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Home My WebLink About2365 CAMINO VIDA ROBLE; ; CB120653; Permit04-12-2012 City of Carlsbad 1635 Faraday Av Carlsbad.CA 92008 Miscellaneous Permit Permit No: CBl20653 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: PC#: Project Title: 2365 CAMINO VIDA ROBLE CBAD MISC Subtype: 2130502700 Lot#: $23,522.00 16010 SF REROOF: TO SINGLE PLY MEMBRANE REROOF 0 Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 04/12/2012 JMA 04/12/2012 04/12/2012 Applicant: GM ROOFING CO. Owner: F R NATIONAL LIFE LLC PO BOX 3908 SEAL BEACH CA 90740 562-429-7663 898 N SEPULVEDA BLVD #750 EL SEGUNDO CA 90245 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES PERMIT FEE $455.00 $0.00 $0.00 $455.00 Total Fees: $455.00 Total Payments To Date: $455.00 Balance Due: $0.00 ^^^^^^^ Inspector: FINAL APPROVAL Date: S'f7-/Z-' Clearance: NOTICE: Please take NOTICE that approval of your project Includes the "Imposition" of fees, dedications, resewations, or other exactions hereafter collectively referred to as lees/exactions." You have 90 days from the date this permit was Issued to protest Imposition of these fees/exactlons. If you protest them, you must follow the protest procedures set forth in Govemment 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 imposltk)n. 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/exactlons of which vou have oreviouslv been given a NOTICE similar to this, or as to which the statute of limitations has oreviouslv othenvise expired. Building Permit Appiication 760-602-2717/2718/2719 Fax 760-602-8558 www.carlsbadca.gov Plan Check No. Est. Value Plan Ck. Deposit Date-SWPPP CT/PROJECT#— LOir 1 PHASE # * OF UN 1 SUITE«/SPACE*/UNrr* * OF UNITS # BEDROOMS It BATHROOMS TENANT BUSINESS NAME CONSTR. TYPE OCC. GROUP DESCRIPTION OF WORK: Ineluda Squara Faat of Affected Areafs) EXISTING USE iol/niivfaA<-l /V 1 PROPOSED USE GARAGE (SF) PATIOS (SF) DECKS (SF) FIREPLACE YES[~]# NO0 AIR CONDITIONING YEsC?fNO| I FIRESPRINKLERS YES I |N0| I APPLICANT NAME (Primary Contact) APPUCANTNAME (Sacondary Contact; ADDRESS ADDRESS CITY STATE (A ZIP CITY STATE ZIP PHONE FAX PHONE FAX EMAIL EMAIL PROPERTY OWNER NAME «ER NAME . , 1 J I I < CONTRACTOR BUS. NAI 1BUS. NAME fl . ADDRESS 4 STATE , . ZIP , ADDRESS 90 feoi^ ^^(7^ PHONE I ^ ^ CITY STATE ZIP I ~~ FAX FAX EMAIL ARCH/DESIGNER NAME 4 ADDRESS 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 the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions of the Contractor's License Law (Cnapter 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)). WORKERS' COMPENSATION Workers' Compsnssitlon Declaration: / heieby alfirm under penalty ofpeijury one of the following declarations: _ I have and will maintain a caitlficate of content to self-Insure for workers' compensation as provided by Section 3700 of the Labor Code, for the perfonnance of the work for whteh this pennit is issued. Jwl have and will maintain workers' compensation, as rej^uired by Section 3700 of the Labor Code, for the perfonnance of the work for whteh this permit Is issued. My wodcers' compensatkiij insurance carrier and poltey number are: Insurance Co.. ^^t^K>^ Hr/utO PoltevNo. Dfypp iUL-tO ll Explratton Date This sectton need not be completed If the pennit is fbr one hundred dollars ($100) or less. I I Certificate of Exemption: I certify lhat In the performance of the work for whteh this pennit is issued, I shali not employ any peison In any manner so as to become subject to the Workers' Compensatton Laws of California. WARNING: Failura to secure workers' compentatlon coverage Is unlawful, and thall tubject an employer to crimlnai penaitles and civil fines up to one hundred thousand dollars (&100,000), in addition to the cost of compensation, damage/as provided for In Section 3706 of the Labor code. Interest and attomey't feet. I I ^/hln-CONTRACTOR SIGNATURE y/i^ Jf • OW N E R - BUILDER DECLARATION • AGENT DATE / heieby affirm that 1 am exempt from Contractor's Ucense Law forthe Ibllowing reason: I I I, as owner of the property or my emptoyees with wages as their soto compensation, wiil do the work and the structure is not intended or offered for sale (Sec. 7044, Business and Professions Code: The Ckintractors Lteense Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through his own emptoyees, provided that such improvements are not intended or oflered for sale. If, however, the building or improvement sold within one year of completion, the owner-builder will have the burden of proving that he did not buiid or improve for the purpose of sale). I I I, as owner of the property, am exclusively contracting with licensed contractors to constmct the project (Sec. 7044, Business and Professtons Code: The Contractor's Lteense Law does not appiy to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) Iteensed pursuant to the Contractor's Lteense Law). I I I am exempt under Sectton Business