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Home My WebLink About2040 CORDOBA PL; ; CB973050; PermitPermit No Project No Development No , I BUILDING PERMIT 10/15/97 11 46 Paqe 1 of 1 Job Address 2040 CORDOBA PL Suite Permit Type MISCELLANEOUS 0245 10/15/97 0001 01 Parcel No 207-240-35-00 Lot# C-PRMT Valuation 2,112 Construction Type Occupancy Group Reference* Status Description REROOF 2200 SF, COMPOSITION Appl/Ownr PACIFICA ROOFING 1615 VALENCIA OCEANSIDE, CA 920544 *** Fees Required *** *** Applied Api/Issue Entered By 760 966-2600 Fees .Collected & Credits CB973050 A9703893 02 89-00 NEW ISSUED 10/15/97 10/15/97 JM * * -v Fees Adjustments Total Fees Fee description 89 • 89 :.... 00 Op 00 . . , ' Tdtal Credits Total Payments Balance- Due - ''.'••-,.. Units 'Fee/Unit, '/ ; • v "• --A..; r- 89 Ext fe 00 00 00 36 Data Miscellaneous Fee #1 * MISCELLANEOUS TOTAL 89, .00 '89 00 PERMIT FEE 89 00 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 O PLAN CHECK NO EST VAL Jftto Plan Ck Deposit, Validated By Date Address (include Bldg/Suite *)Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total # of units Assessor s Parcel #Existing Use Proposed Use Description of Work SO FT #of Stories tt of Bedrooms tt of Bathrooms 3L ", CONTACT PERSON Jif different from applicant) Name a: v Address mtractpr •••-- Q Agent for Contractor '{Dwner. City Q Agent fpr O_wner State/Zip Telephone # ragiT^v *r^.' "- Fax tt Name Address City State/Zip Telephone # (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 1$5 Name State License # // Y '' * Address ___ O ^"1? f^^ License Class *-* >= "7 City Sfate/Zip City Business License * / J< Telephone tt / * ' Designer Name State License # Address City State/Zip Telephone ifiL WORKERS' COMPENSATOR^., "'^ &*---* ,«._ !"'HU.. _____ -.C,*' < - _- 'L. *" V s^ Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations l~1 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 issued My worker s compensation insurance earner and policy number are ._ Insurance Company ^T'J^'T'S' ^Uf^^ _ Policy No c3<g£>-~X "} _ Expiration Date (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 tp/-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 tp^5fr<esW)f compensation damages as provided for in Section 3706 of the Labq/ code interest and attorney s teas SIGNATURE _ Jt^X-- "C Q£^y-~ --- ^> _ DATE' ~~~ 7, OWNER BUIL 1 hereby affirm thaj^l a/rf exempt from the Contractor s License Law for the following reason Q I as owner otthe 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) l~l I am exempt under Section Business and Professions Code for this reeson '\ 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 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) DATEPROPERTY OWNER SIGNATURE _COMI»LETETHIS SECTION FOR HON-HESU3EN1W. BUILDING PERMITS ONLY^.:^.. Is ***s applicant o future tuiid rg occupant isquirad id suumit a bu&me&b 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? O 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? Q YES Is the facility to be constructed within '\ 000 feet of the outer boundary of a school site? Q 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 i8; CONSTRUCTION LENDING AGENCY ;:'; ";:>!?, ~'~ T~ D NO ^. tail — ? ' 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 _ LENDER S ADDRESS 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 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 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 ngtcommenced wrthm 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 