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Home My WebLink About2351 CIPRIANO LN; ; CB023409; Permit11-13-2002 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No CB023409 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Valuation Reference # Project Title Applicant EDDNI STED 636 CORTEZ VISTA CA 92084 760 726 0947 2351 CIPRIANO LN CBAD MISC 1560321900 $2 862 00 Subtype REROOF Lot* 0 HARDACRE RESIDENCE 27 SQUARES OF COMP REROOF Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 11/13/2002 MDP 11/13/2002 11/13/2002 HARDACRE GERALD F&JUDIT^P?9 U/13/02 0002 01 02 COP 77. 2351 CIPRIANO LN CARLSBAD CA 92008 Total Fees $77 00 Total Payments To Date $0 00 Balance Due $77 00 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees • TOTAL PERMIT FEES PERMIT $7700 $000 $000 $7700 Inspector FINAL APPROVAL 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 oreviouslv otherwise expired PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 1 PROJECT ^FORMATION FOR OFFICE USE ONLY PLAN CHECK NO EST VAL " Plan Ck Deposit. Validated By Date Address (include Bldg/Suite #LSSaT/ c.PRin Legal Description Assessor s Parcel tt ^. Description of Work Business Name (at this address) Lot No Subdivision Name/Number Unit No Phase No _ Existing Use -^ Proposed Use SQ FT #of Stories # of Bedrooms Total tt of units tt of Bathrooms „CONTACT PERSON (if different from applicant) Name Address 3 ^MPPLICANt CO Contractor D Agent "for Contractor Q Owner — ' "" " " y\ s) ID Ce (i t- City State/Zip Telephone tt Fax* Name 4 PROPERTY-OWNER Address City State/Zip Telephone tt /ilephone #O\P(-^ll\/(J Address^ 3 % [ C\ (* R ( r\ M Q Clty C Q State/Zip 5 CONTRACTOR »COMPANY NAME '** iff tsc „ *» sfe, (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 [$500]) Name £~~<J d <J State License # ,57*7 CdfJ S Address (a 3 License Class D 6 <J /T. fY City V^ J "ft*- State/Zip Co- City Business License # Telephone # Designer Name Address City State/Zip Telephone State License tt 6 "WORKERSTlOMPENSlffiON^ h" /" { ^ ,«" ^ r ,^F #igr" """ ,y — f Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations 0 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 l~l 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 carrier and policy number are Insurance Company vS T^^t^ff P~U AJ (*> Policy No // H^ 7*75^ Expiration Date / / - O ' ~ °-3 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) l~l 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 fines 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 SIGNATURE DATE <T OWNER BUIlDERfDECLARAfiON ->• "'' ~'*" _—*" ^ --• *»- j* 1 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) l~l 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) n 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 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) ^ PROPERTY OWNER SIGNATURE DATE COMPLETE THIS SECTION FOR NON RESIDENTIAL BUILDINGJ>ERMITS ONLY f ~ <if~ * **" ^ " £^" ** t 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? [H YES D NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district' [~| YES l~l NO Is the facility to be constructed within 1 000 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 8 "CC«NSTRyCTIOlfiENDINlS"AGENCY -ft „ J*7 „-> ^ .TV » "7" 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 , -* „**" '" J*~~ ^ ^ ^ ^ ~ *- > x __ % s 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 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 lUhe building or work authorized by such permit is not commenced within 180 days from the date of such permit or if the building or work authorized by such permit is syepended or abandoned at any time after the work is commenced foca period of 180 days (Section 106 4 4 Uniform Building Code) APPLICANT S SIGNATURE DATE WHITE File YELLOW Applicant PINK Finance City Of Carlsbad SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING 1. JOBADDRESS A3S7 Cl$$lfrfiJ<* ^ ^ 2. TYPE OF BUILDING RESIDENTIAL ^ COMMERCIAL 3 ROOF SLOPE RISE */// Cinches in 12 inches 4 NUMBER OF EXISTING ROOF COVERING (circle one) 1 2 3 5 TYPE OF EXISTING ROOF COVERINGjT^ViJ^SHEATHING *6 NEW ROOF MATERIAL €&-tfc CLASS A- WEIGHT PER SQUARE 7 -NUMBER OF SQUARES 8 TRADE NAME _ MANUFACTURER 9 ROOF SYSTEM LISTING UL No ICBO No 10 IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? (YEsD 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 Date II- Contractor % Owner Contractor Name *6 • Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other City of Carlsbad Bldg Inspection Request For 11/25/2002 Permit# CB023409 Title HARDACRE RESIDENCE Description 27 SQUARES OF COMP REROOF Inspector Assignment SR Type MISC Sub Type REROOF Job Address 2351 CIPRIANO LN Suite Lot 0 Location APPLICANT EDDNI Owner HARDACRE GERALD F&JUDITH Remarks Phone 7605182098 Inspector Total Time CD Description 19 Final Structural Act Comment Requested By EDDY Entered By BINSPECT Associated PCRs/CVs Inspection History Date Description Act Insp Comments 11/20/2002 19 Final Structural CO SR NEED TO PAINT VENTS/NEEDS TO CLEAN OFF ROOF 11/18/2002 15 Roof/Reroof AP SR OK TO COVER SD COMPENSATION INSURANCE FUND PO BOX 807 SAN FRANCISCO CA 94101-0807 CERTIFICATE OF WORKERS COMPENSATION INSURANCE ISSUE DATE 11-01-02 POLICY NUMBER 1149795 - 02 CERTIFICATE EXPIRES 11-01-03 CONTRACTORS STATE LICENSE BOARD ATTN WORKERS' COMP UNIT BOX 26000 SACRAMENTO CA 95826 UOB CONTR LIC #580785 INCEPTION DATE 11-01-02 D 0 SAN DIEGO This is to certify that we have issued a valid Workers Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to the employer We will also give you 10 days advance notice should this policy be cancelled prior to its normal* expiration This certificate of insurance is not an insurance policy and does not amend extend or alter the coverage afforded by the policies listed herein Notwithstanding any requirement term or condition of any contract or other document with respect to which this certificate of insurance may be issued or may pertain the insurance afforded by the policies described herein is subject to all the terms exclusions and conditions of such policies EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS PRESIDENT $1 000 000 00 PER OCCURRENCE STANDARD EXCLUSION INDIVIDUAL EMPLOYERS AND HUSBAND AND WIFE EMPLOYERS ARE NOT ELIGIBLE FOR BENEFITS AS EMPLOYEES UNDER THIS POLICY EMPLOYER LEGAL NAME EDO N I CONSTRUCTION 636-D CORTEZ AVE VISTA CA 92081* MUELLER EDWARD W THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND PRINTED. 10-17-02 PQ409SCIR102S5 (REV: 2-01)