100,000 BTU ~
EACH WATER HEATER ANO/OR VENT BOILER/COMPRESSOR UP TO 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 INSTAL., ALTER, REPAIR WATER PIPE .,__ VENT FAN SINGLE DUCT U --/ 1!"4t',,,/~ f> (!::!:_
EACH LAWN SPRINKLER SYSTEM MECH EXHAUST -HOOD/DUCTS VALlJATICXil: fe>cif', ,sc(l
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER BUILDING PERMIT ! _Li /IC7.tf i(.1
Tee>'~ "> nn 3 ,QQ SIGN PERMIT I I ( . I
TOTAL PLUMBING ::? LJ ,'!. TOTAL MECHANICAL _. · PLAN CHECK_,,4f/_-f:!!.--/Fiyir.f I I /.1114
CONTRACTOR :::, 7 _;;,,,,,-CONTRACTOR // · All INCLUSIVE PERMIT I I
TOTAL PLUMBING J ...:21 LL ..+--
QTY. ELECTRICAL PERMIT AMT. QTY. MOBILE HOME PERMIT AMT. ELECTRICAL 1 <>I-,,. -r-
NEW CONST EA AMP/SWT/BKR ""'S . -AWNING MECHANICAL I J J .. ....,._
1 PH .25 3 PH PORCH MOBILE HOME ( I I
EXISTBL0GEAAMP/SWT/BKR SET-UP SOLAR I l/ll.-.--t-
1 PH .25 3 PH RAMADA, CABANA .----------.. ,· ----...... t I t I
REMODEL/ALTER PER CIRCUIT FENCE OVER 6' ,/ ./71; V. \ 1 I I I
TEMPP0LE 200AMPS TOTALMOBl'1'HOM,._.,,.. 'lj /'Q } MICD-FILM I I I . I
OVER 200 AMPS / Al. • /-' . I r, / ,I/ /,. _. I I ,.d, "<I°&'
TEMP0CCUPANCYl30DAYSI _,,-("V)V 11rv / ~?.,,,_,J<.4///M/'17'.; I 1 1 I
T~--·-~-nn ~ .__; ./ -v I r I I
TOTAL ELECTRICAL _, \ / TOTAL FEES PAYABLE I . ..nr
CONTRACTOR /I 1 '-.. ~ I I , -<l.-'11.?'.:::i--
1 HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATJON AND PERMIT, AND DO "AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVER
HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I 5'-0" DEEP ANO DEMOLITION OR CONSTRUCTION OF SCHOOL F'EES ! -t,-
FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUE □;TO COMPLY WITH ALL CITY, STRUCTURES OVER 3STOAIES IN HEIGHT
co LINTY ANO ST ATE LAWS GOVERNING BUI LOI NG CONSTRUCT ION, WHETHER ll-",
SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM L.---1 ~ -:,, },
LESSTHECITYOFCAALSBA()AGAINSTALLLIABILITIES.JUDGMENTS.COSTSAND --r /_,,f . .,.;'// "' /,,i, ,.., -'
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE ..
• ~ ~
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SITE
ADDRESS: OWNER: PERMIT NO:·
FIEI_D IN SPECTION RECORD
INSPECTION DATE INSPECTOR INSPECTOR'S NOTES
WOOD FLOOR
FOUNDATION• FORMS• SET BACK• TOILET
UNDER FLOOR PLUMBING
UNDER FLOOR HEATING
OK TO INSTALL SUB FLOOR
SLAB FLOOP . UNDER SLAB PLUMBING
FOOT!NG •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
Fl REPLACE
DAMPER &STEEL .
PLATE TIES/HEIGHT OF CHIMNEY
OTHER
TEMP POWER (POLE)
SEWER
GAS TEST
SWIM POOL • STEEL BONDING
• PRE DECK
• FENCE PREP LASTER
SHOWN . FRAME . PAN
1 FINAL iNSP BY BLDG DEPT ~
I OTHER DEPT'S REQ COMPLETED
! ELEC METER-PERM-TEMP
/ C AS METER-PERM-TEMP ~
! i----·
(_..__ --~----
I CERT OF OCCUPANCY 1:.~SUEO -------·-------------" _____________ -
-LO'l' /'[
/.:{~ 5" ~4L-e, ----~~.~ .27 -
BUIL~
FOOTINGS ~ /0-I 'f ---FOUNDATION .. REINFORCED STEEL / 0:: / '1 -MASONRY -GUNITE OR GROUT --SHEATHING
-FRAME
-INSULATION /,... t' -EXTERIOR LATH ... .. INTERIOR LATH & DRY\\IALL J.,;; 2-L,
-...
PLUMBING
SEWER AND PL/CO ( 0 -5 WATER~-
... PLUMBING UNDERGROUND / U-_J ____ _ ..
COPPER ..
... TOP OUT &. {~l)-//
..
◄ GAS TEST /.-( 'J-I J
TUB AND SHO~
• ELECTRICAL
◄ .. .. UNDERGROUN~
ROUGH
CEILING HEAT
• BONDING ... MECHANICAL.
DUCT & FLEM, REF. PIPING fu ...
HEAT--AIR
• VENTILATING SYSTEMS
.... FINAL: 3-2 ~
◄
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;.;..E"'N""S~C-"0-"'R'-'N""IN"-'G'---Thickness/Type --"-'3½"-,•-•-R Value _..:.1.,_1 __
CEILINGS
Batts: Manufacturer _ _..:;_oW ___ E_N..;..s...;:c..co.c.Rc..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 _______ _
I NS ULAT ION CONTRACTOR _D_ANc=A-"J-'-O.;,;Hc...N.;.SO'-N-I'-'N'-SUc...L_A_T_I..;..O_N.:...,IN_C_,__ L IC ENS E NUMBER --30_6_4_93 __
By -------0~1
_· -----TITLE DATE --'2'--'/_1_~L(\.cc..·. ,_ QfC_ Authorized Representative V "CJ
Bl Form #121
22175
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QI r rt i f i r a t r 11 f (J; r r Jr 1-1 u 1 t r ;.,
CITY OF CARLS EL\ D
This Certificate issued pursuant to the requirements of Section 306
tf3. r>l ' -~}' . \i• ~ .......... / · .. " i~:i:/-· .
~-•· ... _;,• ~./1t'lt. ·
::ti{&-.'"'
of the Uniform Building Code certifies that at the time of issuance
this structure complies with applicable ordinances of the City
regulating building construction use.
1 Use Classification SINGLE FAMILY DWELT.ING Bldg. Permit No. BQ-6] 4
c< Group R3 Type Construc:tion VN Fire Zone 3 Use Zone ______ _
Occupant Load_______ •·----____ _______ ________ _ ____ _
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-<,i; Duilding Add,eu::J...665 .James Df1V~ Locality ___ Carlsbad, CA 92008 ,·, --.:: , . ~ . ., ~ . ,--"'. ··• .. ,·-. :.·, ·_ -..,,N,'-----p~ /4 -):)·
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