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Home My WebLink About159 HEMLOCK AVE; ; CB052022; PermitCity of Carlsbad .. 1635 Faraday Av Carlsbad, CA 92008 06-01-2005 Miscellaneous Permit Permit No: CB052022 Job Address: Permit Type: Parcel No: Valuation: Reference #: Building Inspection Request Line (760) 602-2725 159 HEMLOCK AV CBAD MISC 2042521900 $2,280.00 Subtype: REROOF Lot#: 0 Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 06/01/2005 LSM 06/01/2005 06/01/2005 MELIDEO NICHOLAS&MARY REVOCABLE TRUST Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES Total Fees: $77.00 159 HEMLOCK AVE CARLSBAD CA 92008 PERMIT FEE Total Payments To Date: $0.00 Balance Due: $77.00 $0.00 $0.00 $77.00 $77.00 952B 06/01/05 0002 01 CGP Inspector: ~ FINAL APPROVAL "-r-Date: Clearance: NOTICE: Please take NOTICE that approval of your project inciudes tile ~imposition" of fees, dedications, reseNat!ons, or other exactions hereafter coHectively 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 sat forth in Government Code Section 66020{a), and file the protest and any other required information with 1he City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure win bar any subsequent legal action to attack, review, set askle, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactklns DOES NOT APPLY to water and sewer conneciion fees and capacity changes, nor planning, zoning, gradlng or other similar application processing or seivice fees in conneciion with this project NOR DOES IT APPLY to any r ; · .. · · r· · FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK NO. {lf, CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 .;;J ::J~o EST. VAL. _________ _ Plan Ck. Deposit "2?'.. Validated By __ ~--,-_;;;_---:----- Date C:J/1 Jo~ I I Address (include Bldg/Suite #) Business Name lat this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # Existing Use Proposed Use ·z_ V-c _,,,,.,._ 0/~,C SL, -:z Ke -9 cV-s-C:_a--,p0 cJ...ooo Description of Work ' ' SO. FT. I #of Stories # of Bedrooms # of Bathrooms '"'• -Pl:!Qffft,::Y QW.NER'' .. .i • ·•~ ,I' 'r ; ••, ',. ~, City · ; O •.0wn~i ,, 0 ~gant,for Owner City State/Zip Telephone# Fax# State/Zip Telephone# ~I(! K.._ ./'°7 c /11) I 0 /.J::Z l i e---, /uJc .4v . 2:Z 7 '1oo;•:· ' 7 l.. '7 -,?cJ 7 6 Name Address City State/Zip Telephone# '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 ($500)). /..J_erZ~, ........ ,;.~,.,--,'/{17 J2...6.r/4/kv<...!C' CcIJJ C!d, z'2co<f: 72/-... r, 2. '} Name / Address 7 City State/Zip Telephone# State License # L/ ;3 h ...3 C. 9 License Class C.. -...3 ? City Business License # / 2.. 0 ~ 7 <o I Designer Name Address City State/Zip Telephone State License # _________ _ rt;~ Q~COMnNS'.(~· '' ,~,._ ~· ':. ,;.'.f ., ,,;>< ,/ "' : ,. ::· . · ,) ., ! . ;, ,, ' ';_t Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: O 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. O 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 _____________________ Policy No.,_____________ Expiration Date _______ _ !THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) ~ 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 HCura workllfa' companaatlon coverage la unlawful, and ahall aubjact an employllf to criminal penaltlH and civil flnH up to one hundred thouaand dollar• ($100,000 , addition to th• coat of compenaatlon, damagH ea provided for In Section 3706 of the Labor code, lnterHt and attorney's fees. SIGNATURE ~ e:::-DATE C -/ -CJ..) - i•1,~.0Wrt..Efi-il!Vl~(ll1 ·1:,e ' '!'?'7~'""''•· ,, ,. l i' I hereby affirm that I a 0 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>. 0 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 contractorls) licensed pursuant to the Contractor's License Law). 0 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. 0 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 work !include name I address / phone number I 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 I phone number / type of workl: _________________________________________________________ _ PROPERTY OWNER SIGNATURE ----------------------~-DATE _________ _ lCQ~.l'.tlll'.$1:CTIOl!tFOfl ~PN:BfflP.IHtMi.lJ!Jl!JnNQ\PE.RM.11$. Q~l;Y~,.J.~,. ~it t .:i•'; . ,, :1. . v-k..;. ,., 'L~,· .;,,: t . ~t-. 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, 26533 or 26634 of the Presley-Tanner Hazardous Substance Account Act? 0 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? 0 YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 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. Ltl,~q9~$!rll\JCTJ,QN ~-~14(i~G~f4C'(,~. ,';, \itr-,~~.= Li<·.'· .~/ ·; :·· .c,,.•/' . ,"'~·- I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued !Sec, 30971i) Civil Code). 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 Citt 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 commenced for a ·oo of 180 days (Section 106.4.4 Unifonn Building Code). APPLICANT'S SIGNATURE ------.!"--''---.'-=-'-(:--'=--------------DATE WHITE: File YELLOW: Applicant PINK: Finance • • ·' City Of Carlsbad SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING I. JOB ADDRESS: / .s-7 /fl=' /J1 L () c (r fl Vt=, 2. TYPE OF BUILDING: RESIDENTIAL i_/ COMMERCIAL. __ ~ 3. ROOF SLOPE: RISE '-( inches in 12 inches 4. NUMBER OF EXISTING ROOF COVERING (circle one) 1 @ 3 5. TYPE OF EXISTING ROOF COVERING WQO P/Ct'P~HEATHING l'L. Y/Vot>,IJ • *6. NEW ROOF MATERIALJoYA' cu,,,/ CLASS ''/1" WEIGHT PER SQUARE 7. -NUMBER OF SQUARES .?, O' tp 8. TRADE NAME 6!-!f F [te,#A't,'tg MANUFACTURER 6--ft r ._..,_,_'--___ _. 9. ROOF SYSTEM LISTING UL No. ICBO No •. _____ _, 10. IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? @ 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 instalfnew roof covering. 2. Final Inspection I agree to provide a ladder extending at least 2 rungs above the roof for inspection. d~z--Signature_,_x...,__~_~~---=--=-v-Z:-.,,:-_______ Date (p -/-OS- Contractor V Owner v· , . . Contractor Narre itt,lr/3-1/§Til&f, t/if!-TvN *6 • Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other. m . . City of Carlsbad Bldg Inspection Request For: 06/07/2005 . Permit# CB052022 Title: MELIDEO ES· 2000 SF SHAKE TO Description: COMP Type: MISC Sub Type: REROOF Job Address: Suite: Location: 159 HEMLOCK AV Lot 0 Inspector Assignment: Phone: 7604193808 OWNER MELIDEO NICHOLAS&MARY REVOCABLE TRUST ,,.,~""' L Owner: MELIDEO NICHOLAS&MARY REVOCABLE TRUST Remarks: AM PLEASE Total Time: ----- CD Description 19 Final Structural Act Comment Requested By: HEATHERINGTON ROOFING Entered By: CHRISTINE £_ _______ _ Associated PCRs/CVs Inspection History Date Description Act lnsp Comments 06/03/2005 15 Roof/Reroof AP PY EXISTING SHEATHING