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HomeMy WebLinkAbout2606 GALICIA WAY; ; CB041135; Permit\0 D\\ '9 04-05-2004 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No: CB041135 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: Applicant: 2606 GALICIA WY CBAD MISC 2161801200 $11,240.00 Subtype: REROOF Lot#: 0 SILVEIRA RES-REPLACE SHAKE W/ 40 SQRS LT. WT. CONG. TILE (ICBO# 4660) Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 04/05/2004 KMT 04/05/2004 04/05/2004 PIVA ROOFING, BOB ZIFFERBLATT PATRICIA M tlAO J-4/J5/ 04 ,)002 :J.t Ct3F" 1192 INDUSTRIALAV ESCONDIDO, CA 92029 619-745-4700 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES Total Fees: $192.00 Inspector: PERMIT FEE 220 LYON ST NW #800 GRAND RAPIDS Ml 49503 $192.00 $0.00 $0.00 $192.00 Total Payments To Date: $0.00 Balance Due: Date: Clearance: $192.00 NOTICE: Please take NOTICE that approval of your project includes the "Imposition" of fees, ded cations, 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, void1 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/ex ti n fwhi h uh v r vi I Tl E imil r hi r hi h th t limi i n h vi I h rwi ~92,,•')( FOR OFFICE USE ONLY PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 PLAN CHECK NO. Cf:olf I\ 3S EST. VAL. .ft, fl, 2YC) _ oo • Plan Ck. Deposit ---,,---------- Valida~1!1: ~ Date '1"~5\04 Business Name lat this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total /I of units Assessor's Parcel # Existing Use· Proposed Use II of Bathrooms State/Zip Telephone # Fax II "'Hi ,.;~::;~ ;-, ,~,.--~r;~<_;~~, ... ·"'1 ' ... " v,,~· ~ , ·.,.-,•1 · , 2A "'9 ;ii;j_ l ""'"'· •1f; ~·1/1t16 ~· ~ . State/Zip Telephone # S.tato/Zip Telephone II {ifftiicOJi'fRA~tOB~iCo~P~N~-NANie~½.~~!li~t~~~~~~1~;]!;t~ITC~:'t~m:~t:1~JJl':.i:fZ::t!7J'.i~~i~~f~'t~~~~~;t"~~J~,t'.~{.!ttJT;f.~~~~~;r~~:~_,:i~\~ii~~ (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 issuence, 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 exam tjon. A y violation f S tion 7031.5 by any applicant fo a permit s;jects the applicant to a ci !I .9'::nalty of not more thann"ve hundred dollars ($5001). b \ita. e 1/l ~ ,,,g., '4 e. o. 't(() ~O<X 76?)-'?t/S-IJO Name State License II _.:;';2..;;;.,:.1_4;....:.9--=3:..._~--"'----License Class __ c_"'5"'-9,_ ____ _ City State/Zip Telephone # City Business License II /;;). 03/ 1<;?' Designer Name Address City State/Zip Telephone State License# __________ _ (6~}.;W.0.Rke"RS!fcOMPe'NSATION~:f~;\:~:i;~~:~"7t~ij~~:.\il~l}:.~ .. ¾\\\~;t~~Vtt¼'~Q:7~;;~c-1.:~A!t!t~~~~~;.~:i:c~i~:!tt ~j~:~.;;;,._'•,., . \~~??t'i) ~'~~i!:J, -~; ,,~JZ ;,.~1,i \· ·" :~-,;.'·~ ;· i;;t··~-.~-.~'.;: 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. ~ 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 compensa ion jnsuran e carrier nd policy number are: / ! Insurance Company 5". -t--€... 11 Policy No. ~000~33503 Expiration Date b( / fl)/./ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS) . 1 0 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 Lows of California. WARNING: Fellure 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 n to the cost of compensetion, damages as provided for In Section 3706 of the de, interest nnd attorney's fees. SIGNATURE . ;-::;,:t;;:';-J'°-:~0 :t=;:;::;;:;;::::;:--.:_ ••.... ,,·.,·,, .. , ... ,., .. , .. , ~t:~j 6Y:.,Nlfti~'BiliCDE ~1 ,.. ~-. ARAi"1o~N ~·~;::!~!~.:1~?'1'~?::,¥,~1.}I&::~1~:::;1z~~ii~,.;;~r~i~~J,~~:x:: ::~~: r -. "?! t"" ;-~i.L II ~ I hereby affirm that I am exempt from the Contractor's License Law for the following reason: D I, as owner of the property or my employees with wages as their sole compensation, will do the work and tho 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, tho 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 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 contractorls) licensed pursuant to the Contractor's License Law). 