after the prork)s comjgonced^opi penod of 180 days (Section 106 4 4 Uniform Building Code) APPLICANT S SIGNATURE DATE WHITE File YELLOW Applicant PINK Finance CERTIFICATE OF INSURANCE ISSUE DATE (MM D( VYf MAR 12*7 RMRKRU8M HARK RUMMmSUKANCE ' ALL COMMCRCIAt INSURANCE SFftviCES Mil NANCY RiDOE DRIVE SAM DlEOO CA 92121 — PHONE MWM2-02M FAX ti»/t«i-<uo$ THIS CERTIFICATE IS ISSUED AS A MATTER Of INFORMATION ONLY CONFERS NO RIGHTS UPON THE CERTIFICATE HOLOf R THIS CE OO£S NOT AMEND EXTEND OR AlTER THE COVERAGF AFf ORDED B> THF POLICIES BELOW INSURED PACIFICA ROOFtNG INC 1615 Valencia St. Oceanside, CA 92054 COMPANY A COMPANY 8 COMPANY C COMPANY D COMPANIES AFFORDING COVERAGE CREDIT GENERAL INSURANCE CO ClQ COS STATE FUND COVERAGES TM*«S Toccinw THAT t«e PQLICCS Of mswftAivcc uirco BCIOWMAVE KINHSSUFO TO TNT MIUMPNAIKO ABOVE FOR TNC AOLIC* PERIOD MDICATCD NOrwmUTAMNNQ ANY ftfOUMMtNT TIM* OR COM0mOtt O* AMT CONTRACT OR OTHER DOCUMENT WITH MS^CCT TO MOCM TMS CERTIflCATC HAl « ««UCD O* «*» Vf((T«p> THrMStiRANCtArFOMKOCvTNePOUOrSOCtCIMEOHCRCMfiSUILlCrT TO ALL THE t£MJS EXCLUSIONS AMD CONOlTiOMS Of MCM »*H IClf* L*!.ti Vrown WAY 4AVK WEN REOUCCO «V »MO CLAIMS POtirr NUMBER "511-' GENERAL LJABlLtTy X C TuUtRCtAl O£«.f «A> CLAIMS MAM ART000497S FE6 1? 9? or CUR P! > * COWr»»LTO» i PHOT » ICvWjlJHV v On» r.rr t OOQ 000 1000,000 900000 500000 50 000 AUtOMOBUE LIABILITY fcMr AljlO «ll Ol^ft, AUTOS (.OMB1MFT1 GARAGE LIABILITY .• \ 1UTC EXCESS LIABILITY^^LU,O~ WORKER S COMPENSATION AND \ EMPLOYERS LIABILITY STATE FUND 2-17-97 / 1-1-98 sSSSSf^1"* I7a POL.t 285-97 UNIT 1489 AUTuO^V tAACriOEWl I 01«C« THiNAuTOONtY f ACM ACCIDENT t Al^^RfC'TC S EACMOccim<tt.iHf » Ar«HMn. 1 FA>M«.I n»Nr > 1,000,000 D,rfA«,f TO, i > i.K«t « 1,000,000 cwMAMn.i.iwucwtt , l.OOO.OOO OTHER DESCRIPTION Of OPERATiONS/LOCXnONSA/eHICLCS SPECIAL ITEMS — PROOF OF INSURANCE — CERTIFICATE HOLDER CONTRACTORS STATE LICENSE BOARD P O. BOX 26000 SACRAMENTO, CA. FOR INFORMATIONAL PURPOSES ONLY 95826 CANCELLATION OfSt-«IIBSO PGll-i IMF !<>^tllNI (,O>.W>HhV MH-fNOf-V- OK t -.ts BirlEMNoTiCt to rHCCt«)*.t.Alt H-vofft •*»)" 0 r j • ntwi TCUAU MIClWOTire 5IIA11 1M»1 jL wrote iG»Ti!~NOB I ttf -HV KIM liPQM THE COM^AMY |1S ^OtMTjOfl BEP«lf StM-"VT.. Antntwn ACOR0233Wt4 3M1 CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB973050 FOR 10/27/97 DESCRIPTION: REROOF 2200 SF, COMPOSITION TYPE: MISC JOB ADDRESS: 2040 CORDOBA PL APPLICANT: PACIFICA ROOFING CONTRACTOR: OWNER: REMARKS: C/JOHN/966-2600 SPECIAL INSTRUCT: INSPECTOR AREA PK PLANCK* CB973050 OCC GRP CONSTR. TYPE NEW STE: LOT: PHONE: 760 966-2600 PHONE: PHONE: INSPECTOR TOTAL TIME: CD LVL DESCRIPTION 19 ST Final Structural ACT COMMENTS DATE DESCRIPTION 102197 Roof/Reroof ***** INSPECTION HISTORY ***** ACT INSP COMMENTS AP PK CITY OF CARLSBAD BUILDING DEPARTMENT DATE. NOTICE 438-3550 2075 LAS PALMAS DRIVE TIME. LOCATION. PERMIT NO FOR INSPECTION CALL 438 3101 RE-INSPECTION FEE DUE? FOR FURTHER INFORMATION, CONTACT BUILDING INSBCCTOR CODE ENFORCEMENT OFFICER ® CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB973050 FOR 10/20/97 DESCRIPTION: REROOF 2200 SF, COMPOSITION TYPE: MISC JOB ADDRESS: 2040 CORDOBA PL APPLICANT: PACIFICA ROOFING CONTRACTOR: OWNER: REMARKS: C/JOHN/966-2600 AM PLEASE SPECIAL INSTRUCT: STE: PHONE: 760 966.' PHONE: PHONE: INSPECTOR INSPECTOR AREA PLANCK# CB973050 OCC GRP CONSTR. TYPE NEW LOT: 00 TOTAL TIME: CD LVL DESCRIPTION 15 ST Roof/Reroof ACT COMMENTS DATE DESCRIPTION ***** INSPECTION HISTORY ***** ACT INSP COMMENTS