The URL can be used to link to this page

Home My WebLink About2012 CIMA CT; ; CB043879; Permit10-14-2004 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No CB043879 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Valuation Reference # Project Title 2012CIMACTCBAD MISC 2164910600 $618200 Subtype REROOF Lot# 0 QUAYLE RES 2200 SF REROOF WD SHAKE TO LT WT CON TILE Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 10/14/2004 SB 10/14/2004 10/14/2004 Applicant PATRIOT ROOFING 1042 EL CAMINO REAL ENCINITAS CA 92064 760 577 2935 Owner QUAYLE CLIFFORD F&CAROLYN D TRUST 07 20 80 2002 CIMA CT CARLSBAD CA 92009 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES PERMIT FEE $12800 $000 $000 $12800 Total Fees $128 00 Total Payments To Date $000 Balance Due $12800 1236 10,14/04 0002 03 02 128 Inspector FINAL 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 vou 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 "! V.' P FOR OFFICE USE ONLY PLAN CHECK NO EST VAL Plan Ck Deposit Validated By. Date \ h\ Addrbss Tmclude Bldg/Suite »)Business Name (at this address) Legal Description Assessor s Parcel tt *ft fnn-k Description of Work Lot No Subdivision Name/Number Existing Use ^Q"FT #of Stories Unit No Phase No Proposed Use 2, # of Bedrooms Total tt of units 2- tt of Bathrooms applicant) Name Address 11Q Agent for Co lax City State/Zip Telephone #Fax H> (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 yiolaticSfi of Section 7031 5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($5001) fftfr/ '•> r- K-UUrlfW} Name" ' " ' ^-7/1 ' / Address State License # ' 1 (0 ^r? £- 7 License Class .7 City State/Zip Telephone tt /-, 2)<£1 City Business License tt / ^} j H D I L/ r f f Designer Name Address State License tt City State/Zip Telephone 6JIS,WORKERS COMPENSATION jC > > , - -.J s*. - ~ » ' •• ' 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 rj 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 compensatio/i insurance carrier jfjd policy number are , ' /I0//S7I C7 Expiration Date_Insurance Company Policy No (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 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 cnminat penalties and civil fines up to one hundred thousand dollars (9100 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 /%H^&_£/!/} ^wUJS^LL DATE bif^ojVNEft^iBiito •*•-£» *.•+-- * ' - """-' "-*1 i -** - 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) 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 materials 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 o p o'.ids po"icis of the work bu* I have h red 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 sir pollution control district or air quality management district? l~l YES Q NO Is the facility to be constructed within 1 000 feet of the outer boundary of a school site? (~j YEb l~i 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 fe^£ONSTRUCT!ON.L_ENDiN.G^ AGENCY _ ^. . _„ __ ^ £ J. j J^ Jl ___ . _ 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 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 CitV 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 limitation and become null and void if the building or work authorized by such permit is not commenced within 160 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 commertcecMor a period^? 