0 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 ONO 2. I (have / have not) signed an application for a building permit for the proposed work. 3. I have contracted .with tho 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 ______________________ _ tc:o'M"iite:ti:;tBis[sec;rrorJrF.oriwo;-MisioEfifi~Z~euri:oirJ'oie"Eiiivfl:rs10Ni:Y-ier1;:r*;fL~it:}:;r'.t' ;::,~;1:, • :•~:; '~tN!:~'. :.,\(,::r.:.:t~L 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 O NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district 7 0 YES D NO Is tho facility to be constructed within 1 ,DOO feet of the outer boundary of a school sito 7 D YES D 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. l"!f(ilfc9}Ts,t'if\Jc'tic>N'LEiibl~Gf AGE~cv;ff;,;imffi,r1l~[1Nff::~'.t'i;~:r:~11f:.ll\l\fttl'!,iit~;:~'!/};t;/\'.;''.~;\, '~s;:~r:-::, '/ti<[\:· • t''.; ':·'; : ..•.. '. '1,i,' I hereby affirm that there is a construction lending agency for the performance of tho work for which this permit is issued (Sec. 3097(i) Civil Code). I-ENDER'S NAME ______________ _ LENDER'S ADDRESS _________________________ _ f~tAe~L1 CA.Nt{cERTiF.~ICATiP rfft~,?;~).t~m:\\~~~Wf llfi!rG~J.:;;~;r~zt~Mr.::'tEt)w~r;,:1,~,~ .. '\':; -~1 ... -/t~ \ :,;:· · .i ./~ ;\{ •"7~17·1.df ~ ~r, ·,) {'?·"1;1~t·;:\l ?[1{iJ~.~-· f ':A-J/:'::.:t · ~': ~~;.;r~' ~~~:; I certify that I have read the application and state that the above information is correct and that tho 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 Citt 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 limitalion and become null and void 11 lhe building or work aulhorized by such permil Is not commenced within 180 days from lhe date of such permit or if the building or work aulhorized by such permit is suspended or abandoned at any lime after the work is commence a · of 1BO days (Section 106.4.4 Uniform Building Code). ~ // ~d APPLICANT'S SIGNATURE -~_:Z~~~~:::===~~==------------DATE _L) /u-r --'-+--'--7cl----'-------- WHITE: File YELLOW: Applicant PINK: Finance City Of Carlsbad SUPPLEMENTAL BUILDING PERMl1 APPLICATION FOR REROOFING 1. JOB ADDRESS: d-60 ~ Ga.\a.cio.. Wo..y 2. TYPE OF BUILDING: RESIDENTIAL o/---COMMERCIAL. __ _____, 3. ROOF SLOPE: RISE 5 inches in 12 inches 4. NUMBER OF EXISTING ROOF COVERING (circle one) © 2 3 5. TYPE OF EXISTING ROOF COVERING :zb~ kt2. SHEATHING 7//C *6. NEW ROOF MATERIAL f-i )-e. CLASS_A__WEIGHT PER SQUARE 7. -NUMBER OF SQUARES l/ Q r( . 8. TRADE NAME G'o JJU\ 6~1~ MANUFACTURER . E~)e.&'fe. 9 •. ROOF SYSTEM LISTING UL No. _ ICBO No. L/f {Q 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: l.i ,-_, 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. Contractor_.,____ _ ____ Contractor Narre 6116 Ave.. £00-hYlj *6 -Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other. City of Carlsbad Bldg Inspection Request For: 04/27/2004 Permit# CB041135 Title: SILVEIRA RES-REPLACE SHAKE W/ Description: 40 SQRS LT. WT. CONC. TILE (ICBO# 4660) Type: MISC Sub Type: REROOF Job Address: Suite: Location: 2606 GALICIA WY Lot APPLICANT PIVA ROOFING, BOB Owner: ZIFFERBLATT PATRICIA M Remarks: Total Time: 0 CD Description Act Comment Inspector Assignment: JM --- Phone: 7608078350 Inspector: ----- Requested By: BOB PIVA ROOFING Entered By: CHRISTINE 19 Final Structural ft.----- Associated PCRs/CVs lnsgection Histoiy Date Description Act lnsp Comments 04/08/2004 15 Roof/Reroof AP JM OK TO COVER STRUCT RETRO OK 04/07/2004 14 Frame/Steel/Bolting/Welding co JM NOT PER ENG. REPORT 04/06/2004 15 Roof/Reroof co JM NEED STRUCTURAL RETRO PER ENG REPORT