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HomeMy WebLinkAbout2734 CHESTNUT AVE; ; CB020467; Permit^2-14^2002 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No:CB020467 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: 2734 CHESTNUT AV CBAD MISC 1673920700 $2,163.00 Subtype: REROOF Lot #: 0 WRIGHT RESIDENCE 21 SQUARES OF COMP REROOF Status: ISSUED Applied: 02/14/2002 Entered By: MDP Plan Approved: 02/14/2002 Issued: 02/14/2002 Inspect Area: Applicant: PIVA ROOFING, BOB 1192 INDUSTRIAL AV ESCONDIDO, CA 92029 619-745-4700 Owner: WRIGHT CLEVELAND A&SARA A INTER VIVOS TRUST 04-2 4695 MT BIGELOW DR SAN DIEGO CA 92111 0954 02/14/02 0002 01 02 , •• CGP 77.00 Total Fees: $77.00 Total Payments To Date:$0.00 Balance Due: $77.00 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES PERMIT $77.00 $0.00 $0.00 $77.00 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 lees/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. PERMIT APPLICATION OF CARLSBAD BUILDING DEPARTMENT «-*«'-•*••• EST..VALItNl la^UHLMf n,-_^ r,.TH 2075 Las Palmas Dr., Carlsbad CA 92009 _ Date (760)438-1161 . Validated By. 3*734 Cw-f ^ FOR OFFICE USE ONLY PLAN CHECK NO. Ck. Deposit V Address (include Bldg/Suite *) Business Name 1st this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel * Existing Use <? £./~i Proposed Use Description of Work ,»_..» c1 ^/ I fs--J^t SQ.FT. -, / j/'/ *of Stories T{ * of Bedrooms -s # of Bathroomsfc<££ocr jtv)he T&~ ., ^/r ' -* '£-CCrn/tf' ass3x^jwaea^ir;i»s«i^^ : i:~ " City "" State/Zip Telephone * Fax # ^f-^R^t^W^*^"^^"^^'1"alSK&lSSfaliZx&i**i*^£&i-'-~i^--~.'Jti''. '-•-• ••:-" Name Address City State/Zip Telephone # *^^7 * Name ' Address / City State/Zip Telephone * *.^CONTrWCTbR.iCbMPAW^ (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, altar, 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 IChaptor 9, commending with Section 7000 of Division 3 of the Business and Professions Code) or that he Is exempt therefrom, and the Oasis 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 1*5001). HWTnrlu.*rra.l M _ &Bcondtdo CA 330*4 1 lift ' Name State License # Designnr Name State License * el-; -WORKERS' c?;B93r3 •^/^^^S .: COMPENSATJONai^Sw Address License Class Address fe^^sS.taKSr-ic City Ci 3^ City Business City *"^«a»f < **M-»«Hc.'.v >^.1X1 JTi^jrs T— T^TTTK'gCai:r*<t--*l4y-'t*^'&viaaw;«^.*>5n?B«a!*iS^r-;'E??.S'%r'p»x State/Zip License # /Vx 1 State/Zip /k**-vT*r»r.^*->*«-<.Ttr;7*. Telephone * 0^? « Telephone •^K';~!C!-r'^v".^r=-:i;.:>:?:?7"rr:r'' 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. Q' 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 carrier and policy number are: / / Insurance Company^afe. QotflCm&dlOn 3fQtTW£- fund Policy No._^^7^50 Expiration Date H/Olj_ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OH LESS) Q 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 aecunt workers' compensation coverage b unlawful, and shall subject on employer to criminal penalties and civil fines up to one hundred thousand dollar! (4100.000), In addition to the coat of compensation, damages aa provided for in Section 3706 of the Labor code. Interest and attorney's fees. SIGNATURE . DATE T.^OWNER-BUIlDWDECLArlAtlON-::;^ I hereby affirm that I am exempt from the Contractor's License Law for the following reason: Q I, as owner of the property or my employees with wages ss 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 doe* 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). f~l I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sac. 7044, Business end 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). • Q I am exempt under Section Business and Professions Code tor this reason: 1. I personally plan to provide the major labor and materials for construction of the proposed property improvement. Q YES QNO 2. 1 (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 Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and prevention progrim under Sections 26505, 25533 or 25534- of the Presley-Tanner Hazardous Substance Account Act?