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Home My WebLink About1212 OAK AVE; ; CB021308; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 04-29-2002 Miscellaneous Permit Permit No: CB021308 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: Building Inspection Request Line (760) 602-2725 1212 OAK AV CBAD MISC 1561803500 $2,442.00 Subtype: REROOF Lot#: 0 BUSBY RES-2200 SF COMPOSITION Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 04/29/2002 AMA 04/29/2002 04/29/2002 Applicant: Owner: 6111 04/29/02 0002 01 CGP BUSBY GENE&KIM 12120AKAVE CARLSBAD CA 92008 Total Fees: $77.00 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES Inspector: BUSBY GENE&KIM 1212 OAK AVE CARLSBAD CA 92008 Total Payments To Date: $0.00 PERMIT FEE Balance Due: Clearance: $77.00 $0.00 $0.00 $77.00 $77.00 NOTICE: Please take NOTICE that approval of your project includes the 'Imposition" of fees, dedications, reservations, 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 . . . I . . . i h . . . 02 77.00 PERMIT, APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 .._,y PROJECT INFORMATION /\ I d:I :l OAK Pt Ve FOR OFFICE USE 0~ PLAN CHECK N~U/l(,l,, /34?' EST. VAL. d. ':::f_ 41 Plan Ck. Deposit-----~--- Address (include Bldg/Suite #) Business Name (at this address) Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units _ /2· CONTACT PERSON llf different from appllcantl -,....::Cot-l'/ Rosse rr, 101., o" -f3 · Name Address 5,D t[t q.llJ.~ (85S) 'i8'1-'i710-f_°'-Z State/Zip Telephone # Fax #¥ 0 Agent for Contractor .l Name Telephone# 4. PROPERTY OWNER tJ...V-./\.L' Name Address City State/Zip Telephone# 5. CONTRACTOR -COMPANY NAME (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 violation of Section 7031.5 by any !IPPlicant for a rmit subjects the j!fPlicant to a civil penalty of not more than five hundred dollars ($50011. ~R--Cof'.l!7-tf.u..c.-c·o,..) 0 0 -t ~11Vt.1 ~~~ SA., <8S c/8~<'. '/0 Name • 12 State License # ........ ~ ....... 9_,t?"--~-(_8....._ __ Address City State/Zip Telephone # License Class----------City Business License # -------- Designer Name Address City State/Zip Telephone State License # ---------- 6. WORKERS' COMPENSATION 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. 0 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 Policy No. Expiration Date _______ _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESSJ 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 secure workers' compenHtion coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thouHnd dollars ($100,0001. in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, Interest end attorney's fees. )ilGNATURE DATE--------- / 7. OWNER-BUILDER DECLARATION 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 purpose of salel. ~ 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 15No 2. I '@)1 have notl 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 I address I phone number I 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 I address I phone number I contractors license numberl:------------------------------------------------ 5. I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name I address I phone number I type of workl: _________ --,.....,.-----,~.,_------------------------,...,..--,,--------------- ..,,(pROPERTY OWNER SIGNATURE DATE ---'---------• COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY 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 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? 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. CONSTRUCTION LENDING AGENCY 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 CodeJ. LENDER'S NAME -----------------LENDER'S ADDRESS-------------------------~ 9. APPLICANT 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 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 the building Official under lhe provisions of this Code shall expire by limilalion and become null and void if the building or work authorized by such permit is nol commenced within 1 BO days from the date of such permit or if the building or work authorized by such permil is suspended or abandoned at any time after the work is comme ed for a period of 18 ys (Section 106.4.4 Uniform Building Code). DATE WHITE: File YELLOW: Applicant PINK: Finance City Of Carlsbad SUPPLEMENTAL BUILDING PERMlt APPLICATION FOR REROOFING 1. JOB ADDRESS: l ")... \ ?-t!9 f:.... \4. 1\-v ~ 2. TYPE OF BUILDING: RESIDENTIAL )( COMMERCIAL ;c 3. ROOF SLOPE: RISEiinches in 12 inches --~ 4. NUMBER OF EXISTING ROOF COVERING (circle one} 1 {f) 3 5. TYPE OF EXISTING ROOF COVERING CoM£d.:1T1~~HEATHING .So\.;"' W~o~. '( *6. NEW ROOF MATERIAL C:.o I"\\?, /Jc CLAss3 lb i\\,EIGHT PER SQUARE ·f 7. 'NUMBER OF SQUARES .:) )... . ·r s. TRADE NAME E. \ K. ,octA,~~~NUFAcTuRER . £' f K 9. ROOF SYSTEM LISTING UL No. .. ICBO No. ----~ 10. IS 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: :x; // 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. Signatu~ ~ Date ifa"I /2-oo2 . 7 Contractor Owner Contractor Name --------,, ------- *6 -Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other. City of Carlsbad Bldg Inspection Request For: 11/01/2002 Permit# CB021308 Inspector Assignment: RCB Title: BUSBY RES-2200 SF COMPOSITION Description: Type:MISC Sub Type: REROOF Job Address: 1212 OAK AV Suite: Lot Location: APPLICANT BUSBY GENE&KIM Owner: BUSBY GENE&KIM Remarks: PERMIT TO EXPIRE Total Time: CD Description 19 Final Structural 0 Phone: <._.-' Inspector: ) V\/\.. Requested By: CHRISTINE Entered By: CHRISTINE JQ_Commen~ Associated PCRs/CVs Inspection History Date Description 06/06/2002 15 Roof/Reroof 06/03/2002 15 Roof/Reroof Act lnsp Comments AP RC OK TO COVER CO RC ROOF 75% COVERED (SHINGLED) W/0 INSPECTION -LEFT NOTE TO CALL