eTRAKiT Permit

CITY OF OCEANSIDE
DEVELOPMENT SERVICES
300 N COAST HIGHWAY, City of Oceanside CA 92054
BUILDING INSPECTIONS (760) 435-3925

Applied Date:	9/7/2018
Expiration Date:
Permit No:	BLDG18-2989
Permit Type:	BLD POOL SPA

Site Address:

4229 CALLE DEL RIO OCEANSIDE

Site APN:

1580701700

Subdivision:

Site Block:

Site Lot:

Valuation:

$37,000.00

Site Tract:

Permit Status:

FINALED

Description of Work:

STUB FOR GAS PIT & BBQ/SPA 3'6" 48 SF


Contractor:	MISSION POOLS OF ESCONDIDO
Address:	755 W GRAND AVE ESCONDIDO CA 92025
Phone:	(760) 743-2605

Technical Information:

Caption	Value
PLAN ID #
PERMIT #
BIN #
SPRINKLER
REDEV AREA
HOT WATER CONSERVATION
FLOOD ZONE
COASTAL ZONE
OCC GROUP
TYPE CONST
USE CODE
EXISTING BLDG SF
OCC LOAD
UNITS	0
STATE CODE EDITION
BLDG SF	0
NO STORIES	0
ELECTRIC RELEASED BY
NOTIFIED SDGE BY
DATE ELECTRIC RELEASED	12:00:00 AM
ELECTRIC RELEASE TYPE
TYPE OF BUILDING
GAS RELEASED BY
NOTIFIED SDGE BY
DATE GAS RELEASED	12:00:00 AM
GAS RELEASE TYPE
WDID #


Owner:	FORBUS JENNIFER L/MICHAELS MICHELLE L
Address:	4229 CALLE DEL RIO OCEANSIDE CA 92057
Phone:

WORKERS COMPENSATION DECLARATION

WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
____ I have and will maintain a certificate of consent to self-insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
Policy No.
____ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are:
Carrier: Policy Number: Expiration Date:
____ 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, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.

LICENSED CONTRACTOR'S DECLARATION

I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.
License No: Expiration Date: Contractor: Class:

Inspections:

Type	Result	Date	Inspector
60 SETBACKS
820 POOL PLUMBING
822 POOL ELECTRIC
824 POOL STEEL	PASS	9/27/2018	BING COSBY
826 STEEL BONDING	PASS	11/5/2018	BING COSBY
828 PREPLASTER	PASS	12/13/2018	BING COSBY
**920F FINAL	PASS	1/7/2019	BING COSBY
485 GAS TEST	PASS	10/15/2018	MARK WILLIAMS
505 ELEC UNDERGROUND	PASS	10/15/2018	MARK WILLIAMS

Fees:

Description	Amount	Receipt #	Paid Date
PERMIT TECHNOLOGY SURCHARGE	$19.39	900367	09/07/2018
GENERAL PLAN SURCHARGE 10%	$96.98	900367	09/07/2018
PERMIT IMAGING SURCHARGE	$5.00	900367	09/07/2018
PLAN IMAGING SURCHARGE	$3.00	900367	09/07/2018
BLD-SB 1473 GREEN TAX	$2.00	900367	09/07/2018
SWIMMING POOL/SPA PERMIT	$969.78	900367	09/07/2018
SWIMMING POOL/SPA PLAN CHECK	$85.28	900367	09/07/2018

TOTAL FEES:	$1,181.43
TOTAL FEES PAID:	$1,181.43
TOTAL FEES DUE:	$0.00

*BLDG18-2989*