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Home My WebLink About1173 CHESTNUT AVE; ; CB022579; Permit/;a 08-30-2002 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No: CB022579 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: 1 1 73 CHESTNUT AV CBAD MISC 2052103900 $3,399.00 BOSCH RESIDENCE 33 SQUARES OF COMP Applicant: URBACH ROOFING, INC. STE D-7 1 20 N PACIFIC ST SAN MARCOS CA 92069 760471-5065 Subtype: REROOF Lot#: 0 Status: Applied: Entered By: Plan Approved: Issued: Inspect Aje&o 3Z^ Owner: BAASCH HERBERT&ANTOINETTE A TRS 1173 CHESTNUT AVE CARLSBAD CA 92008 ISSUED 08/30/2002 MDP 08/30/2002 08/30/2002 ™M M0002 01 CGF" nn02 89-00 Total Fees:$89.00 Total Payments To Date:$0.00 Balance Due:$89.00 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES PERMIT $89.00 $0.00 $0.00 $89.00 Inspector: FINAL APBROVAL 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 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 similarto 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. PROJECT INf-ORJSAJION FOR OFFICE USE O PLAN CHECK NO. NLY? EST. VAL. Plan Ck. Deposit. Validated By Date Address (include Bldg/Suite #1 Business Name (at this address) Legal Description /a a Lot No.Subdivision Name/Number Unit No. Phase No. Total # of units issqt's Parcel t_n Existing Use Proposed Use . Deseption of Work |2r '-, CONTACT PERSON,;(lT.t SQ. FT. 5 2L^ -3,3, from appB^^ Hoi Stories ft of Bedrooms # of Bathrooms Name 3. APPLICANT C Address City :onuactor Q Agenrfor Contractor QiOWnar .DABeritr{or Owner- State/Zip Telephone Fax ff Name 4. , PROPERTY OWNI Address City State/Zip Telephone # \etie 6otsc/V -So/vie as> Address City State/Zip Telephone $Name B. CONTRACTOR-COMPANY NAME . : ••'.'; . (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 statament that he is licensed pursuant to the provisions of the Contractor's Licanse 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 civH penalty of not more than five hundred dollars I5500)) Name State License # Address License Class City State/Zip City Business License t {_ Telephone * Address City State/Zip TelephoneDesigner Name 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. El 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: s-\^ ft n .-»_ \ / Q) JcInsurance Company Policy No.Expiration Date (THIS SECTION MEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 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 secure workers' compensation coverage i* unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (WfO^.OOO). in addition to thMtost of compensation, damages as provided for in Section 3706 of the Labpjf codeyinteratt and attorney's fees. SIGNATURE ^l&^C^l^ 1% J^t^t^^ DATE 7. OWNER-BUILDERiDBCLARATION . .' ; 1 '-^ .- 1 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 sate. 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). Q 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 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 number) 4. I plan to provide portions of the work, but I have hired the following person to coordinate, supervise and provide the major wo* (include name / address I phom 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 / typ> of work): PROPERTY OWNER SIGNATURE DATE COMPLETE THIS. SECTION FOB NON-RESIDENTIAL BUttJJiNGiraMrtS'dNCY^ !_: I : 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 ,OOO 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. 