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Home My WebLink About1145 CAPE AIRE LN; ; CB000922; Permit03/15/2000 City of Carlsbad Miscellaneous Permit Permit No:CB000922 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: 1145 CAPE AIRE LN CBAD MISC Subtype: REROOF 2061406700 Lot#: 0 $2,650.00 LOWERY RESIDENCE 25 SQUARES ELK COMP. Applicant: PACIFICA ROOFING 613CORTEZAV VISTA, CA 92084 619-630-2216 Total Fees: $87.00 > ^Hef Payments '^li^' Status: ISSUED Applied: 03/15/2000 Entered By: MDP Plan Approved: 03/15/2000 Issued: 03/15/2000 Inspect Are^A 03/15/00 ^02 Q1 02 &MINNICK JULIE ihce Due: $87.00 TOTAL PERMIT FEES 87.00 Miscelaneous Fee #1 Miscelaneous Fee #2 •T^ *?* ^ERMIT - - ' . jft17.00lo.oo Inspector: FINAL APPROVAL Date:Clearance: 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 t'mely 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 you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760)438-1161 1. PROJECT INFORMATION FOR OFFICE USE ONLY PLAN CHECK EST. VAL. Plan Ck. Deposit Validated By Date Address (include Bldg/Suite *)Business Name (at this address) Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Total tt of units Assessor's Parcel #Existing Use Proposed Use Description of Work 2. CONTACT PERSON Of different SOFT.""Stories # of Bedrooms of Bathrooms Name 3. APPLICANT Address Q Agent for C State/Zip Telephone #Fax # Name • Address City State/Zip Telephone # 6. CONTRACTOR-COMPANY NAME •> " '•'•'•- •'-'- ."-..-..-'-'-- 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 aipermit subjects the applicant to a civil penalty of not more than five hundred dollars ($500)). City State/Zip Tele City Business License * ,/I?Oo3 3*j 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: Q 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. . Ptf^ 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 ^~ f^^flf ./"* IP A^ J^ Policy No.^OS'O^ (rO ^7 Expiration Date s "*S ** Oy (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$1001 OR LESS) l~l 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 aecuf0"wo{k«n' comperuationcoverage is unlawful, and shall subject an employer to criminal penalties and civil fine* up to one hundred thousand dollars ($100,0dfc). In ajldrtjoyto the cgafo^ompejaMOipn, damages as provided for In Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE ^^S&***\^^^0*^*^ DATE ^?/^ff»/ OO 7, OWNER-BUIlDEUIttLARATION '"^T ~ I hereby affirm that I am exempt from the Contractor's License Law for the following reason: l~l 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). n 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. f~l YES f~lNO 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 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? Q YES Q NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Q YES Q NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Q 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 OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. 8, CONSTRUCTION LENDING AGENCY . , ir^f "^MAV 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 •9. LENDER'S ADDRESS 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 City 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 S'O" deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued hp<he 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 ia/not dommenced within 365 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 t APPLICANT'S SIGNATURE 180 days (Section 106.4.4 Uniform Building Code). DATE WHITE: File YELLOW: Applicant PINK: Finance City Of Carlsbad SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING 01. JOB ADDRESS: - - -v 2. TYPE OF BUILDING: RESIDENTIAL COMMERCIAL 3. ROOF SLOPE: RISE_J^f_lnches in 12 inches •moB^B^MB*^— 4. NUMBER OF EXISTING ROOF COVERING (circle one) (b 2 3 5. TYPE OF EXISTING ROOF COVERING Uj^fe SHEATHING *6. NEW ROOF MATERIAL C0KNfo CLASS -fy WEIGHT PER SQUARE 7. NUMBER OF SQUARES gj^T . 8. TRADE NAME J^L MANUFACTURER _ . 9. ROOF SYSTEM LISTING UL No. _ ICBO No. 10. IS THE EXISTING STRUCTURAL DESIGNSlifFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? (^YES^v 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 extending at least 2 rungs above the roof for inspection. Signature ^/ v ^ \ ^ Date Contractor ^ Owner Contractor Name *6 - Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other. UNSCHEDULED BUILDING INSPECTION DATE o INSPECTOR PERMIT # CJ9 (JJOm^ PLAN CHECK # JOB ADDRESS _ DESCRIPTION CODE DESCRIPTION ACT COMMENTS UNSCHEDULED BUILDING INSPECTION DATE /IQQ INSPECTOR PERMIT # rtrW3s^ PLAN CHECK # JOB ADDRESS DESCRIPTION v) CODE DESCRIPTION ACT COMMENTS \ STATE COMPENSATION INSURANCE FUND JflNUftRY 1, P.O. BOX 420807. SAN FRANCISCO, CA 94142-0807 CERTIFICATE OF WORKERS1 COMPENSATION INSURANCE POLICY NUNB6R: £8S~80 UNIT 0001489 CERTIFICATE EXPIRES: 1-1-01 r CONTRftCTORS STATE LICENSE BQARtf flTTN: WORKERS' COHP. UNIT BOX 26000 SflCRflMENTO Cfl 95826 L JOB: LIC #7191*3 01/01/00-01/01/SI1 This is to Certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the emptoyer named below for the policy period indicated. This policy is not subject to cancellation by the Fund except upon ten days' advance written notice to the employer. We will also give you TEN 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 after the Coverage afforded by the policies 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 may pertain, the insurance afforded by the policies described herein is subject to all the terms, exclusions and conditions of such policies. AUTHORIZED EMPLOYER'S LIfiBILITY LIMIT INCLUDING DEFENSE COSTS: PR6SIOENT ,000 PER OCCURRENCE. r PftCIFICfl ROQFINB 1615 VftLENCIA STREET OCEfiNSIDE Cft 92054 MR SCIF 10262 (REV. 3-95