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Home My WebLink About2400 ALTISMA WAY; ; CB043267; Permit08-19-2004 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Building Inspection Request Line (760) 602-2725 Miscellaneous Permit Permit No: CB043267 2400 ALTISMA WY CBAD MlSC Subtype: REROOF Status: ISSUED 23szm#+ Lot #: 0 Applied: 0811 912004 $23,200.00 Entered By: RMA Plan Approved: 0811 912004 Issued: 0811 912004 ARROYO VILLAS-8000 SF STD WT CONCRETE Inspect Area: Applicant: J P WITHEROW ROOFING 1001 MORENA BLVD 921 10 6192974701 Owner: PRINCE ROBERT D&HENRY MICHELLE A 2400 ALTISMA WAY #A CARLSBAD CA 92009 Miscelaneous Fee #I Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES PERMIT FEE $345.00 $0.00 $0.00 $345.00 Total Fees: $345.00 Total Payments To Date: $0.00 Balance Due: $345.00 Inspector: Clearance: NOTICE: Please take NOTICE that approval of your project includes the “Imbosition’of fees, dedications, reservations, or other exactions hereafter collectively referred to as “feeslexactions.“ You have 90 days from the date this permit was issued to protest imposition of these feeslexactions. 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 feeslexactions of which vou have Dreviouslv been aiven a NOTICE similar to this. or as to which the statute o flimiai t to n s h as D r ev i ous I v ot h e Iwi se e x D ired. PERMIT APPLICATION PLAN CHECK NO. CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 Assessor's Parcel X Existing Use Proposed Use X of Bedrooms t of Bathrooms 7a Y Name Address City Statelzip Telephone I (Sec. 7031.6 Business and Professions Code: Any City or County which requires a permit to construct, altar, 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 Lew IChanter 9. commendina with Section 7000 of bivision 3 of the Business and Professions Codel or that he is exempt therefrom, and the basis for the alleged City StateKip Telephone I City Business License x /a I I 938 Nama Address License Cless Designer Name Address City StateZip Telephone State License I Workers' Compensation Declaration: I hereby affirm under penalty of pejury 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. g/;have end 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 Insurance Company Policy No. c% 9 Expiration Date / f ' - [THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS I$1001 OR LESS) 0 to become subject to the Workers' Compensation Laws of Celifomia. WARNINQ Fdhm thowand dollars ((11 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 es covomga b unl.wtul, nd atuN e n onrpkyw to aimhd p.n.ltiea urd dvR Rno up to one hundnd cornpen8ation. datnqpa as provided for in Saction 3706 o I hereby affirm that I am exempt from the Contractor's License Law for the following reason: 0 1, as owner of the property or my employees with wages as their sola compensation, will do the work and the structure is not intended or offered for sale (Sec. 7044, Busineu and Professions Code: The Contrnctor's License Law does not apply to an owner of property who builds or improves thereon, and who does such work himself or through Ms own employees, provided that such improvements are not intended 01 offered for sale. if, however, the building of Improvement is mid 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). 0 1, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The Contractor'a License Law does not epply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(8) licensed pursuant to the Comnctor's License Law). 0 1. 2. 3. I am exempt under Section I personally plan to provide the major labor and matarials for construction of the proposed property improvammt. 0 YES ON0 i (hava I have not1 signed an rpplication for a building permit for the proposad work. I have contracted,wlth the following person (firm) to provlde the proposed construction (include name I address I phone number I contractors license number): Budnoas and Professions Code for this reason: 4. number I contrecton licenaa number): 6. of work): 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 I address I phone I will provide some of the work, but I have contracted (hired) the following parsons to provide the work indicated (include name I address I phone number I type PROPERTY OWNER SIGNATURE DATE Is the applicant or future building occupant required to submit a businass plan, acutely hazardous materials registration form or risk management and prevention program under Sections 26506,26633 or 26534 of the Presley-Tanner Hazardous Substance Account Act? c 0 YES Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air qualiy management district? 