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Home My WebLink About142 CHESTNUT AVE; ; CB053835; Permit11-02-2005 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No: CB053835 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: 142 CHESTNUT AV CBAD MISC 2041220900 $2,700.00 Subtype: REROOF Lot #: 0 DIVALERIO RESIDENCE 20 SQUARES OF TOURCHDOWN Status: ISSUED Applied: 11/02/2005 Entered By: MDP Plan Approved: 11/02/2005 Issued: 11/02/2005 Inspect Area: Applicant: ROYAL ROOFING 219 SOUTH ANDREASEN DR ESCONDIDO CA 92029 800-400-7692 Owner: DIVALERIO FAMILY TRUST 08-11-99 21269SE40THST SAMMAMISH ,WA 98075 Miscelaneous Fee #1 PERMIT Miscelaneous Fee #2 Additional Fees $77.00 $0.00 $0.00 TOTAL PERMIT FEES $77.00 Total Fees:$77.00 Total Payments To Date:$77.00 Balance Due:$0.00 >:RMIT HAS EXPIRED IN ACCORDANCE WITH C.B.C.SECTION 106.4.4 AS AMENDED BY C.M.C.18.04.030 GATE SIGNATURE 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 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 Address (include Bldg/Suite^l FOR OFFICE USE ONLY PLAN CHECK NO._ EST. VAL. Plan Ck. Depos Validated By_ Date Business Name (at this address) Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Total # of units Assessor's Parcel # "77/7 /J£> Existing Use Proposed Use J Description of Work 0 SO. FT.#of Sforfes, 1,, , CONTACT PERSON (if different from applicant!"'Si "rr 3 V>of BedroamsoamsA <•,*.-—,# of Bathrooms Name 'APJ>L1CANT Contractor Address City igent'for Contractor Q Owner Q Agent for Owner State/Zip Telephone tf Fax* Name Address City State/Zip Telephone # "\ "'- ,' ' > ? *• * Name 7 Address City State/Zip , Telephone # ffl-WNtfWOfdR'COMPAWNAME-""- ' "•- ' ----- - , • /•-, ',, ~~', .' _ ;; • -. , (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 [$500]). Name Address State License # 2<J72-2-'2- License Class £-^3 Designer Name Address State License # City State/Zip » Telephone * . 'jr City Business License # ^-- ^J?T*r^ ' \\j Cj^>i 0 /City State/Zip Telephone ' & WORJtElS* 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. 6 1 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 d. My worker's compensation insurance carrier and policy number are: ' ^^s Insurance Company -7^/c^^v" ^oLi^Tf^^ f^4tS^t~ 'V'Policv No. { i-^2-^^/^ _ Expiration Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) Q 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 mariner 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 dollarsyTpl 00,000), in addition to the cost of compensation, damages as provided for In Section 3706 of the Labor code, interest and attorney's fees. •* SIGNATURE /A-^_, ^// ^"\ _ — _ _ DATE //<• 2- ~^>£' 7, '•' OWNER-BUILDERDECLARATlW - ~' ^-' ' • V . ' X ". "' : -l;*-^: ' ' «..:*;" 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). D 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. L~] YES C]NO ' 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 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 [3 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(i) 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 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 cornmenped 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 commence,)/ for a period of/MJO days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE //- ITE: File YELLOW: Applicant PINK: Finance City Of Carlsbad SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING 1. JOB ADDRESS: W^ cS&Sf*S<s?' 2. TYPE OF BUILDING: RESIDENTIAL XV" COMMERCIAL 3. ROOF SLOPE: RISE_/__inches in 12 inches 4. NUMBER OF EXISTING ROOF COVERING (circle one) (/%} 2, 3 5. TYPE OF EXISTING ROOF COVERING^^.lSHEATHING.l.y^ *6. NEW ROOF MATERIALT^^/ CLASS_^_WEIGHT PER SQUARE 7. -NUMBER OF SQUARES 8. TRADE NAME. 9. ROOF SYSTEM LISTING UL No. ICBO No. 10. IS THE EXISTING STRUCTURAL DESJGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? /^XES/ 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: 0 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 lX|/V^ (X // Date Contractor Owner __Contractor Name *6 - Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other. JUL-07-2005 THU 02:22 PM FAX, NO,P, 01 AGQBB. CERTIFICATE OF LIABILITY INSURANCE ^gff^ fvawmit Robaxtson Ryan 6 AOSOO-, Inc. Two Slaza East, Suite 650 330 Bast RUbovum Avenue UU*a«ke4 HI 53202 Rhowes 414-2 71-3575 ffax: 414-211-019S mnunBB Coastal Rnwiwrepa IneThto* Poinfce IXriva, Suite 302 area ca. 92821 DWOS/DS THIS CERTIFICATE IS (93U ED AS A MATTER OP INhOKMA ( IUN ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE, HOUPER. THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE oraMERk American Hows Afisuiranne W*SR 8! HHUHERC: ItWHEHtt WSURENG'. . ' T NA|C# ^9380 TUB POUCIBfi OF INSURANCE USTED BELOW HAVE BBBN ISSU6Q TO THE INSURED WMED ABOVE FOR THE POLICY PERIOD INDICATED. HOWITHSTANDINS ANY REQUIREMENT, JOHN) Oft CONDITION OP ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO \MM1CH THIS CERTIFICATE MAY BE ISBU6D OR. MAY PERTAIN, THE INSURANCE APPORPED BT THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERN'S. BXCMJ3ION9 ANP CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE 06W REDUCED BY PAID CLAIMS. MT * mr NMO TVP€DF|NRlf!ANO» OfH __J CWMSMADS [_J OCCUR eisn. AcaieBArE UMI «"?UES CDS;~^n nn ""^ rn Aim — WOtflLCUtPMrv wr/WTO SCHCDULRPAUTQB q™« ~J DCCU« f j COWH6MAOS ^1 BB3UCT1SL13 ™fs«™M OTXBK Coverage Co Job <j POUPYHUMlro ««« TBU6Y PFFE5WE 04/3Q/OS >l!Uey eiplRITlDN 04/30/06 UMIP 8ACHKCUPBEWCE UUUULIUWillL'll ' '" "PREMISES |E> ncturtlJOJJ MEOOT(An,»frpMm) PERHONM.«WiWUpV CCMEW-AaaREBATE PROOUCTS-WTOAOO M.MWMr ssssr" ssr [pwmxUnnt) AUTO ONLY- EAACCIOEKT n^EPTHini ^wwe _ E«HqcoiKflENCE W6BEBATE _ •WJtTATIS1"1 ' OT>L' awwMoxw- EiLi P/9£ASB i EA EMPLOWIS SX,! D1BEABE • POUfrf LIMIT » i * ** • t t • » s 1 t . t - • t * *t I It g 1QOQOOO T 1000000 5 1000000 ?fl«TWW^On«1BoN8>WHKU!«lffl<ei.V01Dra»91)6epY(l|IIWIIinMBir/IIFdOI(ll.P11DV|B|PHII is limited to Coastal e»ploye><« wozteiAg at DBfiB dba^ Royal Roofing itds. • ' '•'•'. CANCELLATION DSBIWIS DSSB dbtt Boyal Soei£iRa Co, 150 Hettetem Bead CA 92083 mouiTMNr op tllB MHVC ocnntioiD PDUCIEB an MtnEUED DOFOWTHi itmiWTIDN e*n»(iiHOT.tn8rainiwoirouRERWiu.?wiwvsi«tPH«L lirif IMP »w osuMTian aRunmirrr OF «NT nnm Uf ON TUB imuurR) n» wxnw »B ACORD25(2001f08)