HomeMy WebLinkAbout2056 LINDA LN; ; 80-85; 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
Cl 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 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 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 ap-
plicant for a permit subjects the applicant to a
civil penalty of not more than live hundred dollars
($500).
L' 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 tor 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-
:nent 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 2nd 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 su1
jects with a contractor(s) license purs"'3,n
contractor's license Law)
I am exempt under Sec. _____ ,
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_. 3-de)
POLICY NO l1iO a:: COMPANY M ,,,
::JCopy is filed with the city.
c...!Certified copy is hereby furnished.
CERTIFICATE OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed if the per·
mit 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
perso~·n any manner so as to become subject to
the Wor!<:ers' Compensation Laws of Calilornia.
NOTICE TO APPLlCANT: If, after making this Cer-
tificate of Exemption, you should become subject
to the WU!'kers' Compensation provisions of the
Labor Code, you must forthwith comply with such
provisions or this permit shall be deemed revoked
CONSTRUCTION LENDING AGENCY
I hereby affirm that there is a construction len-
ding agency for the performance of the work for
which this permit is issued (Sec. 3097, Civil Code).
CITY OF CARLSBAD-BUILDING DEPARTMENT
USE BALL POINT PEN ONLY APPLICATION & PERMIT t~!i-113 ·
1200 ELM AVENUE (714) 4'9025 /
,,qt\50, L, I ,N,D,A LA'.'lv/;;",' I I I I I
'
I I I I
;Vffr --!DATEC/;~ICATION
ow,JO£
( r?JOr)DALL 7J{j~'j"/f;l :~cl TrrrR / ( -~ Ii RT n
,w:!xC/5tr>' '"l!NDA LANE I W%, ., !)i,rf.J1+1 LLJ ~
'" BLOCK I SUBDIVISION I ASSESSOR'S PARCEL NO. OES!GNER ' . ' '
; ' ' ' ' ' ' ' DESCRIPTION OF WORK
DESIGNER'S ADDRESS
//\IS1Fr/ i ,,;,; n!AP.. WA1~!<. 11/~A lei<--
CENSUS TRACT GP LAND USE ZONING
APPLICANT TO FILL IN INFOR-
MATION WITHIN RED LINES.
BUS. LICENSE PERMIT NUM8ER
)..oC~ ia~ ~&en 1:>
~-6~ ~
~TATE LI
DESIGNER'S PHONE
I RES. UNITS I PARKING SPACE I NUMBER OF STORIES
Not Va/;d Unless Mdchine Certified
eLOG SQ. FT. BLOG USE occ. GP I STANDARD PLAN Ii lPLANIO# I TYPE CONST I occ. LOAD
I JJ,5
QTY. PLUMBING PERMIT AMT. QTY. MECHANICAL PERMIT AMT.
/
EACH FIXTURE TRAP ·=.e..r 2 .&"!? INSTALL FURN. OUCTS UP TO 100,000 BTU /
EACH BUILDING SEWER OVER 100,000 BTU 7
I EACH WATER HEATER ANO/OR VENT • . 6'P BOILER/COMPRESSOR UP TO 3 HP /
EACH GAS SYSTEM 1 TO 4 0 UTLETS BOILER/COMPRESSOR 3-15 HP /
EACH GAS SYSTEM 5 OR MORE BOILER/COMPRESSOR 16-30 HP / / Jl«;,~,2, .S-&,.? EACH INSTAL, ALTER, REPAIR WATER PIPE VENT FAN SING.LE DUCT 7
EACH LAWN SPRINKLER SYSTEM MECH EXHAUST -HOOD/OUCTX
WATER SOFTNER RELOC~ON OF EA FURN~E/HEATER BUILDING PERMIT I I I I
/f,f',;,/e c.,n, ' / SIGNPER~ I I I I
TOTAL PLUMBING T Jfl.A/ANICAL PLAN CHE / I I~
CONTRACTOR ?.oV CON.TRACTOR l t) \ ALL INCL US IT I I . I
ELECTRICAL PERMIT AMT. or} ~pt LE HO~P;RI-:;? AMT. TOTAL PLUMBING I I;>\ -2'1 (
QTY. I. ELECTRICAL I .,... .l)ID
NEW CONST EA AMP/SWT /BKR V \, Lwr<M4G '\'' I 1-1' MECHANICAL I I I
1 PH .25 3 PH '\ PZRCH " \ MOBILE HOME I I I
EXIST BLDG EA AMP/SWT/BKR j /!SET-UP \ SOLAR I I I . I
1 PH .25 3 PH ,; ..., RAMADA, CABANA J \ I I I . I a REMODEL/ALTER PER CIRCUIT
__ _.,
/ FENCE OVER 6' \ I I I . I
TEMP POLE 200 AMPS TOTAL MOBILE HOME MICO-FI LM I I I . I
OVER 200 AMPS ./ I I I I
TEMP OCCUPANCY (30 DAYS) / I I I I
. ,,::: ~ .Ol) I I I I
TOTAL ELECTRICAL /9,1£>
TOTAL FEES PAYABLE
I CONTRACTOR I I 1'?1/.115'
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION 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 AND DEMOLITION OR CONSTRUCTION OF
f#<Pfr~ FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED;TO COMPLY WITH ALL CITY, STRUCTURES OVER 3STORIES IN HEIGHT
COUNTY ANO STATE LAWS GOVERNING BUILOlNG CONSTRUCTION, WHETHER
SPECIFIED HEREIN OR NOT. I,ALSO AGREE TO SAVE INDEMNIFY ANO KEEP HARM
LESS THE CITY OF CAR LS BAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND 1" EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE -
OF THE GRANTING OF THIS PEAM!T "KIJ1J'c"'!JUX'li lfJLIJI! ;'(1 OWNER ✓ CONTRACTORQ. ~APe ' q~2S'PE I
AGENT BY PHONE □· ///di-, '/
! ~ 0 ~
5 r= ~ a. V, :;:;
SITE PERM!_,'. NO: z?'Q -'X,;-I
ADDRESS: OWNER:
. FIELD INSPECTION RECORD
INSPECTION DATE INSPECTOR INSPECTOR'S NOTES
11 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 TAPE
EXTERIOR LATH OK• PLACE STUCCO
FIREPLACE ..
DAMPER &STEEL
PLATE TIES/HEIGHT OF CHIMNEY
OTHER
TEMP POWER (POLE)
SEWER
GAS TEST
SWIM POOL • STEEL BONDING
• PRE DECK ,\
• FENCE PREPLASTER
SHOWN • FRAME ,_
• PAN j l. '" ,f.:I II
FINAL INSP BY BLOG DEPT ).../'-<./t y I \J.i
OTHER DEPT'S REQ COMPLETED I I I
ELEC METER-PERM-TEMP
GAS METER-PERM-TEMP
•
' ~-7 CERT OF OCCUPANCY ISSUED