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HomeMy WebLinkAbout1275 STRATFORD LN; ; 79-5336; 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 0 1 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 five hundred dollars ($500). 0 1, 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). 'JI, as owner of the property, am exclusively con- tracting 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 \•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, ___________ _ COMPANY ____________ _ □Copy is filed with the city. □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 ls~ued, 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· tlficate 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 there Is a construction len- ding agency for the performance of the work for which this permit Is Issued (Sec. 3097, Civil Code). C IT Y OF CARLSBAD-BUILDING DEPARTMEN T USE BALL POINT PEN ONLY APPLICATION & PE RMI T 1200 ELM AV ENUE (714) 438-5525 APPLICANT TO FILL IN INFOR - MATION WITHIN RED LINES. NO. JOB ADDRESS tRr 1DA'T;:1 ~~L 1 l~A~ON BUS, LICENSE PERMIT NUM8ER I ,2,1 ,c::., ,<:,+,i?..,u 1+1F1 0 1Q.1cl 1 I Li lt.1'(\J1-e1 I I I I I I I I I I \717-Z... v~5~ff~ !8842 OWNER OWNER'S PHONE PRIME CONTRACTOR STATE LICENSE lJ t°Yl Cl. .w u. r {-\:t k' p 17_ ~ Lt:\-h "A--1 l ~ '\) I 11 """'' ~ ~ 24t..,q~~ .. ue v 7~ OWNER'S MAILING ADDRESS CONTRACTOR'S ADDRESS ~ CONTRACTOR'S s 'A-{r\ p 1q()7 i_ cieue\A-nd PHONE Sa 72Z-3=0 LOT BLOCK I SUBDIVISION I ASSESSOR'S PARCEL NO. DESIGNER ?o-P.:>o~ 414 STATE LICENSE I I I I I I I I I I I . ' OE SCRIP TION Of rORK '11 I --0 " --?;;;· -DESIGNER'S ADDRESS DESIGNER'S PHONE \.f'-/ ....... --, -- .. , .. .,u, .. ~..::::: CENSUS TRACT GP LANO USE ZONING I RES. UNITS I PARKING SPACE F l NUMBER OF STORIES ~ C::rr BLDG SQ. FT. BLDG USE occ. GP I ST AND ARD PLAN # ~AN ID# I TYPE CONST--c< I occ. LOAD I I . u //// 11 QTY. PLUMBING PERMIT AMT. QTY. MEC~PERMIT AMT. J ,1) EACH FIXTURE TRAP INSTALL FURN. DUCTS UP'Nl.100,000 BTU EACH BUILDING SEWER OVER 1~00 BTU 11; I EACH WATER HEATER AND/DR V ENT '7 .r,o BOILER/COMPRESSOR UP TD 3 HP '-....._ EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP ' EACH GAS SYSTEM 5 0 R MORE BOILER/COMPRESSOR 16-30 HP I'-..... EACH INSTAL, ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT ',. VALUATI ON EACH LAWN SPRINKLER SYSTEM MECH EXHAUST -HOOD/DUCTS WATER SOFTNER RELOCATION OF EA FURNACE/HEATER BUILDING PERMIT I . I I T~C::Tll? "LO( T~!=:110 3.00 SIGN PERMIT I . I I TOTAL PLUMBING TOTAL MECHANICAL PLAN CHECK I I I 5-oo ' CONTRACTOR CONTRACTOR ALL INCLUSIVE PERMIT I I s.□~ 5 n . I I I I AMT. TOTAL PLUMBING I I -!; l(J)l~ QTY. ELECTRICAL PERMIT AMT. QTY. MOBILE HOME PERMIT ELECTRICAL I I . I . N~NST EA AMP/SWT/BKR AWNING MECHANICAL I I I 1 PH .25 ............... 3 PH PlmC.H MOBILE HOME I I I EXIST BLDG EA A~/BKR SET-UP ............... SOLAR I I I I 1 PH .25 ............ 3 PH RAMADA, CABA~ I ' I I I REMODEL/ALTER PER CIRCUIT .............. FENCE OVER 6' .......... I . I I I TEMP POLE 200 AMPS """'-...... TOTAL MOBILE HOME ............... MICO·FILM ' . I I I OVER 200 AMPS ............ ............ I I I ; I TEMP OCCUPANCY (30 DAYS) -..... -i-,...__ I ' I I I - ISSTTE ?.fl(l I ' I I TOTAL ELECTRICAL TOTAL FEES PAYABLE I CONTRACTOR . I I . I I S lc::r:: I HAVE CAREFULLY EXAMINED THE COMPLETED ""APPLICATION AND PERMIT. AND DD •AN OSHA PERMIT IS REQUIRED FDR EXCAVATIONS OVER HEREBY CERTIFY THAT ALL INFORMATION HEREON IS TRUE AND CORRECT AND I 5 '-0 " 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 CO UNTY AND ST ATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER SCHOOL FEES SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY AND 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 OF THE GRANTING OF THIS PERMIT. APPzr~,zU~~ OWNERQ CONTRACTOR□ rPPROVED BY DATE • • / .J' AGENT 0 BY PHONE 0 I p 'Fl ,.. . • w < 0 ~ ~ i= ~ C. V') ~ SITE ' I ADDRESS: OWNER: P ERMIT NO: • .. -·~•· -. FIELD INSPECTION RECORD "c.. . INSPECTION DATE INSPECTOR INSPECTOR'S NOTES WOOD FLOOR FOUNDATION • FORMS• SET BACK • TOILET UNDER FLOOR PLUMBING ,. ). . ... ,. -;-.-L ..,. >-.. ., = -. -. 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 i .,,, ,,.,. ' ROUGH HEATING/VENTILATING r 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 I TEMP POWER (POLE) -- SEWER GAS TEST - SWIM POOL • STEEL BONDING "' -~ • PRE DECK • FENCE PREPLASTER SHOWN • FRAME < • PAN ' FINAL INSP BY BLDG DEPT OTHER DEPT'S REQ COMPLETED ELEC METER-PERM-TEMP GAS METER-PERM-TEMP -. CERT OF OCCUPANCY ISSUED