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Home My WebLink About2411 APPIAN RD; ; CB043483; PermitCity of Carlsbad Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: b Applicant: PIVA ROOFING, BOB 1 192 INDUSTRIAL AV ESCONDIDO, CA 92029 61 9-745-4700 1635 Faraday Av Carlsbad, CA 92008 Building Inspection Request Line (760) 602-2725 Miscellaneous Permit Permit No: CB043483 241 1 APPIAN RD CBAD MlSC Subtype: REROOF Status: ISSUED 1673810200 Lot #: 0 Applied: 09/07/2004 $4,218.00 Entered By: MDP Plan Approved: 09/07/2004 Issued: 09/07/2004 HOLLIBAUGH RESIDENCE Inspect Area: 37 SQUARES OF COMP REROOF Owner: HOLLIBAUGH KAREN 2411 APPIAN RD CARLSBAD CA 92008 Miscelaneous Fee #I Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES PERMIT $1 03.00 $0.00 $0.00 $103.00 Total Fees: $103.00 Total Payments To Date: $0.00 Balance Due: $103.00 Inspector: Date: Clearance: - NOTICE: Please take NOkE that approval of your project includes the ‘Impos’ition” of feet 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 feeslexactions 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 given a NOTICE similar to this, or as to which the statute of limitations has Dreviouslv otherwise exDired. PERMIT APPLICATION cin OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 Address (include BldglSuite #I Legal Description Lot No. Subdivision NamelNumber Unit No. Phase No. Total # of units Assessor’s Parcel # Existing Use Proposed Use # of Bedrooms Description of Work Business Name iat this address) # of Bathrooms Q $S_.,,,,* ~~~l~lffe~en~~~ Name Address City StateEip Telephone # Fax # (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 permlt 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 Codel or that he is exempt therefrom, and the basis for the alleged Name Address City Statelzip Tele hone # State License # 3 )g 7 3 License Class C 3 7 City Business License # 120 3 I 98 Designer Name Address City Statelzip Telephone State License # Workers’ Compensation Declaration: a of the work for which this permit is issued. ssued. My worker’s compensation insurance carrier and policy number are: Insurance Company ss.-C.tr a 1 M€R ATkIf4 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 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 6JV-d Policy No. 2%~ o~~ 3-53 56 CI Expiration Date b// lo 5 P (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ~siooi OR LESS) 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 s up to one hundred attorney’s fees. coverage Is unlawful, and shall subject an employ compensatlon. damages as provided for in Sectlon 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 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). 0 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business snd 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(s1 licensed pursuant to tpe Contractor’s License Law). 0 1. 2. 3. I am exempt under Section I personally plan to provide the major labor and materials for construction of the proposed property improvement. 0 YES ON0 I (have I have not1 signed an application for a building permit for the proposed work. I have contracted with the following person (firm) to provide the proposed construction (include name I address I phone number I contractors license number]: Busirtess and Professions Code for this reason: 4. number I contractors license number): 5. 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 (hiredl the foliowlng persons to provide the work indicated (include name I address I phone number I type of work): PROPERTY OWNER SIGN ma&p 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? 0 YES 0 NO Is the applicant or future byildlng occupant required to obtain a permit from the air pollution control district or air quality management district? 0 YES 0 NO Is 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 FlN&L CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUlREMENTS OF THE OFFICE OF EMERGGNCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (See. 3097(i) 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 tu comply with all City ordinances and State laws relating to building construction. 