HomeMy WebLinkAbout2777 ROOSEVELT ST; ; CB112164; PermitCity of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
10-11-2011 Miscellaneous Permit Permit No: CB112164
Job Address:
Permit Type:
Parcel No:
Valuation:
Reference #:
PC#:
Project Title:
Applicant:
Building Inspection Request Line (760) 602-2725
2777 ROOSEVELT ST CBAD
MISC
2031810900
$2,191.50
Subtype: REROOF
Lot#: 0
HENNESSEY'S: 1500SF REROOF:
TORCH DOWN TO 2PL Y COLD ADHESIVE SYSTEM
Owner:
Status:
Applied:
Entered By:
Plan Approved:
Issued:
Inspect Area:
ISSUED
10/11/2011
JMA
10/11/2011
10/11/2011
DAMIAN GULAK CONSTRUCTION
PO BOX338
HOWARD-JONES MARITAL TRUST 03-31-81
C/O CAROLYN WOERPEL
ESCONDIDO
CA 92033
619-840-7385
Miscelaneous Fee #1
Miscelaneous Fee #2
Additional Fees
TOTAL PERMIT FEES
Total Fees: $101.00
Inspector:
2785 ROOSEVELT ST
CARLSBAD CA 92008
PERMIT FEE
Total Payments To Date: $101.00 Balance Due:
Clearance:
$101.00
$0.00
$0.00
$101.00
$0.00
NOTICE: Please take NOTICE that approval of your project includes the "lrnposttion" 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 FUATHEA 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 h v r vi been iven N Tl imil r thi r as t whi h h t t of limitati ns h
t:J...
<<~')> ~ CITY Of
CARLSBAD
Building Permit Application
1635 Faraday Ave., Garlsbad, CA 92008
760-602-2717 / 2718/ 2719
Fax: 760-602-8558
www.carlsbadca.gov
Plan Check No. C8
Est. Value
Plan Ck. Deposit
Date tO 1[\ l l SWPP
CT/PROJECT# C NSTR. TYPE OCC. GROUP
EXISTING USE PROPOSED USE GARAGE (SF)
APPLICANT NAME (Primary Contact)
ADDRESS
CITY STATE ZIP
PHONE FAA
L
?vPII
ZIP
FAA
E IL
ARCH/DESIGNER NAME & ADDRESS STATE UC.#
PATIOS (SF) DECKS (SF) FIREPLACE
YES □#_ NOD
APPLICANT NAME (Secondary Contact)
ADDRESS
CITY STATE
PHONE FAA
L
AIR CONDITIONING
YES O NO □
ZIP
FIRE SPRINKLERS
YES □ NO □
(Sec. 7031.5 Business and P_rofessions Code: Any City or Coun_ty 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 fhat he is exempt therefrom, and the basis for the alleged exemption. Any violation of Section 7031.5 by any applicant for a permit subjects the applicant to a
civil penalty of not more than five hundred dollars {$500)).
WOBKUU" COMPf!NIA.UDN
Workers' Compensation Declaratlon: I hereby affirm under penalty of perjury one of the following declarations:
0 I have and wlll 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 workers' compensation insurance carrier and policy
number are: Insurance Co. _____________________ Policy No. ______________ Expiration Date _________ _
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 ;! section need not be completed If the permit is for one hundred dollars ($100) or less.
fomia, WARNING: Failure to securerwo' compensation coverage is uni ~l~~~hall subject an employer to criminal penaltles and civil fines up to one hundred thousand dollars (&100,000), In
addition to the cost of compensation, daiya s;as provided for in SKl:ion 3706 Zlode, Interest and attorney's fees. ~
,g CONTRACTOR SIGNATURE 1-. 1 • Ci.,f/V! ;a,, -~ □AGENT DATE /t. 'II. '/ I
I hereby affirm that I am exempt from Contractor's Ucense Law for the following reason: □ 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, af\d who does such work himseH 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).
□ 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, af\d contracts for such projects with contractos{sfTicensed pursuant to the Contractor's License Law).
□ I am exempt urider 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 D No
2. I {have/ have not) signed an application for a building permit for the proposed work.
3. I have contracted with the following person (flrm} to provide the proposed construction (include name address I phone I contractors' license number):
4. I plan to provide portions of the work, but I have hired the following person lo coordinate, supervise and provide the major work (inciude name/ address I phone/ 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 I phone/ type of work):
,I$ PROPERTY OWNER SIGNATURE □AGENT DATE
-"
COMPl.111'11 THU H!CtlON FOR ffOlil•Rlii$1DENtlAI. IIIILDIN!i l'liilll!4ITS OfftY
Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management al'\d prevention program under Sections 25505, 25533 or 25534 of the
Presley-Tanner Hazardous Substarce Account Act? □ Yes □ No
Is the applicant or future building occupant required to obtain a pennil from the air pollution control district or air quality management district? □ Yes □ No
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ Yes □ 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 certtfythat I have read the application and state that the above infonnatlon is correct and that the Information on the plans is accurate. I agree to comply with all City ordinances and State Ja\t.5 relating to building construction.
I hereby authorize representative of 1he Qty of Cartsbad lo enteruJX)n the atxJve mentbned property klr inspection p.JIJX)Ses. I ,ALSO AGREE TO SAVE, INDEMNIFY .AND KEEP HARMLESS THE Cl1Y OF CARLSBAD
AGAINST AU_ LIABILITIES, JUDGMENTS, COSTS ANO EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.
OSHA: M OSHA pennd is required br excavations over 5'0' deep and demolition or construction of structures over 3 stories in height.
EXPIRATION: Every pennit ISSued by the Buik:ling Ofocial under the provisions of this Code shall e:,qjre by limitatbn and become null and vod ~the buik:ling or 'Mlrk authorized by such permtt is not commenced 'Mthin
180 days from the date of such permit or if7 ~,i:g ~ oork aulhorize9'r1/ such permtt is suspended or abandoned at any lime after the v.ork is commenced for a ~rod of 180 days (Seeton 100.4.4 Uniform Building Code).
AS' APPLICANT'S SIGNATURE /lk'.,.l. /..A.,,, .,,,,L. {,,'-'<-. DATE / C 'I/ I I
REROOFING SUPPLEMENTAL BUILDING PERMIT APPLICATION
1. JOB ADDRESS: lktta-eSsej.f Utttr(l J7 77 l<oasg//tlf/h'e1 (/;ctl ;t,i'oo?
COMMERCIAL.__,~'---2. TYPE OF BUILDING: RESIDENTIAL. ___ _
3. ROOF SLOPE: RISE ;) INCHES IN 12 INCHES
4. NUMBER OF EXISTING ROOF COVERING (CIRCLE ONE) 1 {J;i 3
5. TYPE OF EXISTING ROOF COVERING feY-ch /);tAln Cl/f SHEATHING '3ftffllf
*6. NEW ROOF MATERIAL 513..S {di> /Jc(k;;~. -~s II WEIGHT PER sa./5t?fev /bi'~#
/'jtu/ftl(?-.S~~ ~ I
7. NUMBER OF SQUARES_+/_S:::..,___ __ _
8. TRADE NAME5J~ fl!rx:ld-,qf MANUFACTURER_if_lf_r ___ _
!cf Mf#'1t/e c;Jos/cM-1
9. ROOF SYSTEM L STING: ~ F
UL NO.----I.C.C.E.S. Report# Rt/er -:ic h,t I~.
ASTM N-/-/-/YJG-(c11j ~U/011 /.6~-
10.IS THE EXISTING STRUC~ 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 prov~i, ladder extending at least 2 rungs above the roof for inspection.
Signature ~ Date_A_'O~')!.~I/_I_I ___ _
~ntiact~~ Owner ____ Contractor Cl~ /!t',:1(/ O 2u6-
Name /)t M1(alt &tt/,f,'f::_
*6. Rolled Roofing, Standard/Lite Tile, Asphalt/Comp fiberglass,~ Other
B-10 Page 4 of4 Rev. 02/11
City of Carlsbad Bldg Inspection Request
For: 10/27/2011
Permit# CB112164 Inspector Assignment: JM ---
Title: HENNESSEY'S: 1500SF REROOF:
Description: TORCH DOWN TO 2PL Y COLD ADHESIVE SYSTEM
Type:MISC Sub Type: REROOF
Job Address:
Suite:
2777 ROOSEVELT ST
Lot: 0
Phone: 6198407385
Location: Inspector:
OWNER HOWARD-JONES MARITAL TRUST 03-31-81
Owner: HOWARD-JONES MARITAL TRUST 03-31-81
Remarks: card w/ manager
Total Time:
CD Description Act Comments
----
Requested By: DAN
Entered By: JANEAN
19 Final Structural _£( ______ _
Comments/Notices/Holds
Associated PCRs/CVs/SWPPPs Original PC#
Inspection History
Date Description
10/21/2011 15 Roof/Reroof
10/20/2011 15 Roof/Reroof
Act lnsp Comments
AP JM OK TO COVER ALL
PA JM MAIN ROOF