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Home My WebLink About2718 CHESTNUT AVE; ; CB982982; PermitBUILDING PERMI .09/04/98^11:43 Page 1 of 1 Job Address: 2718 CHESTNUT AV , Suite; Permit Type: MISCELLANEOUS Parcel No: 167-392-15-00 Lot#: Valuation: 3,120 Occupancy Group: Reference*: Description: RE-ROOF,3000 SF-COMPOSITION Appl/Ownr :, PACTFICA ROOFING 1615 VALENCIA ST (: OCEANSIDE CA 92054 *** Fees Required *** 760 Fees : Adjustments: Total Fees: Fee description Miscellaneous Fee #1 * MISCELLANEOUS TOTA 102.0 10 Permit No: CB982982 Project No: A9803893 Development No: Construction Type: NEW Status: ISSUED Applied: 09/04/98 Apr/Issue: 09/04/98 Entered By: RMA 966-2600 0827 09/04/98 QOM 01 02 Elected & Creditsg^flf *** 102.00 .00 .00 102.00 Ext fee Data 102.00 PERMIT FEE 102.00 CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760)438-1161 &I.;I1PROJECT INFORMATION FOR OFFICE USE ONLY PLAN CHECK NO. EST. VAL. Plan Ck. Deposit Validated By_/_ f Date /) A(7/ Address (include Bldg/Suite tt)Business Name (at this address) Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Total tt of units Assessor's Parcel tt Existing Use Proposed Use SO. FT.#of Storie tt of Bedrooms tt of Bathrooms 2. CONTACT. PERSON (if different from applicant) Name 3.",, Address Agentrfor Cpntractorf...' City State/Zip Telephone tt Fax tt Address State/Zip Telephone #Name 5. CONTRACTOR - COMPANY NAME ,--.-.;.-•-: ,.,,_. ~ (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 I$500I). C 39 City State/Zip ' City Business License tt Telephone Designer Name State License tt -6.' Address City State/Zip Telephone Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: n 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. jjy 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 issaed. My worker's compensation insurance carrier and policy number are: ,rt_ - /*t s> Insurance Company ^ f^A I 3* f* \s nf^ Policy No. o*> &^^ ~"7jj Expiration Date_ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS) f~l 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 addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE DATE 7. I hereby affirm that I am exempt from the Contractor's License Law for the following reason: [3 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). n 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). n 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 FIND 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 COMPLETE THIS-SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY . . , ' " 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? C] 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? Q YES Q 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. •8:*.. CQJSsillgONliNDJiNiG'AGENCY . -.-.-,'.-.-•'- -i '•."-'- 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 ADDRESSLENDER'S NAME •9. 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 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 nouammenced within 365 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned at anytime after the y«>rk is} comrjpenced for ajjfljHJd of 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 V inches in 12 inches 4. NUMBER OF EXISTING ROOF COVERING (circle one)C2) 2 3 5. TYPE OF EXISTING ROOF COVERING^M^?SHEATHING *6. NEW ROOF MATERIAL CQNyfc CLASS A WEIGHT PER SQUARE 3 fr O 7. NUMBER OF SQUARES ~-3Q 8. TRADE NAME ^^Ah4f) MANUFACTURER H\ 9. ROOF SYSTEM LISTING UL No. ICBO No. 10. IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOFK^YES^X 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-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 Contractor Owner Contractor Name *6 - Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other. CITY OF CARLSBAD INSPECTION REQUEST PERMITS CB982982 FOR 09/11/98 DESCRIPTION: RE -ROOF, 3000 SF-COMPOSITION TYPE: MISC JOB ADDRESS: 2718 CHESTNUT AV APPLICANT: PACIFICA ROOFING CONTRACTOR : OWNER: REMARKS: C/JOHN/966-2600 SPECIAL INSTRUCT: INSPECTOR AREA PD PLANCK# CB982982 OCC GRP CONSTR. TYPE NEW STE: LOT: PHONE: 760 966-2600 PHONE : PHONE: INSPECTOR TOTAL TIME: CD LVL DESCRIPTION 19 ST Final Structural ACT COMMENTS A DATE DESCRIPTION 090998 Roof/Reroof ***** INSPECTION HISTORY ***** ACT INSP COMMENTS AP PD P.O. BOX 420807, SAN FRANCISCO, CA 94142-0807 COMPENSATION IN SU R A N CE P" U N O CERTIFICATE OF WORKERS' COMPENSATIOfcWNSURANCE JANUARY 5i»,1&9« , . POLICY NUMBER:285-98!.!NtT 1499 CERTIFICATE EXPIRES:Q1 /01/1099 r CITY OF OCCANSIOi: ATTN. BUILDING DEPARTMENT 300 NORTH HILL. STREET OCGANSiDE, CA 9?054 JOB ALL OPERATIONS L This is to certify that we have issued a valid Workers' 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 ten days' advance written notice to the employer. We will also give you TEN 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 the pi 'oies listed herein. Notwithstanding any requirement, .'term,»or condition of any contract or other document with res ?ct to which this certificate of insurance may be issued or may pertain, the insurance afforded by the policies des* ibed herein is subject to all the. terms, exclusions and conditions of such policies. PRESIDENTAUTHORIZED REPRESENTATIVE PRESID EMPLOYER'S LIABILITY LIMIT INCLUDING D6I-ENSE COST: $1, 000,000 PKR OCCURReNCt EMPLOYER F PACiFiCA ROOFING iNC 1615 VALENCIA STREET GCEANSIDL. CA 92G54 RB SCIF 10262 (REV. 3-95) pni irSvaMrf :r>ER!s