1 hereby authorize representatives of the Cltv of Carlsbad to enter upon the hove mentioned property for inspectioh purposes. I ALSO AGREE TO SAVE. INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST LL LIABILITIES, JUDGMENTS, COSTS PND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS % ERMIT. EXPIRATION: Every permit issued by the building rovisions of this Code shall expire by llmltation and become null and void if th 1 building or work OSHA An OSHA perrhit is required for excavations over 5’0” deep and demolition or construction of structures over 3 stories in height. authorized by such penhit is not commen ate of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the wdrk is commenced lion 106.4.4 Uniform Building Code). APPLICANT’S SIGNATURE W@W+~TiQT~@ WHITE File YELLOW. Applicant PINK Finance . City of Carlsbad Bldg Inspection Request For: 12/22/2004 Permit# CB043483 Title: HOLLIBAUGH RESIDENCE Description: 37 SQUARES OF COMP REROOF Type: MlSC Sub Type: REROOF Job Address: 241 1 APPIAN RD Suite: Lot 0 Location: OWNER HOLLIBAUGH KAREN Owner: HOLLIBAUGH KAREN Remarks: Total Time: Inspector Assignment: PC Phone: 7607454700 Inspector: Requested By: CONTRACTOR Entered By: JANEAN CD Description 'Act Comment 19 Final Structural Associated PCRs/CVs InsDection History Date Description Act lnsp Comments la1 512004 15 RooflReroof AP PC City Of Carlsbad SUPPLEMENTAL BUlLDlNG PERMIT APPLICATION FOR REROOFING 1. JQB ADDRESS: l?. q\\ ft ?v\c\\n d( 2. TYPE OF BUILDING: RESIDENTIAL A COMMERCIAL 3. ROOF SLOPE: RISE 5- inches in 12 inches 4. NUMBER OF EXISTING ROOF COVERING (circle one) CJ z 3 5. TYPE OF EXISTING ROOF COVERING 5bk SHEATHING #b . "6. NEW ROOF MATERIAL &w,? CLASS E WEIGHT PER SQUARE 7. NUMBER OF SQUARES 8. TRADENAME f'tt~ MANUFACTURER k7 9. ROOF SYSTEM LlSTJNG UL No. - ICBONo. 5Tt4 3 3- 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. Combu'Stibie roof coverings of any type or classification are prohibited. 1 understand the following inspections are required: a 1. Tear OfflPre-inspection prior to installhew roof covering. 2. Final Inspection I agree to provide a ladder g at least 2 rungs above the roof for inspection. Other. .. '. 1, mM CERTlFiCATE OF. LIABILITY INSURANCE PP.ODuCER (619) 5x4- 6400 FAX (619) 584-6425 West1 and Insurance Brokers 3838 Camino Del Rio North #315 Box 85481 Diego, CA 92186-5481 '1. b Bob Piva Roofing Company, Inc. 1192 Industrial Avenue Escondido, CA 92029 I DATE (MiwDormr) 1 06/02/2nns THlS CERTIFICATE IS ISSUED AS A MATTER OF INFORMAT~ON ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THiS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE NAfC # INSURER A. Admiral Insurance Company/Sterl irig 24851 INSURER 6: Peer1 ess Insurance Company 24198 iNsuRERc.State Compensation Fund 629 INSURER D lNSURW E: COVERAGES I . E POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PEMOO INDICATEQ. NOTWITHSTANGIN( 3CUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE lSSUED OR Y REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHEF Y PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBEC LICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PA CLAIMSMADE OCCUR Ij GEN'L AGGREGATE LMi APPLIES PER I ANY AUTO ALL OWNED AUTOS H SCHEDULED MOS 'H I If I ANY AUTO EXCESSNMBREW UABlcrrY DEWCTlBLE . REFENTION $ IC WORKERS COMPENSATION AN0 EMPLOYERS' WUTY ANY PROPRIETORIPARTNEWEXECUTIVE OFFlCERlMEMBER EXCLUDED? 285000233504 I IF yes. describe under SPECIAL PROVISIONS below OMER 11 I DESCRIPTION OF OPERATIONS I LOCATIONS I VEHlCLES I EXCLUSIONS ADDED BY ENDORSE Re: ISSUED AS EVIDENCE OF INSURANCE ONLY ;REIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH I 06/01/2004 06/01 /Od NT I SPECIAL p8OY .. DAMAGE TO RENTED 06/01/200s COMBINED SINGLE LIMIT s 1,000,000 (Ea aacident) BODILY INJURY I person) I I -1 I (per accident) I$ I BODILY INJURY $ PROF43lYDAMAGE (Far accident) AUTO ONLY - EA ACCIDENT. S I- OTHERTHAN EAACC1$ AGG S AUTO ONLY I i EACHOCCURRENCE I $ AGGREGATE Is I CERTIFICATE HOLDER CANCELLATION SHOULD ANY OF THE AGOVE DESCRIBED POLlClES BE CANCELLED BEFORE THE EXF'IRATION DATE THEREOF, THE ISSUING INSURER WlLL ENDEAVOR TO MAIL 10 . DAYS WRtlTEN NOTICE TO THE CERT1FlCATE HOLDER NAMED TO THE LEFT. i ISSUED TO NAMED WSURED **o.~QQQ*i;Q"Q%-*x;>c~>*~-~-C~;B*i;i;~.%.B~?.~~~-~-~;~<-~-B~~.3>-~~: