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Home My WebLink About1095 PALM AVE; ; CB050136; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 01-13-2005 Miscellaneous Permit Permit No: CB050136 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: 1095 PALM AV CBAD MISC 2051910600 $3,192.00 Subtype: REROOF Status: Lot#: 0 Applied: Entered By: Plan Approved: Issued: Project Title: \ • pplicant: TAKAYAMA RES-2800 SF COMPOSITI Inspect Area: C)@LS ROOFING CO. ()' 1089 LEUCADIA BL \ ENCINITAS, CA 92024. ( '(e\2t·IB88 2 ,QW)o 2. Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES Total Fees: $89.00 Owner: TAKAYAMA FAMILY TRUST 07-01-92 PO BOX4248 CARLSBAD CA 92018 PERMIT FEE Total Payments To Date: $0.00 Balance Due: ISSUED 01/13/2005 RMA 01/13/2005 01/13/2005 $89.00 $0.00 $0.00 $89.00 $89.00 9689 01/13/05 0002 OJ C::f3F=" Inspector: FINAL Date: Clearance: NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reseivations, 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 fee exactions f which ou have reviousl been iven a NOTICE imilar o thi or a which th statue of limitations has revi usl otherwi e ex ire . ·.J2 FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NO. ____ _ EST. VAL. J l er_ :2-CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 Plan Ck. Deposit ----..,,.-1-.....-.,...-- Validated By : ·ffj_VJ;; Address (include Bldg/Suite #) Date J /_t_ 2/ __ ""£" zr ~ Business Name lat this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # Existing Use Proposed Use Oescrip~ion rk ,,.~"'"''" ' . , .. !"-· .-:- # of Bedrooms # of Bathrooms ~l::e C N!AC: PEil. : .... ,..r.·•:, • •'• ••••v•,; + Name Address City State/Zip Telephone# Fax# ~;I\1~@~~!c~t,i[', ';CJ~ggJi1r.ii).iprl.b &,AiiifiittQt~ci6;tactgc ',;□ 0)'.ilner'J ':GJP!genutoi-ownei , . ,;. Name Address City State/Zip Telephone# fii~E2iJii:rl!Jtlltiw.ijiif :~!%:!:?ITf P:l\i:::.:s,':;;c::: ::,;r,•t1:J'7· 1:/,:., }'.l'.1/ ·-:.t(•·~.l'. o i o:"' € J:~ I< a. yCTI M ~ 20 ""e Name Address City State/Zip Telephone# 1:;:;]._;;cl'ffirMcJtd.'s~; ceii'NY.i'IBME~:ia'l:''-'frttt . .:: 'Yf'i:±•1•<.: ~ l'.''. . ISec. 7031.6 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 tor such permit to tile 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 for the alleged exemption .. Any violation of Section 7031.6 by any applicant for a permit subjects the applicant to a civil penalty of not more than five.hundred dollars ($600]). D;\$ Roofiy,o 2'23l> L, ft\;v-11J111 Dr V1'5t~ CA 92bil (BOOj SDl-76b3 Name ✓ Address City State/Zip a )'~one # State License # . ~ 399 ~ I License Class (-'39 City Business License # { I ':.L (Q <hf-.) Designer Name Address City State/Zip Telephone State License# _________ _ te1~:wliimrlf!'.c.t)lilifUliAnomt;;: ,~~tJi~ .; ;:,,, . ,:., i• , ,,, : i~ ~,, · 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 for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 81 I have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My worker's compensation insurJnce carrier and policy number are: Insurance Company S:\-cltf fu,. Policy No. !75" 7 l 7 b-2oo'j Expiration Date I -I -b b (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) 0 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 Hcure workers' c:ompenaatlon c:overage la unlawful, and shall aubjec:t en amployer to c:rlmlnel penaitlea and civil fine• up to one hundred thousand dollera ($100,000), in •~itlon to th• c:ost of c:ompenaation, damage, as provided for in Sec:tion 3706 of the Labor code, lntereat end attorney'• fees. s1GNATURE )<OM;... i~ DATE 1-,3-oS il~:::i1~wiim'iYifiui{Q.i.~fgjil[~i-~~'.