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Home My WebLink About2737 VICTORIA AVE; ; CB080920; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 ., 05-19-2008 Miscellaneous Permit Permit No: CB080920 Job Address: Permit Type: Parcel No: Valuation: Reference #: PC#: Project Title: Applicant: Building Inspection Request Line (760) 602-2725 2737 VICTORIA AV CBAD MISC 1673911900 $0.00 Subtype: REROOF Lot#: 0 SIMPSON RES-2000 SF COMP Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 05/19/2008 LSM 05/19/2008 05/19/2008 VICTOR PADILLA ROOFING SIMPSON REVOCABLE FAMILY TRUST 06-14-91 P O BOX 537 92079 760 754-1157 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES Total Fees: $83.00 2737 VICTORIA AVE CARLSBAD CA 92010 PERMIT FEE Total Payments To Date: $83.00 Fl NA'tPPROVAL Date: • z . 0 '8' Balance Due: Clearance: $83.00 $0.00 $0.00 $83.00 $0.00 NOTICE: Please take NOTICE that approval of your project includes the 'Imposition' of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a}, and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any City of ·carlsbad 1635 Faraday Ave., Garlsbad, CA 92008 760-602-2717 / 2718/ 2719 Fax: 760-602-8558 Building Permit Application JOB ADDRESS Z73 T/PROJE T # __L "I Plan Check No. (!BQS, 0 9 ~ Est. Value Plan Ck. Deposit SUITE#/SPACE#/UNIT# APN NAME r. DECKS(SF) FIREPLACE YES □#_ NOD AIR CONDITIONING YES D NOD FIRE SPRINKLERS YES D NOD CONTACT NAME (ff Different Fom Appl/cant) ADDRESS CITY STATE ZIP PHONE FAX EMAIL PROPERTY OWNER NA ADDRESS c1TY LG..r~ ARCH/DESIGNER NAME & ADDRESS APPLICANT NAME VI c_:f-o '\ ADDRESS -?~-z..6 STATEC&- EMAIL up r <Jo ~ ® c...,(11.c. flt:z CONTRACTOR BUS. NAME ADDRESS /;') ~a. STATE UC.# 1/ud ZIP 92.o7 CITY BUS. UC.# /22-S°'?ZS- (lee. 703 I.S Busintu and Profu1ion1 Code: Any Gty or Countx which rtquirti a ptnnit to conn111ct. alter1 improve, demolish or l!P,air any 1tructul!1 prior IO iti iuuanct, also rtquirti tht appfiant lor 1udl ptnnit to lilt a signed 1t11tfflfnt that ht ~ fictnstd .J!UrJUanl to tht provisions of tht Conliactor1 Lictnst Law {Chapltr 9, commending with Section 000 of Division 3 of tht Bu1ineu and Pr9Jfflions Code} or that ht is mmpt thtl!~om, and tht baio for tht altgtd mmption. Any ,iolation of lt<tion 7031.S by any applicant for a ptnnit subjtcti the applicant 10 a mi penalty of not more than fin hundred dohn {SSOO}). . Worilers' Compensation Declaration: / hereby affirm under penalty of perjury one of the following declarations: D I have and WIii maintain a certificate of consent to self-Insure for workers' compensation as provided by Section 3700 of the Labor Code, fo, the performance of the work fo, which this permit is issued. I have and WIii maintain woril!,l'. ;om~~utlon, as requir~ Section 3700 of the labor Code, for the performance of I~ work for which lhi;.permit Is Issued. My workers' compensation insurance carrier and number are: Insurance Co. :2~~ cz, /\ 4.._ Polley No. / ~ ~ 5 L J '(_ Expiration Date I' ' / • 2-~ This section need not be completed if the permit is fo, one hundred dollars ($100) or less. D Certificate of Exemption: I certify that In the performance of the work for which this permit is issued, I shall not employ any person In any manner so as to become subject to the Workers' Compensation Laws of Gallfornla. WARNING: Failure to secure worilers' compensation coverage Is unlawful, and ubject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), In addition to the cost of compenution, damag as provl for In Section 370 b cod Interest and attorney's fees. _,6$ CONTRACTOR SIGNATURE I hereby aff,rm that I am exempt from Contractor's License Law for the following reason: D I, as owner of the property o, my employees with wages as their sole compensation, will do the work and the structure is not intended o, offered fo, safe (Sec. 7044, Business and Professions Code: The Contractor's license Law does not apply to an owner of property who builds o, improves thereon, and who does such work himseff o, through his own employees, provided that such improvements are not intended o, offered fo, sale. If, however, the building or Improvement Is sold within one year of completion, the owner-builder will have the burden of proving that he did not build or improve fo, the purpose of sale). □ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor's license Law does not apply to an owner of property who builds or improves thereon. and contracts for such projects with contractor(s) licensed pursuant to the Contractor's License Law). D I am exempt under Section _____ Business and Professions Code for this reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. □ Yes D No 2. I (have / have not) signed an application for a building permit for the proposed work. 3. I have contracted with the following person (firm) to provide the proposed construction (include name address / phone/ contractors' license number): 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major work (Include name/ address/ phone I contractors' license number): 5. I will provide some of the work. but I have contracted (hired) the following persons to provide