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Home My WebLink About2504 CHESTNUT AVE; ; CB042963; Permit07-30-20 Job Address: Pernjiit Type: Parcel No: Valuation: Reference #: Project Title: City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No: CB042963 \/\y) Building Inspection Request Line (760) 602-2725 <r 2504 CHESTNUT AV CBAD MISC 1672703800 $2,775.00 SMILEY RES 2500 SF REROOF COMPTOCOMP Subtype: Lot#: REROOF 0 Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 07/30/2004 SB 07/30/2004 07/30/2004 Applicant: PATRIOT ROOFING 1042 EL CAMINO REAL ENCjNITAS, CA 92064 760-577-2935 Owner: SMILEY DENNIS B&PATRICIA L 2504 CHESTNUT AVE CARLSBAD CA 92008 Miscelaneous Fee #1 PERMIT FEE Miscelaneous Fee #2 Additional Fees $77.00 $0.00 -•':• $0.00 TOTAL PERMIT FEES $77.00 JTptal Fees:$77.00 Total Payments To Date:$0.00 Balance Due:$77.00 Inspector: 7747 07/30/04 0002 01 02 FINAL Date:4-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 previously otherwise expired, PERMIT APPLICATION CITY CJF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 FOR OFFICE USE ON PLAN CHECK NO. EST. VAL. Plan Ck. Deposit Validated Date Address (include Bldg/Suke #)Business Name (at this address) Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Total tt of units Assessor'Proposed Use ddress Agent for,Contractor\,,. ~Q Owne Telephone tt / Name Address City State/Zip Telephone tt (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 exeniplion. jArjy,vio^tion (^Section 7031.5 by any applicant for a permit subjects the/applicant to a civi|^jenaltyjof not mgiB.tha/i five launched dollar; I$5JX>]|.r Naml ' J 'Address ' City , State/Zip Telephone tt State License # ~7 1 faQ ^ V License Class ( "" 2, / City Business License tt lCj-\ *//) 1 L/ ~ f u i ' f Designer Name Address State License tt f " / City State/Zip Telephone 6., ,„ WORKERS' COMPENSATION : , _ „. ,,„,,„,- Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: O 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 thework for which this permit is issued. £3 \ 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 coppensation insurance carrier arfd) policy number are: , , -- ,_^ / IS/0Insurance Company , , -- Policy No. l((fTla-\J-~'Expiration Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) O 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 addAion to the cost of compensation, damages as provided for In Section 3706 of the_La/ipr coo)b, interest and attorney's fees. SIGNATURE C&/A0JU\^fSM^^ DATE. " .*> L I 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). O '• 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). O 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 1 have contracted (hired) the following persons to provide the work indicated (include name / address / phone number / type of work): - PROPERTY OWNER SIGNATURE DATE .. 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? - Q YES Q NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? l~l YES T~) 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 KAY 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. 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^-APPUCAiml5EBTp<^TK>ll|^.3*Ar»f^^ j , , , I certify that I have read the application and state that the above information is correct and that the information on the plens 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 if the 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/iermit is suspended or abandoned at any time after the work is comn/eijbed fora perigffjbf 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. JOB ADDRESS:. 2. TYPE OF BUILDING: RESIDENTIAL /^ COMMERCIAL 3. ROOF SLOPE: RISE__^Oinches in 12 inches 4. NUMBER OF EXISTING ROOF COVERING (circle one) 5. TYPE OF EXISTING ROOF *6. NEW ROOF MATERIAL(/yiUp ->' CUASS S / ^WEIGHT PER SQUARE 7. -NUMBER OF SQUARES 9S 8. TRADE NAME "f7 ftUoiV )|V\J MANUFACTURER 9. ROOF SYSTEM LISTING UL No. tJ-1, ) ICBO No. 10. IS THE EXISTING STRUCTURAL DESIGN SUEPkCIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? /ES J NO All roof coverings are required to be CLASS A. Combustible roof coverings of any type or classification are prohibited. ; understand the following inspections are required: •-, 1. Tear Off/Pre-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. Signature y^{V\lJ/^l/l/s*J Date Contractor yC_Jowner Contractor Name. *6 - Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other. City of Carlsbad Bldg Inspection Request For: 08/10/2004 Permit* CB042963 Title: SMILEY RES 2500 SF REROOF Description: COMP TO COMP Inspector Assignment: JM Sub Type: REROOF 2504 CHESTNUT AV Lot 0 Type:MISC Job Address: Suite: Location: APPLICANT PATRIOT ROOFING Owner: SMILEY DENNIS B&PATRICIA L Remarks: Phone: 7608452489 Inspector: Total Time: CD Description 19 Final Structural Act Comment Requested By: AILEEN Entered By: ROBIN / ® Associated PCRs/CVs Inspection History Date Description Act Insp Comments 08/02/2004 15 Roof/Reroof AP JM OK TO COVER EXISTING PLYWOOD Proof of Worker's Compensation Coverage COPY STr/XTE P.O. sox COMPSNSAtlON ' ' ' , ; - INSURANC8 '.- F~U N D CERTIFICATE OF WOPKERS' ISSUE DATE: 12-01-2003 CONTRACTORS STATE LICENSE BOARDWORKERS COHPENSATION-UUfT •'P.O. BOX 26000 - -.SACRAMENTO, CA 95826 '• SD This is to certify that w» have issued * vaHd Workers' California Insurance Commissioner to the emptoteit named '* This policy is not subject to We will also give you it LICENSE #718884 INCEPTION awi;.- D^j?r... • ,-• ' $0-. , ir«gr*ic8 policy W * fonrn. approved by the fer-'^w-'iJoW^ jwwod J(*tHc»ted .-' to S»' ernployer. ji9ijc«."sJ)otiM W*' peWcy This certificate of insurance ts riot ^a«-trlSiJrance policy and does not arrwnd, oxtend1%r- j|t«r Jhe coverage afforded oy the policies listed herein. Notwithstanding any requirement, term. Of condition of'any contract or other document with respect to which [his certificate of insurance may t>« issued or may pertiin, the insurance afforded by the c-es described herein is subject to «lt the terms, exclusions and conditions of such policies, - ' , \ -•"-., AUTHORIZED RePRESENTATIVE - ' EWLOYER'S LIABILITY LIMIT INCt,UD|>fc DEFENSE COSTSt $1 .OOO.OW.OO PER .OCCURRENCE. SO EMPLOYB? A-l ACCURATE EL CAMJNO ,- •'% ~Vv.'••••*•/''-"-•' i'l ;'• ,:.':-'A>'-''•.-.:;• '.'- - --. , -,-. 'r ?r|/«!/-'"',>-•' "•'--• . -' ,f- l>\ ' --+ ' !*{?• ;'- .-»,.; . - '••*- :i'ei! - "-" ~ ;5"t*T»IOT' *KJfI«fe'':,^' -„' -, i^s?frBUo0- . ,v*fv' ••- f> i -• •MV,---;*. r ENCINITAS CA-92024.-^ /.^^»% ..''VxV^/? >-'",•"?":-'/:"-,> -'^-^"^'.-K/-,' V!^^%?:^^ TH!S DOCUMENT HAS A BLUE PATTERNED BACKGROUND