HomeMy WebLinkAbout2883 LANCASTER RD; ; CB052143; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
06-08-2005 Miscellaneous Permit Permit No: CB052143
Building Inspection Request Line {760) 602-2725
Job Address:
Permit Type:
Parcel No:
Valuation:
2883 LANCASTER RD CBAD
MISC
1674612600
$3,192.00
Subtype: REROOF Status:
Lot#: 0 Applied:
Entered By:
Reference #: Plan Approved:
ISSUED
06/08/2005
LSM
06/08/2005
06/08/2005
Project Title: CALAVERA HOA-28 SQUARES COMP
SHINGLES. INCLUDES 2885 LANCASTER RD
OOFING CO
Miscelaneous Fee #1
Miscelaneous Fee #2
Additional Fees
TOTAL PERMIT FEES
Total Fees:
Inspector:
$89.00
PERMIT FEE
Owner:
PRICE KIMBERLEY A
2883 LANCASTER RD
CARLSBAD CA 92008
Total Payments To Date: $0.00
FINA
Date:
L
Issued:
Inspect Area:
Balance Due:
$89.00
$0.00
$0.00
$89.00
$89.00
01.07 ')6/08/05 X:02 01 02
CCiiF•
Clearance: ------
NOTICE: Please take NOTICE that approval of your project includes the "lmpo ition" of fees, dedications, reservations, or other exactions hereafter collectively
referred to as "fees/exactions." You have 00 days from the date this pennit 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 infonnation 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, se1 aside, void, or annul their imposition.
FOR OFFICE USE ONLY
PERMIT APPLICATION 0£ dll./3
CITY OF CARLSBAD BUILDING DEPARTMENT
1635 Faraday Ave., Carlsbad, CA 92008
PLAN CHECK NO. (!.,,RJ
3/ 9~ EST. VAL.-~~..;_:__..:..,_ ____ _
Plan Ck. Deposit __ t:/::,.,._,.,,,.,__ _____ _
Validated By __ ___,,.,..:~-,---""-------
Date. ___ ___:e~::..,t~/<(/.!:t+-~0_;~::...,-___ _
Business Name (at this address)
Legal Description Lat Na. Subdivision Name/Number Unit Na. Phase No. Total # of units
Proposed Use
#of Stories II of Bedrooms II of Bathrooms
Fax II
•·. G'77-7o
Name Address City State/Zip Telephone II
:!i,i;;'l11~.0:'11T.Mt.JQ81i,tCOMPr4ffiYi'I\IMt11!;c¾'.' ,If):'. i' ~; 'ei .• !~ •. ,,;i r'l · •'.J:~,r..:l' .'.°;'i' ,;,i·'.J,~:
(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 far 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
• Any vi Sec 'onJ 031 .5 by an~plicant for a permit subj cts the applic nt to civil penal( of notQ ore than five q ndred 511ars ($501:i-
State/Zip Telephone II
State License II --=~==--4-i.L.-=--~ License Class -'=----"----=------City Business License II / ).:1., DI :Z l
Designer Name Address City State/Zip Telephone
State License II _________ _
(0, \..i\Wi;UU~ffl.~QM.f.ifi~1l()JjJ.$~,,,Jf;~~·t•.;;,;r,,.;t,.~·;;,,, ·•,'y,•f.e'hlril,'>Je ,',!/ · ,it ': ··
W rs' Compensation Declaration: I hereby affirm under penaltv of perjury one of the following declarations:
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
• the work for which this permit is issued.
D I have and will maintain workers' compensation, as required by Section 3700 of the Labor Cade, for the performance of the work for which this permit is
issued. My worker's ca e ation · surance carrier and policy number are: • I '? D l $'i LJ
Insurance Company _.LJM~..L-~~l.!ll!1'l~-----------Pahcy Na._._ .. (J....,_ _____ 7~-----Expiration Date _______ _
(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 ta the Workers' Compensation Laws of Celifornia,
rker1' compen1atlon coverage la unlawful, and ■hall aubjact an amployar to criminal penalties and civil flnea up to one hundred
thousand dollar addition to the coat of compan1atlon, damages ea provided for In Section 3706 of th lab ~• taraa.t and ettorney'a fees.
SIGNATURE~:_____::....::_:_.:::.,1-1-i.;_;:....:;',1.:::.::______________________ DATE -=--~---'-r-+-/_,,<--:""""--
\l;L~'!>WNefl':f!ti~iJr';,Q · ~ •... O.N~f;:'l:f '.1ft/~t~,.?'i'cti'il~ •1~,;,~J' ~-~i£.i1:J\,i1~t.'!,~f ~1::Jft,~ '•U·,i'·rt·h~;t,\i. ,,f~c,,:,,,;•.o,,,~/ .r ·
I hereby affirm that I am exempt from the Contractor's License Law far the following reason:
D 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 ta an owner of property who builds or improves thereon, and who does
such work himself or through his awn 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 far 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 ta an owner of property who builds or improve& thereon, and contracts for such projects with contractor(s) licensed
pursuant ta the Contractor's License Law).
