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Home My WebLink About2629 LA GRAN VIA; ; 81-109; PermitLICENSED CONTRACTQl:l'S DE~c ~ATION I hereby affirm that I am licensed linder 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 ~ I 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 courlty which requires a permit to con- struct, alter, improve, demolish, or repair any structure, prior to its issuance also requires the app!icant 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 al!eged 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 five hundred dollars ($500). C' 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 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). :::.1, as owner of the property, am exclusively con- tracting with licensed contractors to construct the project (Sec. 7044, Business e.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 f.::uch • jects with a contractor(s) l.icense pursuan the contractor's License Law) I am exempt under Sec. _____ , _ & P.C. for this reason ____________ _ Date Owner WORKl:RS' 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 3800. Labor Code). POUC"1'0NO :GMo!PANY _____________ _ "JCopy ir-filed with the city. ,·_ C0rtified 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 tn the performance of the work for which this per1J1il 1s issued, I shall not employ any person many manner so as to become subject to the Workers' Compensation Laws of California NOTIGE TO APPLICANT: If, after making this Cer- tificate of Exemp"tion, 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. CONSlRUCTION LENDING AGENCY CITY OF CARLSBAD-BUILDING DEPARTMENT APPLICATION & PERMIT USE BALL POINT PEN ONLY 1200 ELM AVENUE (714) 438-5525 111:,.-)°,i'{, , L, A ,r... e. A.tJ, JOB ADDRESS tRr· t;;E_o~:~ON ,V,T,A-, ,LA r, ~ c-,-r, A, I I I I OWNER f:> ,' /'.\r,c.t: / OWNER'S PHONE..._ PRIME CONTRACTOR ~Dt°)(\ r, -. _. ---h. . '".f'-'; -l>v-. ~•1< '-f ~ 1,,.,-___ / r7 ·; ···--.... OWNER'S MAILING ADDRESS, ' CONTRACTOR'S ADDRESS ~,: ,Vi LA, Crf\t\ 01:A l-A-~,k c. .. , ;1-, ~&1 ';1'' 1su;Dt1s;o:<+~ ?-O, k2.,Af51?:>S10R'~iAS.\,N~ •• 3. 'I DESIGNER DL. I DESCRIPTION OF WORK ~-0,/ 11 A ·• • DESIGNER'S ADDRESS c.-ci~( ' ,;l.:i .,,._ R/ CENSUS TRACT GP LAND USE ZONING APPLICANT TO FILL IN INFOR- MATION WITHIN RED LINES. BUS. LICENSE PERMIT NUM!lER STATE LICENSE ~l -/00 ' CONTRACTOR'S I PHONE STATE LICENSE DESIGNER'S PHONE ~I .:; / O' ! ~ c, , 1· I RES, UNITS I PARKING SPACE I NUMBER OF STORIES Not Va.id Unless Machine Cartifitld BLDG SQ. FT. !lLDG USE CCC. GP I STANDARD PLAN # I "YI' 9 I TYPE CONST I occ. LOAD I ' -(0 QTY. PLUMBING PERMIT AMT. QTY. MECHANICAL tERMIT AMT. EACH FIXTURE TRAP -INSTALL FURN. DUCTS UP TO 100,000 BTU EACH BUILDING SEWER ,~ OVER 100,000 BTU EACH WATER HEATER ANO/QR)([NT BOILER/COMPRESSOR UPTO 3 HP EACH GAS SYSTEM 1 TO 4.0'0TLETS BOILER/COMPRESSOR 3-15 HP EACH GAS SYSTEM 5..wfl MORE I RQJI SPlCQUPREii&liilR 18 38 IIP ~.,.._, '..