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Home My WebLink About2817 SOMBROSA ST; ; 79-5205; PermitLICENSED CONTRACTOR'S DECLARATION I hereby afllrm 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 hereby affirm that I am exempt from the Con- tactor'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 Ille a signed state- ment that he Is licensed pursuant to the provl• slons 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 I, as owner of the property, or my employees ,with wages as their sole compensation, will do lhe work, and the structure Is not Intended or of- fered for sale (Sec. 704-4, Business and Profes· slons 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• 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 •.•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. ,;'8· ~-_ for this reason ,.: / . ·" Date ---\\ -y WORKERS' COMPENS;('TION DECLARATION I hereby affirm that I have a certificate of con- sent to self-Insure, o, a certificate of Workers' Compensation Insurance, or a certified copy thereof (Sec. 3800, Labor Code). POLICY NO ____________ _ COMPANY ____________ _ □Copy Is filed with the city. O Certified copy Is hereby furnished. CERTIFICATE OF EXEMPTION FROM WORKERS' COM PENSA TIO Ill' INSURANCE (This section need not be completed If the per• mlt Is for one hundred dollars (S100) 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- tificate of Exemption, you should become subject to the Workers' Compensation provisions of the Lllbe>r Code, you must forthwith comply with such provisions or this permit shall be deemed revoked. CONSTRUCTION LENDING AGENCY •1 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 1200 ELM AVENUE (714) 438-5525 APPLICANT TO FILL IN INFOR - MATION WITHIN RED LINES. :2,8 1 ; 0i1, 15 1t,l~~I ~ 01>1A I ~OB IAD~RESIS I I I I I I I I I I I tRtT· D7:._o~:;~l:?;N1 ir1I:J. PERMIT NUM9ER 7 j>-r.i. oJ-OWNER l<W ) /I-Jt,l{/1/ OWN1J1'f ADDR~ hA/J.lJ/1- OWNER'S PHONE ') ~r-c-lf4/ Cf)f?l fl3A/J ciilif AC Tc u V f 'r/?{)C-ift4;A3E1 ~c;;; CONTRACTOR'S ADDRESS /3),_ t{..Jf'/fM/fJ ?Lev 11/ 0LOT BLOCK '4l.i3 !, I DE:CR~l&J°' WO K _ :~~~D~~~~C77~,_/ ~:~~~:: 0 174Lt3 /28179 ~ .J • :i~ I 1'1.le> ttll5Tt1vG--1#/tvtJevJ I Ret&<.e u/5lfl2..IE./t-~Mf (;y~pp:,J~c, ~~ 717-/z:1,,,°J ZONIN;-/ I I PARKING SPACE l TYPE CONST CENSUS TRACT GP LANO US£ RES. UNITS -p_c_ PLAN Ii PLAN ID II BLDG SO. FT. er,75 BLDG USE OCC. GP 1 ST AND ARD QTY.I ~LIMBING PERMIT EACH FIXTU/t!..i.RAP EACH BUILDING S~R EACH WATER HEATER~/OR VENT EACH GAS SYSTEM 1 TO 4 O~ETS EACH GAS SYSTEM 5 OR MORE~ EACH INSTAL, ALTER, REPAIR WATER Pl~ EACH LAWN SPRINKLER SYSTEM WATER SOFTNER TOTALl,J'LUMBING CONTRACTOR lnrv. ELECTRICAL PERMIT NEW CONST EA AMP/SWT/BKR 1 PH .25 3 PH EXIST BLOG EA AMP/SWT/BKR I PH .25 3 PH 7 REMODEL/ALTER PER CIRCUIT TEMP PO LE 200 AMPS OVER 200 AMPS TEMP OCCUPANCY (30 DAYS) C\. .... _.... --.... ¥ ~ECTRICAL C-ONTRACTOf!/~ ---- ""( AMT. ............ ~ -.;;;;:;: AMT. <---- :L.