D 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. D YES ONO
2. I (have / have natl signed an application far a building permit for the proposed work.
3. I have contracted with the following person (firm) ta provide the proposed construction (include name / address / phone number / contractors license number):
4. I plan ta provide portions of the work, but I have hired the following person ta coordinate, supervise and provide the major work (include name / address / phone number I contractors license number):, ________________________________________________ _
5, I will provide same 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 _________ _
[«;.Q~J.e; If!l!iili.C.llli1NJ.FQB;'NQM~l?IJV17M:J"!.11Ll.Qltfll!Pi.8M!IS!PNtY,~"'.:':°)i'.t1,;t:it'1\tS:'.~•,~it1:;,, ,~h£b,.M'IJ\~Jlt ih,l~ :;.,, \k' ' ·.'~,. • ,, ,, · ,,
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 Act7 D YES D NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district7 O YES D NO
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES D 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.
l@,;Jk ~9.~$!tB\!C.TIQlH!i:NRIN<i:'AG~N!l. ,: 1.1'.r~it,:'U;:,;;;; t.:i: ,,, , ·, '..-'
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 _____________ _
!ti•~•·•~11me.~ttTia.C::..E8TIFU.A1J;10N'i[,li:.'\,~~J~',,;;~;,;,hii1•~·.1l
I certify that I have read the application and state that the above information is correct and that the information an the plans Is accurate. I agree to complv with all
City ordinances and State laws relating to building construction, I hereby authorize representatives of the Cit\' of Carlsbad ta enter upon the above mentioned
property far 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 end 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
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 lime after the work is comm for ape of 180 days (Section 106.4.4 Uniform Building Code). /·t f / ~
APPLICANT'S SIGNATURE --.C.......Ll<.:..-"'F+'--=-7-------------------DATE b_ --fL2_ --"-4--+-ll'----=--,:__ ___ _
YELLOW: Applicant PINK: Finance
City Of Carlsbad
SUPPLEMENTAL BUILDING P, RMIT APPLICATION FOR REROOFING
1. JOB ADDRESS:~~~" ,__7_??f .... · _3 _ ___.F-____,~------
2. TYPE OF BUILDING: RESIOENTfAL. ____ COMMERCIAL ____ _
3. ROOF SLOPE: RISE l-\ Inches In 12 lnchas
4. NUMBER OF EXISTING ROOF COVERING (cin;le one) 02 3
5. TYPE OF EXISTtNG ROOF COVERJNG~SHEATHJNG 1/2 C/Jb
•e. NEW ROOF MATERIAL~CLASS~EIGHT PER SQUARE
7. NUMBER OF SQUARES tW 'J.f .
8. TRADE NAME ~~ MANUFACTURER f-ff..
9. ROOF SYSTEM LISTING UL No. 7 '[Q ICBC No. 3 / b J
IO. IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE
WEIGHT OF THE PROPOSED ROOF? & NO
AU roof coverings are required to be CLASS A. Combustible roof coverings
of any type or classlflcatlon are prohibited.
I understand the following Inspections are required: .:.:.
t. 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 '?k. tu~lif''--Date (. h {DJ
Contractor t..l Owner ____ Contractor Nall'& £ eW
*6 -Rolled Roofing, Standard/lite TIie, Asphalt/Comp Fiberglass, Built up,
Other.
' . .
UNSCHEDULED BUILDING INSPECTION
DATE -~Q~?~--:Z~~s~:_· __ INSPECTOR :;:..l!,, • c::r
PERMIT# QSA;.\ ~ . PLAN CHECK# ____ .;,.._
DESCRIPTION __________________ _
CODE DESCRIPTION ACT COMMENTS
City of Carlsbad Bldg Inspection Request
For: 06/16/2005
Permit# CB052143
Title: CALAVERA HOA-28 SQUARES COMP
Description: SHINGLES. INCLUDES 2885 LANCASTER RD
Type: MISC Sub Type: REROOF
Job Address: 2883 LANCASTER RD
Suite: Lot 0
Location:
APPLICANT PETRONELLA ROOFING CO
Owner: PRICE KIMBERLEY A
Remarks: AM PLEASE
Total Time:
CD Description Act Comment
15 Roof/Reroof A£-'k Cj
Associated PCRs/CVs
lns12ection Histo!Y
Date Description Act lnsp Comments
Inspector Assignment: ~
Phone:
Inspector: ----
Requested By: GARY
Entered By: CHRISTINE
f, (Li(i~
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