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Home My WebLink About1645 SANDALWOOD LN; ; CB970617; PermitPermit No Project No Development No Cin9/<r? BUILDING PERMIT 03/19/97 10 59 Page 1 of 1 Job Address 1645 SANDALWOOD LN Suite Permit Type MISCELLANEOUS " Parcel No 205-130-52-00 Lot* Valuation 2,400 Construction lype Occupancy Group Reference* Status Description RE-ROOF, 2500 SF COMPOSI1ION Applied Apr/Issue Entered By Appl/Ownr J L ROOFING 619 941-4571 9 GO MARYLAND DR VJSTA CA 92083 *** Fees Required *** *^ ^rVi-fjw^ Col} ected & Ciedits CB970617 A9700802 9C-CO NEW ISSUED 03/19/97 03/19/97 RMA Fees 90 00'** t f f f,'1 ""- *„ **i 'x J t \ * *» * I »j A V -., , <V Adjustments •ifCJ* f -*>-, '/ * •»•*, 'T.ijfeii'l ^GickM"^ Total Fees 9ft' rffl/, (^t/,, '"'re^I^y^/^lA /> / ' "^It 'A"" '/ ' <fifi.^fi£%*iD^, \ Fee description /f4^<. J **¥>/,'* f ,,HSi'xs ^F^e/tftit Miscellaneous Fee #1 ^ / - ^f ^ > ^'^""so 00 X -^ -*^ t MISCELLANEOUS TOTA%. ' /4 ^ *• f / "~|»-^ -^^r^^ --* *,"* »'•> *'J1 ^ *V -^ 8». ^ * ^^~Sy^ »/ ^i« ^ 1 ««. / " f 4 /•» ^/ ' f ,T J » J *-»' / I I**1 * \ ••"'*?' / ^frk 1 w "*^ '•:.-,./;., ^i;/ / -'v f":- r:;: „ M i -^ % ^"~ - i I f It rr}i'/ / f J v ' C ^ ,; ^ ^ i^; ,r ;> -t, 3? * I \4^^^pr^4 ^r«~ , J *.f \ ' «- n i * j f ,* 7J /f'T f Si--*-* / / ,. J1 1 00 00 90 00 Fxt fee Data 90 00 PERMIT FEE 9Q 00 4 ~\ *" (T^,1 f J^ ^»C jV -,-*** * ^ *"* ». «,i- JH3 ^^4 / f* **- 4v~ • •"• '?J «* " w , J 5 ** * , * * ** =: iolr / *^* FINAL APPROVAL INSP CLLAa-iANCE. CITY OF CARLSBAD 2075 Las Palmas Dr , Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr, Carlsbad CA 92009 (619)438-1161 FOR OFFICE USE ONLY PLAN CHECK NO Q LEST VAL Plan Ck Deposit Validated By. Date *3) Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total * of units Assessor's Parcel t Existing Use Proposed Use 5£L.C0jrTACT PERSON Crf different fromappiTcaTit State/Zip Telephone # Fax« Name Address City State/Zip Telephone * Name Address City State/Zip Telephone * (Sec 7031 5 Business and Professions Code Any City or County which requires a permit to construct altar improve demolish or repair any structure pnor 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 tora^civil penalty of not morexthan five hundred dollars J£5 Name i /j— — > . Jfj State License # \~~*-' I 4^S Address Sf ^ License Class ^^ 0^7 City State/Zip City Business License t / 0** Telephone 9 &3/(* 3 Designer Name State License # Address City State/Zip Telephone 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 OXi 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 ranpensatton insurance carter and policy number are , ^5? / Insurance Company Q^-J^C^-O T^/t-vkf Policy No I ^ f 6£^fyfD~" *^-? Expiration Date (THIS SECTION NEED 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 parson 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 ($100 000) in addition to the cost of compensation damages as provided for In Section 3706 of the Labor coda interest and attorney t fee's SIGNATURE DATE 7,'_ OWNER BUILDER DECLARATION - _ . „ „ . 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 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) C_| I am exempt under Section Business and Professions Code for this reason 1 I personally plan to provide the major labor and matenals for construction of the proposed property improvement Q YES QNO 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 iCOMPJJEIETWS SECTION FOR rVOAWZES/OaiOWi IUILDING P^EBMIIJ^NLYij^^ is tho applics-rt c future tu.u -,g occupant loqmrod io »uL,n t a businais pian acutely nazaroous materials registration form or nsk management and prevention program under Sections 25505 25533 or 25534 of the Presley Tanner Hazardous Substance Account Act? Q 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? O YES O NO Is the facility to be constructed within 1 000 feet of the outer boundary of a school site? O 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 ^^CONSTRUCTION LENDING AGENCY~~' "C^lp^S-i?