HomeMy WebLinkAbout1736 Havens Point Pl; ; 81-478; Permit-..,f LICENSED CONTRACTOR'S DECLARATION
/"'-l 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
C'J heretl affirm that I am exempt from the Con-
tractor's L ense Law for the following reason
(Sec. 7031.5 iness and Professions Code), Any
city or county ich requires a permit to con-
struct, alter, imp e, demolish, or repair any
structure, prior to ii suance also requires the
applicant for such per to file a signed state-
ment that he is licensed rsuant to the provi-
sions of the Contractor's Uc se Law (Chapter 9
commencing with Section 7 of Division 3 of
the Business and Professions Co ) or that is ex-
empt therefrom and the basis fort alleged ex-
emption. Any violation of Section 7031. by an ap-
plicant for a permit subjects the applicant to a
civil penalty of not more than five hundred dollars
($500).
L. I, as ner of the property. or my employees
with wage s their sole compensation, will do
the work, and e structure is not intended or of-
fered for sale ( 7044, Business and Profes-
sions Code: The tractor's License Law does
not apply to an owne
improves thereon and ho does such work
himself or through his ow mployees, provided
that such improvements are t intended or of-
fered for sale. 11, however, the bui g or improve-
ment is sold within one year of co etion, the
owner-builder will have the burden of pr ·ng that
he did not build or improve for the pur e of
sale).
ner of the property, am exclusively con-
. licensed contractors to construct
the project ( . 7044, Business c'.nd Professions
Code: The Cont ctor's License Law does not ap-
ply to an owner property ·~ho builds or im-
proves thereon, and o contracts for such pro-
jects with a contractor( license pursuant to the
contractor's License Law).
I am exempt under Sec. , B. & P.C.
for this reason,_ ____ _
Date Owner \,}
~
•!\
WORKERS' COMPENSATION DECLARATIO \
I hereby af_firm that I have a certificate of c~
sent to self-insure, or a certificate of Workers
Compensation Insurance, or a cer1ified copy
thereof {Sec. 3800, t.,abor Code). -A
POLICY NO ~---, ~ -i ~ COMPANY c 1,-,p-(_ e:f::,
ig,copy is filed with t~ cit)".
::..::Certified copy is hereby furnished
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the per-
mit 1s for one hundred dollars {$100) or less)
I cer1ify that in the performance of the work tor
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, alter making this Cer-
tificate of Exemption, you should become subject
to the Workers' Compensation provisions of the
Ljibor _Code, you must forthwith comply with such
1,,,c1vis1ons orth1s permit shall be deemed revoked.
CONSTRUCTION LENDING AGENCY
~ hereby affirm that there is a construction len-
ding agency for the performance of th_e wo_rk for
CITY OF CARLSBA' 1UILDING DEPARTMENT
APPLICA1 ,ON & PERMIT
liSE BALL PIINT PEN INLY 1200 ELM AVENUE (714) 438-5525
APPLICAh. TO FILL IN INFOR -
MATION WITHIN RED LINES. ____ ,
NO. -p I JOB Af-Rff"f. I
/ 171-11<0! 1\-\-1'½V1e11\15, 1 ,o, \'t) 1 ,~,O,l'1\1-S1b1~d,
OWNER
"'-I (' ______l'-l_ '2 -W\ @, U P. -r-.
OWNER'S MAILING A~SS J
I 7 j & l+c._ v en i",
I I I _GT. ID/?/4~;;;NL2s:i;~;:E ~
OWNER'S PHONE j~RlME CONTRACTOR +-f . . LJ O A --50....._\-\.,_1.<..>c<:S ""'-"-<> ';!, ,,,-~ 7:J /·r /'89£2 _ c...-v1et.9evnc-" .r..,. <::,. 7".)
i\~IT NUMBER
p/
LOT j BLOCK
,Q ~ 0~
-'--"="-'""--'--''----'~
C1ENSUS TRACT GP LAND USE ZONING PARKING SPACE F l "'· ,,,,,
Iil,.; ,);r,, l """'" o, STO"SS
Not V.•lid Unless Machine CartifiaJ
BLOG SQ. FT. BLDG USE
PLUMBING PERMIT AMT. QTY. MECHANICAL PERMIT AMT. _ <,,Q -~
EACH FIXTURE TRAP . INSTALL FURN. DUCTS UP TO 100,000 BTU . A\~v-~-'QJ'
1 1 EACH BUILDING SEWER . OVER 100,000 BTU • '(~\~---·,,.-;O
1 1 EACH WATER HEATER AND/OR VENT . BOILER/COMPRESSOR UPTO 3 HP . '\,, ,,,-\\)' -
1 1 EACH GAS SYSTEM 1 TO 4 OUTLETS . BOILER/COMPRESSOR 3-15 HP • //
occ. °' I STA'OA,0 eLA'. IPLANIDfl \/ yf TYPE CONST ICC~ COAO 7
QTY.
1 1 EACHGASSYSTEM50RMORE . B01LER/COMPRESSOR16-30HP • ,•
EACH INSTAL., ALTER. REPAIR WATER PIPE I II I VENT FAN SINGLE DUCT L
EACH LAWN SPRINKLER SYSTEM I II I MECH EXHAUST -HOOD/DUCTS ./ 7lad~ ~, #,WI ...
