HomeMy WebLinkAbout2121 PALOMAR AIRPORT RD; 105; 83-31; PermitQ I ttlirm thai t am licensed under
provisions of Chapter 9 (commencInQ with
Section 7000) of Division 3 of the Business
and Professions Code, and my license Is In
full force and effect.
i.jc No Class
I herstiy alfirm that i am tMmpt Irom the Contrac
tor's Licanse Law for ttis foUowlng reason (Sec. 7031 S
Business and l^otassKins Code'. Any dty or county wfiicli requires a permit to construct, aller. improve, d^llsfi. orr^r any structure, prior to Its tssuance also requires the ap-
pwani lor such permit to hie a signed statement that ha Islicensed pursuant to the proviso of itie Contractor'sLicense Law (Chapter 9 commencing with Section 7000 of
Division 3 of the Business and Prolessms Code) or that Isex-
empt therefrom and the Isasis lor the aileged exemption. Anyvitxallon of Section 7031 ,S liy an applwanl lor a permit sub-)ects the applicant to a civtl penalty of not more than five hun
dred dollars ($500).
□ I. as owner of the properly, or my employees with wagesas their sole compensaHon, will do the work, and the structure is not Irrtended or olleced tor sale (Sec. 7044. Business
and Professions Code: The Contractor's License Law doesnot apply to an owner of pr^rty who twiids or improvesHiereon and who does such wohc himself or through his ownemployees, provided ihai sucti imprcnrements are not Intended or offered lor sale. It, however, the building or Improvement Is scM wimtn one year o( cornpieiion, the owner-builderwill have the burden of proving that he did not build or Improve for the purpose of sale).
D I, as owner of the property, am exclusively contractingwith licensed contractors to construct the protect (Sec. 7044,Business and Professions Code The Contractor's Licenselaw does not apply to an owner ot property who builds or Improves Ihereon, and who contracts for each prqects with acontractorts) lleanse pursuant to the Contractor's LicenseLaw).
□ As a homeowner! am Improving my home, and the following conditions exist:1. The wont is being performed priot to sale.2. I have lived in my home lor iwdve monthsprior to completion of this work.3. I have not claimed tftts exmption during thelast three years.
□ I am exeunt under Sec .B&PX.
tor this reason
O I hereby ellir^ihatJ have acertilicaieot consentto sei'-insure. Vr h ca^nicaie of Woriiers'Compensation Innra^ige^ a certified copy thereof(Sec 3800, Labor upde)
POLICY NO
COMPANY
□ Copy IS filed with the ciiy
□ Certified copy is hereby furnisr^
CeRTIFICATt OF EXEMPTION FROM
WORKERS COMPENSATION INSURANCE(This section need not be completed if trie permit•s for one hundred dollars iStroi or less)
□ I ceniiy that m the performance ot the wont lotwhich this permit is issued. I shall not employ anyperson m any manner so as to tiecome subieci tothe Workers Compensation Laws of California
NOTICE TO APPLICANT If, after making this Cerlilicaie of Exemption, you should become subject tothe Workers Compensation provisions ol the LaborCode. yOu must forthwith comply with suchprovisions or this permit shall be tleemed revoked
□ 1 hereby affirm that trtere is a constructionlending agency for the performance or itve work forwhich this permit is issued (Sec 3097, Civil Cooei
Lender S Name
Lertder's Address.
USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.
CARLSBAD BUILDING DEPARTMENT AF/ / 1200 Elm. Cafisbad, Catifornia 92008-19e9/<e^19) 438-5525JOB AODRESs"~~V^ /\/ ST. OAT E Ol APPLjfc ATI ON
OWNER'S NAME * | OWNER'S PHONE CONTRACTOR / /^ I I la
APPLICATION & PERMIT
OWNER'S MAI LING ADDRESS
LOT BLOCK SUBDIVISION ASSESSOR PARCEL NO.
OES^I^ION OF WORK
lA-A-TTT/Oh^ ^ t
CONTRACTOR'S ADDRESS
002 }\)- flio^
OESrGNER'S ADDRESS
F. P f uR ELEV.
vD nQ
CENSUSTRACT GP LAND USE P ARk INO :>PACk RESuNlTS GRADING PERMIT ISSUED
Y □ N □
QTY.PLUMBING PERMIT - ISSUE
EACH FIXTURE TRAP
EACH BUILDING SEWER
EACH WATER HEATER AND/OR VENT
EACH GAS SYSTEM 1 T040UTLETS
EACH GAS SYSTEM 5 OR MORE
EACH INSTAt, ALTER, REPAIR WATER PIPE
EACH VACUUM BREAKER
WATER SOFTNER
EACH ROOF DRAIN (INStDE)
TOTAL PLUMBING
OTY.
7.Sb QTY.
REDEVELOPMENT
AREA
*□ nG
NO
STORIES
TYPE
INST
^3vy(:
CONTRACTORS PHONE «
i/.r7-37/7
UCENSE NO.
DEStGNER'S PHONE
EOU
FtRE SPR
vG nG
VALUATION! 0,000hMF fZONE
PLAN t.D. #
STANDARD PLAN #
PERMIT NUMBER
BLOC USE CODE
BLNLDfNG SO. FOOTAGE
««Ke7VSBSi)H
Not Vak'd Unkts Machine Certified
MECHANICAL PERMIT - ISSUE
INSTALL FURN. DUCTS UP TO 100.000 BTU
OVER 100.000 BTU
BOILER/COMPRESSOR UP TO 3 HP
BOILER/COMPRESSOR 3 IS HP
METAL FIREPLACE
VENT FAN SINGLE DUCT
MECH EXHAUST - HOOO/QUCTS
RELOCATION OF EA FURNACE/HEATER
ELECTRICAL PERMIT - ISSUE
NEW CONST EAAMP/SWT/8KR
1 PH 3PH
EXIST BLOC EA AMP/SWT/6KR
1 PH 3PH
REMODEL/ALTER PER CIRCUIT
TEMP POLE 200 AMPS
OVER 200 AMPS
TEMP OCCUPANCY (30 DAYS)
TOTAL ELECTRICAL
TOTAL MECHANICAL
QTY.
M
3'
SOLAR - ISSUE
COLLECTORS
STORAGE TANKS
ROCK STORAGE
PUMP
PLAN CHECK FEE
TOTAL SOLAR
I HAVE CAREFULLY EXAIVItNEO THE COMPLETED "APPLICATION AND PERMIT" AND DO HEREBYCERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT ISISSUED: TO COMPLY WITH ALL CITY, COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER SPECIFIED HEREIN OR NOT. 1 ALSO AGREE TO SAVE INDEMNIFY ANDKEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL HABILITiES. JUDGMENTS, COSTS ANDEXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE
GRANTING OF THIS PERMIT.
SUMMARY/ACCOUNT NUMBER
BUILDING PERMIT 01-00-00-8220
SIGN PERM
PLAN CHEi
TOTAL PLUMBING
^✓01-00-00-8221
01-00-00-8806
01-00-00-8222
ELECTRICAL 01-00-00-8223
MECHANICAL 01-00-00-8224
MOBILEHOME 01-00-00-8225
MOBILEHOME PARK INSP
SOLAR 01-00-00-8226
STRONG MOTION 80-92-33-0519
FIRE SPRINKLERS 01-00-00-8227
PUBLIC FACILITIES FEE 32-00-00-S923
BRIDGE FEE
SCHOOL FEE - DISTRICT
Carlsbad 80-92-21-0519
Encinltas 80-92-22-0519
San Dieguflo 80-92-23-0519
San Marcos 60-92-24-0519
So n -^o
TOTAL FEES PAYABLE SOA)
Expiration Every permit issued by the Building Official under iheprovisiortsofthis
Code ahsil expire by limitation and become null and void if the building or worii
authorized by such permit is not commenced within 180 days from the dale of Such
permit, or if the building or work authorized by auch permit is suspend'
abandoned st any time after the work is commen(;ed for a tieriod of 180 da
APPLIQANT'S SIGNATURE "ff ' OWNER D CONTRACTOR
* AN OSHA PERMIT IS REQUIRED F<DR EXCAVATIONS OVER
5' 0 • DEEP AND OEMOLfTION OR CONSTRUCTION OF
STRUCTURES OVER 3 STORIES IN HEIGHT
APPROVE
BY PHONE G
INSPECTION TYPE DATE INSPECTOR
BUILDING
FOUNDATION
REINFORCED STEEL
MASONRY
GUNITE OR GROUT
FLOOR & CEILING SUB FRAME
SHEATHING
FRAME
EXTERIOR LATH INSULATION
INTERIOR LATH & DRYWALL
PLUMBING
SEWER AND BL/CO
PLUMBING UNDERGROUND i
PLUMBING TOP OUT
TUB AND SHOWER PAN
GAS TEST
ELECTRICAL
TEMPORARY POWER
ELECTRIC UNDERGROUND
ROUGH ELECTRIC
ELECTRIC SERVICE
BONDING
G. F. 1. - SMOKE DETECTOR
MECHANICAL
DUCT & PLEM., REF. PIPING T .
HEAT — AIR COND. — SOLAR SYSTEMS
VENTILATING SYSTEMS
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE BEEN APPROVED.
JOB SITE FINAL
PLUMBIWG
ELECTRICAL
MECHANICAL
GAS
BUILDING
SPECIAL CONDITIONS
CERT OF OCCUPANCY ISSUED
FIELD INSPECTION RECORD (
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTION REQ IF
CHECKED
INSPECTOR'S
APPROVAL DATE
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER ?000 PSI
PRESTRESSED
CONCRETE
POST TENSIONED
CONCRETE
FIELD WELDING
HIGH STRENGTH
BOLTS
SPECIAL MASONRY
•
*
PILES'CAISSONS
n -
\
*'
A
. ^
\ \ ..
.i .
n n V ' J,
• n
.
0 INTFRPFPARTfCNIAL INFORFIATION SHEET
DATE:
BUILDING ADDRESS
A.P.N: -/< C.T: ^
************* A***-A A A ft
ZONE:
ENCINITAS
-SCHOOL FEES: SAN DIEGUITO
CARLSBAD
SAN MARCOS
UNITS RHQ'D:
% COVERAGE ALLOWED:
PROVIDED:
PROVIDED:
PARKING SPACES REQ'D:_
BUILDING HEIGHT REQ'D:
FRONT SETBACK
ALLOWED:
PROVIDED:
PROVIDED:
SIDE SETBACK REAR SETBACK
PROVIDED: \ \\
\
INTRUSIONS: V7 D
RE-DEVELOPMENT APPROVAL REQ'D:
LANDSCAPE ^ IRRIGATION PLAN COMMENTS:
ENVIRONMENTAL PROTECTION REQ:
ADDITIONAL COMMENTS:
OK TO ISSUE:
R.O.W:
DATE:OK TO FINAL:DATE:
**********^******************g***************^*****;^:fc:riA}^;%
IMPROVEMENTS:
PUBLIC FACILITIES FEE:SEWER CONNECTION:
DRIVEWAY LOCATIONCS):
GRADING PERMIT:
EASEMENTS:
LEGAL DESCRIPTION:
ADDITIONAL COMMENTS:
DRAINAGE:
*CHECK IF ENGINEERING INSPEqTI0N REQ'D. ON FINAL:
OK TO ISSUED
DATE:
DATE:^-PWI:OK TO FINAL:
******* A ******* ^ ***** ^ ******** ^ ^ ^ ^' ^' ^ ^ ^ ^ '*■'
* IF THIS ITEM IS NOT CHECKED, BUILDING DEPARTMENT WILL MAKE
FINAL INSPECTION.
^GE 1 OF
CARLSBAD FIRE DEPARTMENT-
275 ELM AVENUE, CARLSBAD, CA 92008
(71^) 438-5521
PLAN CHECK REPORT
y APPROVED
DISAPPROVED
PROJECT OFTt'CS
ARCHITECT
OWNER 1>-M
OCCUPANCY <3-^.CONST.
ADDRESS ^h-.i /V7/g
ADDRESS
ADDRESS
PLAN CHECK §
OTHER REF §
. TOTAL SO. FT. f T ^
^SPRINKLERED^^)^ENANT IMP.
PHONE ^ /
PHONE
STORIES
APPROVAL OF PLANS IS PREDICATED ON CONFORMING TO THE
FOLLOWING CONDITIONS AND/OR MAKING THE FOLLOWING
CORRECTIONS:
■H I I I I I I I I I I I I I I I I I 1 I I I I I I I I I I I I I I I I I I I I 1 1 I I I I I ' I I I I
. Provide one copy of the floor plan(s), site plan, and sheets
Storage, dispensing or use of any flarrmable or combustible liquids, flammableliquids, flammable gases and hazardous chemicals shall comply with Uniform
Fire Code and
^5,
Bulldlng(s) not approved for high piled combustible stock. Storage In closelypacked piles shal l not exceed 15 feet In height, 12 feet on pal lets or in racksand 6 feet for tires, plastics and some flammable liquids. If high stock pilingIs to be done, comply with Uniform Fire Code, Article 81.
Medical gas system(s) shall comply with N.F.P.A. Standard 56F.
Fire extinguishers shall be provided based upon'the following criteria:^a) 1-2A rated ABC extinguisher for each ^sq. ft. or portion thereof^b) maximum travel distance to an extinguisher of ^feet
c) other:
X 6. Fire sprinkler system(s) per N.F.P.A. Standard X3
provided to protect g...
shal1 be
7.Dry chemical extinguishing system(s) shall be Installed per N.F.P.A. Standard
96 to protect cooking equipment and exhaust system.
—Plans of
. 9.
10.
system(s) sha11 be approved by the Fire Department prior to In sta1 1 at I on ofsystem(s).
Show on site plan locations of all nearby proposed or existing hydrants within
200 feet.
Hydrant(s) shall be provided and located
Show ]ocatIon(5) on site plan. Fire Flow:
hydrants.
1 1 . Access for fire apparatus is not adequate. Provide
_^pm for hours from
12.shal1 be of
with openings protected with hour assembl les.
13. Comply with regulations on attached sheet(s).
P^n^Exafliiner
Report mailed to architect Met with
hour construction
Date/^Attach to Plans