HomeMy WebLinkAbout2649 BRIGHTON RD; ; CB151524; Permit05-19-2015
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Miscellaneous Permit Permit No: CBI51524
Building Inspection Request Line (760) 602-2725
Job Address:
Permit Type:
Parcel No:
Valuation:
Reference #:
PC#:
Project Title:
2649 BRIGHTON RD CBAD
MISC
2081310400
$3,927.00
Subtype:
Lot #:
REROOF
0
SIMPSON RES-2400 SF COMPOSITIO
Status:
Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
ISSUED
05/19/2015
RMA
05/19/2015
05/19/2015
Applicant:
MIKE JOHNSTON ROOFING
Owner:
SIMPSON KEITH J&MARIE E
802 GALAXY DR
VISTA CA 92083
760 945-6846
2649 BRIGHTON RD
CARLSBAD CA 92010
Miscelaneous Fee #1
Miscelaneous Fee #2
Additional Fees
PERMIT FEE $106.00
$0.00
$0.00
TOTAL PERMIT FEES $106.00
Total Fees: $106.00 Total Payments To Date: $106.00 Balance Due: $0.00
Inspector:
FINAL APPROVAL
Date: V Clearance:
NOTICE: Please tal<e NOTICE that approval of your project includes ttie "Imposition" of fees, dedications, reservations, or otfier exactions hereafter collectively
refen'ed 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
follov* 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 attacl<,
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 vou have previouslv been aiven a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired.
I THE FOLLOWING APPROVALS REQUIRED PRIOR TO PERMIT ISSUANCE: OPLANNING •ENGINEERING •BUILDING npIRE OHEALTH nHAZMAT/APCD
Ccityof
Carlsbad
Building Permit Application
1635 Faraday Ave., Carlsbad, CA 92008
Ph: 760-602-2719 Fax:760-602-8558
email: building(gcarlsbadca.gov
www.carlsbadca.gov
JOB ADD V7 Srf\9^^^^ /^c/. SUITE*/SPACE*/UNITI
Tofi I PHASE # I # OF UNITS I # BEDROOMS # BATHROOMS I TENANT BUSINESS NAME I CONSTR. TVPE I OCC. GROUP
L: /nc/ude Square Feet of Affected Areafsj ~~ ~t ~// i / ~y In
CT/t'RDJECT #
DESCRIPTION OF WORK:
EXISTING USE GARAGE (SF)
'*y'coTact /^//e ^^^^/}^/r iflii>^ff'n^
PATIOS (SF) DECKS (SF) FIREPLACE
YESQ* N0| I
AIR CONDITIONING
YES QNO I 1
FIRE SPRINKLERS
YES I |NO| I
APPLICANT
Prima
ADQfiESS 770 71 / T ^ A/ I
o 'to
DESIG^ROFESSIONAL^^"^^'^^'^^/^^'^^^'^^^^'^^"^"
EMAIL
RBUS. NAMI
ADDRESS
CITY STATE ZIP
PHONE 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, prfcr to Its IssujMI, also requires the applicant for such permit to file a signed statement that he is licensed pursuant to the provisions ofthe Contractor's License Law (Chapter 9, commending with Section vOOO of Division 3 ofthe 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 ($500)).
IWOi7KERS' COMPENSATION
wor
Policy No,
nance
h Expiration Date
isatlon insurance earner and polic
Workers' Compensation Declaration: / /lereAy affirm under penalty ofpeijury one ofthe following declarations:
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 perfonnance of the work for which this pennit is Issued.
I have and will maintain woikejsiconmensatlpn, as requipd by Sectiori^rOO of the Labor Code, for the perfonnan^ pfthe^glj^ for which ttiis pe^lt is Issued. My workers' compensation In^^rancj earner andpolicv
number are: Insurance Co --^^ 7 ^ ^
This section need not be completed If ttie permit Is for one hundred dollars ($100) or less.
I I Certificate of Exemption: I certify that In the performani
Caiifomla. WARNING: Failure to secure j^orkers' coippensatloji
addition to the cost of compensatje«^Mnages a%iSrovided {
CONTRACTOR SIGNAT^^^^
OWNER-BUiLOER 0ECiLA»ATION
Issued, I, I shall not employ any person In any manner so as to become subject to the Workers' Compensation Laws of
subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (&100,000), In
interest and attomey's fees,
• AGENT DATE
/ hereby affinn that I am exempt fmm Contractor's Ucense Law for the following mason:
I I 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, pnjvided 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).
I I I, as owner of the property, am exclusively contracting with licensed contractors to constmct the project (Sec. 7044, Business and Professions Code: The Conlrxtor'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 Ucense Law).
I I I am exempt under Section Business and Professions Code for this reason:
1.1 personally plan to provide the major labor and materials for construction of the proposed property improvement. QYes j iNo
2.1 (have / have not) signed an application for a building pemiit for the proposed work.
3.1 have contracted with the following person (flmi) to provide ttie proposed constmction (include name address / phone / contrxtors' license number):
4.1 plan to provide portions of the wort<, but 1 have hired the following person to coordinate, supervise and provide the major work (include name / address / phone / contractors' license number):
5.1 will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone / type of woik):
jgS'pROPERTY OWNER SIGNATURE QAGENT DATE
COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILOING PERMITS OHLY
Is ttie applicant or future building occupant required to submit a business plan, acutely hazardous materials reglstratton form or risk management and preventton program under Sections 25505,25533 or 25534 of ttie
Presley-Tanner Hazardous Substance Account Act? Yes No
Is ttie applicant or future building occupant required to obtain a permit from the air pollution control disttict or air quality management district? Yes No
Is ttie facility to be consttucted within 1,000 feet of the outer boundary of a school site? Yes 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.
CONSTRUCTION LENDING AGENCY
1 hereby affirm that there is a construction lending agency for the performance ofthe wod( this pemiit is issued (Sec. 3097 (1) Civil Code).
Lender's Name Lender's Address
APPLICANT CERTIFICATION
I certi^tliat I have lead the applkation and state that ttie alxwe infbrmation is correct and that the information on the plans is accurate. I agree to comply with all Cily oidinances and State laws relating to building construction.
I hereby authorize reprEsentafive of ttie City of Cartsbad to enter upon ttie above menttoned property for inspection purposes, I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HAFiMLESS THE CITY OF CARLSBAD
AGAINST ALL UABILfTIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CfTY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT,
OSHA: An OSHA permit Is required fbr excavations over 5'0' deep and demolition or construction of sttuctures over 3 stories in height.
EXPIRATION: EvEiv permit issued by ttie Building Oflicial under the provisions of ttiis Code shall expire bWimitation and beoome null and void if ttie building or naff, auttioiized by such pemiit is not oommenoed viiithin
180 days from the date of such permit opt thg^ikjing on«)r1<^orized by_;8^9Wp^nnit isjiBpendedyibandoned at any time after ttie viiork is commenced fbr a period of itSO days (Sectbn 106.4.4 Unifbmi BuiWing Code).
APPLICANT'S SIGNATURE DATE
STOP: THIS SECTION NOT REQUIRED FOR BUILDING PERMIT ISSUANCE.
Complete the following ONLY if a Certificate of Occupancy will be requested at final inspection.
Fax (760) 602-8560, Email bulldinatScarlsbadca.aov or Mail the completed form to City of Carisbad, Building Division 1635 Faraday Avenue, Carisbad, Califomia 92008.
C0#: (Office Use Only)
CONTACT NAIVIE OCCUPANT NAIVIE
ADDRESS BUILDING ADDRESS
CITY STATE ZIP CITY STATE ZIP
Carlsbad CA
EMAIL OCCUPANT'S BUS. LIC. No.
DELIVERY OPTIONS
PICK UP: CONTACT (Listed above)
CONTRACTOR (On Pg. 1)
MAIL TO:
MAIL/FAX TO OTHER:
CONTACT (Listed above)
CONTRACTOR (On Pg. 1)
OCCUPANT (Listed above)
OCCUPANT (Listed above) ASSOCIATED CB#-
NO CHANGE IN USE / NO CONSTRUCTION
CHANGE OF USE / NO CONSTRUCTION
^ef APPLICANT'S SIGNATURE DATE
Inspection List
Permit*: CB151524 Type: MISC REROOF SIMPSON RES-2400 SF COMPOSITIO
Date Inspection Item
05/27/2015 19 Final Structural
05/27/2015 19 Final Structural
05/20/2015 15 Roof/Reroof
05/20/2015 15 Roof/Reroof
Inspector Act
Rl
PB AP
Rl
PB AP
Comments
AM PLEASE
AM PLEASE
Thursday, IVlay 28, 2015 Page 1 of 1
REROOFING SUPPLEMENTAL BUILDING PERMIT APPLICATION
^^^^ BncjUo. /fy 1. JOB ADDRESS
2. TYPE OF BUILDING: RESIDENTIAL COMMERCIAL
3. ROOF SLOPE: RISE ^ INCHES IN 12 INCHES
4. NUMBER OF EXISTING ROOF COVERING (CIRCLE ONE)^ 2 3
V 5. TYPE OF EXISTING ROOF COVERING Skpl^ /(dtj^HEAJHlHG j/i^S
*6. NEW ROOF MATERIAL/^'3^y^^-CLASS ^^^^EIGHT PER SQ.^f^
7. NUMBER OF SQUARES rj Y ^
8. TRADE HAME^^^J^^J^JMANUFACTURER fe^^^ / ^
9. ROOF SYSTEM LISTING:
ULNO. UL-790 I.C.C.E.S. Report# ZTT 5A 6
ASTM
10. IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE
PROPOSED ROOF? fn^^ 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:
1. Tear Off/Pre-lnspection prior to install new roof covering
2. Final Inspection
agree to provide a ladder extendjpg-^t least 2 rungs above the roof for inspection.
1.^//?//^ . Siqnatu6i^;:>y^>^^ Dat
Contractor Owner Contractor
*6. Rolled Roofing, Standard/Lite Tile, Asphalt/Comp fiberglass. Built Up, Other
B-10 Page 4 of 4 Rev. 02/11