- D--VES 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? D 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. ••IFjeONSTRUCTOiNt^^ I hereby affirm that there is a construction lending agency for tha performance of the work for which this permit is issued (Sec. 30970) Civil Code). LENDER'S NAME _____ _ LENDER'S ADDRESS I certify that I have read the application end 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. 1 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 requited 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 authored by such permit is not commenced within 365 days from the date of such permit or if the building or work authonzed by such permit is suspended or abandoned at anytime after the worlyscommjnced few^a popsd of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE _ 'O^L OsJ- V^U- NT""' _ ____ DATE : WHITE: File YELLOW: Applicant PINK: Finance City Of Carlsbad SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING 1. JOB ADDRESS: 2 "73V CL&S-jw / 2. TYPE OF BUILDING: RESIDENTIAL COMMERCIAL 3. ROOF SLOPE: RISE 6" inches in 12 inches 4. NUMBER OF EXISTING ROOF COVERING (circle one) 2 3 5. TYPE OF EXISTING ROOF COVERINGSbjc^SHEATHING AJ O . *6. NEW ROOF MATERIAL C&^f CLASS /f WEIGHT PER SQUARE Z.5£> > 7. -NUMBER OF SQUARES *2~ / ' . ' 8. TRADE NAME /vL^^^G^ MANUFACTURER ' O.C* • . 9. ROOF SYSTEM LISTING UL No. _ _JCBO No. 10. IS THE EXISTING STRUCTURAL DESIGN SUEEJCIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? XYEsO 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 ^-^~O*L, ^>^ \ Date Contractor Owner Contractor Name £ ftiM /&hu.* *6 - Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other. City of Carlsbad Bldg Inspection Request For: 03/04/2002 Permit# CB020467 Inspector Assignment: RGB Title: WRIGHT RESIDENCE Description: 21 SQUARES OF COMP REROOF Type:MISC Sub Type: REROOF Phone: 7607454700 Job Address: 2734 CHESTNUT AV Suite: Lot 0 Ash Location: Inspector: /(CJ? APPLICANT PIVA ROOFING, BOB Owner: WRIGHT CLEVELAND A&SARA A INTER VIVOS TRUST 04-2 Remarks: Total Time: Requested By: DONNA Entered By: CHRISTINE CD Description Act Comments 19 Final Structural **' Associated PCRs Inspection History Date Description Act Insp Comments 02/15/2002 15Roof/Reroof AP RC OK TO COVER ACORDm CERTIFICATE OF LIABI PRODUCER (619)584-6400 FAX (619)584-6425 West! and Insurance Brokers '38"38 Camino Del Rio North #315 P.O. Box 85481 San Diego, CA 92186-5481 INSURED Bob Piva Roofing 1192 Industrial Avenue Escondido, CA 92029 l LITY INSURANCE DATE (MM/DD/YY) 10/22/2001 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURER A: Lexington Insurance Company/Sterling West INSURERS: Peerl ess Insurance Company/GEIC INSURER c: State Compensation Insurance Fund INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING MAY PERTAIN. THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR A B C TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY 1 CLAIMS MADE | X | OCCUR GEN'L AGGREGATE LIMIT APPLIES PER: ~~1 POLICY njPERc°f HLOC AUTOMOBILE LIABILITY X X X ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY ANY AUTO EXCESS LIABILITY | OCCUR | | CLAIMS MADE DEDUCTIBLE RETENTION S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OTHER POLICY NUMBER 1140338 CBP9497628 467758 POLICY EFFECTIVE DATE (MM/DD/YY) 06/01/2001 06/01/2001 06/01/2001 POLICY EXPIRATION DATE (MM/DD/YY) 06/01/2002 06/01/2002 04/01/2002 LIMITS EACH OCCURRENCE FIRE DAMAGE (Any one fire) MED EXP (Any one peroon) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY (Per accidenl) PROPERTY DAMAGE (Per accident) AUTO ONLY - EA ACCIDENT OTHER THAN EA ACC AUTO ONLY: AGQ EACH OCCURRENCE AGGREGATE WC StATu- OTH- TORY LIMITS ER E.L. EACH ACCIDENT E.L. DISEASE - EA EMPLOYEE E.L. DISEASE - POLICY LIMIT s 1,000,000 s 50,000 $ excluded s 1,000,000 s 2,000,000 s 1,000,000 $ 1,000,000 s s s s s s s s s s s s 1,000,000 s 1,000,000 s 1,000,000 CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER:CANCELLATION INFORMATIONAL CERTIFICATE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 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 REPRESENTATIVE ^—yr . . s ^U^rvJ {£,-<*—Robert Kempa/JOYR ^J ACORD 25-S (7/97)©ACORD CORPORATION 1988