£. ,,.... /Iv-& EACH INSTAL., Ai;n"R, REPAIR WATER P1PE VENT FAN SltiGLE DUCT -. EACH I.AW,f(sPRlNKLER SYSTEM MECH EXHAUST ,tJ,,,-~ , -. HOOD/DUCTS -. , WATER SOFTNER RELOCATION OF EA FURNACE/HEATER BUILDING PER~ '\ "'· I V/i -V. ,'('",-, . --: ~ a; <JO ' ) . . , ~ ,., . a~ SIGN Pl::1ffVIIT "'1 ~ ,-:r ......, t I ' I . - TOTAL PLUMBING TOTAL MECHANICAL {o. r PLA"(CHECK/Vd' • J /; Jt-4 l / f {.,.," ,/, I -I CONTRACTOR CONTRACTOR All lm.J U8'1'VE PERMIT ~ I I ELECTRICAL PERMIT AMT. AMT. TOTAL PLU I • I QTY. QTY. MOBILE HOME PERMIT ELECTRICAL I · 1.--? NEW CONST EA AMP/SWT/BKR AWNING MECHANICAL I ,tL --- 1 PH .25 3 PH PORCH MOBILE HOME I I . I EXIST BLOG EA AMP/SWT/BKR SET·UP SOLAR I I I . I 1 PH .25 3 PH . -RAMADA, CABANA I I I . I REMODEL/ALTER PER CIRCUIT ~I. -FENCE OVER 6' _--, J'.,,...l'll • -,r;,v.:r' . ~ ' I I I . I TEMP POLE 200 AMPS TOTAL MOBILE HOME MICOdlLM ! I I . I OVER 200 AMPS I I I I TEMP OCCUPANCY (30 DAYS) I I I . I , \ -,,,. •• l"J ;;z. _<J 0 I I I I TOTAL ELECTRICAL 7 TOTAL FEES PAYABLE I ' /1 I), ..r:Jio CONTRACTOR -I I ,.!,t,~u{ £1,, I HAVE CAREFULLY EXAMINED THE COMPLETED '"APPLICATION AND PERMIT.AND DO "AN OSHA PERMIT IS REQUIRED FOR EXCAVATION OVER tJ HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT ANO I s·-o·· DEEP AND DEMOLITION OR CONSTRUCTION OF FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED;TO COMPLY WITH ALL CITY. STRUCTURES OVER 3 STORIES IN HEIGHT COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM .---t. LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS. COSTS AND -r I EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. APP/1fA~'S SIGNAT'il!_E" I OWNER,fil CONTRACTOR□ IAPP'lfVED BY ~~/~. ~ ~ B ;::: u = a. V1 ~ i. S!TE '£5/-109 ADDRESS: OWNER: PERMIT NO: FIELD INSPECTION RECORD INSPECTION DATE INSPECTOR INSPECTOR'S NOTES WOOD FLOOR ' FOUNDATION• FORMS• SET BACK • TOILET UNDER FLOOR PLUMBING UNDER FLOOR HEATING OK TO INST ALL SUB FLOOR SLAB FLOOR UNDER SLAB PLUMBING FOOTING• FORMS• SETBACK • TOILET OK TO POUR CONCRETE FRAME ROUGH ELECTRICAL ROUGH PLUMB I NG ROUGH HEATING/VENTILATING FRAME OK• PLACE INSULATION INSULATION dK .• PLACE WALLBOARD WALLBOARD OK• PC ACE TAPE EXTERIOR LATH OK~ PLACE STUCCO FIREPLACE . DAMPER 8: STEEL PLATE TIES/HEIGHT OF CHIMNEY OTHER TEMP POWER (POLE) SEWER GAS TEST SWIM POOL • STEEL BONDING • PRE DECK • FENCE PREPLASTER SHOWN • FRAME , • PAN " , FINAL INSP BY BLDG DEPT 2-2--n 'T i OTHER DEPT'S REQ COMPLETED I ! ELEC METER-PERM-TEMP !GAS METER-PERM-TEMP L_~~ f C:ERT OF OCCUPANCY ISSUED ~itp of ~arl~bab REQUEST FOR INSPECTION RECORD • ..