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HomeMy WebLinkAbout2733 CHESTNUT AVE; ; CB033336; Permit12-02-2003 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No: CB033336 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: 2733 CHESTNUT AV CBAD MISC 1673922400 $2,886.00 Subtype: REROOF Lot #: 0 HYSONG RES 2600SF REROOF WD SHAKE TO COMP SHINGLE Status: ISSUED Applied: 12/02/2003 Entered By: SB Plan Approved: 12/02/2003 Issued: 12/02/2003 Inspect Area: Applicant: EXCALIBUR ROOFING 2447 LA RAMADA LN ESCONDIDO CA 92027 760 275-7384 Owner: HYSONG TRUST 08-18-97 2733 CHESTNUT AVE CARLSBAD CA 92008 . Miscelaneous Fee #1 . • PERMIT FEE : Miscelaneous Fee #2 Additional Fees ' , . / ° , ' $77.00 - .'' $0.00\ . • $0.00- TOTAL PERMIT FEES : $77.00? Total Fees:$77.00 Total Payments To Date:$0.00 Balance Due:$77.00 0006 12/02/03 0002 01 02 77-00 Inspect F I NAL PPROVAL 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 Seciion 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 vou have previously been given a NOTICE similar to this, or as to which the statute of limitations has oreviouslv otherwise expired. PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 1. PROJECT INFORMATION 2.73 3 ^r^v-fcZJ FOR OFFICE USE ON PLAN CHECK NO. EST. VAL. Plan Ck. Deposit Validated Date l*Z Address (include Bldg/Suite #)Business Name (at this address) Legal Description Lot No.Subdivision Name/Number e\ Unit No. Phase No. ft? f oarf f Total # of units Assessor's Parcel #Existing Use Proposed Use Description of Work SQ. FT.#of Stories # of Bedrooms tt of Bathrooms .2. CONTACT PERSON (If different from applicant) Name Address 3. APPLICANT J3 Contractor D Agent for Contractor City Owner Q Agent for Owner t«v. State/Zip Telephone tt Fax* Name .5. , CONTRACTOR, Address City State/Zip Telephone tt 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 uinlatipn^nf Sactinn 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($5001). City State/Zip Telephone # CT* 3r City Business License # Name State License # Address License Class Designer Name Address City State/Zip Telephone State License # "?Qa'j?! fl 6. WORKERS' COMPENSATION , , Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: Q 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. fi 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 compensationjflsurance carrier and policy number are: ; Insurance Company -SCcXyip ylxnty Policy No. 2-S,?! £Q ^\ Expiration Date f * t * O *1 (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) 0 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^tfT),igj0ditjg^fothe cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE S&T *£>l£^&^\ DATE lZ'2'°.3 7. OWNER-BUILDER DECLARATttlf*^ - • ' • , , . - 1 hereby affirm that I am exempt from the Contractor's License Law for the following reason: f~1 I, as owner of the property or my employees with wages as their sole compensation, will do the work and the structure is hot 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). l~l 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). O 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. f~1 YES flNO 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): . j 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? O 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 l~l NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? fJ 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. 