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2736 GALICIA WAY; ; CB033024; Permit
City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 11-04-2003 Miscellaneous Permit Permit No: CB033024 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: Applicant: 2736 GALICIA WY CBAD MISC 2162200500 $10,116.00 Subtype: REROOF Lot#: 0 NEMETH RES-36 SOR LT WT CONCRE Owner: Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 11/04/2003 RMA 11/04/2003 11/04/2003 PIVA ROOFING, BOB NEMETH ROSE A TRUST 02-16-93 1192 INDUSTRIALAV ESCONDIDO, CA 92029 619-745-4700 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES Total Fees: $179.00 Inspector: PO BOX 1531 RANCHO SANTA FE CA 92067 PERMIT FEE Total Payments To Date: $0.00 $179.00 $0.00 $0.00 $179.00 Balance Due: $179.00 8005 11/04/03 0002 01 CGP Clearance: NOTICE: Please take NOTICE that approval of your project includes the "Imposition· of fees, dedications, reseNations, 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 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 f /ex i n h' h h v r vi iv n N Tl E imil whi h h f i i i n h ' 02 179"00 PERMIT APPLICATIO.N FOR OFFICE USE ~;1 PLAN CHECK No.Lf;>@Jt? EST. VAL. / C), flt,. ~ , CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 Plan Ck. Deposit ---...,,...-r---- Validated By , iJlJ=.. Date /{ / 9 (C49-~,,2~CT[~,~~T;~N,Wi ';, :,,: ,,, · -~,)~',: ~~:WJP'l\l1E'\';,,4?,t;-"?.;,;':3~~,:I~t;:·;~·;f;'.:~•iJ,y;·;~,r: i .. ·:.\, ]', ·, ,,\ Address (include Bldg/Suite #) 'tAAj Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # Proposed Use # of Bedrooms # of Bathrooms ;:. ·~ i ,· :· ~--s.:-j ;. ~ Name Address City [3~•:J'J~i:1c·~N~?~co'ritrA.c~'or;it~B J/ie"(i.6(:c9r,tragjor.i,~Q ;:cfw;";:~o T~g~11tiioliov/·;;9~.,. State/Zip Telephone# Fax# (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 viol tio""-°! Section 7031.5 by any applicant for a perit subjects the applicant to ~jivil penalty of not more than five hundred dollars ($5001) . .b "~ · QIO-t-, t,9~ 1-t ,~ Ave & a& cA 9,lo s--~ State License # _2~_( --g~9~.:3/6 ___ _ Address License Class __ c=~~'"-''------ City State/Zip Telephone # City Business Lic.ense # _J/ ... ~-~3_/%~.c...-- Designer Name Address City State/Zip Telephone State License # __________ _ rs:,l:~w.6.RKEFts~rc·oMPE.NSATION~'Yfi~~~~~ii111:~:Is;1~1~~t:~~Jf:;J1~if?i[;tJ.:;~;:rrp~iz.t~Jl~t1-,;,1;J~;~),~~~~~,,I.,,.,. ./~·>l;~ Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: '~ .... ·r ., 0 I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of tho 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 Codo, for the performance of the work for which this permit is issued. My worker's com~psavon insurance ca rier and policy number are: , /. / Insurance Company --~=--'-'-'-'-=--+-;c..=..-'-'----------Policy No.J;f~ ~33$0 3 Expiration Date lijljd'f (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS] 17) CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to tho Workers' Compensation Laws of California. , WARNING: Failure to secure workers' compensation coverage Is unlawful, and sholl subject on employer to criminal ponoltlos ond civil fines up to one hundred thousand dollars ($ 001 addition to the cost of compensation, damages as provided for in Section 3706 of the La e, interest ond attorney's fees. SIGNATURE . 0 Pl!i6WNER~Bllilo -.oECi!ARAt.10N·~,~ttrsm~:]~j}~J:~J~l~:~~f•~;::J:•~fit?J:;ti;~:t:Ti::i~:t".f:)<:'.:¥< ·~':-·-~: ::t· I hereby affirm that I am exempt from tho 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, II, 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). 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(sl licen~ed 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 tho following person [firm) to provide the proposed construction (include name / address / phono number / contractors license number): 4. I plan to provide portions or 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 _______________________ _ DATE _________ _ [COMP,LE;tEJi'ijjs/SECTToN;F,oRWrSi·MES /DENiiij//~uJ~b'i~Gj P,ERMi'(si oNN~[;:YC:j4,F•i:k:r;;~,. i .: ..:'.,i:, ' ;:, -~f!,!,,;/} ; '!;ft,;:;:".:L, >t:.:~: 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 tho applicant or future building occupant required to obtain a permit from the air pollution control district or air qualitY management district7 O YES O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site 7 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. ~~ijffCQ.~~tff UQ~lPJJTLe'i-JP1NG~:AGE~CYif.0~t¥U~:{?fl~if!~~rJV11i~~f{~f~,J!Y~l~~~l~~:3;'.~l~~-t•I~/•.>:-· ~1 /•:; t · ·,•'·Yl ::-. /•: ·~/, .. '' ... ;e, \. I hereby affirm that there is n construction lending agency for the performance of the work for which this permit is issued (Sec. 3097li) Civil Code). LENDER'S NAME ______________ _ LENDER'S ADDRESS _________________________ _ !9liitAi?et1CANf{CERT1F"1CATl9 N}:;:r?J~t~<lt~~~!'~~~~l~ffl~:~m~:'h~~:i~'Z~';f~l\:l:, . ;-:,;;;Ji, .~{~;-~ \";t~1 -~~i ~~ i:!~:~;.1-~\1:)r)}.; i:rr: .,111;;1:fi,\t!.JJt'J;tt.?:iJ.Z~~; ?.::.iJ~~"; .~(;:'l1~ 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 lhe building Official under lhe provisions of lhis Code shall expire by limitation and become null and void if lhe building or work authorized by such permit Is not commenced within 180 days from lhe dale of such permit or if lhe building or work authorized by such permit is suspended or abandoned at any lime aller lhe work is comme d r a period of 180 da s · .4 Uniform Building Code). / · / APPLICANT'S SIGNATURE ~~~~~2=========::::::::________ DATE -t~Z..,.,-~l-f'/ ... {)"---'-:3 ______ _ WHITE: File YELLOW: Applicant PINK: Finance City of Carlsbad Bldg Inspection Request For: 12/19/2003 Permit# CB033024 Title: NEMETH RES-36 SOR LT WT CONCRE Description: Type: MISC Sub Type: REROOF Job Address: Suite: Location: 2736 GALICIA WY Lot APPLICANT PIVA ROOFING, BOB 0 Owner: NEMETH ROSE A TRUST 02-16-93 Remarks: Total Time: CD Description Act Comment Inspector Assignment: RB --- Phone: 7607454700 Inspector: J \>J\ Requested By: PIVA ROOFING Entered By: CHRISTINE 19 Final Structural ~------ Associated PCRs/CVs lns~ection Histo!Y Date Description Act lnsp Comments 11/14/2003 13 Shear Panels/HD's WC RB 11/14/2003 15 Roof/Reroof AP RB FAMING & PLYWD NAILING OK 11/13/2003 15 Roof/Reroof co RB MISSING ADDED FRMG PER ENG City Of Carlsbad SUPPLEMENTAL· BUILDING PERMll APPLICATION FOR REROOFING 1. JoB ADDREss: ?-'73b ~ /i:;iC{a W:i,y 2. TYPE OF BUILDING: RESIDENTIAL 'f. COMMERCIAL. __ __, 3. ROOF SLOPE: RISE q inches in 12 inches 4. NUMBER OF EXISTING ROOF COVERING (circle one) © 2 3 5. TYPE OF EXISTING ROOF COVERING 7/r. oc!b SHEATHING ___ _. _ *6. NEW ROOF MATERIAL file cLAss A WEIGHT PER SQUARE 7. -NUMBER OF SQUARES 36 )¥ . 8. TRADE NAME Ggje.li'¥-&Jt{oS:tMANUFACTURE~ €45/e 9. -ROOF SYSTEM LISTING UL No. _ ICBO No. t/toO 10.15 THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? § 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: _ 7,1 1. Tear Off/Pre•inspection prior to instalf'~ew roof covering. 2. Final Inspection I agree to provide a ladder extending at least 2 rungs above the roof for inspection. Signature_-~---"'-h~fo~_• __ .Date 1¢/23 Contractor X Owner ____ Contractor NafPe Bob Pi VO\ /2_oe5t,'f\~ *6 -Rolled Roofing, Standard/Lite Tile, AsphalUComp Fiberglass, Built up, Other.