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Home My WebLink About2817 JACARANDA AVE; ; CB033340; PermitC 162 5 Fe 12-02-2003 M Building In p0 Job Address: 2817 JACARANDA AV Cl A[: Permit Type: Parcel No: Valuation: Reference #: MISC 2551032300 $7,587.00 Project Title: HANNUM RES-2700 SF I f \ .' Applicant: PATRIOT ROOFING 1042 EL CAMINO REAL ENCINITAS, CA 92064 760-577-2935 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES Total Fees: $140.00 Inspector: Total P, 1wG ,, NOTICE: Please take NOTICE that approval of your proJ t ir,:;: referred to as "fees/exactions.' You have 90 days from t1· da·,~ follow the protest procedures set forth in Government Ce-: S,._ ·), processing in accordance with Carlsbad Municipal Code: cti. ,; review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right top ·es: : changes, nor planning, zoning, grading or other similar ar .. ca:,·_ fees/ wh' h h v r I n i en : o-!.. -Carlsbad v Carlsbad, CA 92008 .,neous Permit Permit No: CB033340 r:_equest Line (760) 602-2725 ,,: REROOF 0 Jwner: HANNUM SCOTT E Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 12/02/2003 RMA 12/02/2003 12/02/2003 2817 JACARANDA AVE ,~ARLSBAD CA 92009 te: $0.00 $140.00 $0.00 $0.00 $140.00 Balance Due: $140.00 0008 12/02/03 0002 01 CGP Clearance: ,ition" f fees, dedications, reseivations, or other exactions hereafter collectively issued to protest imposition of these fees/exactions. If you protest them, you must ,11d file the protest and any other required information with the City Manager for ure to timely follow that procedure will bar any subsequent legal action to attack, . ,' ,:is/exactions DOES NOT APPLY to water and sewer connection fees and capacity r service fees in connection with this project. NOR DOES IT APPLY to any ow i h f limit . n h I th FOR OFFICE USE ONLY PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 PLAN CHECK NO. C{,CIJ 3 ? Cf tJ EST. VAL. '7 7L£ 7 Plan Ck. Deposit----=---- Validated By : . ¢2/4 Date ,/,./,, 1~ 1~ Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # Existing Use -;JJO() Proposed Use 3 2 yq Voaf Description of Work SO. FT. # of Bedrooms # of Bathrooms Name Address City 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 p ·on. An ion 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$6001). . 00 Address License Class ~l'-•~b.,_'l~------ City State/Zl Telephone # City Business License 1f/ 1/-/J? ~ Designer Name Address City State/Zip Telephone State License # _________ _ ~~Wll.WJIDll1'1~RMP~llTI.PNi4lli\Ti'J~)E::~hd'.hGb;;;i[Jc'.<;;;t ~: :0ns«<<> ·c: s;~·"· :~,\:'' c ,::-ii!1/n<t >(t/~Jj[if:!:!'.;fJY:fJ'.s JY>' Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: D 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. ISl} I have and will maintain workers' compensation, as required by Section 3 700 of the Labor Code, for the performance of the work for which this permit is issued. My worker's pens tion insur ce carrie and policy number are: ... C, J Insurance Company _,_.u_111,!>,i<c___-f<C.J.Ad<'.!J.!....._______ Policy No. / {J] 2 2:/ ?--Expiration Date I 2-.J / .- (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100] OR LESS) D 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: Fallu to aacura workers' companaatlon coverage 11 unlawful, and 1hall subject an employer to criminal penalties and civil fines up to one hundred thousand doUar1 1 0,000), I dltlon to the cost of compensation, damages as provided for In Section 3706 of the Labo code, terest end attorney's fees. SIGNATURE DATE l?~~'L-= I hereby affirm that I am exempt lowing 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 purpose of sale). D 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). 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 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 _________ _ \O(fMimll'tt(IV,J(~:T:i~MffiOff":,IQMRBfaW:'iMAlliO:PliPir{gjjiJiAJjfl;QN~¥l@,¼#:£Jt;!bll%tilktli£~:1]»11tt~~~~Ll¥A:Vfiliiit:~m!i~t1Zi,~l~filef:t~~ljt~i:<t!~,~:M:2:0:: ,i:Jr.iitthtMl2R:- ls 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 the applicant or future building occupant required to obtain a 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? D 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. I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec. 3097(il Civil Code). LENDER'S NAME LENDER'S ADDRESS 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 Citt 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 limltation and become null and void it the building or work authorized by such permit 1s not comm need w1thm 1 BO days from the date of such permit or 1f the bu1ld1ng or work authonzed by such permit Is suspended or abandoned at any t1me after the work is com en d for a per of 180 days (Section ~06 4 4 Uniform Building Code) / / APPLICANT"S SIGNATURE ,.,t.~,'.l,1~'7ll-4~~74llt~------------DATE ,..la,'-'-'l",p,_'Q-,,_,_./ 11"-'}--'>--------,-, /::.I WHITE: File YELLOW: Applicant PINK: Fmance City Of Carlsbad SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING 1. JOB ADDRESS:.2-'.is/:J , )t\. l'qyc.&1 cff< ,Jv;,e 2. TYPE OF BUILDING: RE;_!DENTIAL y COMMERCIAL. __ _,_ 3. ROOF SLOPE: RISE {p · .J inches in 12 inches 4. NUMBER OF EXISTING ROOF COVERING (circle one) @ 2 3 5. TYPE OF EXISTING ROOF COVERING s1vJl--{sHEATHING ___ _.e *6. NEW ROOF MATERIAL -tila CLAss5liDwEIGHT PER SQUARE 7. -NUMBER OF SQUARES ,;2] . 8. TRADE NAME C.e.&0¥ / I f:p MANUFACTURER MO V\ ,·-e--r: 9. ROOF SYSTEM LISTING UL No."ft2--2.Qt'[-Z, ICBO No. -_____ _, 1 O. IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? i!, 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 instali new roof covering. 2. Final Inspection I agree to provide a ladder extending at least 2 rungs above the roof for inspection. Signature .,~I ~~ Contractor ±-Owner ____ Contractor Narre · *6 • Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other. m . . . City of Carlsbad Bldg Inspection Request For: 01/09/2004 . Permit# CB033340 Inspector Assignment: JM --- Title: HANNUM RES-2700 SF LT WT CONCR Description: Type: MISC Sub Type: REROOF Phone: 7608452489 Job Address: 2817 JACARANDA AV Suite: Lot 0 Location: APPLICANT PATRIOT ROOFING Owner: HANNUM SCOTT E Remarks: Total Time: CD Description 19 Final Structural Inspector: ---- Requested By: AILEEN Entered By: CHRISTINE Act Comm/nt / j tf;_ /Vd f/f1/4,/~ C~- Associated PCRs/CVs Inspection History Date Description Act lnsp Comments 12/23/2003 15 Roof/Reroof AP JM OK TO COVER, NO RECORD CARD