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HomeMy WebLinkAbout2703 YORK DR; ; CB002348; Permit06/23/2000 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: Applicant: City of Carlsbad Miscellaneous Permit Permit No:CB002348 Building Inspection Request Line (760) 602-2725 2703 YORK RD CBAD MISC 1673931 100 $2,496.00 Subtype: REROOF Lot#: 0 REROOF 2400 SF COMPOSITION Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 06/23/2000 JM 06/23/2000 06/23/2000 HACIENDA ROOFING INC SUMNER WALTER N 1001 06/23/00 0001 01 C-PRMT 451 OLIVE AV VISTA, CA 92083 619-630-7850 Total Fees: $87.00 Miscelaneous Fee #1 Miscelaneous Fee #2 TOTAL PERMIT FEES 2703 YORK RD CARLSBAD CA 92008 Total Payments To Date: $0.00 PERMIT Balance Due: $87.00 $0.00 $87.00 FINAL APPROVAL Date: 7-7 -oQ Clearance: $87.00 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 Ca~sbad 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 capactiy changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project. NOR DOES IT APPLY to any fees/exactions of which ou have reviousl been iven a NOTICE similar to this, or as to which the statute of limitations has reviousl otherwise ex ired. CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 02 87-00 FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NO .. ____ _ CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 EST. VAL. __________ _ Plan Ck. Deposit _________ _ (760) 438-1161 Validated By __________ _ Date _______________ _ 1. PROJECT INFORMATION 'l 'f S) 3 't O fv\<. Address (include Bldg/Suite #) Business Name (at this address) Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel II Q._t., -{'-,~0~ St~(rlX~ f-Al"'\0{ vw&l-l,,/tJ~ Existing Use Proposed Use Description of Work SO. FT. #of Stories # of Bedrooms # of Bathrooms 2. CONTACT PERSON (if different from applicant) t.-\,6 <> loQC-\ Name 3 . APPLICANT ~Contractor r~ Name 4. PROPERTY OWNER ity 0 Agent for Contractor O Owner D Agent for Owner Address City State/Zip State/Zip L,bW\'~· .... f-.. !\J M ~ f./R Name ' Address City State/Zip 5. CONTRACTOR -COMPANY NAME Telephone# Fax II Telephone II Telephone II (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law !Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code) or that he is exempt therefrom, and the basis tor the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not mor~than J)ve hun red doll-'rs 1$500)). f frv\<~ ~A {--, l-\."' L-v·<:,. ~. v v er , "l ,._ !> J ?b~ 1 u-1C>~ State License # 5 b <;-5 \ '-\ License Class __ C,='_\._°l_,_ ___ _ Cit State/Zip Telephone II City Business License # 1.-\ 'bi L-\ i)'i) Designer Name Address City State/Zip Telephone State License# __________ _ 6. WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: 0 I have and will maintain a certificate of consent to self-insure tor workers' compensation as provided by Section 3700 of the Labor Code, tor the performance of the work for which this permit is issued. ~I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work tor which this permit is issued. My worker's compensation insurance carrier and policy number are: f).O Insurance Company vc ~ \ ~ t0 \ ~,.., Co~ Policy No, W\-10 ~ ~ ~ll 'fi> Expiration Date oq-t.s."-- (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1$1001 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 California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties end 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. SIGNATURE.________________________________ DATE _________ _ 7. OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: D 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 offered tor sale (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 who does such work himself or through his own employees, provided that such improvements are not intended or offered for 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 tor the purpose of sale). 0 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). 0 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. D YES ONO 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 number / contractors license numberl: 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 number/ 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 number / type of work): ____________________________________________________________ _ PROPERTY OWNER SIGNATURE _______________________ _ DATE __________ _ 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 form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? 0 YES O NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? 0 YES O 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. 8. CONSTRUCTION LENDING AGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(i) Civil Code). LENDER'S NAME ______________ _ LENDER'S ADDRESS. _________________________ _ 9. APPLICANT CERTIFICATION I certify that I have read the application and state that the above information is correct and that the information on the plans is accurate. I agree to comply with all City ordinances and State laws relating to building construction. I hereby authorize representatives of the Citt of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS 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: An OSHA permit is required for excavations over 5'0" deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the Building Official under the provisions of this Code shall expire by limitation and become null and void if the building or work authorized by such permit is not commenced within 365 dav.s from the date of such permit or it the building or work authorized by such permit is suspended or abandoned at any time after the ork is comm nee tor peri of 180 (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE WHITE: File YELLOW: Applicant PINK: Finance ~ \1P City of Carlsbad Bldg Inspection Request For: 7/6/200 0 Permit# CB002348 Title: REROOF 2400 SF COMPOSITION Description: Type: MISC Sub Type: REROOF Job Address: 2703 YORK RD Suite: Lot Location : APPLICANT HACIENDA ROOFING INC Owner: SUMNER ROBERT J Remarks: Total Time: CD Description 19 Final Structural Associated PCRs Inspection History Date Description 6/29/2000 15 Roof/Reroof 0 Act Comments A/J Ow:JU Act lnsp Comments AP JL Inspector Assignment: JL --- Phone: 7606307850 Inspector: J~ Requested By: N/A Entered By: ROBIN CITY OF CARLS BAD SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING 1. 2. 3. JOB ADDRESS I" 1 \) J Y OR\(. ft~. _ _;,__.....;.._ __ ._:._ _____________ _ TYPE OF BUILDING : RESIDENTIAL K COMMERCIAL __ ROOF SLOPE: RISE L-\ inches in 12 inches 4. TYPE OF EXISTING ROOF COVERING _ __::......,___i_.::.....:=_~S.HEATHING _______ _ 5. NUMBER OF EXISTING ROOF COVERINGS (circle one) 1 2 3 *6. NEW ROOF MATERIAL ~\<!>6f-C-t-%~ ft:S~l\flviCLASS___&_ WEIGHT PER SQUARE d-. '--t() L,(). 7. NUMBER OF SQUARES -*-~--- 8. TRADE NAME p\t\<.. f ¥-,'-/2 ', \ Q. v-€ MANUFACTURER b,L \, to tp. 9. ROOF SYSTEM APPROVAL Ut-Ne. ft<. \1"\ ~ 10\~ Other ___ _ 10 . IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF YES X: NO __ _ I f the answer i~ no, a roof plan must be provided with this application. 11 . Fire rating of roof: Class A~ Class B __ I unders tand the following inspections are required: 1. Tear Off/Pre-inspection prior to installing new roof covering. 2. Final Inspection I agree to provide a ladder extending at least 2 rungs above the roof for inspection. ~kt£ SIGN DATE Contractor __ )( __ Owner ---Contractor Name ~\f~ ...i9f\ ~~lfv\--\\JC.,. *6 -Rol led Roofing, Ti le, Shake, Shingle, Asphalt/Comp Fiberglass, Built up.