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Home My WebLink About2800 ROOSEVELT ST; ; CB012335; Permitvr I '1 1 7 L-- City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 07/10/2001 Miscellaneous Permit Permit No:CB012335 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: 2800 ROOSEVELT ST CBAD MISC Subtype: Lot#: $28,560.00 REROOF -240 SF TORCH DOWN REROOF 0 Applicant: Owner: VAN DYKE & ASSOCIATES STEG 28 HAMMOND IRVGINE CA 92618 949 586-3828 Status: Applied: Entered By: Plan Approved: Issued: Inspect Area: ISSUED 07/10/2001 JM 07/10/2001 07/10/2001 Total Fees: $395.00 Total Payments To Date: $0.00 Balance Due: $395.00 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES PERMIT FINAL APPROVAL Date: /2 -//., 0( $395.00 $0.00 $0.00 $395.00 4180 07/10/01 0002 01 02 CGP 395-00 Clearance: NOTICE: Please take NOTICE that approval of your project includes the "Imposition· of fees, dedications, reseivations, 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 infom1ation 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 capactiy changes, nor planning, zoning, grading or other similar application processing or service fees in connection with this project NOR DOES IT APPLY to any fees/exactions of which ou have reviousl been iven a NOTICE similar to this or as to which the statute of limitations has reviousl otheiwise ex ired. FOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK N0{£6/ 1}35 CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 EST. VAL. __________ _ Plan Ck. Deposit':.. ___ __, _ __,_ __ _ Validated By _ _..iJ..C-__,.,,.....-+-,...,....f....,..,....--- Date. ________ -4-"-"I-"''-+---- (1. PROjECT INFORM~TION 28CO Roo~,a It new Address (include Bldg/Suite #) Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # 1712r-oo Existing Use 2¼0 Proposed Use N SO. FT. #of Stories # of Bedrooms # of Bathrooms Name Address City State/Zip Telephone# Fax# V 3. APPLICANT ¼ Contractor j . '.PttV: VQI/\ 0_9k. 0 Agent for Contractor O Owner O Agent for Owner 28 HaM ooQl\oi ~u d~ G q:yu,11\.Q U q2618 (q4q)t;8b:s3Z8 Name Address City State/Zip Telephone # 4. J PROPERTY qym~ . ohV\ L{eLlO.~ %VI\N2,, o-q26,s /Name 6. OIURACTQB.:..COJ',1PANY NAME City S.tate/Zip Telephone# (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 eVimp~oni::tfy violatio of Section 7.031.5 b any applicant for a permit subjects~; applicant to a ctil penalty of not moit:'ta fiv{hundre) do1863500]. City State/ ip Telephone # State License # .z.;:::....c:......:~-'-.£..._....:...+--License Class _ _., __ ='-!-----City Business License # l 2. I O ':{ f ( Designer Name Address City State/Zip Telephone I State License # _________ _ 6. WORKERS' COMPENSAT(ON 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. {2( 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 ~ed. My worker's com ensatio~surance carrier and polic ,,_number are: ac _ _ t't' 600 1-=,-'>0 _ _ Insurance Company c...,,..1-,,,s-+--,, V"V\ Policy No. 2 -./ (j / Ult\ Expiration Date I I O 2.. (THIS SECTION NEED NOT BE COMPLETED IF TH PERMIT IS FOR ONE HUNDRED DOLLARS ($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' ompensation Laws of California. WARNING: Failure to sec rk s' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundrad thousand dollars ($100 0) tion to the cost of compensation, damages as provided for In Section 3706 of tha Labor code, Interest and attorney's fees. sIGNATURE. __ -b~'V'lf'4-------------------DATE ]-110/za::, 1 7. OWNER-BUILDER P!;.CLA . __ ,., _ 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 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(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 I address / phone number / type of work): ________________________________________________________ _ PROPERTY OWNER SIGNATURE ______________________ _ DATE _________ _ COMPLETE THI:; SECTION FOR NON-RESIDENT7AL 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. ,,!.ONSTRUCTION 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(i) Civil Code). LENDER'S NAME ______________ _ LENDER'S ADDRESS ________________________ _ ~-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 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 excavation var 5'0" deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the ding Offici I 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 comma d it 180 d ys from the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commen · d of 80 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE DATE -----'T"F-l--'/1=0+--/2=~:=c=...!....{ -- YELLOW: Applicant PINK: Finance City Of Carlsbad SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING 1. JOB ADDRESS: 2 e 00 12ro;e ve It 2. TYPE OF BUILDING: RESIDENTIAL ____ COMMERCIAL ')< 3. ROOF SLOPE: RISE ½.. inches in 12 inches 4. NUMBER OF EXISTING ROOF COVERING (circle one) 1 2 3 5. TYPE OF EXISTING ROOF COVERING N,1: SHEATHING 1/2 '' *6. NEW ROOF MATERIAL A CLASS __ WEIGHT PER SQUA~E / 7. NUMBER OF SQUARES Z½O ~t:,{ dc70h 8. TRADE NAME ~ ~ MANUFACTURER Ll~:::fi?rjec. 9. ROOF SYSTEM LISTING UL No. ____ lCBO 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: 1. Tear Off/Pre-inspection prior to install 'new roof covering. 2. Final Inspection I agree to provide a ladder extending at least 2 rungs above the roof for inspection. Contractor ___ Owner ____ Contractor Na111e *6 -Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other. .. City of Carlsbad Bldg Inspection Request For: 12/11/2001 Permit# CB012335 Tille: REROOF -240 SF TORCH DOWN Description: Type:MISC Sub Type: REROOF Job Address: 2800 ROOSEVELT ST Suite: Lot 0 Location: APPLICANT VAN DYKE & ASSOCIATES Owner: Inspector Assignment: GG --- Phone: 949;;62£ Inspect~ Remarks: ROOF-LADDER OUTSIDE BLDG BACK LEFT CORNE Total Time: CD D_e_s_c-rip-1-io_n _______ ;;)} Comments 19 :inal Structural ~ Associated PCRs Inspection History Date Description 07/13/2001 15 Roof/Reroof Act lnsp Comments CA PD Requested By: PETER NILS Entered By: KAREN