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Home My WebLink About2740 ROOSEVELT ST; ; 80-20; PermitLICENSED CONTRACTOR'S DECLARATION I hereby affirm that I am licensed under provl· 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 0 1 hereby affirm that I am exempt from the Con• tractor's License Law for the following reason (Sec. 7031.5,Buslness 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 five hundred dollars ($500). □ 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). :11, as owner of the property, am exclusively con• tractlng with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's License Law does not ap- ply to an owner of property 1•ho builds or Im· proves thereon, and who contracts for such pro• jects with a contractor(s) license pursuant to the contractor's License Law). I am exempt under Sec. _____ B. & P.C. 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. 3800, Labor Code). POLICY NO. t v COMPANY I\ V □Copy Is filed with the city. o 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 ($1CJO) or less). I certify that In the performance of the work for 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, after making this Cer• tlflcate of Exemption, 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. CONSTRUCTION LENDING AGENCY I hereby affirm that th_ere is a co~st_ructlon_ l~n- CITY OF CARLSBAD-BUILDING DEPARTMENT USE BALL POINT PEN ONLY APPLICATION & PERMIT 1200 ELM AVENUE (7 14) 438-5525 NO. JOB ADDRESS Z1l 1LL01 .e.,01 "'<.1e1I ,1e1 -h+1 I I I I I I I I I I I I I I I tRt l0 ~? APPLICANT TO F ILL IN INFOR- MATION WITHIN RED LINES. ::rr~;N BUS. LICENSE PERMIT NUMBER /)'#6--io- OWNER OWNER'S PHONE PRIME CONTRACTOR 2~9~(p )_O R.?. rn. 43 4-\lq\ Y\J u.....\-\.. ~ \ ls ? l kh-\~I~' ,, OWp'~ ~Al\r;::ES~ \ \ \ C¥\'? \~ ~"" J CONTRACTOR'S ADDRESS -......: CONTRACTOR'S ? o . Bax-.. 4-1 4-PHONE ,"77_'"' LOT BLOCK I SUBDIVISION I ASSESSOR'S PARCEL NO. ~ao ~Q M I / 0 '~ r:J "D' I DESIGNER STATE LICENSE DES JS~':+;:• v -() \ 'Pt,.. ~ .,... .,c ,,. 'rtl.i 1 1\. X1J DESIGNER'S ADDRESS DESIGNER'S PHONE \\~ ~ ~ CENSUS TRACT GP LANO USE ZONING ·-~ -·--~n I RES. UNITS l;ARKINGSPACE sf I NUMBER OF STORIES Not V•fid Unless M•chiM Cfflifi«J BLDG SQ. FT. BLDG USE occ. GP I STANDARD PLAN It I PLAN ID II l TYPE CONST I occ. LOAD I UTY. PLUMBING PERMIT AMT. UTY. MECHANICAL PERMIT AMT. EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TO 100,000 BTU EACH BUILDING SEWER OVER 100,000 BTU -L EACH WATER HEATER ANO/OR VENT z l"V" BOILER/COMPRESSOR UP TO 3 HP EACH GAS SYSTEM fTO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP EACH GAS SYSTEM 5 OR MORE BOILER/COMPRESSOR 16-30 HP -EACH INSTAL., ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT EACH LAWN SPRINKLER SYSTEM MECH EXHAUST -HOOD/DUCTS VALUATION: WATER SOFTNER RELOCATION OF EA FURNACE/HEATER BUI LOI NG PERMIT I . I I I Issue 3.00 lssue .S ~UU SIGN PERMIT I , I I I TOTAL PLUMBING TOTAL MECHANICAL PLAN CHECK I . I I I CONTRACTOR ~-00 CONTRACTOR ALL INCLUSIVE PERMIT I I I ELECTRICAL PERMIT AMT. AMT. TOTAL PLUMBING I I Sei<'. UTY. UTY. MOBILE HOME PERMIT ELECTRICAL I I I NEW CONST EA AMP/SWT /BKR AWNING MECHANICAL I I I 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 FENCE OVER 6' I I I I TEMP PO LE 200 AMPS TOTAL MOBILE HOME MICO-FILM I , I I I OVER 200 AMPS I . I I : I TEMP OCCUPANCY (30 DAYS) STRONG MOTTOM• I . I I I Iss11~ 2-. 00 I . I I I TOTAL ELECTRICAL TOTAL FEES PAYABLE I CONTRACTOR I I . I 1£nc) 'AN OSHA PERMIT IS REOUIREO FORE XCAVATIONS OVER SCHOOL FEES: I HAVE CAREFULLY EXAMINED THE COMPLETED .. APPLICATION AND PERMIT, AND DO HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I s·-o--DEEP AND DEMOLITION OR CONSTRUCTION OF FURTHER CERTIFY AND AGREE IF A PERMIT IS ISSUED;TO COMPLY WITH A LL CITY. STRUCTURES OVER 3 STORIES IN HEIGHT COUNTY AND STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER Th1A ~ ~rt A1r1-l -oO I SPECIFIED HEREIN OR NOT. l,ALSO AGREE TO SAVE INDEMNIFY AND KEEP HARM-O"'/ LESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO i1 EXPENSES WHICH MAY IN ANV WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE - OF THE GRANTING OF THIS PERMIT. APPLICANT'S SIGNATURE• OWNER □ CONTRACTOR□ IAPPROV~ rt#PATE AGENT D BY PHONE D ! < 0 ~ > ~ ~ ~ 0.. V) ~ SITE ~0---dV ADDRESS: ,., .... -. a OWNER: PERMIT NO: ~ ... --FIELD INSPECTION RECORD INSPECTION DATE INSPECTOR INSPECTOR'S NOTES I • WOOD F L OOR FOUNDATION • FORMS • SET BACK • TOILET -. . UNDER FLOOR PLUMBING C ~ ~ UNDER FLOOR HEATING 1 .•' ' . j. y . ~-:-~ + ~ ,' '. I f ' ' . 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 l • ~~ ' - FRAME OK• PLACE INSUL ATION INSULATION OK • PLACE WALLBOARD ' ' WALLBOARD OK• PLACE TAPE E XTERIOR L ATH 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 PREPLAST ER SHOWN • FRAME I/ • PAN ,.J ./ FINAL INSP BY BLDG DEPT B_ l1 // 1, OTHER DEPT'S REQ COMPLETED 1/L <'.-~1--,~Y E LEC METER-PERM-TEMP /l/f1'/ /V # GAS METER-PERM-TEMP I 1v C I .. ,,.._ i CERT OF OCCUPANCY ISSUED ' , .. I '