and Prafessions Code for this reason: 1.1 personally plan to piovide the major labor and materials for constructton of Ihe proposed property improvemenL •jYes I INO 2.1 (have / have not) signed an appiteatton for a building permit for the proposed wodt. 3.1 have conlracted wilh the foitowing person (finn) to provide the proposed constructton (include name address / phone / contractors' license number): 4.1 plan to provide porttons of the work, but I have hired the foitowing person to coordinate, supeivise and provide the major work (Include name / address / phone / contractois' iteense number): 5.1 will provide some of the work, but I have conlracted (hired) the foitowing persons to provide the wodt indtealed Ondude name / address / phone / type of wodt): >e5'pR0PERTY OWNER SIGNATURE •AGENT DATE COMPLETE THIS SECTION FOR N O N - R E S I D E N T I A L BUILDiNG PERMITS ONLY Is the applteant or future buitoing occupant required to submit a business plan, acutely hazardous matedals registration form or dsk management and preventon program under Secttons 25505,25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? Yes No Is the applteant or future buitoing occupant required to obtain a pemilt from the air pollution control district or air quaiity management district? Yes No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Yes No IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPUCANT HAS MET OR IS MEETING THE REQUiREMENTS OF THE OFFiCE OF EMERGENCY SERVICES AND THE AiR POLLUTION CONTROL DISTRICT. CONSTRUCTION LENDING ACENCY I hereby afUrm 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 APPLICANT CERTIFICATION I certify tliat I have read the applicalion and state that the above infbrmation is conect and that the infonnalion on the pl^ I hereby aulhorize representative of the City of Carisbad to enter upon the above menttoned property for Inspection puiposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL UABIUTIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITT IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT OSHA An OSHA pemnit is required for excavattons over 5'0' deep and demolitton or constnjctton of stnjctures over 3 stories In helghL EXPIRATION: EvBiy pemiit issued by the BuMng Oflicial under the provistons of Ihis Code shal expire by llmltatkjn and become nul and void if the buiWing or wortt aulhorized by such pemit is not commenced within 180 days from the date of such pemilt or if the buMIng or wortt aithortzed by such pemiit is suspended or abandoned at any time after the wortt is commenced for a period of 180 days (Section 106.4.4 Unifonn Building Code). US'APPUCANT'S SIGNATURE f the buMIng or wortt suthorized b) DATE STOP: THIS SECTION NOT REQUIRED FOR BUILOING PERMIT ISSUANCE. Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection. Fax (760) 602-8560, Email www.bulldlno(a!carfsbadca.qov or Mall the completed fonn to City of Cadsbad, Building Division 1635 Faraday Avenue, Carlsbad, Califomia 92008. C0#: (Offlce Uae Only) CONTACT NAME OCCUPANT NAME ADDRESS BUILDiNG ADDRESS CITY STATE ZIP CITY STATE ZiP Carlsbad CA PHONE FAX EMAIL OCCUPANT'S BUS. LiC. No. DELIVERY OPTIONS PICK UP: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg. 1) MAILTO: CONTACT (Listed above) OCCUPANT (Listed above) CONTRACTOR (On Pg.1) MAIL/FAX TO OTHER: ASSOCIATED C8# NO CHANGE IN USE / NO CONSTRUCTION CHANGE OF USE / NO CONSTRUCTION ASSOCIATED C8# NO CHANGE IN USE / NO CONSTRUCTION CHANGE OF USE / NO CONSTRUCTION ^APPLICANT'S SIGNATURE DATE City of Carlsbad Bldg Inspection Request For: 05/16/2012 Permit* CB120653 Title: 16010 SF REROOF: TO SINGLE Description: PLY MEMBRANE Inspector Assignment: £L SubType: REROOF 2365 CAMINO VIDA ROBLE Lot: 0 Type: MISC Job Address: Suite: Location: APPLICANT GM ROOFING CO. Owner: Remarks: ACCESS THRU ROOF HATCH Phone: 5627551130 Inspector: Total Time: CD Description 19 Final Structural Act Comments Requested By: NA Entered By: JANEAN Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# inspection Historv Date Description Act Insp Comments REROOFING SUPPLEMENTAL BUILDING PERMIT APPLICATION 1. JOBADDRESS: ^34>5 CAAAII/\D VVDA (IQ^LU 2. TYPE OF BUILDING: RESIDENTIAL COMMERCIAL ^ 3. ROOF SLOPE: RISE^1^_ INCHES IN 12 INCHES 4. NUMBER OF EXISTING ROOF COVERING (CIRCLE ONE) (j^ 2 3 5. TYPE OF EXISTING ROOF COVERING MeA^jCV)^ SHEATHING 9\^UfboO *6. NEW ROOF MATERIAL WO CLASS WEIGHT PER SQ. W 7. NUMBER OF SQUARES ikl 8. TRADE NAME__ MANUFACTURER h \ TD r^./^ 9. ROOF SYSTEM LISTING: UL NO. I.C.C.E.S. Report # 6- <> ^ '2. g g 2_- ASTM_MtLL_ ^ 10. IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? (J^^ 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-lnspection 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. VA^ P/^O^ Date Skl)^ Signature Contractor Owner Contractor Name (^y^UIOfJ *6. Rolled Roofing, Standard/Lite Tile, Asphalt/Comp fiberglass. Built Up, Other B-10 Page 4 of 4 Rev. 02/11