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HomeMy WebLinkAbout130 HEMLOCK AVE; ; CB032820; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 10-10-2003 Miscellaneous Permit Permit No: CB032820 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: 130 HEMLOCK AV CBAD MISC Subtype: REROOF Status: ISSUED 10/10/2003 SB 10/10/2003 10/10/2003 Parcel No: 2042510600 Lot#: 0 Applied: Valuation: $2,775.00 Reference #: Project Title: DAVYLOV RES 2500 SF REROOF WD SHAKE TO COMP APT BLDG Applicant: JMV ROOFING INC. SIUTE #200 504 WEST MISSION AVE 92025 740-0379 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES PERMIT FEE Entered By: Plan Approved: Issued: Inspect Area: Owner: MAKHACHEV KHANNA 130 HEMLOCK AVE CARLSBAD CA 92008 $77.00 $0.00 $0.00 $77.00 Total Fees: $77.00 Total Payments To Date: $0.00 Balance Due: $77.00 6283 10/10/03 0002 01 02 CGP 77 .. 00 FINAL PPROVAL INSP. ,..(__p. ..... _OATE / 0 /4 g /~--- CLEARANCE FOR OFFICE USE ONLY PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 PLAN CHECK No.lTu2 ?.-g2o EST. VAL. ;?-:7 7 ,s:= Plan Ck. Deposit ________ _ Validated By..,,....___.""'--+-~:--....,....---- Date 0 1. PROJECT INFORMATION Address (include Blq!l('Suite #) \ 30 ·\Je..J'<:'\ \ o Ck.. Business Name (at this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # Existing Use S 'f .L) Proposed Use Description of Work SO. FT. #of Stories #of ~ooms # of Bathrooms '2th1o II'{_ '(\) ooo S hA\..l.t.. \ n\o}o. \ I UIYY\ e Sn ,.,~z '500 2. CONTACT PERSQN (If dhterent from applicant) 2-- Name Address 3. APPLICANT ~ Contractor D Agent for Contractor CONTRA«;:TOR • COMPANY NAME City D Owner D Agent for Owner City 3 State/Zip Telephone# Fax# State/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 exemption. Any violati n of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five ~n_dred dollars [$500)). · · \l)G Ml . · W. ,c;.s 14-ZW tS'<.b 1d...v rt£!?S State License # -~-""'-'\,.._':>~l/5c-.L-=---- Address City State/Zip Telephone# 7lJlo · 7 4D ·t..V ?~ /'\o c\ \ 2.\ ~ ~t.> I License Class -~L-~~-~-----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 th~or which this permit is issued. ~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~O~l"'~'ol~,r,.,JA.~~c....:=t~S.!!C::'.=!::J,.-.ll..l.:l.._ ___ _ [THIS SECTION NEED NOT BE COMPLETED IF TH Expiration Oats"' I Jo\ to 4 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 he W ers' Compensation Laws of California. r workers' compensation coverage Is unlawful, end shall subject an employer to criminal penalties end civil fines up to one hundred • In addition to the cost of compensation, damages as provided for In Section 3706 of the Labor rodj, Interest and attorney's fees. s,GNATURE_.,...>o-.~,-+--------------------===-DATE lo f' _;) > C RATION pt from the Contractor's License Law for the following reason: 7. OWNER- D rop rty or my employees with wages as their sole compensation, will do the work and the structure is not intended or offered for sale Pro essions 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 thro is 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). 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 contractor(s) licensed pursuant to the Contractor's License Law). D I am exempt under Section _____ _ 1. I personally plan to provide the major labor and materi ONO 2. I (have / have not) signed an application for a building 3. I have contracted with the following person (firm) to pr de 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 / address / phone number / type of work): ________________________________________________________ _ 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 Hazardo~Su~tance Account Act? D YES D NO Is the applicant or future building occupant required to obtain a permit from the ai poll i~ontrol district or air quality management district? D YES D NO Is the facility to be constructed within 1,000 feet of the outer boundary of a sc o I si 7~ YES D NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY Y OT BE ISSUED UNLESS THE APPLICANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES ANO THE AIR PO LUTI N CONTROL DISTRICT. 18. CONSTRUCTION LENDING AGENCY , cli I hereby affirm that there is a construction lending agency for the performance f th rk for which this permit is issued (Sec. 3097(i) Civil Code). LENDER'S NAME_______________ LENDER'S REr"------------------------- 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 Citt of Carlsbad to enter upon the above mentioned property for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY ANO KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS ANO EX WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. ired for xcavations over 5'0" deep and demolition or construction of structures over 3 stories in height. bY. e building Official under the provisions of this Code shall expire by limitation and become null and void if the building or work enced within 180 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned ced for a period of 180 days (Section 106.4.4 Uniform Building Code). DATE WHITE: File YELLOW: Applicant PINK: Finance ·, City Of Carlsbad SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING 1. JOB ADDRESS: I 3 G I :kt,-\.. \(.)C Lr (rv-f. . 2. TYPE OF BUILDING: RESIDENTIAL ~ COMMERCIAL . __ __. 3. ROOF SLOPE: RISE :{ inches in 12 inches 4. NUMBER OF EXISTING ROOF COVERING (circle one) G) 2 3 wcQ/} 5. TYPE OF EXISTING ROOF COVERING ~½c,/~HEATHING /'vo *6. NEW ROOF MATERIALQ_0!'.1::f CLASS¥k-WEIGHT PER SQUARE 7. -NUMBER OF SQUARES a? 5 8. TRADE NAME) Q 1 tt. O (, . MANUFACTURER Q.,u0u~ C<'.3f,uc ~ 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: -,, ..... .t. Tear Off/Pre-ins~ectior prior to instalfnew roof covering. 2. Final Inspection I agree to provide a ladder extending at least 2 rungs above the roof for inspection. Date /01~-"' 0 '"3, Signature~ \J~ V Cusnn-'"' Contractor ~ Owner ____ Contractor Narrie0 M.\/\CjUy.. ~4-u(_, *6 -Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other. City of Carlsbad Bldg Inspection Request For: 10/27/2003 Permit# CB032820 Title: DAVYLOV RES 2500 SF REROOF Description: WD SHAKE TO COMP APT BLDG Type: MISC Sub Type: REROOF Job Address: Suite: Location: 130 HEMLOCK AV Lot APPLICANT JMV ROOFING INC. Owner: MAKHACHEV KHANNA Remarks: OR CELL 619/518-2552 Total Time: CD Description 19 Final Structural ----------- 0 M2Comm,o, Associated PCRs/CVs Inspection History Date Description 10/16/2003 15 Roof/Reroof 10/15/2003 15 Roof/Reroof Act lnsp Comments AP PY SHEATHING CO PY Inspector Assignment: PY --- Phone: 7607 400379 Inspector: ---- Requested By: TIM Entered By: CHRISTINE