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Home My WebLink About1120 CHINQUAPIN AVE; ; CB032837; PermitCt 10-14-2003 City of Carlsbad 1635 Faraday Av Carlsbad CA 92008 Miscellaneous Permit Permit No CB032837 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Valuation Reference # Project Title 1120 CHINQUAPIN AV CBAD MISC 2062612300 $2 775 00 Subtype REROOF Lot# 0 JACKSON RES 25 SQRS COMPOSITIO Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 10/14/2003 RMA 10/14/2003 10/14/2003 Applicant SYLVESTER ROOFING CO 812 W WASHINGTON AV ESCONDIDO CA 92026 7395138 Owner JACKSON GENE M&JOAN T 1120 CHINQUAPIN AVE CARLSBAD CA 92008 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES PERMIT FEE $7700 $000 $000 $7700 Total Fees $7700 Total Payments To Date $000 Balance Due $7700 6440 10/14/03 0002 Ox 02 CGF 77 00 Inspector FINAL APR Date 2-7 2-7/*Clearance NOTICE Please take NOTICE tBat 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 fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave Carlsbad CA 92008 1 ^ROJECTINFORMAfflON, FOR OFFICE USE ONLY PLAN CHECK NO EST VAL Plan Ck Deposit Validated By_ Date Address (include Bldg/Suite #) \ i Business Name (at this address) Legal Description Assessor s Parcel # Description of Work f <?-ri>^if" Name i3j APPLICANT ^QT&antraotaj s Lot No Subdivision Existing Use SO. FT *2£0& t from applicant) ) «. -^^7 4'* % < Name/Number #of Stories >* . J ^ Address City ,i. CRAgBntjfofjjjintfa&oi x !S 6*w£Br 4 D^flsntlfor Owner Unit No Phase No Total # of units Proposed Use # of Bedrooms # of Bathrooms State/Zip Telephone # Fax "** ! i- 1 N „ f" 1 9 Name 4 1PRQPERW OWNBRrf a- Address City "••> State/Zip Telephone ff > s CKt rtaiAfl.01 /vaiAfl.01 Name Address ' ' City State/Zip Telephone # IB*; Q0lfjRAOTQR# COMPANY NAME* t**%fJ „, ™t " *"t> " »? /""*" "" C I* " Vi J- (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 for the alleged exemption Any violation of Section 7031 5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$50011 3UgAi V^e^t g(t*J3Z£& Awl<_ ^jct^y ftuQ j 1 ( Name J State License * 5 / d? L> S\ (r Address License Class City State/Zip City Business License # Telephone # Designer Name State License # 6 1MBKERS COMPENSATION » Address 4 •* City State/Zip Telephone Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations l~l 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 '"Sf 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 insurance carrier and policy number are Insurance Company l^ji^iH^^'^ Ol/uif-£<i- ftg^WCgr Policy No (_>l IVltS L> S^> 3 O I Expiration Date Y~7V'°.J (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$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 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 SIGNATURE JTU/Vvifct.. O^S&A^&v DATE / Q - (1 - #3 7 DOWNER BUILDERf* *- ^ « JVs» % - f _ I hereby affirm that I am exempt from the Contractor s License Law for the following reason Q 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 for 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 for the purpose of sale) Q 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) C3 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 Q YES QNO 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 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) _ _____ __ 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^SECTIONF01/VO/l//?£S/OaVnMtBUI(,PINQ!|r'ERIVI(TSONi;femt f^li „„ u * „ ^, - j H. 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? Q 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? d YES Q NO Is the facility to be constructed within 1 000 feet of the outer boundary of a school site? Q YES Q 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 hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(0 Civil Code) LENDER S NAME _ LENDER S ADDRESS^ __ _____ 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 CitV 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 stones 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 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 period of 180 days (Section 106 4 4 Uniform Building Code) APPLICANT S SIGNATURE _ _____ __ __ DATE WHITE File YELLOW Applicant PINK Finance City