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Home My WebLink About2801 SOMBROSA ST; ; CB982911; PermitFOR OFFICE USE ONLY PERMIT APPLICATION PLAN CHECK. NO. f!j2l?/ EST. VAL j, ) CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760) 438-1161 Address (include Bldg/Suite #) Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Existing Use Proposed Use f 6{6 of Bath,ooms Name Address City State/Zip Telephone# Fax II entfjrJ~ Name Address Name City ~-. "CONTflA(;TQA~. COMl'AIIIYitlAME':: ,:,Yi . · .. (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 exemp~n. A':c,violation of Section 7/31.5 by any 71icant for a permit sub'ects the pplica:t to a ci~~i,i-not more than five hundred do ars [$5~ O (:) Name Address State Zip Telephone # State License # 2 / 9 /q.. ~ 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: 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. 'l5t.. I have and will maintain v-:ork~rs• compens~tion, as r~uired by Section 3700 of the Labor Code, for the performance of the work for whic thi permit is ....fs;u;"a, My worker's compen~on insurance ca~'\d P.Ohcy number are: ~ ,,., b .} / 9 r7) Insurance Company s z;l(T'E rv ND Policy No. c:2~ .,. ~ Expiration Oat ·-~-.,_~ __ Y __ ITHIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1$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: Failure to •ecura worken' compenaatktn coverage la unlawful, and shalt subject an employer to crlmlnal penalties and civH fines up to one hundred thousand dollan 1$100,000), In addltfon to the coat of compensatk>n, damages u provkted for In Section 3706 of the Labor code, Interest and attomey's fees. SIGNATURE DATE _________ _ 7. '0WNER•BUILDER1>ECLARATION ·c I hereby affirm that I am exempt from the Contractor's License Law for 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 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 aale. 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 contractorls) licensed pursuant to 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. 0 YES ONO 2. I (have/ have not) signed an application for a building permit for the proposed work. 3. t have contracted with the following person (firm) to provide the proposed construction (include name / address / phone number / contractors license numberl: 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 soma 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 _________ _ COMPLETE7HIS:SECTION FOR· NQN..RESIDENTIAL BUILDINO·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? 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 district? D YES O 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. :a, CONSTRUCTIONUNDING1A·CY·,: 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 ______________________ _ :9. 1APl'l,ICAllll'-Ti0111'11,,· 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. PERMIT# CB982911 DESCRIPTION: REROOF 2400 SF - TILE #4660 TYPE: MISC CITY OF CARLSBAD INSPECTION REQUEST FOR 09/11/98 LIGHT WEIGHT JOB ADDRESS: 2801 SOMBROSA ST APPLICANT: PACIFICA ROOFING CONTRACTOR: PHONE: PHONE: OWNER: PHONE: INSPECTOR AREA DH PLANCK# CB982911 OCC GRP CONSTR. TYPE NEW STE: LOT: 760 966-2100 REMARKS: C/JOHN/966-2600 SPECIAL INSTRUCT: INSPECTOR -~t2-~~-------- TOTAL TIME: CD 19 LVL DESCRIPTION ST Final Structural ------------------------------------ ------------------ ACT COMMENTS ***** INSPECTION HISTORY***** DATE 090398 090298 DESCRIPTION Roof/Reroof Roof/Reroof ACT INSP AP DH NR DH COMMENTS City Of Carlsbad SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING 1. JOB ADDRESS: 2. TYPE OF BUILDING: RESIDENTIAL><.__ COMMERCIAL ·--~ 3. ROOF SLOPE: RISE 1/ inches in 12 inches 4. NUMBER OF EXISTING ROOF COVERING (circle one) (y 2 3 s. TYPE OF EXISTING ROOF covERINdtl~\di:'sHEATHING ::§:P.AOC -D *6. NEW ROOF MATERIALlT. ~;; CL SS S/8OwEIGHT PER SQUARE 7. NUMBER OF SQUARES ,;)':f . 8. TRADE NAME -ca.C (;~ //:¥MANUFACTURER ~6'.c::. £:'_ 9. ROOF SYSTEM LISTING UL No .. ____ .lCBO No. ~'=,b O . 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 Name /?A C' t'Fr ()\ ~ \J {:> *6 • Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other.