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CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161
PllRMIT APPLICATION PLAN CHECK NO. er C
c;fy of ,Carlsbad Building D-rtant
2075 Las P■l-Dr., carlsbad, CA 92009 (619) 438-1161
1. PERMII IYPE
From List 1 (see back) give code of Pennit-Type: ___________ _
For Residential Projects Only: From Use 2 (see back} give
Code of Structure-Type: ____________________ _
Nee Loss/Gain of Dwelling Units
2. PRClJECT INFORMATION FOR OFFICE USE ONLY
Address 2 3 '2 / /n C>tZC I+ "p /..., Building or Suue No.
Nearest Cross Street J:} NI LL O
LEGAL OEStkIP I ION Lot No. Subd1V1s1on Name/Number Lime No. Phase No.
CHECK BEWW IF SOBMll 1£D:
C 2 Energy Cales -B"!structural Cales C 2 Soils Report C I Addressed Envelope
ASSESSOR'S PARCEi ~STI~USE PBO~sFn-ijgE
DESCRIPTIONOFWORK--ri..~ C>fl"SJH)I/µ, poo-v pz_,;wooi) ...J-Tfi.¥ ll <>60
SQ. FT. 00 C, # OF SlURIES / # OF BEDROOMS '.3 # OF BATIIROOMS 2_
1 1 eren ram app ,can
NAME (last name first) ADDRESS
Cl1Y ST A TE ZIP CODE DAY TELEPHONE
4-~tlnam~~l~~u;;pAGENI FORwN1o~~1'.zq~~1N~O,<.i~EJ9p~~DWNER
CITY So,v C.1t:J STATE(/,K. ZIP CODE 9t!Y7 DAY TELEPHONE ¥'cXJ-}Y0-(7Cf/,
s. ~l~;,':.!'e"l}rst) Sf-oL°BJ..'f'l1 ADDRESS 232/ /l'Jf.WZ.,,Cf'/-V'-·
CITY C~BP<Q STATE l/Ql,, ZIPCODEq"2. 00'1 DAY TELEPHONE 73r--"3"3,9'
•. z.i!Pl!i~me first) "\!Y-}J=:4/!YZ. ILoor-,IVfy' ADDRESS 2q2.7r C()IU~·-]() 7)tZ •
-I ,YO-J7'f 1.. CITY 5°(),v Cc C, STATElf.H.-ZIPCODEq-;?S°Y7 DAYTELEPHONE 9'QCJ-
STATE UC. # '(,&1-'j'-2. LICENSE Cl.ASS C-°3' CITY BUSINESS UC. # / ¢>0 5
ast name 1rst
CITY STATE ZIP CODE DAY TELEPHONE STATE UC.# 7. WOIOMiS1 WM.PENSA I ION
C
C
□
Workers' Compensation Declarauon: I hereby affmn that I have a cerlitlcate of consem to seii-msure issued by the Director of lndusrnal
Relations, or a certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified
by the Director of the insurer thereof filed with the Building Inspection Depanment (Section 3800, Lab. C).
POLlcY NONWl °7M 'Q'..Qp(PIRATION DATE 'J 7'/ 'f6
DATE '?"J:z_. fl,
Owner-Builder Declaration: I hereby afnnn that I am exempt from the Contradofs 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.).
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 Llcense 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).
1 am exempt under Section _______ Business and Professions Code for this reason:
(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 Llcense Law (Chapter 9, commencing 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 [$500]).
SIGNATIIRE DATE
COMPO:IE IRIS S£CIIUN FUR NON-RESIOEN I !At B0iilllNG PERMI i's 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 25S34 of the Presley-Tanner Hazardous Substance Account Act?
□ YES □ NO
ls the applicant or future building occupant required to obtain a permit from the air pollution control discrict or air quality management district?
C YES C NO
Is the facility to be constructed within 1,000 feet of lhe outer boundary of a schex>l site?
C YES C NO
IF ANY OF nm ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANcY MAY Nor Bl!~ AFl"ER JULY 1, 1989 UNlJ:SS nm APPLICANT
HAS MET OR IS MEJmNG nm REQUIREMENTS OF nm OFFICE OF EMERGENcY SERVICES AND nm AIR POlllJTION ffiNTII.OL DISfRICT.
