HomeMy WebLinkAbout1708 EVERGREEN CIR; ; 85-130; Permit"' z 0 ;:
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~ I hereby affirm that I am licensed under
PfOvlslons of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Professions Code, and my license 1s ,n
~~I! ~~~.:t'~~las' _g__ s ,b
I hereby a1f,rrn that I am exempt trom tne Contrac-
T8r s License Law lor !he lollow,ng reason ,sec 7031 5
8LJS1ness and Professions Code ~ny c,:y o-count1· w~1cc, re
q·J,res a pe"'nit to ~orstr .,ct al·er ,rp·8ve demol,sh or
repa,r any str~ciure pr,o· To ,·s ,ssuar~e <lso requires ir,e ap
pl1cant tor such pe•'nit to f11e a srqneu sra·emen! that he ,s
1,censed o~rsuant to the pro·.is,ons of the Comractor s
Lrce~se Law '.CnaQter g commenc,ng w,Th SerJ,oc IOUU Jt D,vrs,on 3 81 the Business and Profess10% Code, o· :nat ,s e,
e'llpl tr,erefrom and the b2s,s 1or the a,leqec e,wnpt,on A1y ·1101a11on ol Section 7031 5 by an aopl,cant lor a ~wm,t sob
1ecls the applicant lo a c,v,I penalty of no! rrore than 1,ve h,"r
dred dol'ars 1$:lOO)
I as owner of the property or my employees ~,,tr wages
as lhe,r sole cornpensat,on will do the work ard The struc lu'e ,snot ,nte~ded or offered lor sale !Sec 70~4 B,s,ness
,ind Professmns Gode The Con1,ac1or·s license Law does
~o, apply to an owner of properly who builds or ,m~ro·1es
thereon and who Ooes such work h,mself or through h,s own
employees. provided that such ,mprovements are ~o: 1nlend ed or o11eced lor sale If, however. The building or ,mprove-
ment ,s sold w1!h>n one year of complel,on, 1he owner-builder
w11I have the burden 01 prov,ng that he did not build o' 1-n-
orove for The ourpose of sale)
I as owner of ltie properly, am exclusively contracting
with licensed contractors 10 construct the pro1ect !Sec 704~
Business and P<ofess,ons Code The CMlracto, s License
Law does ~ot apply 10 an owner ol prooerly who builds or ,m
woves !hereon. ana who contracts for each pro1ects with a contraclor(sl license pursuant to the Conl<acTo,·s License Law)
As a homeowner I af'l 1mprov1ng my home and t~e follow ,ng cond1t1ons ex,st
I The work ,s tie,ng pertormed pr,o, to s21e
2 I have lived ,n my home fur 1welve rro1•hs
prior lo cornplet,on of th,s work
I have not c!a,rred this exemo1·on dur,rig :he last 1hree years
B & PC
~I hereby ;,ff1rrn th;,! I h;,,e;, cerl,hc;,te o' conser,t to sell ,nsure. or a :.er1,f,cate u' Worke<s
O:,mpensat,on lnsu,ance or a cf>rl,f1ed cop~ ttie,e,'Jf
!Sec 3BtXl Labor Code1
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I eouc, NO T<!-5 oU b 9 ?o</,1/'
COMPAN' fY1a..ryl«1tel. (:,,s "'"f'
)a,copy ·~ hied w,th the cily /
D Cer11!1ed copy ,s hereby lurn,s'1e(l
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I CERTIFICATE OF EXEMPTION H'IOM
WORKERS COMPENSATION INSURANCf: (Th,s s.ect,on nN>d ncl be c:ompleled f Ttie ;>err,,1
,~ 10, one tiundred aollars 1s100, or 1es>,
0 I cer11ty that 1n the per1o,mance c,t :rw "'""' 1,1,
