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Home My WebLink About2145 CHESTNUT AVE; ; CB110876; Permit04-27-2011 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No: CB110876 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: PC#: Project Title: 2145 CHESTNUT AV CBAD MISC 1670800200 $2,184.00 Subtype: REROOF Lot #: 0 HENRY: 1600 SF SHAKE TO COMP SHINGLE Status: ISSUED Applied: 04/27/2011 Entered By: JMA Plan Approved: 04/27/2011 Issued: 04/27/2011 Inspect Area: Applicant: HENRY MELVIN J&KAY I 8229 E 950 N DELPHI IN 46923 Owner: HENRY MELV1N J&KAY I 8229 E 950 N DELPHI IN 46923 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES PERMIT FEE $91.00 $0.00 $0.00 $91.00 Total Fees:$91.00 Total Payments To Date:$91.00 Balance Due:$0.00 Inspector:,^ii~FINAL APPROVAL 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 you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. »^ x/t|f,, ' Building Permit Appli< S^ <*y|J/ 1635 Faraday Ave., Carlsbad, CA NX' CITY OF 760-602-2717/2718/27 f~*ARI ^RAHl Fax:760-602-8558V«/Ai\L.*.)D/AL</ www.carlsbadca.gov JOB ADDRESS / ' ( ^. xi CT/PROJECT# IOT# *" PHASE* # OF UNITS # BEDROOMS t. Plan Check No. (—j£}\ \O~&7£>cation 92008 Est. Value 19 Plan Ck. Deposit Date (L/2,7 / / 1 SWPP SUITE#/SPACE#/UNIT# APN # BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP /DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) x1 j' y^l— ""^ ^ \^*ffcOv ^ Sr EXISTING USE PROPOSED USE GARAGE (SF) CONTACT NAME (If Different Fom Applicant) ADDRESS CITY STATE ZIP PHONE FAX EMAIL ^ROPERTYOWNER NAME ADDRESS S CITT\ f STATE ZIP _ PHONE FAX '* I ENJAJfc ARCH/DESIGNER NAME & ADDRESS STATE LIC. # PATIOS (SF) DECKS (SF) FIREPLACE AIR CONDITIONING FIRE SPRINKLERS YES-D # NOD YES D NOD YES D NOD APPLICANT NAME ADDRESS CITY STATE ZIP PHONE FAX EMAIL CONTRACTOR BUS. NAME ADDRESS ' CITY STATE ZIP PHONE FAX EMAIL STATE LIC.# CLASS CITY BUS. LIC.# (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 theapplicant 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 theBusiness 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 thecivil penalty of not more than five hundred dollars ($500]). ubjects the applicant to a Workers' Compensation Declaration: / 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 perm it is issued. Q 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 workers' compensation insurance carrier and policy number are: Insurance Co.. Policy No. Expiration Date This section need not be completed if the permit is for one hundred dollars ($100) or less. U Certificate of Exemption: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California. WARNING: Failure to secure workers' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil Tines up to one hundred thousand dollars (&100.000), in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. J£$ CONTRACTOR SIGNATURE DAGENT DATE / he/ieoy affirm that I am exempt from Contractor's License Law for the following reason: *$£ ' 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). D 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). O I am exempt under Section Business and Professions Code for this reason: 1.1 personally plan to provide the major labor and materials for construction of the proposed property improvement. D Yes D No 2.1 (have / have not) signed an applicatiorffor a buying permit for the proposed work. 3.1 have contracted with the following person (firm) to provide the proposed construction (include name address / phone / contractors' license number): 4.1 plan to provide portions oUne work, but I have hired the following persolQp coordinate, supervise and provide the major work (include name / address / phone / contractors' license number): 5.1 will provide some of the/work, but I havejzontracted (hired) tt^frjllowiiig persons to provide the work indicated (include name / address / phone / type of work): PROPERTY OWNER SIGNATURE J&GENT 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? rj Yes D No 1$ the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? D Yes D No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D Yes D No IF ANY OF THE ANSWERS ARE YES, t EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address I hereby authorize representative of trie < AGAINST ALL LIABILITIES, JL OSHA: An OSHA permit is required for« EXPIRATION: Every permit issued by the I 180 days from the date of sucjr permit or if I JS$APPLICANT'S SIGNATURE 1 to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD rtS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY INCONSEQUENCE OF THE GRANTING OF THIS PERMIT. Ins over 5'0' deep and demolitnn arsonstruction of structures over 3 stories in height, tfing Official under theDroyfejopSof tnte Cbde shall expire by limitation and become null and void if the building or work aulhonzed by such permit is not commenced within 6 buildina^twwk^OrizecWsudi permit is suspended or abandoned at any time after the work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). City of Carlsbad Bldg Inspection Request For: 05/16/2011 Permit* CB110876 Title: HENRY: 1600 SF SHAKE TO COMP Description: SHINGLE Type:MISC Sub Type: REROOF Job Address: 2145 CHESTNUT AV Suite: Lot: 0 Location: APPLICANT HENRY MELVIN J&KAY I Owner: HENRY MELVIN J&KAY I Remarks: a m please Total Time: CD Description Act Comments Roof/Reroof Inspector Assignment: TP Phone: 7604345865 Inspector: > Requested By: HENRY Entered By: CHRISTINE Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# Inspection History Date Description Act Insp Comments