The URL can be used to link to this page

Home My WebLink About1704 EVERGREEN CIR; ; CB983196; PermitB U I L D I N G 09/23/98 09:53 1Page 1 of 1 Job Address: 1704 EVERGREEN Permit Type: MISCELLANEOUS Parcel No: 205-080-69-00 Valuation: 3,120 CR P E R M I T Suite: Lot#: Permit No: CB983l9b Project No: A9804160 Development No: Construction Type: Occupancy Group: Reference#: Status: NEW ISSUED 09/23/98 09/23/98 RMA Description: RE-ROOF,3000 SF-COMPOSITION Applied: Apr/Issue: Appl/Ownr : SECURE ROOFING INC 2210 MEYERS AV 760 Entered By: 432-9084 ESCONDIDO CA Fees Required Fees: Adjustments: Total Fees: Fee description Miscellaneous Fee #1 * MISCELLANEOUS TOTA *** 92029 & Credits .00 .00 102.00 *** Ext fee Data ..---------------- 102.00 PERMIT FEE 102.00 1384 09 /23/98 0001 01 02 C-PRHT 102.00 :-----FINALAPP ROVAc --· INSP. _ j2._(3 J -DATE ~ CLEARANCE -::::::-=~----... ---............. ~ CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 • PERMIT APPLICATION FOR OFFICE USE ONLJY C? I PLAN CHECK NO.~ _ f) lb EST. VAL. 3 ( ')_; CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 Plan Ck. Deposit --------.?.--A Validated By_~.,......,.___----1---Ll~~ Date ____ ::=:.;'--t~-J--,""'---l-~-1:-1-- Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Proposed Use #of Stories # of Bedrooms # of Bathrooms City State/Zip Telephone# Fax# 3. APPLICANT 0 Contractor ~ent for Contractor 0 Owner . 0 Agent for Owner Name Address City State/Zip Telephone # 4. Name Address City State/Zip Telephone # 5. 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 Code) or that he is exempt therefrom, and the basis for the alleged Any viol · n of Secti 7031.5 by any applicant for a permit subjects the app · ant to a civil enalty of not more than five hundred d lars ($500 0 '2..9\ 1- Address City State/Zi~ Telephone # State License # License Class City Business License # f 7.D '3 S7o L Designer Name Address City State/Zip Telephone State License # ---------- 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. 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 d. My worker's compens tion i urance arrier and icy number are: . ~ ~ ~ ,f,~D O . . \ \ I q ~ ance Company Policy No. Ol. ~I~ ::1.~.} C, Expiration Date ___ l_\ _ _,,Q"'-- (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 person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Fallura to aecure workers' compensation coverage la unlawful, and shall subject an employer to criminal penalties and clvll fines up to one hundred thousand dollars ($1 ,0001, l'N'ddltl t coat of cdmpenaati , damages aa rovlded for In Section 3706 of the Lab coda, and attorney's fees. SIGNATURE .,/c) ' DATE __ C\-'-+c)=-i....q--1..:....1.._ 7. OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: D 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 contractor(s) 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. D YES ONO 2. I (have I 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 I address I phone number I 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 I 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 I address I phone number I type of work): __________________________________________________________ _ PROPERTY OWNER SIGNATURE----------------------- COMPLETE THIS SECTION FOR NON-RES1DENT1AL 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? 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 D 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(i) Civil Code). LENDER'S NAME-------------- 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 t o 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 inspect;on 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 wo,k ,.,ho,;,od b, s,oh po,m;, ;, "" oommfflOod w;<h;o 365 do,s f,om ,,., '"' of o,oh po,m;, " ;1 >h• b•;,a;.,, " wo,k ,.,ho,;,od 1'uch permit is suspended or abandoned at any time after the work is co menced for a period of 1.ao dav. (Section 1 .4.4 Uniform Building Code). \ ~ APPLICANT'S SIGNATURE L < DATE q ])!J °( \, PINK: Finance J/06 f-5 PERMIT# CB983196 DESCRIPTION: RE-ROOF,3000 TYPE: MISC CITY OF CARLSBAD INSPECTION REQUEST FOR 10/14/98 SF-COMPOSITION JOB ADDRESS: 1704 EVERGREEN CR APPLICANT: SECURE ROOFING INC CONTRACTOR: PHONE: PHONE: STE: INSPECTOR AREA DH PLANCK# CB983196 ace GRP CONSTR. TYPE NEW LOT: 760 432-9084 OWNER: REMARKS: R/TERESA/432-9084 SPECIAL INSTRUCT: PHONE: * INSPECTOR -----L-/_(,._c~(3~- TOTAL TIME: CD LVL DESCRIPTION ACT COMMENTS 15 ST Roof/Reroof 4 -------------- (,(,,[/ "lil!.. ---------- ***** INSPECTION HISTORY***** DATE DESCRIPTION 100798 Roof/Reroof ACT INSP AP DH COMMENTS