Of Carlsbad SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING 1 JOB ADDRESS | \lQ 2 TYPE OF BUILDING RESIDENTIAL /x COMMERCIAL 3 ROOF SLOPE RISE 4 inches in 12 inches 4 NUMBER OF EXISTING ROOF COVERING (circle one) (7) 2 3 5 TYPE OF EXISTING ROOF COVERING^Km^j; SHEATHING f 'l t*«? *6 NEW ROOF MATERIALsKI^UJ CLASS A- WEIGHT PER SQUARE 1 -NUMBER OF SQUARES 8 TRADE NAME Tu^W/ l> ne. vo MANUFACTURER 6 A P 9 ROOF SYSTEM LISTING UL No I^H ICBO No 10 IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF' (YEs) 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-mspection prior to install new roof covering 2 Final Inspection I agree to provide a ladder extending at least 2 rungs above the roof for inspection Signature rfrA *uA. O huh- _ Date /c? M Contractor Owner _ Contractor Name ^/tve^-le^ ft ->0{?su. %>. *6 - Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other City of Carlsbad Bldg Inspection Request For 02/26/2004 Permit* CB032837 Title JACKSON RES 25 SQRS COMPOSITIO Description Inspector Assignment PY Sub Type REROOF 1120 CHINQUAPIN AV Lot 0 Type MISC Job Address Suite Location APPLICANT SYLVESTER ROOFING CO Owner JACKSON GENE M&JOAN T Remarks CAN YOU FINAL'' Phone Inspector Total Time CD Description 19 Final Structural Act Comment Requested By CHRISTINE Entered By CHRISTINE Associated PCRs/CVs Inspection History Date Description Act Insp Comments 10/15/2003 15 Roof/Reroof AP PY SHEATHING jun JU Ubp h'ror ic i n t-egr <=t tor ^ EVIDENCE OF COVEHAGE Waste Policyholder Northern United Resources 302 Mam PO Box 518 Walt Hill NE Staff g Che I Sylvester Roofing Co Inc 812 W Washington Ave Escondido CA 92025 COVERAGES DATE (MM/DDJYY) 06 30 03 THIS EVIDENCE OF COVERAGE AS A MATTER OF INFORMATION ONL~i aND CONFERS NO RIGHTS UPON THE CERTIFICATE HULDEK 1 Hlb L> K FIC.^1 h DOES NOT AMEND EXTEND OR ALTER THE COVERAGE AFFORDED BY THE COVERAGE BE O\\ ENTITY AFFORDING COVERAGE INSURER A Northern United Captive Company INSURERS INSURER C INSURER D INSURER E THE COVERAGES LISTED BELOW HAVE BEEN ISSUED TO THE ENTITY NAMED ABOVE FOR THE PERIOD INDICATED NOTWITHSTANDING ANY REQWM NT TcRM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT Vi ITH RESPECT TO WHICH THIS CERTIFICATE J IAY BE ISSUCD OR MM f PERT« N Trie COVERAGE AFFORDED BY THE CERTIFICATE OF COVERAGE D£SCR®£O HERE N IS SUBJECT TO AL THE TERMS EXCLUSIONS ANO CO tOIT G\S 0! S^C COVERAGE AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS >K A TYPS5 Of COVERAOf GENERAL LIABILITY I <,OKMEHIl.ALaEN£HAI. LIABILITY I J CLAIMS MADE (_ [ OCCUR F GEW'l. ACCfttC 7£ i.*M K APPLtS-S f*£fl P j POLICY [ jg^T f I LOG AUTOMOBILE LIABILITY A r aro A L 0 NED U 0 SC EOUL.EO AUTOS HOtf-OWHE&AUrOS 1 GARAGE LIABILITY B AN U O EXCESS LIABILITY [ | OCCUR \ | CLAIMS UADE n OfOUCnSLE RETENTIO $ OCCUPATIOHAi WJURY INDEMNITY ASD MEDICAL BENEFIT COVERAGE OTHER POLICY n,wutK OIMBQ50301 POLICY EFFECTIVE DATE (MMJDD/YY) 04/75/03 POLICY EXPERATION DATE (MM/DDfYY) 04 /t 5/0-4 L M fS t/CriOCCURRECi,E f FIRE DAUACE (Ai •> c. e fre) S MED EXP (Any o e person) PERSONAL & ADV ItSjURY GENERAL AGGREGATE PRODUCTS - COMP OP AGG COMBINED SINGLE LIMIT (Ea ace dent) BODILY INJURY (P pe o ) BODILY INJURY ({Pe code t) PROPERTY DAMAGE Per accdeit) AUTO ONLY - EA ACCID NT OTHER TH«N EA C" AUTO ONLY Arr EACH OCCURANCE AGGREGATE STATUTORY O UMITo E EL EACH ACIDENT EL DISEASE EMPLOYEE EL DISEASE LIMIT S S S s 1 0 s i 1 s s Is 1 5 s f S MIL S 1 MIL S 1 > t^ S 1 MIL I DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORESEMENT/SPECIAL PROVISIONS This coverdge is afforded only lo the employees provided to the staffing client listed above Waiver o1 Subrooalion is applicable to the above mentioned coverage in favor of Contractor Owner and any olhe v as reqi.; ed bj °r ™?e f~", ' set Job Description Crematorium CERTIF/CATE HOLDER f X | WIW Construction Inc 61 5 N Citrscado Pkwy Escondido CA 92029 Attn Michelle Erlenbach | CANCELLATION J SHOULD ANY OF THC ABOVC DESCRIBED POLICIES BE CANCELLED BEFORE THE E <f- k TON O f£ IHtKOI- Ihb IbMJINLi tNmY WILL ENDFAVORTU MAIL 30 D«Y SKlTT r t Tl E O T CERTIFI «1fc HOLDER NAMED TO THE LEF BUT FAILURE TO DO iO SH^LL 1 1 OS£ ^ >. OR LIABILITY OF ANY KIND dL o~ Cr AUTHORIZED REPR£§gW7.Y/VE ) j