9. WNS I KOCI ION LENDING AGENCY
I hereby afhrm iliac iliere 15 a construction iendmg agency for the periormance of the work for which thts permit 1s 1SSued (Sec 309?(1) Civil Code).
LENDER'S NAME I.ENDER'S ADDRESS
JU. XPPUCXN I cmttFICAIION
I certify iliac I have read the appUcauon and state that the atxive mformat1on 1s correct. I agree to comply w1ili ail C1ry ordinances and State laws
relating to building construction. I hereby authorize representatives of the City of Carlsbad to enter UJX>n the above mentioned property for inspection
purposes. I AISJ AGREE m SAVE INDEMNIFY AND KEEP HARMLESS nm crtY OF CAR1SBAD AGAINSf AIL LlABIUllES, JUDGMENTS, CDSTS
AND EXPENSES WHICH MAY IN ANY WAY J\OCI\UE AGAINSf SAID crtY IN mNSEQUENCE OF nm GRANTING OF nns PERMIT.
OSHA: An OSHA permit is required for excavations over S'O" deep and demolition or construction of structures over 3 stories in height.
Expiration. Every permit issued by the Building Official under lhe provisions of this Code shall expire by limitation and become null and void if lhe
building or work authorized by such permit is not commenced within 36S days from the date of such permit or if the building or work authorized by
such permit is suspended or abandoned any time after the work is commenced for a period of 180 days (Section 303(d) Uniform Buildi g e).
APPIJCANrs SIGNATURE ~ DATE: ,,, ... ti
YELLOW: Applicant PINK: Finance
CITY OF CARLSBAD
SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING
1. JOB ADDRESS 2'.J 2.1 M A-VZ.ffi i'L
2. TYPE OF BUILDING: RESIDENTIAL -----COMMERCIAL --
3. ROOF SLOPE: RISE Lj inches in 12 inches
4. TYPE OF EXISTING ROOF COVERING S (.f,l}IL/£ SHEATHING / X (, -~~-----
5. NUMBER OF EXISTING ROOF COVERINGS (circle one) {1) 2 3 iJ'~.
*6. NEW ROOF MATERIAL "Tf /-:f:: CLASS A-WEIGHT PER SQUARE_9~--
7. NUMBER OF SQUARES "J 0 ~-......----
8.
9.
TRADE NAME ~kt:-l{L!.? MANUFACTURER'-'~'--'--+'L'-'~'-------
ROOF SYSTEM APPWiAL UL No.____ Other I '-8 6 -1-/ '(, 0
10. IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF
THE PROPOSED ROOF YES ----NO __ _
If the answer is no, a roof plan must be provided with this application.
11. Fire rating of roof: Class A .,..----Class B __
I understand the following inspections are required:
1. Tear Off/Pre-inspection prior to installing new roof covering.
2. Final Inspection
I agree to provide a ladder extending at least 2 rungs above the roof for inspection.
SI~~_,,..___ DATE
Contractor ~er Contractor Name
•
-----------------
*6 -Rolled Roofing, Tile, Shake, Shingle, Asphalt/Comp Fiberglass, Built up.
CITY OF CARLSBAD
INSPECTION REQUEST
PERMIT# CB962151 FOR 11/12/96
DESCRIPTION: RE-ROOF,3300 SF,REMOVE SHAKE-
APPLY STANDARD CLAY TILE W/STRUCT CALCS
INSPECTOR AREA
PLANCK# CB962151
OCC GRP
TYPE: MISC
JOB ADDRESS: 2311 MARCA PL
APPLICANT: JAEGER ROOFING
CONTRACTOR:
OWNER:
REMARKS: BJN/ALLAN/800-580-1792
SPECIAL INSTRUCT:
TOTAL TIME:
CD LVL DESCRIPTION
PHONE:
PHONE:
PHONE:
STE:
CONSTR. TYPE NEW
LOT:
800 580-1792
INSPECTOR_\....__ ________ _
AC'.}j' COMMENTS
15 ST Roof/Reroof /f_ ') Ji)'b 1 (/~/ 1/ cJ<~, ~ _S;'J'-cL~
----------------------'-'--------------------------------------------------
***** INSPECTION HISTORY*****
DATE DESCRIPTION ACT INSP COMMENTS