wti,ch lh,s perm,t ,s ,ssued. I shall not emp,·'.>; an, person ,n any manner so as to become >ut,,e,' t, the Workers Compensat,on Ldws ul Ca11t,yn,a
NOTICE TO APPLICANT If, atter ma~,n;i 1h1<; Cer1,
hca1e of Exempt,or you stiould De-come sub1eC1 I'
111e Worl<.e<s C-Ompensa1,on pro,,s,ons ol the ~.atx,r Cooe you musl to'1hv,1tr, comp1, with such
provis,ons or lh,s perm,! shal be '.leefT1ed ,e,o~e,;
D I hereby attirfT1 lhat tnere ,s a (O'>Slfud1or
ending agenc; •or lht> perforrnar,,·e c.,I the "'""' •,), ,..h,ch this pe,m,1 ,s •<;sued ,Se, !IJ'll L,·,i COOP,
Lenoe,sName __ ,~~",:>~t,J"C:~~----
Lenoe, s AdOress -----------
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USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
>(/ys' CARLSBAD BUILDING DEPARTMENT APPLICATION & PER IT
1200 Elm, Carlsbad. California 92008-1989 (619) 438-5525
JOB AopRe~,s AV. ST.RO. NEAREST CROSS ST. DATE OF APPLICATION BUSINESS LICENS VALPATION PERMIT NUMBER
, x 7CJ.?E'rerf"'r,oen l",;.,,.Je, -J/a.J/,.,,,. l ~ S-1-.:2. -S-,P-5 R1?'7 ,51 3() I SU801VISION I ,.ASSESSOR PARCEL NO. ' CONTRACTOR CONTRACTORS PHONE# ZONE
llr/E./1 hs4..-r 6,97-L/,l.5/ OWNER"$ NAME 17~ ;~~;;;;E ~.af~v ~seberrl./ CONTRACTOR"$ ADDRESS LICENSE NO. PLAN 1.D." BLDG USE CODE
.:2.tf'J 9 /" e ni-rai llve-~.3.3~ OWNER"$ MAlLINO'AOORESS
l1;rt1/e, / '7/lf; Gverare@n DESIGNER LICENSE II STANDARD PLAN# BUILDING SQ FOOTAGE
DEs/;1:17 OF wo?4J ~J.1 .,., er ea er r
__ / cen,-.,,.~ DESIGNER'S ADDRESS DESIGNER'S PHONE .
----------------' ' F LR ELEV NO ace GP EDU • STORIES ,c ,o ---
CCNSUS TRACl
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GP LAND USE I PARKING 5PACC I RFS UNITS
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GRADING PERMIT ISSUED I REDEVELOPMENT TYPE ace LOAD FIRESPP
AREA CONST ' ,o ' D ,o ... o ,o ,o Not Valid Unless Milchme Certified
QTY. PLUMBING PERMIT· ISSUE 7.-~! QTY. MECHANICAL PERMIT. ISSUE 3-SUMMARY/ACCOUNT NUMBER
EACH f-lXTURE TRAP , INSTALL FURN DUCTS UP TO 100.000 BTU BUILDING PERMIT 01 ·00·00·8220
EACH BUI LO ING SEWER I OVER 100.000 BTU ~ SIGN PERMIT 01-00·00·8221
---------------+---------------< --------------------_,.,;;/ --------- ------I EACH WATER HEATER ANlJ OR VENT _j__ d{ .5'f . BOILER,COMPRESSOR UP TO 3 HP PLAN CHE'.CK 01-00-00-8806 --
EACH GAS SYSTEM I l U 4 OUT LETS j ~OILER CO~~-
TOTAL PLUMBING 01-00-00-8222 /0, 00 ----------- ---
EACH GAS SYSTEM J OR MORE --+----I 11ET ML ~IREPLAC':: ELECTRICAL 01-00-00-8223 -~--------------------+ -------
EACH INSTAl Al TER, REPAIR WATER PIPE VENT f-AN SINGLE 0 MECHANICAL 01-00-00-8224 -·------------·------+ -----~ --------!-· .:__ ----·----
EACH VACUUM BREAKER . MECH EXHAUS HOOD DUCTS MOBILEHOME 01-00-00-8225
WATER SOFTNER RELDCATlo,r(QF EA FURNACE·HEATER MOBILEHOME PARK 1·~sP . --·-----------I' . ~r.u1 ;i::,cr 1:·R~ \ 1:'-,<;,;r:. : _ $OLA£) 01-00-00-8226 ------------C----------I TOT~L MECHANICAL STRONG MOTIO"J 80-92-33-0519 ;
j() pOi ------ -
TO I Al PLUMRI~(, I FIRE SPRINKLERS 01-00·00-82?7 ---------s---Ii QTY.