the work indicated (include name / address/ phone / type of work): _,6$ PROPERTY OWNER SIGNATURE DATE icy 'COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY • Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration fo,m or risk management and prevention program under Sections 25505, 25533 o, 25534 of the Presley-Tanner Hazardous Substance ACC01Jnt Act? □ Ye~ □ No Is the appllcanl or future building occupant required to obtain a permit from the air pollution control district o, air quality management dislrict? D Yes D No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D Yes D No IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. I certify that I have read the application and strte that the above Information Is correct and that the lnfonnation on the plans Is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representative of the City of Carlsbad to enter upon the above mentioned properfy for i1spection purposes. I ALSO AGREE TO SA VE, INDEM\JIFY AND KEEP HARM.ESS 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. OSHA: AA OSHA peml~ is requred for excavations <Ner 5'0' deep and demolition or construdion of struc:rures rNer 3 stories in height. . EXPIRATION: Every pemlit issued by the ilding Official under the provisions of this Code shall expre by limitation and become nul and void w the buildilg or WOO( authorized by such pelTTlt i:, not cormienced withi'l 180 days from the date of such permit or· the building 1'IOl1< authorized by such pem1it is sus ed or jl any trne after the WOO( is commenced for a period of 180 days (Section 106.4.4 Unifoon Bulldilg Code) . .115 APPLICANT'S SIGNATURE , DATE s-, 1 r ~ o~ . r ' • REROOFING SUPPLEMENTAL BUILDING PERMIT APPLICATION V!c+crr 1. JOB ADDRESS: Z 7 3 7 -----------"----------------- 2. TYPE OF BUILDING: RESIDENTIA~ COMMERCIAL __ _ 3. ROOF SLOPE: RISE S--INCHES IN 12 INCHES 4. NUMBER OF EXISTING ROOF COVERING (CIRCLE ONE)~ 2 3 5. TYPE OF EXISTING ROOF COVERINdfi;&J 5h q)a SHEATHING'$k'1@ .. S~~ *6. NEW ROOF MATERIA,GAf SA;11o{l?( CLAS~WEIGHT PER so. __ 7. NUMBER OF SOUARESr-z_,D --------- 8. TRADE NAME ______ MANUFACTURERG A f Sti l ~ 9. ROOF SYSTEM LISTING: UL NO. _____ I.C.C.E.S. Report# _____ _ ASTM ____ _ 10. IS THE EXISTING STRUCTURA~N SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? ~ NO All roof coverings are required to be CLASS A. Combustible roof coverings of any type or classification are prohibited. • I understand the following inspections are required: 1. Tear Off/Pre-Inspection prior to install new roof covering 2. Final Inspection I agree to provide a ladder exte • g at least 2 rungs above the roof for inspection. Signature.___,,._LJR-A ___ O ____ \ _____ Date S-'/ 9~ \) ~ Contratto~ Owner Contractor Name 0 c.io f u v0) /2 *6. Rolled Roofing, Standard/Lite Tile, Asphalt/Comp ~be~glass,_ Built Up, Other City of Carlsbad Bldg Inspection Request For: 06/02/2008 Permit# CB080920 Title: SIMPSON RES-2000 SF COMP Description: Type: MISC Sub Type: REROOF Job Address: Suite: Location: 2737 VICTORIA AV Lot: 0 Inspector Assignment: PC --- Phone: 760J.f5j-- lnspec~ OWNER SIMPSON REVOCABLE FAMILY TRUST 06-14-91 Owner: SIMPSON REVOCABLE FAMILY TRUST 06-14-91 Remarks: Total Time: CD Description Act Comments Requested By: VICTOR Entered By: CHRISTINE 19 Final Structural _f-_____ _ Comments/Notices/Holds Associated PCRs/CVs Original PC# Inspection History Date Description 05/28/2008 15 Roof/Reroof Act lnsp Comments AP PC --- POLICYHOLDER COPY STATE COMPENSATION INSURANCE P.O. BOX 420807, SAN FRANCISCO,CA 94142-0807 l=UND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE : 12-01-2007 CONTRACTORS STATE LICENSE BOARD WORKERS COMPENSATION UNIT P.O . BOX 28000 SACRAMENTO CA 95828 SD GROUP: POLICY NUMBER: 1803239-2007 CERTIFICATE ID: 1 CERTIFICATE EXPIRES: 12-01-2008 12-01-2007/12-01-2008 LICENSE NUMBER:LICN 718780 INCEPTION DATE:12-01-2007 00:SD This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved bv the Ca::to;11i. lns .. ,,m.;,; Commissioner 10 the employer namea below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to the employer. W e w ill also give you 10 days advance notice should this policy be cancelled prior to its normal expiration. This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by the policy listed herein. Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or to which it may pertain, the insurance afforded by the policy described herein is subject to all the terms, exclusions, and conditions, of such policy. tREPRESENTATI PRESIDENT UNLESS INDICATED OTHERWISE BY ENDORSEMENT, COVERAGE UNDER THIS POLICY EXCLUDES THE FOLLOWING: THOSE NAMED IN THE POLICY DECLARATIONS AS AN INDIVIDUAL EMPLOYER OR A HUSBAND AND WIFE EMPLOYER ; EMPLOYEES COVERED ON A COMPREHENSIVE PERSONAL LIABILITY INSURANCE POLICY ALSO AFFORDING CALIFORNIA WORKERS ' COMPENSATION BENEFITS; EMPLOYEES EXCLUDED UNDER CALIFORNIA WORKERS ' COMPENSATION LAW. EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS : $1,000,000 PER OCCURRENCE . EMPLOYER PADILLA, VICTOR ADAM OBA: VICTOR PADILLA SD ROOFING PO BOX 537 SAN MARCOS CA 92079 IREV.2·051 PRINTED [LAR,CS] 12-18-2007 SD