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Home My WebLink About2618 EL CAMINO REAL; ; CB032959; Permit,o 10-29-2003 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No CB032959 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Valuation Reference # Project Title Applicant A V ROOFING INC 390 OAK AV 92008 760 730-0273 2618 EL CAMINO REAL CBAD MISC 1670307700 $107,10000 Subtype REROOF Lot# 0 MATTRESS CITY REROOF 90000SF BUILT UP TO BUILT UP Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 10/29/2003 SB 10/29/2003 10/29/2003 Owner VANDERBURG-LIVING TRUST 08-22-90 150 N SANTA ANITA AVE #645 ARCADIA CA91006/ ^ / Miscelaneous Fee #1 ' Miscelaneous Fee #2 / Additional Fees , PERMIT FEE v ' --- ^ - , \ $95400: ^ $o oo \ - "• - '' --$000 TOTAL PERMIT FEES '•'$95400 Total Fees $954 00 Total Payments To Date / > $0 00 Balance Due $954 00 ^7512 10/29/03 0002 01 02 CGP 954- Inspector FINALAPPHOVA Date -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 nave 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 CfTY OF'CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, 'CA 92008 INFORMATION FOR OFFICE USE ONLY PLAN CHECK EST VAL / Plan Ck Deposit Validated B Address (include Bldg/Suite #)Business Name (at this address)'' Legal Description Assessor's Parcel # . v^ \.1~ Description of Work * Lot No Subdivision Name/Number _ ExistingUse . — ^ 1 A •*! ^{C5 t^" tv |*T" L/\~f SQ FT #of Stories Unit No Phase No Proposed Use If of Bedrooms Total # of units # of Bathrooms 12 fly CdNT&TiLPERSON !{if JdilTerenrf rVm^appTicant) ^ Name 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 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 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 IS500)) Name State License # Address License Class C. ~ City State/Zip City Business License # /Jj_ Telephone Address Cily Slate/Zip TslepnoneDesigner Name State License If (6 ^fiWORkERS'iCdMPENSATIO N« Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations Q 1 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 compensation insurance carrier and policy number are Insurance Company ^j>F*CTI£ r-e/t^f Policy No /7y^yVv" ^00? Expiration Date_ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS (51001 OR LESS) Q CERTIFICATE OF EXEMPTION 1 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 on employer to criminal penalties and ctvil fines up to one hundred thousand dollars ($100 OQQtTTn"3ditiontpJrie cost of Kjmpepeatiqn, tfamage^es provided for in Section 3706 of the Labor^de, merest and attorney's fees SIGNATURE s^ _-***( ^f^/£^\^__^ J DATE 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 wtthm one year of completion, the ownef builder will have the burden of proving that he did not build or improve for the purpose of sale) Q 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 contractor(s) licensed pursuant to the Contractor's License Law) Q 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 Q 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 I 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? Q YES LJ 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 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 i •><> m -~ -_„" „ —;.', - ~ -. **"*'^r-'~n-»w^%l!'rit?i-^ W^Prh * Ji 'i*^ ¥?('£ 1 S f^'.s 'Jit1? C'l't*'' "I ' ' '.^Hi,i H (i(: r ^N'jP' A ^•Mi^a^^ '^4 '*''* ^ 'I i'^' k bT ' ^ "l^'l'lf ' ll^ ^IlLfr 1W ^ 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. . 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 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 stones 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 ofsuch permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commejieeQTj?r a period of 1 aOdj^^Sectipn 1<66 4 4 UnlTjrm Building Code) APPLICANT'S SIGNATURfe^^^ * •^S^L s'^£s//Z^^-~"^^- -*_ DATE f ^ WHITE File YELLOW Applicant PINK Finance City Of Carlsbad SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING 1. JOB ADDRESS: <£&/g £/ ^**««,*** &**/ 2. TYPE OF BUILDING: RESIDENTIAL 3. ROOF SLOPE: RISE *fy inches in 12 inches 4. NUMBER OF EXISTING ROOF COVERING (circle one) 5. TYPE OF EXISTING ROOF COVERING SHEATHING _^ *6. NEW ROOF MATERIAL A CLASS fe WEIGHT PER SQUARE 7. tlUMBER OF SQUARES 8. TRADE NAME //&n MANUFACTURER 9. ROOF SYSTEM LISTING UL No. ICBO No. 10. IS THE EXISTING STRUCTURAL DESIGrjJUJgEiaENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF?.XYES^X NO i 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-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 -?/ /^ — ._. Date/ -^ *-fc^ Contractor x Owner Contractor Name - Rolled RoofmgTjgtandard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Othe UNSCHEDULED BUILDING INSPECTION <A//^ f •DATE I, L U ° T INSPECTOR 7 PERMIT # H^ ~- 7 ° ^ PLAN •^^—^||BBBB^H - , ^_ JOB ADDRESS 26/^ €^ (J^^7//IA /£^L— DESCRIPTION CODE DESCRIPTION ACT COMMENTS Q STVXTE pO BOX 420807. SAN FRANCISCO, CA 94142-0807 COMPENSATION INSURANCE FU l\l D CERTIFICATE OF WORKERS' COMPENSATION INSURANCE JUNE 6, 2003 CONTRACTORS STATE LICENSE BOARD WORKERS' COMPENSATION UNIT P 0 BOX 26000 SACRAMENTO CA 95826 GROUP POLICY NUMBER 1741449-2003CERTIFICATE ID 2 CERTIFICATE EXPIRES 05-01-2004 05-01-2003/05-01-2004 #804868 05 01 03 SCDO This is to certify that we have issued a valid Worker's Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated This policy is not subject to cancellation by the Fund except upon 10 days advance written notice to the employer We will also give you 10 days advance notice should this policy be cancelled prior to its normal expiration This certificate of insurance is not an insurance policy and does not amend, extend or alter the coverage afforded by thepolicies listed herein Notwithstanding any requirement, term or condition of any contract or other document with respect to which this certificate of insurance may be issued or may pertain, the insurance afforded by the policiesdescribed herein is subject to all the terms, exclusions, and conditions, of such policies C AUTHORIZED REPRESENTATIVE PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS $1,000,000 PER OCCURRENCE EMPLOYER AV ROOFING INC P 0 BOX 1892 CARLSBAD CA 92018 SCIF10262E IEPF-U1 NS1