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Home My WebLink About1980 LA COSTA AVE; ; CB043628; PermitCity of Carlsbad J ri~1\ ~~e)\· 1635 Faraday Av Carlsbad, CA 92008 09-20-2004 Miscellaneous Permit Permit No: CB043628 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 1980 LA COSTA AV CBAD MISC Subtype: REROOF Parcel No: Lot#: 0 Valuation: $2,850.00 Reference #: Project Title: CHABAD@ LA COSTA-REPLACE SHAKE W/ 25 SQRS COMP SHINGLE (UL R21) Applicant: PATRIOT ROOFING 1042 EL CAMINO REAL ENCINITAS, CA 92064 760-577-2935 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES Total Fees: Inspector: $77.00 Owner: PERMIT FEE Total Payments To Date: FINAL APPROVAJ. Date: S: ,,..,. -t:15 $0.00 Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: Balance Due: ISSUED 09/20/2004 KMT 09/20/2004 09/20/2004 $77.00 $0.00 $0.00 $77.00 $77.00 1536 09/20/04 0002 01 CGP 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/0 xactions of which "OU have nreviou'*' been niv0 n ::i NnTlf"'E similar to this or ::is to which the nln•ute of limitation"' hM nrevi"USI" n'h<>rwin~ ~xnired. 02 77-00 PERMIT APPLICATION CITY 0F CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 Legat Description Lot No. Subdivision Name/Number Unit No. Phase No. Total II of units Assr,or's Parcel t: < vno Existing Use '2-5"0 () Proposed Use Description of Work SQ. FT. #of Stories # of Bedrooms # of Bathrooms Name State/Zip Telephone# Fax# Name Address City ,S:~drWJIAQt.Q~QNYflNAMltri(~~-:~";,1,:1'if:t:1~at,t;)t,"1c~~i-"i t'iti~,.,-.,_:++·:."~-,;,f'.;:_;,, ... -- (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 e pti n. fnY viola ·on of Section 7031 . 6 by any applicant r a permit subjects the JIPP~t to a civil penalty of not more than five hundred dollars l $ 50011. I " ' A-S C..{p -,r-C- City State/Zip Telephone # State License# _..L.....,"""'-,_+-___ License Class _.1 __ ...ac..i._____ City Business License# /2/<,/Qq Y, Designer Name Address State License # _________ _ fl~OJIKE8't<OQMJ!mlATJ0Qk'Jik,; 1.f .. i:Ja:Wti!i<.;·, · ;~,;,;i~il , Workers' Compensation Declaration: I hereby affirm under penalty City State/Zip Telephone .---; D 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. D 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 ~pen,ation insurance c~rier and policy number are: Insurance Company ?zt,~e. MAM, ~ Policy No. / (J 7 7 a/ 'd--Expiration Date / ~/4 c,/ CTHIS SECTION NEED NOT BE COMPI.ETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1$1001 OR LESS) 0 CERTIFICATE OF EXEMPTION: I cer1ify 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: Falhl to secure worken' compensation coverage Is unlawful, and shal subject en employer to crimlnal penalties and clvll fine• up to one hundred thouund dolllrli ( 1 ,000), In on to the coat of companaetlon, damagu •• provkled for In Sectkm 3708 of the Labor •· lntereat and attorney's fees. SIGNATURE DATE ;) CJ na,,a ,!ftttittltttlffilltlHI Rii~ffi~iuir~:{~~wl>,i~-~-\; ·•Ah-0;~·i:;hf1t-+s:~~< -~<~4''~:?~>r\i:;,,;s~%fr,::, .. 1·-•:-: " , ,,·•" ''"' ":,::;, •"''· I hei-eby affirm that I am exempt from the Contractor's License Law for the following reason: O 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, Buainess 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). O I, as owner of the propar1y, am.exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Profeaaions Code: The Contractor's License Law does not apply to an owner of proper,y who builds or improves thereon, and contracts for such projects with contractorls) licensed pursuant to the Contractor'• License Law). D 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/ 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 numoer / contractors license number): ________________________________________________ _ 6. I wlll provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone number I type of workl: ____________________________________ ~------------------ 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 26606, 26633 or 26534 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 FINr\L CERTIFiCATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS Y:.IE APrLICANT 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. 3097Ul Civil Code). LENDER'S NAME _____________ _ I certify that I have read the application and atate 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 authoriza 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 ANO 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 Quilding Official under the provisions of this Code shall expire by limltation and become null and void lf the building or work authorized by such permit is not co menced 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 com en d for a per' f 180 days (Section 106.4.4 Uniform Building Code). / . APPLICANT"S SIGNATURE_L.+J,::l.t:..t!,&_'.!,:::;c:\'.E::J~:2:::J::-_____________ DATE / ;}-e 1/ 7 WHITE: File YELLOW: Applicant PINK: Finance City Of Carlsbad SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING I. JOB ADDRESS: rqw LA ~4 s.f:.. ,A-vt (C,rovwuic', on) 2. TYPE OF BUILDING: RESIDENTIAL ____ COMMERCIAL __ __, 3. ROOF SLOPE: RISE ':> inches in 12 inches 4. NUMBER OF EXISTING ROOF COVERING (circle one) (9 2 3 5. TYPE OF EXISTING ROOF COVERING S}l,.)£9 SHEATHING hO . *6. NEW ROOF MATERIA{OVVVf SI-\J'Vld~ASS~WEIGHT PER SQUARE 7. -NUMBER OF SQUARES~?,.__5 __ ~ 8. TRADE NAME 3Q \,/fM MANUFACTURER (o.A-f: 9. ROOF SYS,TEM LISTIJG UL No. gi I ICBO No. _____ __, IO. 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. ; understand the following inspections are required: 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 7 ~J.,M___./kM.P Date __ 1.L-,...,..,,@""-~""'(2'-'Lf'-+-- *6 • Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other. I!!\ • City of Carlsbad Bldg Inspection Request For: 05/05/2005 Permit# CB043628 Title: CHABAD @ LA COSTA-REPLACE Description: SHAKE W/ 25 SQRS COMP SHINGLE (UL R21) Type: MISC Sub Type: REROOF Job Address: Suite: Location: 1980 LACOSTAAV Lot APPLICANT PATRIOT ROOFING 0 Owner: GRANT TUCKER PROPERTIES Remarks: Total Time: Act Comment Inspector Assignment: RB --- Phone: 7605222285 Inspector: ----- Requested By: AILEEN Entered By: CHRISTINE CD Description 19 Final Structural f}_E _____ ____c____ Associated PCRs/CVs lnsgection Histo01 Date Description Act lnsp Comments 09/30/2004 19 Final Structural co RB SEE NOTICE ATTACHED 09/21/2004 15 Roof/Reroof AP RB SEE NOTICE FOR FINAL 09/21/2004 15 Roof/Reroof AP RB