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. APPLICANT CERTIFICATION , 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 arid 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: Ev^ery 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 of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenc^f^^QgjodQ^^ days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE j(*lr /M&£^~) ' DATE /g- WHITE: File YELLOW: Applicant PINK: Finance II\ City Of Carlsbad SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR RERQOFING 1. JOB ADDRESS: T733 ^l^Tll^r ^TrlrUo) Q. 92-OQ? 2. TYPE OF BUILDING: RESIDENTIAL fY COMMERCIAL 3. ROOF SLOPE: RISE 4 inches in 12 inches 4. NUMBER OF EXISTING ROOF COVERING (circle one) Cj) 23 5. TYPE OF EXISTING ROOF COVERING ^/X SHEATHING! *6. NEW ROOF MATERIAL A CLASS^lWEIGHT PER SQUARE 7. -NUMBER OF SQUARES. 8. TRADE NAME k^'^0^) c*>^*stft^ MANUFACTURER £"/ 9. ROOF SYSTEM LISTING UL No. /e 3?/5 ICBO 10. IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? <26^ 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 i inspection. Sianature/l^ ^^y Date. Contractor O Owner Contractor Name £T.'^ t-i<?(louoy *6 - Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other. City of Carlsbad Bldg Inspection Request For: 04/21/2004 Permit* CB033336 Title: HYSONG RES 2600SF REROOF Description: WD SHAKE TO COMP SHINGLE Sub Type: REROOF 2733 CHESTNUT AV Lot 0 Type: MISC Job Address: Suite: Location: APPLICANT EXCALIBUR ROOFING Owner: HYSONG TRUST 08-18-97 Remarks:'<CAN YOU FINAL? Inspector Assignment: PD Phone Inspector Total Time: CD Description 19 Final Structural Act/, Comment Requested By: CHRISTINE Entered By: CHRISTINE Associated PCRs/CVs Inspection History Date Description Act Insp Comments 12/04/2003 15 Roof/Reroof AP PD 12/03/2003 15 Roof/Reroof CO PD 4uwm CERTIFICATE OF LIABILITY INSURANCg^I^ THIS CERTOiCATE IS ISSUED AS A MATTER OF INFORMAT ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER- THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. /ga/oa ION S, Xievine Insurance Services, Inc. 3377 Camel Mountain Road san niego ca 92121 i 858~48l-8«»2 INSURERS AFFORDING COVERAGE INSURED INSURER* Builders A Contractors Ins. Co INSURER B. American states insurance co. Inc.WSURER c:State camp rand INSUHHttO: INSURER E. COVERAOE8 fl Al M PI ff A B C « REQUIREMENT. TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUIIENr WITH RESPECT TO VWflCH THIS CERTIFICATE MAY BE ISStCD OH CH.ICIES.AQOREGATCLIMrrSS«3VW4MAYHAVEBEEMREDCrcEDBYPAIDCLAJMS. TYPE OF INSURANCE OENEWLLMBUTY x_ _ee Ml COMMERCIAL GENERAL LIABILITY ^ a. AIMS Mans | ~3C | nmst 1 A60REGATE LIMIT APPUES PER- HUOStLEUABBJIY ANYAUID ALL OVWCD ALTtS SCHEDULED AUTOS HIRED AUTOS GMWCEUMMIY ANY AUTO EXCtB< UACaJTY | OCCUR | | CLAIMS MOPE ssr * WORKERS OOMPENMTim AM> EMPLOYERS' LWBflJTY OTHER POJCYMIIfBat RE34000025 01CT6S98S44 285166903 sgrfsmor 01/08/03 12/31/02 ' 01/01/03 ^.ISM* 01/08/04 12/31/03 01/01/04 UWR EACH OCCURRENCE FIRE QfMNX WHO* *»1 MFni?<P(A(vami)«n«i) PERSC*W.«ADVWJURTf GENERAL AGeftESATE PROOUCTS - COMP/OfjWO ccwetfejaueLELwn- BODILY MJURV (Per person) BOOH Y INJURY (PWetadert) pnOPEffrrpAMAGE AUTO ONLY - EA ACCJDFHT ftTHRTimJ B0"1^ AUT60NLY. ^eg EACHOCCUKKCMCE AOOREOATC | — IWCSTATu- 1 'I6W( TORY LIMITS 1 1 ER Ei.CACHACCtOENT EX. DtSEA^-EA EMPLOYEE Ei. DISEASE - POLICY LIMIT fl, 000, 000 * so,ooo * 5,000 fl, 000,000 $1,000,000 yi/ooo^ooo $500,000 * f f f * f 1000000 t 1000000 t 1000000 WSCOTTONOFOPGRATON««X!A^^ • Proof of Insurance *10 day notice of cancellation applies for non-payment of premium. ADDmONALWeWffiO;tN8URWUT7Ht CANCELLATION BBOOrOO Proof of insuxance only ACORDZS-8POT) -3fl-*.OA\8WWTTEH MmW:ETO-mBCSirTineATEHOU5«NAMMTOTHELErr,BLTF^UIffiTODOOT»lALL DWCSeNOOBUaATl«4(MLIABLnV( REPReSQJTATIVES, Jhsxf ©ACORD CORPORATION 1888