- 7- QTY. ~CHANICAL PERMIT INSTALL FU~UCTS UP TO 100,000 BTU :S: OVER 100,000 BTU BOILER/COMPRESSOR ~ 3 HP BOILER/COMPRESSOR 3-15 H1'.._ BOILER/COMPRESSOR 16-30 HP -.....::::: VENT FAN SINGLE DUCT ' MECH EXHAUST -HOOD/DUCTS RELOCATION OF EA FURNACE/HEATER _TOTAL MECHANICAL CONTRACTOR QTY. MOBILE HOME PERMIT ~ING ~ SET-UP ' RAMADA, CA~NA FENCE OVER 6' '\_ TOTAI. ___ MOBILE HOM~ "-~ ' " NUMBER or STORIES Not V•lid Unlt!ss fbchiM fMtifi«I AMT. """'-· AMT. I occ. LOAD 1 .. Y· l/AuJAt /ON BUILDING PERMIT SIGN PERMIT PLAN CHECK ALL INCLUSIVE PERMIT TOTAL PLUMBING ELECTRICAL MECHAificAL MOBILE HOME SOLAR MICO-FILM TOTAL FEES PAYABLE =if>;;)_ I 9'3 9- I L11V 4' I , I I , I I . t/12 ~ -r-- 1 I I I I · I -,v~ I ~ I I I • I I I I • I I I I , I I I I , I I I I . I I I I I I I I I I I I I 1 . I I .4-~-~ I HAVE CAREFULLY EXAMINED THE COMPLETED "'APPLICATION AND PERMIT. ANO OD •AN OSHA PERMIT IS REQUIRED FOR fE:.l!J;;AlUI.DOJ>IS.Ja.i,~ HEREBY CERTIFY THAT ALL INFORMt.TION HEREON IS TRUE AND CORRECT AND I 5•.o•· DEEP AND DEMOLITION OR FURTHER CERTIFY ANO AGREE IF A PERMIT IS ISSUED;TO COMPLY WITH ALL CITY, IL_.._...._..1.WL.lllRES OVER 3 STORIES I COUNTY ANO STATE LAWS GOVERNING BUILDING CONSTRUCTION, WHETHER SPECIFIED HEREIN OR NOT. I.ALSO AGREE TO SAVE INDEMNIFY ANO 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. DATE -.;::::::, AGENT D -II.... -If ~ • ~ ~ ~ j:::: ~ 0.. V") ~ ,p SITE \, -\ 1ti-S-c:::2V6 ADDRESS: ~-OWNER: PERMIT NO: --.. FIELD INSPECTION RECORD -. '. ~ INSPECTJON DATE INSPECTOR INSPECTOR'S NOTES WOOD FLOOR FOUNDATION • FORMS• SET BACK • TOILET -----·-. • I \ ' . . ' -. I . . UNDER FLOOR PLUMBING I • < • i . , ---..: -·..:; .,.. .. -.. _ ... ~ = -- UNDER FLOOR HEATING . , ' ' . OK TO INSTALL SUB FLOOR .. . . SLAB FLOOR - UNDER SLAB PLUMBING FOOTING o FORMS• SETBACK • TOILET I ~. ' OK TO POUR CONCRETE - . / FRAME ,; -ROUGH ELECTRICAL ,:_' ROUGH PLUMBING , --·· j •• ., ,. ROUGH HEATING/VENTILATING _....r -FRAME OK• PLACE INSULATION , / -- INSULATION OK • PLACE WALLBOARD J- WALLBOARD OK• PLACE TAPE .. _,,,-,-~ EXTERIOR LATH OK• PLACE STUCCO -,,,,-. ' FIREPLACE / - DAMPER 8c 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 . -., ~ ,..,, :- OTHER DEPT'S REQ COMPLETED </, /'to ,,r,v,,v I~ ' .. ··-~-. -:----...;.;.,;. ELEC METER-PERM-TEMP I r --... . ... GAS METER-PERM-TEMP --- C .. , CERT OF OCCUPANCY ISSUED • .. PLANNING D R MENT C\~\dinf. oe,art.ment ZONE LOT SIZE LOT WIDTH ---~=>""-~---------------------- UNITS ALLOWED UNITS PROVIDED ------------------------ PARKING SPACES REQUIRED PROVIDED ____ ~ ___ / ____ _ % COVERAGE ALLOWED PROVIDED I/ ------------- BU IL DING HEIGHT ALLOWED PROVIDED FRONT SETBACK: / ALLOWED &- PROVIDED ------- INTRUSIONS SIDE SETBACK: vi LANDSCAPE & IRRIGATION PLAN COMMENTS: ENVIRONMENTAL PROTECTION REQ: REAR SETBACK: ADDITIONAL COM~n NTS: OK TO ISSUE: ~ DATE tt /io/ROK TO FINAL ______ DATE ___ _ ENGINEERING DEPARTMENT R.o.w. ______ INDUSTRIAL WASTE IMPROVEMENTS --------------- SEWER CONNECTION GRADING PERMIT LEGAL DESCRIPTION ________ DRIVEWAY LOCATIONS ___________ _ EASEMENTS ll'!J"tt--P __ ------, DRAINAGE ____ _ ----------------------------- ADD IT I ON AL COMMENTS __________________________ _ OK TO ISSUE:~DAT;/1/t~q PWI OK TO FINAL DATE ------------ FIRE DEPARTMENT SPRiliKLING SYSTEM FIRE PROTECTION EQUIP . _______ _ FIRE ALARMS EXITS _______________ _ FIRE HYDRANTS __________ LOCATION _________________ _ ADDITIONAL COMMENTS OK TO ISSUE: _____ DATE _______ OK TO FINAL ______ DATE ___ _ WATER DEPARTMENT REQUIREMENTS OF APPROPRIATE DISTRICTS MET ________ DATE ________ _