The URL can be used to link to this page

Home My WebLink About1320 CHINQUAPIN AVE; ; CB040425; Permit02-10-2004 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No CB040425 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Valuation Reference # Project Title 1320 CHINQUAPIN AV CBAD MISC 2062621000 $4 995 00 Subtype REROOF Lot# 0 ERICKSON RES 4500 SF COMPOSITI Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 02/10/2004 RMA 02/10/2004 02/10/2004 Applicant A V ROOFING INC Owner ERICKSON DAVID E&LINDA L 390 OAK AV 92008 760 730 0273 1320 CHINQUAPIN AVE CARLSBAD CA 92008 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES PERMIT FEE $10200 $000 $000 $10200 Total Fees $10200 Total Payments To Date $000 Balance Due $10200 FINAL APPROVAL 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 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 PROJECT INFORMATION /!4///«^ FOR OFFICE USE ONLY PLAN CHECK N EST VAL Plan Ck Deposit. Validated By_ Date Q. / ihf O <-i - i ( Address (include Bldg/Suite fr ' /if s/ //•.•mOf Legal Description Lot No Assessor s Parcel # A Existing Description of Work fffM/W 0^^ SO 2 CONTACT PERSON (if different from applicant) Name Address 3 APPLICANT 0" Contractor Q Agent for Contractor A(/ &00l9r7<Y ^£rr* ? ° 2<" Name * Address 4 PROPERTY OWNER S)/*!,^ <^/V/^5oz-7 /31-& Business Name (at this address) Subdivision Name/Number Unit No Phase No Total # of units Use Proposed Use FT #of Stories # of Bedrooms # of Bathrooms City State/Zip Telephone # Fax # Q Owner D Agent for Owner City State/Zip Telephone # Name Address City State/Zip Telephone t S 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 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 Codel 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 [$500]) Ai/ t ' Name State License # Address License Class City State/Zip City Business License # Telephone # '.X ' t «-? <:>\-S Designer Name Address City State/Zip Telephone State License tt 6 WORKERS COMPENSATION Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations 0 I have and will maintain a certificate of consent to self insure for workers compensation as provided by Section 3700 of the Labor Code for the performance of the work for which this permit is issued 05" I have and will maintain workers compensation as required by Section 3700 of the Labor Code for the performance of the work for which this permit is issued My worker s compensation insurance carrier and policy number are Insurance Company *^$Y'4'/{' J~i/SK?7 Policy No / 7 ^/ (~S**/ ~^-QO } Expiration Date ^£~~ / ~ @'!~/' (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) n 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,pjOP) in addition to the cost of ^compensation damages as provided for in Section 3706 of the Labor code interest and attorney s fees SIGNATURE ^^"^f—y ^f ^^f^^J^ DATE ^' "/O - Orf 7 OWJrfR^BUILDER DECLARATION 1 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) l~1 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) l~l 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 l~l YES l~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? O 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? l~l YES l~l 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 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(0 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 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 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 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 commencedjerie period of 180 days (Section 106 4^JJfHferm Building Code) ^^ ff ^ ^sT ^ ) APPLICANT S GNATURE DATE WHITE File YELLOW Applicant PINK Finance City Of Carlsbad SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING 1. JOB ADDRESS / 33-O 2. TYPE OF BUILDING. RESIDENTIAL A~ COMMERCIAL 3 ROOF SLOPE RISE V inches in 12 inches 4. NUMBER OF EXISTING ROOF COVERING (circle one) ZD 2 Z 5. TYPE OF EXISTING ROOF *6 NEW ROOF MATERIAL^ ^ ' ^K^CLASS A WEIGHT PER SQUARE 7 •NUMBER OF SQUARES ^ S" 8. TRADE NAME^rW /2^ug^ MANUFACTURER 9 ROOF SYSTEM LISTING UL No. _ ICBO No. 10 IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? /^ES ) 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 ^ -*_/ /^/-^— Date ^ Contractor C Owner Contractor Name *6 • Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other City of Carlsbad Bldg Inspection Request For 02/23/2004 Permit* CB040425 Title ERICKSON RES-4500 SF COMPOSITI Description Type MISC Sub Type REROOF Job Address 1320 CHINQUAPIN AV Suite Lot 0 Location APPLICANT A V ROOFING INC Owner ERICKSON DAVID E&LINDA L Remarks Inspector Assignment PD Phone 760730027J Inspector Total Time CD Description 19 Final Structural t_ Comment Requested By N/A Entered By ROBIN Associated PCRs/CVs Inspection History Date Description Act Insp Comments 02/11/2004 15 Roof/Reroof AP PD POLICYHOLDER COPY P O BOX 420807 SAN FRANCISCO CA 94142-0807 » COMPENSATION INSURANCE FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE 01-09-2004 C PAC ENGINEERING INC 608 S NEW HAMPSHIRE AVE LOS ANGELES CA 90005 GROUP POLICY NUMBER 1741449-2003 CERTIFICATE ID 19 CERTIFICATE EXPIRES 05-01-2004 05-01-2003/05-01-2004 JOB DISPATCH POLICE STATION @ NAVAL AIR WEAPONS STATION 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 employer named below for the policy period indicated This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to the employer We will also give you 10 days advance notice should this policy be cancelled pnorto its normal expiration This certificate of insurance is not an insurance policy and does not amend extend or alter 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 C AUTHORIZED REPRESENTATIVE PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS $1,000,000 PER OCCURRENCE ENDORSEMENT #1600 - COREY R MILLER, P,S T - EXCLUDED EMPLOYER A V ROOFING INC PO BOX 1892 CARLSBAD CA 92018