---,---' Tl ME: INSPECTO~/~ PERMITNO. ---,-------DATE: rJ: -7- ~~DNREE:}~fi ~ ~ V;u0 REQUESTED BY '. &.d>1 t---3 PHONE NO. __ Y_,_...,3"-'-l._-_).._,____:_7_~ __ _ BUILDING D FOUNDATION D REINFORCING STEEL □ MASONRY □ GROUT · GUNITE D FLOOR AND CEILING SUB FRAME □ SHEATHING □ ROOF □ SHEAR □ FRAME □ EXTERIOR LATH □ INSULATION □ INTERIOR LATH OR DRYWALL ,,-6 FINAL J '-----. --- PLUMBING □ UNDERGROUND PLUMBING n SEWER AND PUCO D TOP OUT PLUMBING rJ TUB OR SHOWER PAN □ GAS TEST □ WATER HEATER □ SOLAR WATER D FINAL PERSON TAKING REPORT ____ _ ELECTRICAL □ TEMPORARY SERVICE D UFFER GROUND □ ELECTRIC UNDERGROUND D ROUGH ELECTRIC □ POOL BONDING □ ELECTRIC SERVICE D FINAL 2-1-?3 1 MISCELLANEOUS □ CONDITIONED AIR SYSTEMS □ SOLAR HEAT D PATIO D POOL □ SPA D SIGN □ GRADING □ DRIVEWAY o FINAL SPECIAL INSTRUCTION$ ___________________________ _ Ready Fo~n ection: D Monday □ A.M. .M . ... ,~-.,-------------------• ( ~ □ Wednesday rJ Thursday □ Friday IN~ERDEPARTMENTAL INFORMATION SHEET ~ECEI'7ED BUILDING DEPARTMENT d.k r/ ~ DATE: MAR 25198l B uILDING AD DRE s s : __:o<.c.=.-6_o2.--+f_____._~..........,=---"---'C...:::...:-~-=------..... c'"rr~Y'10F__,. c~AKAH-Lfla9.jAH"IID Building DQpar111ent • ',)'LANNING DEPARTMENT zo\rn _________ L.OT s IZE ________ LOT WIDTH ________ _ UPANITS ALLOWED _______ 0,..,,,.,-~H~--UNITS PROVIDED ____ ~G,.,....~/?'-,------ RKING SPACES REQUIRED ~ ~ PROVIDED ____ '--1-~-~(_ _____ _ % COVERAGE ALLOWED _____ _,_ ______ PROVIDED----"-----'------- BUILDING HEIGHT ALLOWED PROVIDED FRONT SETBACK: SIDE SETBACK: REAR SETBACK: PROVIDED __ ~---'-'P"-.::,,...-ALLOWED--@•,.__.'=__,_ __ INTRUSIONS ____ _ LANDSCAPE & IRRIGATION PLAN D (L 0~, COMMENTS: _jJL-4(~8.:,__ __________ _ ENVIRONMENTAL PROTECTION REQ: ~G'j""--"~=-a.:..::-L--:(4--------------- ADDITIONAL COMMENTS: ENGINEERING DEPARTMENT ~ J. , R.O.W. _____ INDUST~ WASTE ; rr,--o f I - ______ IMPROVEMENTS ______ _ , SEWER CONNECTION ~f£~Q""-"(l~S=-____ DRIVEWAY LOCATIONS ___________ _ GRADING PERMIT _______ EASEMENTS _____ -,-___ DRAINAGE LEGAL DESCRIPTION ~ tl ~.sn -~l ~ lf'f 1 ADDITIONAL COMMENTS __________________________ _ ~ TtJMa,~JbJ,.- OK TO ISSUE~JW DATE -3.-,, t1 I PWI ____ OK TO FINAL ____ DATE ___ _ FIRE DEPARTMENT SPRINKLING SYSTEM ___________ FIRE PROTECTION EQUIP. ______ _ FIRE ALARMS EXITS ______________ _ FIRE HYDRANTS LOCATION ________________ _ ADDITIONAL COMMENTS ___________________________ _ OK TO ISSUE: _____ DATE _______ OK TO FINAL ______ DATE ____ _ WATER DEPARTMENT ~EQUIREMENTS OF APPROPRIATE DISTRICTS MET ________ DATE _______ _ '31-/o !