PUBLIC FACILITIES FEE 32-00-00-893] ~ QTY. ELECTRICAL PERMIT· ISSUE SOLAR· ISSUE -------____ -..:..__ --
/ BRIDGE FEE ---· ., -----· - ------·-----~
NEVV CONST t:.A AMP SW l eKR CDI I ~CTf":·RS --SCHOOL FEE · DISTRICT
I PH I PH ' STf)RA(;[ TM,KS __,,-Carlsbad 80-92-21-0519 --EXIST BtOG EA AMP·S~\'T 8KR ./ I RDCf< S UR~G[ ./ Enc1r11tas 80-92-22·0519 --------· ~-/ I PH 3 PH ,,, PU •,10 Sa'I D1_~gu1to 80-92·23·0519 -
REMODEL ALTtR PFR C~T PLAfs CHErK •·El -r Sa'l Marcos 80-9?-24-0519 . ---------------
TE\1PPULE ?00~ -------
UVE R lOOJIJ,l"F"S
,, / LICENSE TAX 01-00-00-8162 ----
TEMP OCCUPANCY '30 DAYSI MFF 80-92-57·0519
i CREDIT DEPOSIT
TOTAL flr"CTHICAL I : r,:;T ,'.,! SO! ;,,R
I ' TOTAL FEES PAYABLE i I /c:J, 00
I HAVE CAREFULLY EXAMINED THE COMPLETED ··APPLICATION AND PERMIT'. AND DO HEREBY Expiration. Every permit ,ssued by the Bu1ldmg Ofhc1al under !he provisions of this * AN OSMA PERMIT IS REOUIREO FOR EXCAVATIONS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT All INFORMATION HEREON INCLUDING THE Code shall expire by ltm1tal10n and' become nu!I and vord II the building or work 5· O" DEEP ANO DEMOLITION OR CONSTRUCTION Of
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS authorized by such permit 1s not commenced w1th1n 180 days from the date of such STRUCTURES OVER 3 STORtES IN HEIGMT
ISSUED: TO COMPLY WITH All CITY COUNTY AND STATE LAWS GOVERNING BUILDING CON· ~~~'::!n°~ i~, 1~~v ~r:~1;fte~~ri:~~r:~:h2i~:1eiJe~~~~ ~~~~t~t~ee~na~~ or
STRUCTION, WHETHER SPECIFIED HEREIN OR NOT I ALSO AGREE TO SAVE INDEMNIFY AND
CONTRACTOR)ii![J APPROVEO):J-y)t y• Ji <iDA.E KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL UABlUTIES. JUDGMENTS. COSTS AND ~Plzz;~U~~ -4-OWNERD
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAtD CITY IN CONSEQUENCE OF THE . -BY PHONE 0 GRANTING OF THIS PERMIT 7 .
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TYPE I DATE INSPECTOR
BUILDING '
FOUNDATION I
REINFORCED STEEL '
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MASONRY I
GUNITE OR GROUT '
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FLOOR & CEILING SUB FRAME I
SHEATHING D ROOF D SHEf>.R
FRAME I
EXTERIOR LATH '
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INSULATION I
INTERIOR LATH & DRYWALL I
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PLUMBING ' .
' SEWER AND BUCO DIP UCO I
UNDERGROUND D WASTE D WATER
TOP OUT D WASTE D WATER
TUB AND SHOWER PAN I
GAS TEST I
D WATER HEATER D SOLAR WATER
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ELECTRICAL I
D ELECTRIC UNDERGROUND DUFFER
ROUGH ELECTRIC I
D ELECTRIC SERVICE D TEMPORARY
D BONDING D POOL I
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MECHANICAL '
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D DUCT & PLEM., D REF. PIPING
HEAT -AIR COND. SYSTEMS '
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VENTILATING SYSTEMS I
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CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HA VE! BEEN APPROVED ' ,
FINAL I ,
PLUMBING I ,'
ELECTRICAL ' ~ I ~,
MECHANICAL ' . () .) .
GAS ' !r. . " ..... ' ~-
BUILDING I
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SPECIAL CONDITIONS I n --,i
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'30-/30. ----~'--------~--------...... ----·--------
<i,,{;/p' ,L2 (iJ r-~-------------~~7.H"Q.,~-----4-
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS
INSPECTION
SOILS COMP'_ 'A'\,Cf
PRIOR TO
FOllNDATION 1r,.sv
REO IF INSPECTORS
CHECKED APPROVAL
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DATE
-----+----STRUCTur:iAL ce:"'cq-f:U -------i--
OVER 2000 PSI
j-.,,P~RE~S~T~RE~S~S~E~IJ-----t---+---------+----
CONCRE~E
POST TEN8'0NE:.n
CONCRETE r------------~----+------
FIELD \/l,'ELOlr,.,1G
1--,,cc,r~; H-s~-~R~E~NG""' T"'H ----·-,. --+-------------
BOL Ts
"-iPEC,A; MASONRY
INSPECTORS NOTES
~-----------+----+-----i~----j 1-------------------------------1 I P1c_Es cA1ssor-,..:-
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