WATER SOFTNER I ...._ II I RELOCATION OF EA FURNACE/HEATER BUILDING PERMIT
./ ./
TOTAL PLUMBING
CONTRACTOR
QTY. ELECTRICAL PERMIT
NEW CONST EA AMP/SWT/BKR
1 PH .25
EXIST BLOG EA AMP/SWT/BKR
1 PH .25
REMODEL/ALTER PER CIRCUIT
TEMP PO LE 200 AMPS
OVER 200 AMPS
TEMP OCCUPANCY (30 DAYS)
L .... ..-.,1.,1_0
TOTAL ELECTRICAL
CONTRACTOR
3 PH
3 PH
_:7e,~
AMT.
.,;i.+;
.,,,_..., __ .
TOTAL MECHANICAL
CONTRACTOR
QTY. MOBILE HOME PERMIT
AWNING
PORCH
SET-UP
RAMADA. CABANA
FENCE OVER 6'
TOTAL MOBILE HOME / ,Pt/,?//!'
,,,, L.f ., X 'jf' F (. --f,, ,F YI bi I / .. ~
/ LA 1(1 p_ ti:.. "')C}-,,,<~cv;..1~iL L
.... , .... d lPr-.-4-,.,,...-./~~/-_L,/ ~~ Fi
~' ~p / ~ ,,.., /.--. ..--Sir, r"n ~ ,c, ·+,., V\ Y
<J
-' -6 r.1
AMT.
,::I.. .(JO
_-=?!D'u
,2._;CD
".l}C'T',
SIGN PERMIT
PLAN CHECK
ALL INCLUSIVE PERMIT
TOT AL PLUMBING
ELECTRICAL
MECHANICAL
MOBILE HOME
SOLAR
,;,y',,._,,~
MICO-flLo/,7
TOTAL FEES PAYABLE
;). -0-,.,. }
I
•AN OSHA PERMIT IS REQUIRED FOR EXCAVATIONS OVE.-tf--t/4'11--t(-4,L~
5'-0" DEEP AND DEMOLITION OR CONSTRUCTION OF V
I
I
.1
I
I
I
I
I
I
I
I
I
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION ANO PERMIT, ANO 00
HEREBY CERTIFY THAT ALL INFORMAT10N 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 ANO 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
STRUCTURES OVER 3STORIES IN HEIGHT
f}14 to/,nfJ
OF THE GRANTING OF THIS PERMIT ~~c g OWNER•
~ I ~ f) AGENT'K'I -, I APPROVED BY CONTRACTOR• ~.Jil""_/
BYPHONE0 ..,.::,-: ~
I I -
.L1
I I -I I
I I
I I
I I
I -~
Jl1c.;,
I -
I
I
I
I I . I -
I I JJ(;Ji,-,,
I I . I
I I . I
I I . I
I I , I
I I I
I I . I
1t12i0
-DATE
) f/4·U-il
! ~ 0 ~ >
{5
e= u w Q.
V, ~
SITE
PERMIT NO: XI' '--j ·% ADDRESS: OWNER:
FIELD INSPECTION RECORD
INSPECTION DATE INSPECTOR 1 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 C1NC ~~CEl""'APE
EXTERIOR LA"'f-~· OK S-1='L-'eSTUCCO
Fl REPLACE
DAMPl;:R 8: 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
FINAL INSP BY BLOG DEPT
OTHF;:R .R..EPT'S REQ COMPLETED
ELEC M~£R-PERM-TEMP
GAS METER-PERM-TEMP
CERT OF OCCUPANCY ISSUED •.
R~OVEST TIME ::~,2..c._,; ,,...__3"-+/--
INSPECTOR--~.llcW~!\-,---PERMIT NO ______ DATE: _,_/~0_,..;;}-=----..,r'-~-=....,.( __
BUILDING
D FOUNDATION
D REINFORCING STEEL
D MASONRY
D GROUT -GUNITE
D FLOOR AND CEILING FRAME
D SHEATHING
D FRAME
D EXTERIOR LATH
D INSULATION
D INTERIOR LATH OR DRYWALL
D
PLUMBING
D UNDERGROUND PLUMBING
D UNDERGROUND WATER
D ROUGH PLUMBING
0 TOP OUT PLUMBING
D SEWER AND PL/CO
D TUB OR SHOWER PAN
D GAS TEST
~RA~EAT~
ELECTRICAL
D TEMPORARY SERVICE
D ELECTRIC UNDERGROUND
D ROUGH ELECTRIC
D POOL BONDING
D ELECTRIC SERVICE
D CEILING HEAT
D G.F.1.
D SMOKE DETECTOR
~AL )
/
(
' MISCELLANEOUS
D PLENUM AND DUCTS
D COMBUSTION AIR
D PATIO
D SIGN
D GRADING
D DRIVEWAY
D CONDITIONED AIR SYSTEMS
D R~ll'ING-.-•--FINAL ~
'-------.
READY FOR INSPECTION: ~AV •TUESDAY •WEDNESDAY DTl!URSDA~
-1'~· ~ac:>~~-h,,l...j:1'5"""~~--:--~~
• .. ~I~ 'fl~ &-P·D·/''-'~ ~ ~
""'" ""'"rno,s cl""'!r ~ k' $~\ot-: ~ \ct __
REQUESTED BY )/Vv., • )1C21,n RJ"§,, PHONE NO. tt 1Jfj-{) 8 CJ
C,1J ---PERSON TAKING REPORT ~