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HomeMy WebLinkAbout2728 CHESTNUT AVE; ; CB993242; Permit08/30/1999 City of Carlsbad Miscellaneous Permit Permit No:CB993242 Building Inspection Request Line (760) 438-3101 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: 2728 CHESTNUT AV CBAD MISC Subtype: 1673921000 Lot#: $6,625.00 REROOF 0 GONZALES RES-2500 SF LIGHT WT CONCRETE-PER ICBO ER-4660 Applicant: EXCALIBUR ROOFING 2447 LA RAMADA LN ESCONDIDO CA 92027 760 275-7384 Status: ISSUED Applied: 08/30/1999 Entered By: RMA Plan Approved: 08/30/1999 Issued: 08/30/1999 Inspect Area: Owner: - GONZALES BELYNN R 2728 CHESTNUT AVE CARLSBAD CA 92008 '.3433 08/30/99 OOOi 01 02 C-PRMT 145-00 Total Fees: $145.00 Total Payments To Date:"$0.00 Balance Due: $145.00 Miscelaneous Fee #1 Miscelaneous Fee #2 TOTAL PERMIT FEES PERMIT FEE '$145.00 $0.00 $145.00 Inspector: FINAL APPROVAL Date:Clearance: NOTICE: Please take NOTICE that approval of your project includes the Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions." You have 90 days from the date this permit was issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions DOES NOT APPLY to water and sewer connection fees and capactiy changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project NOR DOES IT APPLY to any fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired. CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760)438-1161 1. PROJECT'INFORMATION '.. :.....,.. FOR OFFICE USE ON PLAN CHEqK NO. EST. VAL. Plan Ck. Deposit Validated B' Date (7 Address (include Bldg/Suite #) Legal Description Assessor's Parcel # /siT-t^of^ Description of Work Lot No. Subdivision Existing Use 2$o^ SJTJFT. Business Mime/Number £__ #of Stories Name (at this address) Unit No. Phase No. Proposed Use # of Bedrooms Total # of units ^# of Bathrooms 2.ACTslpKONsflfpfferent from applicant) Name Address City *3. APPLICANT f&Contractor Q Agent for Contractor Q Owner Q,Agent for Owner " State/Zip Telephone i Fax* Name 4. PROPERTY OWNER Address City State/Zip Telephone ff Address City State/Zip Telephone #Name I 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 [$500]). U Name ' . Address State License # < 0 (r>5 1 v* License Class C ' City State/Zip Telephone # — z> I City Business License # \ 1~ G ' t>SO Designer Name Address City State/Zip Telephone State License # 6. WORKERS'COMPENSATION ' - ' „ 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 compensation insurance earner and policy number are: Insurance Company .5 (A (<£" ft^fJ D Policy No. "2. 8 J ~1 (0(01 Expiration Date Ot**" C.&QO (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS'[$100] 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 an employer to criminal penalties and civil fines up to one hundred thousand dollars (SIOO.OSQK in additiorvfb the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE \^V"" V\- ^ DATE g ~^Q "Tf 7. OWNER-BUILDER DECORATION " ~~- ,^~" , 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason: |~| 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). O 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). CD 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. l~l YES 0NO 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 /VO/V-flfS/DBVrWi 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? l~l YES fj 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 fj NO Is the facility to be constructed within 1 ,000 feet of the outer boundary of a school site? (~l YES l~l 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. CONSTRUCTION LENDING AGENCY , , 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 _ _ __ _ 9. APPUCANTlelRTIFiCATlON 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 City 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 not commenced within 365 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 vjafk-ts-cfimrn^ncsd {or ajje»ed-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~T*&- CHeVfNoTAo tT~; ^.XOOS 2. TYPE OF BUILDING: RESIDENTIAL X COMMERCIAL 3. ROOF SLOPE: RISE *"f" inches in 12 inches 4. NUMBER OF EXISTING ROOF COVERING (circle one) GO 2 3 5. TYPE OF EXISTING ROOF COVERING SHfvfc^ SHEATHING MD *6. NEW ROOF MATERIAL ~~7\uC CLASS A WEIGHT PER SQUARE 7. NUMBER OF SQUARES 8. TRADE NAME Afi-Lf & MANUFACTURER 9. ROOF SYSTEM LISTING UL No. _ ICBO No. £ i^~ 10. IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? C5=S^ 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. Date ? Contractor yC^ Owner Contractor Name £V(A:L«3L/£ *6 - Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other. City of Carlsbad Inspection Request For: 9/8/99 Permit# CB993242 Title: GONZALES RES-2500 SF Description: LIGHT WT CONCRETE-PER ICBO ER-4660 Inspector Assignment: SR 2728 CHESTNUT AV Lot 0 Type:MISC Sub Type: REROOF Job Address: Suite: Location: APPLICANT EXCALIBUR ROOFING Owner: GONZALES BELYNN R Remarks: Phone: 7602757384 Inspector: Total Time: CD Description 19 Final Structural Act Comments Requested By: JIM Entered By: CHRISTINE Inspection History Date Description Act Insp Comments 8/31/99 15Roof/Reroof AP SR AIMWWT. Ci^TIFICATE *T^ % v %^->. «. iv •.•."• •••.•. -.-.OW.' v> •. \ ->X- * ss ^\ ISSUE DATE (MM/bb/YY) 2/ 1/1999 PRODUCER THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATEPat Palmer Insurance P.O. Box 23849 San Diego, CA 92193 (619) 560-1478 KSURED JAMES GENTRY DBA: EXCALIBER ROOFING 2447 LA RAMADA LANE ESCONDIDO CA 92027 DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. COMPANIES AFFORDING COVERAGE ^NY A CENTURY SURETY COMPANY COMPANY B STATE FUND COMPENSATION COMPANY p LETTER ° COMPANY i-j LETTER U COMPANY c THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED; NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT-OR-OTHERDOCUMENT WITH RESPECT TO-WHICH-THIS - CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO •ITRI TYPE OF INSURANCE A i GENERAL LIABILITY X ; COMMERCIAL GENERAL LIABILITY j CLAIMS MADE ; X I OCCUR. OWNERS & CONTRACTORS PROT. POUCY NUHBER CCP158507 02/05/99 I 02/05/00 POUCY EFFECTIVE POLICY EXPIRATION DATE (MM/DD/YY) : DATE (MWDD/TY)UWTS GENERAL AGGREGATE PRODUCTS-COMPJOP AQQ. PERSONAL & ADV. INJURY EACH OCCURRENCE FIRE DAMAGE (Any one fire) MED. EXPENSE (Any one person) S 1,000,000 « 1/PPP/$ 1,006,000 pppf 50,000 If AUTOMOBILE UABttJTY I ANY AUTO ; ALL OWNED AUTOS i SCHEDULED AUTOS ! HIRED AUTOS i NON-OWNED AUTOS i GARAGE LIABILITY COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE EXCESS LIABILITY i UMBRELLA FORM i OTHER THAN UMBRELLA FORM EACH OCCURRENCE AGGREGATE B WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY 285-1669 01/01/99 ! 01/01/00 STATUTORY LIMITS EACH ACCIDENT \S 1,000,000 DISEASE - POLICY UMfT ; J 1 , 000 , 000 DISEASE - EACH EMPLOYEE ;J 1/000,000 OTHER DESCRIPTION OF OPERATnNSAOCATIONS/VEHICLESnPECIAL ITEMS DIRECT REQUEST FROM THE CERTIFICATE HOLDER FOR ACTIVE LICENSE 706816 IN ACCORDANCE WITH SECTION 3700 OF THE LABOR CODE CONTRACTORS STATE LICENSE BOARD STATE OF CALIFORNIA P O BOX 26000 SACRAMENTO CA 95826 SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY Wia ENDEAVOR TO MAIL 30 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY. ITS AGENTS OR REPRESENTATIVES. AUTHORIZED ©ACOflD CORPORATION 1990