*.. '"TS^T " 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 &T APPLICANT CERTIFICATION J ' ,_ - _ _>_*& . - 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 stones in height EXPIRATION Every permit issued by the Building Official under the provisions of this Code shall expire by limitetion and become null and void if the building or work authonzed by such permit is not commenced 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,*^ the work is coir,menc>d/for a period of 18Q days^Section 106 4 4 Uniform Building Code) APPLICANT S SIGNAT DATE WHITE File YELLOW>Applicant PINK Finance ( 1 2 3. 4. 5. *6. 7. 8 9 10. 11 CITY OF CARLSBAD SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING JOB ADDRESS TYPE OF BUILDING- RESIDENTIAL /^ COMMERCIAL ROOF SLOPE RISE *T inches ^12 inches TYPE OF EXISTING ROOF COVERING i^'^ASlmb&O SHEATH ING NUMBER OF EXISTING ROOF COVERINGS (circle one) flj 2 3 /7 r-^/ fa '/A. ' NEW ROOF MATERIALL^U^^> /7<ftiO/tx"-yfl5S Q WEIGHT PER SQUARE NUMBER OF SQUARES _ TRADE NAME Ofo^ C^u^^fU^f^ MANUFACTURER ROOF SYSTEM APPROVAL Si No. X^V.ffi Other IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF YES /^ NO If the answer is no, a roof planmust be provided with this application. <^/ 3Fire rating of roof Class \r__ Class B A ""™~"~"""~ o I understand the following inspections are required. , 1 Tear Off/Pre-inspection prior to installing new roof covering. 2. Final Inspection I agree to provide a ladder extending at least 2 rungs above the roof for inspection. Contractor Contractor Name / \ *6 - Rolled Roofing, Tile, Shake, Shingle, Asphalt/Opmp Fiberglass, Bjnlt up CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB970617 FOR 03/31/97 DESCRIPTION RE-ROOF,2500 SF COMPOSITION TYPE MISC JOB ADDRESS 1645 SANDALWOOD LN APPLICANT. J L ROOFING CONTRACTOR OWNER REMARKS RS/JAMIE/941-4571 SPECIAL INSTRUCT PHONE PHONE PHONE. INSPECTOR AREA DC PLANCK# CB970617 OCC GRP CONSTR TYPE NEW STE LOT 619 941-4571 INSPECTOR TOTAL TIME CD LVL DESCRIPTION 15 ST Roof/Reroof ACT COMMENTS DATE DESCRIPTION 032697 Roof/Reroof ***** INSPECTION HISTORY ***** ACT INSP COMMENTS AP DC SD COMPENSATION INSURANCE PO BOX 807 SAN FRANCISCO CA 94101-0807 FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ISSUE DATE 06-01-96 POLICY NUMBER 1076940 - 96 CERTIFICATE EXPIRES 06-01-97 CITY OF CARLSBAD ATTN BUILDING DEPARTMENT 2075 LAS PALMAS DRIVE CARLSBAD CA 92009-^859 JOB ALL OPERATIONS 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 30 days advance written notice to the employer We will also give you 30 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 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 PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS $1 000 000 00 PER OCCURRENCE STANDARD EXCLUSION INDIVIDUAL EMPLOYERS AND HUSBAND AND WIFE EMPLOYERS ARE NOT ELIGIBLE FOR BENEFITS AS EMPLOYEES UNDER THIS POLICY .ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE O6/01/96 IS ATTACHED TO AND FORMS A PART OF THIS POLICY EMPLOYER LEGAL NAME J L ROOFING 960 MARYLAND DRIVE VISTA CA 92083 GRONLUND LARS P AND GRONLUND JAMIE L