180 days (Section 106 4 4 Uniform Building Code) , APPLICANT S SIGNATURE ^/^^A^^UL/ _ DATE _/^) //fl/ _ WHITE File YELLOW Applicant PINK Finance City Of Carlsbad SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING 1 JOB ADDRESS 2 TYPE OF BUILDING RESIDENTIAL V COMMERCIAL 3 ROOF SLOPE RISE *f inches in 12 inches 4 NUMBER OF EXISTING ROOF COVERING (circle one) /t) 2 3 5 TYPE OF EXISTING ROOF COVERING <^^/SHEATHING <> t , ^-"^ * * ""^^T'J ^*" *6 NEW ROOF MATERIAL //// -h (0 CLASsSK/ WEIGHT PER SQUARE ^•hX ^ ^^ 1 -NUMBER OF SQUARES <? <r 8 TRADE NAME J MANUFACTURER 9 ROOF SYSTEM LISTING UL No _ ICBO No 10 IS THE EXISTING STRUCTURAL DESIGN SUFRCIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? /YES/ 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-mspection 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 MLU) Date Contractor L^ Owner Contractor Name k *6 Rolled Roofing, Standard/Lite Tile, Asphalt7Comp Fiberglass, Built up, Other City of Carlsbad Bldg Inspection Request For 11/01/2004 Permit* CB043879 Title QUAYLE RES 2200 SF REROOF Description WD SHAKE TO LT WT CON TILE Inspector Assignment PD Type MISC Sub Type REROOF Job Address 2012 CIMACT Suite Lot 0 Location Inspector OWNER QUAYLE CLIFFORD F&CAROLYN D TRUST 07-20-80 Owner QUAYLE CLIFFORD F&CAROLYN D TRUST 07-20-80 Remarks Phone 7605222285 Total Time CD Description 15 Roof/Reroof 19 Final Structural Requested By ALLEEN Entered By BARBARA Act Comment Associated PCRs/CVs Inspection History Date Description Act Insp Comments 10/15/2004 15 Roof/Reroof AP PD Proof of Worker's Compensation Coverage SD PQLICYHQLDER COPY P 0, 90X 807 ,. SAM j*RANC«SCO CA*>34 l^l%37 > ' INSUH'ANCB "*•"** 1»v! **'" ,J\*' ^ " ? ^'"'^ / F~LJfSlD CERTIFICATE OrJ WORKEfS COM^|F^ATIQIi'>il ifaSUE DATE 12-01-2003 " "* 4 * " *t ^tC't? CONTRACTORS STATE LICENSE BOARO WORKERS COHPENS AT ION-UN IT P 0 BOX 26000 T SACRAMENTO, CA 95826 SD 12-01-200* ." •r?-Of-2003A1%-01-2004 * Lrc1fH$ir»«J»«W UCgNSE #716894 INCEJ*TION DATE 12^1,2003 - SO by thetpolicy trt » ^ v» ,> t, - «V !>•" •" ' •*. This is to certify that we have issued a Valid-Workers" Compensation instffanCB poncv tn » torrrj'-ap California Insurance Commissioner to the%BploV«I«'n«mecf bttaw^Brlths polieytl&riod indicated °f f i' *' » "*,H ^V ? " *?; t*-* ff^^ "" - • - - -* --' ' ' rabVrfttwFund 9Xc^|uporwlo%i«'J«^(*wS"vW-ii|iiiw'ri|ti|^to the emplgyer!vv^ -i'fev "^ ^V5!^ 1-^ ^ ^1 ** 4-- l* * f " ^ s.^> ? ^ ^ .|& ?f *P J j; «• <J> i^V J « ^i j.^ ir. j Ks •J:^* •»" i w i-^.. „ -*^ •*&» •ite.^^.'ki' , ?*"" This policy is not subject to cancetlation We will also gw* you 10 days aclvancV "policy to^ jti i v/'«**«(»\ * I!***|»AI«* ""i *x *-* '/*^ f **§ "y ~ •% i. <f This certificate o' insurance is not an (nsur^nce policy ana does not arfwrto 7e|tl«no* &r aljer the coverage afforded oy the policies listed here a Notwilhstwidinj any reqyir sment, terra or conditiorf <jf any cohvae* or other document with respect to which ihis certificate of insurance may b»xi$su«<J or may p«rt»irt th8(,msWfance afforded by the policies described herein is subject to all (He terms exclusions and conditions of such policies ' <1 I , frf t , AUTHORIZED REPRESENTATIVE j - ^>f ^^'"ts -s.^"^ 3 * EMPLOYER'S LIABILITY LIMIT INCLWDJWBtOEFESSE COSTS 41 000 0^0*00 P£R, Of^U " ' EMPLOYER A-l ACCURATE ROOF 10U2 N EL CAHJNO ENCINITAS CA 9202%' THIS DOCUMENT H*S A BLUE PATTERNED BACKGROUND