8. • CONSTRUCTION LENDING AGENCY . > -,., '_• y -y. . I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(il 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 CftV of Carlsbad to enter upon the above mentioned property for inspection purposes, t ALSO AGREE TO SAVE. INDEMNIFY AMD 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 buSding Official under Ihe provisions of this Code shall expire by limitation and become null and void if the building or work authorized by such permit is hot 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 alter the work is commerfce§| for a period^ol 1O> days (Setion 106.4/t 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: 7 / V5 Ch^J^^J. d^Zs • 2. TYPE OF BUILDING: RESIDENTIAL X COMMERCIAL 3. ROOF SLOPE: RISE_^L_inches in 12 inches 4. NUMBER OF EXISTING ROOF COVERING (circle one) d? 2 3 5. TYPE OF EXISTING ROOF COVERING ^^ggSHEATHING <i/t *6. NEW ROOF MATERIAL /f CLASSjtf A WEIGHT PER SQUARE 7. NUMBER OF SQUARES 8. TRADE NAME £A>^/^£^. MANUFACTURER 9. ROOF SYSTEM LISTING UL No. _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: 7j --^ 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 CX^ag^x ^^c^t^^\_ pate Contractor )0 Owner Contractor Name_ *6 - Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other. City of Carlsbad Bldg Inspection Request For: 09/12/2002 Permit# CB022579 Title: BOSCH RESIDENCE Description: 33 SQUARES OF COMP Inspector Assignment: PY Type:MISC Sub Type: REROOF Job Address: 1173 CHESTNUT AV Suite: • Lot 0 Location: APPLICANT URBACH ROOFING, INC. Owner: BAASCH HERBERT&ANTOINETTE A TRS Remarks: ROOF Phone: 7604715065 Inspector: Total Time:Requested By: AMBER Entered By: GIOVANNA CD Description 19 Final Structural Act Comments Associated PCRs/CVs Inspection History Date Description Act Insp Comments 09/05/2002 15 Roof/Reroof AP PY 9/4 09/04/2002 15 Roof/Reroof AP PY EXISTING SHEATING 09/03/2002 15 Roof/Reroof CA PY PRODUCER Michael Ehrenfeld Company 2655 Camino Del Rio North, Suite 200 San Diego, CA 92108 (619) 683-9990 Fax (619) 683-9999 License #0537922 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW COMPANY COMPANIES AFFORDING COVERAGE ADMIRAL INSURANCE COMPANY (NEITCLEM) INSURED Urbach Roofing, Inc. 120 N. Pacific Street, D-7 San Marcos, CA 92069 AMERICAN STATES INSURANCE CO. COMPANY STATE COMPENSATION INSURANCE FUND COMPANY 0 INDICATED. NOTWITHSTANDING ANY REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE PATE (MM/DD/YY) POLICY EXPIRATION DATE (MM/DD/YY)LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY I CLAIMS MADE FXJOCCUR OWNER? & CONTRACTOR'S PROT GENERAL AGGREGATE To Be Assigned 6/1/02 6/1/03 PRODUCTS - COMP/OP AGG PERSONAL & ADV INJURY EACH OCCURRENCE FIRE DAMAGE (Any one fire) MEOEXP (Any one person) $2.000.000 J»2,000,OOC J£1.000,000 $1,QOO,OOC $50.00i $5,00( B AUTOMOBILE LIABILITY ALL OWNED AUTOS SCHEDULED AUTOS NON-OWNED AUTOS COMBINED SINGLE LIMIT $1,000,000 01-CE-868885-4 06/01/2002 06/01/2003 BODILY INJURY (Per Person) BODILY INJURY (Per Accident) PROPERTY DAMAGE GARAGE LIABILITY ANY AUTO AUTO ONLY - EA ACCIDENT OTHER THAN AUTO ONLY: EACH ACCIDENT AGGREGATE EXCESS LIABILITY BUMBRELLA FORM OTHER THAN UMBRELLA EACH ACCIDENT AGGREGATE WC5TATU- ITORY LIMITS IWORKERS COMPENSATION EMPLOYERS' LIABILITY THE PROPRIETOR/ I PARTNERS/EXECUTIVE (_ OFFICERS ARE: IINCL "XJEXCL 285 902 2000 01/01/2002 01/01/2003 EL EACH ACCIDENT .$1000,000 EL DISEASE - POLICY LIMIT Jtl.OOO 000 EL DISEASE-EA EMPLOYEE J6l.OOQ.nOO OTHER DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL FTEMS ALL OPERATIONS NOTE: 10 day notice of cancellation in the event of non-i SAMPLE CERTIFICATE ent of premium. SBT5ULD ANY OF THE ABOVE tilsCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVE