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Home My WebLink About2712 MATEO PL; ; CB033175; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 12-02-2003 Miscellaneous Permit Permit No: CB033175 Buildi J Inspection Request Line (760) 602-2725 Job Address: 2712 MATEO PLC Permit Type: MISC Parcel No: 2162513200 Valuation: $7,868.00 Reference #: Project Title: LUDWICZAK RES- CONCRETE Applicant: PIVA ROOFING, BOB 1192 INDUSTRIAL AV ESCONDIDO, CA 92029 619-745-4700 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES D Subtype: REROOF Status: ISSUED Lot#: 0 Applied: 11/18/2003 Entered By: RMA Plan Approved: 11/18/2003 Issued: 11/18/2003 SQRS LT WT Inspect Area: RB Owner: LUDWICZAK STEPHEN H&JOAN K 2712 MATEO PL CARLSBAD CA 92009 PERMIT FEE RE-INSPECT FEE $140.00 $120.00 $0.00 $260.00 Total Fees: $260.00 Tc I Payments To Date: $200.00 Balance Due: $60.00 Inspector: isc3 ' NOTICE: Please take NOTICE that approval of, referred to as "fees/exactions." You have 90 day follow the protest procedures set forth in Govern1 processing in accordance with Carlsbad Municip. review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your r, changes, nor planning, zoning, grading or others fees/ex tions of which ou have r viou I bee: FINAL APPROVAL Date: J::i..--I?, f:3 9949 12/02/03 0002 01 CGP Clearance: , project includes the "Imposition' of fees, dedications, reservations, or other exactions hereafter collectively Jrll the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must t Code Section 66020(a), and file the protest and any other required information with the City Manager for .ide Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, . to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capacity :ir application processing or service fees in connection with this project. NOR DOES IT APPLY to any /On a N TICE imil r to his or as t whi h he t f limitati n h s reviou h rwise ex ir .jQ" -JO FOR OFFICE USE ONLY PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 PLAN CHECK NI...J'.J] tl(j J i 7.J' EST. VAL. -~+d-~~=-A------ Plan Ck. Deposit --------,....-e---- Validated By ____ +--+--{I-Jo°'-,--- Date _______ .... -1--...,__+-.,,;ZJ.-+--+"-4- Address (include Bldg/Suite #I Business Name (at this address) legal Description lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # Existing Use· Proposed Use # of Bathrooms Telephone# Fax# Name Address City State/Zip Telephone# (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 vio atio of Section 7031.5 b any appli ant for a p rmAit subjects the applicant to a ivil penalty of not more than five hundred dollars ($5001). vd · ·11 i I J 1.1s 'tt ve 6.K1)nd' ~ cA i)d;)J State License # __.a'-'-'\ .... ~.a...,.9_3=6 ___ _ license Class ___ C_3~?~-----City State/Zip Telephone # City Business lic.ense # _,L/_M_3-=-/...,9_<J-=-- Designer Name Address City State/Zip Telephone State License # _________ _ [8:ey~w.oRKERS~f cOMPE°NSA TION ¼·~~:e;::r~~~:r~;iJ:-.,~i~~J1Z::iil7J~~~i;i:1.~~1::~~~ !31;\i;;:.;;~f~:~s~}.:f)r: .. ~.;~~::;-•:·,., 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. S I have and will maintain workers' compensation, as required by Section 3700 of the labor Code, for the performance of tho work tor which this permit is issued. My worker's compensation insurance carrier nd policy number are: , / / Insurance Company fe Policy No. ~.g-5000~335O5 Expiration Date b(~ ,L'Ot/ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 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 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 ond civil fines up to ono hundred thousand dollars ($10 00), In a ition to the cost of compensation, damages as provided for In Section 3706 of the Labor c~, Interest ond attorney's fees . • ~~~~~:,~ .... ,,, .... '" .. If ... ·· .. · • ··· · · · · J.l••·••··,e--,r "'ctl2"'1'~-,.,~,·;w1'J;. 'l""~F••·••"''•'1'"'"'~f.,'"'' ,.,., .• •· ,, ·, "·'"'·"~~'.:~~., ,,,./t/(?t.J."!... .. · .. , , n.r r \( .'.i,t,}JO,WNER~BUILDE : DECl.:ARA "rlON ;~:.~ .. -''.j:;.:'.'L,_~ ::_,~,;:~;.:~~{~~'ktJ. .J>~>:i,,;;.:, .. ~1,wiUi~ 1;w.;,;tc.:~·;·;~.,;},t~~-!h,1;~<.: '· --. , ,~"'.-; ... '"· -:y~t-Ji" '-/.t. ~ j, 4.~-:, ,,~~,1.(::t" r:,:1 to.:"" t:· . :~.:.r1: -•.}· · / · c ~- I he;eby affirm that I am exempt from the Contractor's License Law for the following reason: 0 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 ho 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 contractor(s) 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. 0 YES ONO 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 tho work indicated (include name / address / phone number / type of work):. ____________________________________________________________ _ PROPERTY OWNER SIGNATURE _____________________ _ 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 apl)licant or future building occupant required to obtain a permit from the air pollution control district or air quality management district7 0 YES O NO Is tho facility to be constructed within 1,000 foot of tho outer boundary of a school site 1 0 YES O 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. [!!~¢.o_"r,1.s)'f(fqjip,:J;(er,io,~fAG.E~PY~t½tS't.•0]i1~l\li;i!ii'~!ff,:~-rr:a~m,g;:J;\V:,fc~1~t::~l;'}i~;?:.::•.:'i;~:t.;~,::Vi;1i'./{f~::,•1· I hereby affirm that there Is a construction lending agency for the performance of tho work for which this permit is issued (Sec. 30970) Civil Codo). I.ENDER'S NAME ______________ _ LENDER'S ADDRESS _________________________ _ i§lft:i[AP,~L1cANt{CERTiF.IC)ir10NJ~17~;j~~~~:i'~~~i~il~~~;;.,~'.r~F~~~~i)~.;.;rt\~~\;~l~ft5~J:~i-'!t~~\{~;,:f,t.~n;~_:;:rJ: .. i:\:~/·~}B%f:~,;~r;g-1~~'.'t';t~'[;;i;t~\~'\:;i.~1.\.,:;~~ 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 Cit\' 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 ii 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 permit is suspended or abandoned at any time after the work Is commence r riod of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE WHITE: Filo YELLOW: Applicant PINK: Finance /1/rzjo:s 7/" ·\j . ~ ; City Of Carlsbad SUPPLEMENTAL.: BUILDING PERMIT APPLICATION FOR REROOFING 1. JOB ADDRESS: d-.'7 / :i. /Vlqteo Pia ce 2. TYPE OF BUILDING: RESIDENTIAL 'f. COMMERCIAL~-~ 3. ROOF SLOPE: RISE lf inches in 12 inches 4. NUMBER OF EXISTING ROOF COVERING (circle one) (!) 2 3 5. TYPE OF EXISTING ROOF COVERING 5wike_ SHEATHING '>/1c • *6. NEW ROOF MATERIAL +; /-e_ CLASS A WEIGHT PER SQUARE r--;, 3 7. -NUMBER OF SQUARES ~$ , .. 8. TRADE NAME Everwesf-MANUFACTURE~ t/4/ls:or1 9. ROOF SYSTEM LISTING UL No. _ ICBO No. 3?t/'t, 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'stible roof coverings of any type or classification are prohibited. I understand the following inspections are required: .. 1,1 1. Tear Off/Pre-inspection prior to instalf1new roof covering. 2. Final Inspection I agree to provide a ladder extending at least 2 rungs above the roof for inspection. Signature ~;;f?: . Date . lj/2~/45 f I Contractor X Owner ____ Contractor Narre 5oh Pivq £.oof;ri'3 *6 -Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other. City of Carlsbad Bldg Inspection Request For: 12/16/2003 Permit# CB033175 Title: LUDWICZAK RES-28 SQRS LT WT Description: CONCRETE Inspector Assignment: RB --- Type: MISC Sub Type: REROOF Phone: 7607454700 Job Address: Suite: Location: 2712 MATEO PL Lot APPLICANT PIVA ROOFING, BOB 0 Owner: LUDWICZAK STEPHEN H&JOAN K Remarks: Total Time: ----- Inspector: ----- Requested By: BOB PIVA ROOFING Entered By: CHRISTINE CD Description Act Comment 19 Final Structural Llf ____________ _ Associated PCRs/CVs lns12ection Histo!Y Date Description Act lnsp Comments 12/03/2003 15 Roof/Reroof AP RB 12/02/2003 15 Roof/Reroof NR RB PAY REINSP FEE 1 ST & SEE CO NOTICE 12/01/2003 15 Roof/Reroof co RB ON CORRECTIONS AGAIN, PAY RE-INSP FEE 11/26/2003 15 Roof/Reroof PA RB SEE NOTICE ATTACHED 11/25/2003 15 Roof/Reroof co RB AGAIN PAY REINSP. FEE -SEE NOTICE 11/20/2003 15 Roof/Reroof co RB (1147-G2) SEE NOTICE ATTACHED