0 YES 0 NO la the facility to be constructed within 1,000 feet of the outer boundary of a school site? 0 YES 0. NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS METING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. 0 NO I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 30971i) Civil Code). LENDER'S NAME LENDER'S ADDRESS 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 Cit). 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 la required for excavations over 6'0' deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit Issued by ttie building Offlcial under the pmvisions of this Code shall explre by limitation and become null and void If the building or work authorized by such permit is the date of such permit or if the building or work authorized by such permit 18 suspended or abandoned at any time after the work is mmm APPLICANT'S SIGNATURE DATE ion 106.4.4 Uniform Building Code). WHITE: File YELLOW: Applicant PINK: Finance I '. City Of Carlsbad SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING 2. TYPE OF BUILDING: RESIDENTIAL 6/ COMMERCIAL 3. ROOF SLOPE: RISE 1 inches in 12 inches 4. NUMBER OF ExisTi~G ROOF COVERING (circle one) @J 2 3 5. TYPE OF EXISTING *6. NEW ROOF 7. mer SHEATHING ppm~ . CLASB WEIGHT PER SQUARE 9. ROOF SYSTEM LISTJNG UL No. IC60 No. 37H . 10. IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? @ 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: -, 4, 1. Tear OfflPre-inspection 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. A Signature Date $* 19-4 Owner Contractor Name Contractor /- *6 - Rolled Roofing, StandardlLite Tile, AsphalVComp Fiberglass, Built up, Other. City of Carlsbad Bldg Inspection Request For: 0 1 /05/2005 Permit# CB043267 Inspector Assignment: JM Title: ARROYO VILLAS-8000 SF STD WT Description: CONCRETE Type: MlSC Sub Type: REROOF Job Address: 2400 ALTISMA WY Suite: Lot 0 Location: OWNER PRINCE ROBERT D&HENRY MICHELLE A Owner: Remarks: Total Time: Phone: 61 92974702 Inspector: Requested By: BOB BYRD Entered By: CHRISTINE CD Description Act Comment 19 Final Structural Associated PCRs/CVs InsDection History Date Description Act lnsp Comments 09/20/2004 13 Shear Panels/HD's WC JM 09/20/2004 13 Shear PaneWHD's WC JM 09/20/2004 13 Shear PaneldHDs WC JM 09/20/2004 15 RooWReroof AP JM NORECORDCARD P-04 4 01:4€3P .yi<?&-,;* ~ -** -- .;. &-+5! . ., ... State Of California QRS STATE LICENSE B~ARI-I '-V Entity bUKr BIF~~I- Nirw J P WITHEROW ROOFING COMPANY ,. .L .. .. .. ..._ -. ... ^_ -__ . . Any change of business addresslname must be reported to the Registrar within 90 days. This license is not transferrable, and shall be returned to the Registrar upon demand when suspended, revoked, or invalidated for any reason. , This pocket card is valid through the expiration date only. Postage guaranteed by: Contractors State License Board P.O. Box 26000 Sacramento, CA 95826 If f9und, drop in any mailbox. Licensee Signature 65JPWITH --Ir Client#: 14986 - ACORD, CERTIFICATE OF LIAgILlfY INSURANCE DATE (MMIDM 01106/04 HRH of Colorado 720 S. Colorado Blvd. Ste. PH N P.O. Box 469025 I INSURER E: I THIS CERTIFICATE IS ISSUED AS A MATTER OF INFoR~T,~ ONLY AND CONFERS NO RIGHTS UPON THE CERTIF~ATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. I I Denver, GO 80246-9025 INSURED J.P. Witherow Roofing Company, Inc. 1001 Morena Boulevard San Diego, CA 92110 AUTO ONLY - EA ACCIDENT I $ I ~GEUABIUN I I I I INSURERS AFFORDING COVERAGE NAlC# ' INSURER A: Valley Forge Insurance Company INSURER 8: Transcontinental Insurance Companies INSURERC: State Comp. Ins. Fund INSURER D t. I HANYAUTO B CLAIMS MADE ANY PROPRlETORlPARTNERECUTIVE OFFlCERlMEMBER EXCLUDED? KSCRlPTlON OF OPERATIONS I LOCATlONS I VEHICLES I EXCLUSIONS ADMD BY ENDORSEMENT I SPECIAL PROVISIONS "IO DAY NOTICE OF CANCELLATION FOR NON-PAYMENT OF PREMIUM GENL AGGREGATE LIMIT APPLIES PER. PRODUCTS - COMPfOP AGG $2,~~~,~~~ ipoLlCy~~gf n LOC -? ~1,000,000 AUTOMOBILE LIABILITY BUA2067535304 12/31/03 12/31/04 COMBINED SINGLE LIMIT (Ea stdent) ANY AUTO ALL OWNED AUTOS BODILY INJURY - - s (Per penm x SCHEDULED AUTOS - BODILY INJURY CERTIFICATE HOLDER CANCELLATION lSIiOUl0 ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE ME O[PI-nON I REPRESENTATIVES. - - Proof of lnsurance- DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL 3 OnYs WRI~N NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE To Do SO SHAU IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE-INSURER. lis OR