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Home My WebLink About2810 JACARANDA AVE; ; CB970438; PermitPERMIT APPLICATION J CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (619) 438-1161 FOR OFFICE USE ONLY PLAN CHECK NO. '(76'f Jzj EST. VAL. _2-"---'-2-~=-/ ____ _ Plan Ck. Deposit _,(?,-.""'-'':f'..._,.,.'-'(DK""' ___ _ Validated By __ Jl-=-~------- Date. _____________ _ Business Name (at thi1 address) Lot No. Subdivision Name/Number Unit No. Phase No. Total II of units Assessor's Parcel II Existing Use Proposed Use II of Bedrooms # of Bathrooms (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, attar, 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 axe · n. ~Y/~~f Section 7 ~n~applicant for permi;;bjec~ the applicant o a cji)penalty of not more ~e/ve hundred dollars ~$500 '.3(:!;' Name e") } ~J, 1 !2 Address C.. -::::2 9 City State/Zip Telephone II State License # ___ /----'-'l---'/•_f __ ~__ License Class _____ 7 _ _,_____ City Business License II } -20 ;??3 i Designer Name Address City State/Zip Telephone State License II _________ _ [i. ' ~OJ,IPEN$A_ll0 , .. ~~••;;_,--.• ~ .,,..,,,::~,~·:, • .-•~-~-.~,._',;.i, 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. ~have and will maintain workers' compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this per~it is issued. My worker's compensation insurance carrier a~nd p~ number are: ~ S-,,_ O 7 J/;t-? a; Insurance Company 5"7;A-rjjf: EVN U Policy No. .;;). ~ 7 Expiration Date T C::J ------1~-~--(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1$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 aecure•workera· compenaation 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 compenaation, damages as provided for In Section 3706 of the LabQr code, lntere1t and attorney', fees. SIGNATURE. ______________________________ DATE _________ _ i7, .. ~ OWNER,BUILD~ DECLARAJION o.. "' . ';· ,. , '·,.. ~--::...'.:..... . ., ~~-""'-• ·-,.~.£-~';iS};:;!E'..:fflw~gl;':..,_.~ I hereby affirm that I am exempt from the 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. 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 purpoH of salal. 0 I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Buain8SI and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improves thereon, and contracts for auch projects with contractor(1) licensed 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 the following person (firm) to provide \he 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 \®~:'.S~TION.EQR.i{O~P~kmN..<t~BMIU:QijLy DATE 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 26534 of the Presley-Tanner Hazardous Substance Account Act? 0 YES O NO Is the applicant or future building occupant required to obtain • permit from the air pollution control district or air quality management district? 0 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. 8_._ ;:J,ONSTRUCTION.LENDING AGEN.C¥ 0 •• ':-1• ~-. ~ -, -~ ., ' _,, '.:'."''~~ , ,. -,zf:z:E"" "ti?l 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 ______________ _ ~:. .APPUCANT 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 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 work authorized by such permit i or abandoned at any time after YELLOW: Applicant PINK: Finance • 1. 2. 3. 4. 5. *6. 7. 8. 9. 10. 11. ~ V CITY OF CARLSBAD SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING JOB ADDRESS._d;;.__6;;.__l()_...;;._J_.,,/J_C'.;;,_';/J_~_}✓-_J)_A _____ _ TYPE OF BUILDING: RESIDENTIAL v' COMMERCIAL ROOF SLOPE: RISE 1/ inches in 12 inches -- TYPE OF EXISTING ROOF COVERING .:Sh/:AK&°' SHEATHING Sn C';E ,/!:) NUMBER OF EXISTING~Jgf!:l~RIN~~~e) \.L) 2 3 NEW ROOF MATERIAL~t½ Pi\!&4 ~...tl_ WEIGHT PER SQUARE 5'8c:, NUMBER OF SQUARES ;2___3 TRADE NAME A,dA/v§l' fe,l.J.,,,41/? .D MANUFACTURER J_oCJ~;Al{,,,i J:31 C. rPC ROOF SYSTEM APPROVAL UL No. S' p_) Other ___ _ IS THE EXISTING STRUCTURAL DES~UFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF YES ____ NO ___ _ If the answer is no, a roof plan must be provided with this application. Fire rating of roof: Class A ~lass 8 __ I understand the following inspections are required: 1. Tear Off/Pre-inspection prior to installing new roof covering. 2. Final Inspection I agree to provide a ladder extending at least 2 rungs above the roof for inspection. 6' Contractor ✓ OWner DATE Contractor Name ~~ /Flyll £~ 1 ~ (; --- *6 -Rolled Roofing, Tile, Shake, Shingle, Asphalt/Comp Fiberglass, Built up. PERMIT# CB970438 DESCRIPTION: REROOF 2300 SF, UL #5121 TYPE: MISC CITY OF CARLSBAD INSPECTION REQUEST FOR 03/17/97 FIBER CEMENT JOB ADDRESS: 2810 JACARANDA AV APPLICANT: PACIFICA ROOFING CONTRACTOR: PHONE: PHONE: OWNER: PHONE: INSPECTOR AREA DC PLANCK# CB970438 OCC GRP CONSTR. TYPE NEW STE: LOT: 619 434-1938 REMARKS: BJN/JOHN/434-1938 SPECIAL INSTRUCT: INSPECTOR~,!)~----------- TOTAL TIME: ACT COMMENTS CD 15 LVL DESCRIPTION ST Roof/Reroof .df_ Q 1:AL,b L,,- ------------------ ------------------ ------------------ ***** INSPECTION HISTORY***** DATE DESCRIPTION 031097 Roof/Reroof ACT INSP AP DC COMMENTS ORIG SKIP SHEATHING