~~1It~iii~-[}1t~~;t;:;1r~~~;~i~:;:Jf :i~r'.;>i}•:~~-~;~~;tt•:i~it'ii'.:'.'.~:::~· •~:,:~:~1-:·-,.~:.~: i~: .:~•~}c;::~~:1~·::;~.;r.?·~· ~:~r ~,:j;;".:?~~\:J;Jf.~~~~-?~~1~;,;.:~=~~ :::nr1~:!:~~i:~;~:_;='.;/;!·.~: ::~;- 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason: 0 I, as owner of th!! property or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale ISec. 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 for the purpose of sale). 0 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project ISec. 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 contractorls) licensed pursuant to the Contractor'• 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. 0 YES ONO 2. I lhave / 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 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 number/ contractors license number!: ______________________________________________ _ 6. 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 _________ _ tc9..Nim-'i~1:ifi1!J:jl1c:tio_M:.~QIDNQN/RU1tiENtJA1ca_u1,tl1tm!iERNi!irs'ONuv1t,,, · :.... :it. ~1,,·:s::i ;; .: .. ~,, t;•::: _;,; ~\ .•.. , , 1. 1'::'-{,f h• tth r ; , ·. ts':t,:,. ,, , ,, , · . ;,\JL 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 26505, 25633 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 7 0 YES O 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 OFF.ICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. §f 1•ifg~ilti'!!i.¢rio.~~~1?1N_Q}A§jNc:.i11.::.,;j,1::J1,·~r:::.;;:>:~in;::~rr, -:-· . ·~ ;,/-:;:f: : r: ·. ;;,:,; • .. /?i·•· .:, 1 •• ·-·'~--:"=:• ·,. :-· ;.!i·T•~- 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). 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 ANO 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 lhe building or work authorized by such permit is not commenced within 180 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work Is commenced for a tieriod of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE ~ ~ · DATE _!._-_,_!-=-,_,-b,:;_5.;:;.__ ____ _ WHITE: File YELLOW: Applicant PINK: Finance l City Of Carlsbad SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING 1. JOB ADDRESS: IO ~5 P .. IM At1e' ( ,.-Is b" J 5 '2.00 s 2. TYPE OF BUILDING: RESIDENTIAL V COMMERCIAL. __ _. 3. ROOF SLOPE: RISE '2 inches in 12 inches 4. NUMBER OF EXISTING ROOF COVERI~~ ~circle one) (j) 2 3 5. TYPE OF EXISTING ROOF COVERING VR SHEATHING w-0oJ *6. NEW ROOF MATERIAL corp CLASS fr WEIGHT PER SQUARE 7. -NUMBER OF SQUARES_'2....__.5'---~ 8. TRADE NAME L~~J~\( }o yr. MANUFACTURER Ce~H,nf.-eJ Asi/1'\ 9. ROOF SYSTEM LISTING UL No. . W No. D ?.it-J. 2. 10. IS THE EXISTING STRUCTURAL DESIGN 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 instalfnew roof covering. 2. Final Inspection I agree to provide a ladder extending at least 2 rungs above the roof for inspection. Signature ¼Ad« ~ Contractor /owner ____ Contractor Narre Da2 Roofi .. J *6 -Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other. m m City of Carlsbad Bldg Inspection Request For: 02/14/2005 Permit# CB050136 Title: TAKAYAMA RES-2800 SF COMPOSITI Description: Type: MISC Sub Type: REROOF Job Address: 1095 PALM AV Suite: Lot 0 Inspector Assignment: RB --- Phone: 0000000000 Location: Inspector: OWNER TAKAYAMA FAMILY TRUST 07-01-92 Owner: TAKAYAMA FAMILY TRUST 07-01-92 Remarks: SKIPPED ON FRIDAY Total Time: CD Description Act Comment ---- Requested By: NA Entered By: CW 19 Final Structural _.i__f_ _______ _ Associated PCRs/CVs Inspection History Date Description 02/11/2005 19 Final Structural 02/07/2005 15 Roof/Reroof Act lnsp Comments NS RB RESET FOR MONDAY AP RB