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HomeMy WebLinkAbout1324 CYNTHIA LN; ; CB031689; Permit06-18-2003 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No CB031689 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Valuation Reference # Project Title 1324 CYNTHIA LNCBAD MISC 1562316300 33,330 00 Subtype REROOF Lot# 0 WRIGHT RES-3000 SF COMPOSITION Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 06/18/2003 RMA 06/18/2003 06/18/2003 Applicant PIVA ROOFING, BOB 1192 INDUSTRIAL AV ESCONDIDO, CA 92029 619-745-4700 Owner WRIGHT BENITA A TRUST 12-SWfc 06/18/03 0002 01 02 4319 SEA BRIGHT DR CGP 178.00 CARLSBAD CA 92008 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES PERMIT FEE DOUBLED $178 00 $000 $000 $17800 Total Fees $17800 Total Payments To Date $000 Balance Due $17800 Inspector FINAL APPROVAL Date 0 6^2*'°3 Clearance NOTICE Please tak&WOTICE (ifaftipproval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exactions" 7ou/iave 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 sendnh 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 fees/exactions of which you have previously been given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 FOR OFFICE USE ONLY PLAN CHECK NO EST VAL Plan Ck Deposit Validated Date Address (include Bldg/Suite #)Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total tt of units Assessor's Parcel #Existing Use Proposed Use Description of SQ FT #of Stones erehtlirom applicant) tt of Bedrooms # of Bathrooms Name Address City itractor , .niAgentifpr-Coijtractor. .""CDisPwnerpfO'Agent for Owner :• State/Zip Telephone tt Fax tt Name7 Address City State/Zip Telephone tt Name Address City State/Zip Telephone tt i^oMP.ANY;NAME'lifc3^ ,;,„... 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CM' ''K,,' .:....<. f':'V .^ • (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 IChapter 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 g} Section 7031 5 by any applicant for a permit subjects^the applicant to a civil penalty of not more than five hundred dollars [$500]) Name — n 1 *'?'''-) **3 *y?State License ft ^\ ~^» ' •—> Q Designer Name State License tt ,J Address License Class Address £39 City State/Zip , Telephone tt City Business License tt / f\ /) 3/ ^P' ' L& City State/Zip Telephone Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations l~l 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 J2f- 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 ~ ,f ^, ^ _^^ __ Insurance Company ~^i^}(^_ \b\/\O\ Policy No ^~\>^ t/CJOc\C?^)C>'^_>» Expiration Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [*100] OR LESS) ' ' "Q__ 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 compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), in addrttefftcTjHe cost of compensation, damages as provided for in Section 3706 of the Labor code,, interest and attorney s fees SIGNATURE *~3*fc ' /^-^—— DATE jJlitOWNER-BUILb I hereby affirm that I am exempt from the Contractor's License Law for the following reason |~l |, 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 ha did not build or improve for the purpose of sale) |~l 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) PI 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 Q YES CDNO 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 / address / phone number / type of work) PROPERTY OWNER SIGNATURE DATE j£prJW>LET£frHiS5SECT^^ .... •'•*' ., ;i , '..."-., '•••• 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? Q] 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? O YES CD NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? CD YES fj 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 j^i^p^Cr.lON LENDINGiAGENCY::-, „'""... "1-iW^;, ^i^V ; ",.,• .,'.: \' ,'">.." ^ ".' • . •• • I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(0 Civil Code) LENDER'S NAME LENDER'S ADDRESS 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 CitV 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 stones in height EXPIRATION Every permit issued by the building Official 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 commenced within 180 days 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 commenced for a period ofJBO days (Section 106 4 4 Uniform Building Code) APPLICANT'S SIGNATURE ^-2*^-^-?^^ ~' DATE WHITE File YELLOW Applicant PINK Finance 7 City Of Carlsbad SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING i. ..QRAnpREMfc /3^-J 2. TYPE OF BUILDING: RESIDENTIAL COMMERCIAL 3. ROOF SLOPE: RISE ^'^ inches in 12 inches 4. NUMBER OF EXISTING ROOF COVERING (circle one) © 2 5. TYPE OF EXISTING ROOF COVERING QfrttO SHEATHING *6. NEW ROOF MATERIAL Co^f CLASS WEIGHT PER 7. -NUMBER OF SQUARES SOX . 8. TRADE NAME/l/rf/fl/g ^/^MANUFACTURER 9. ROOF SYSTEM LISTING UL No. " ICBO No. 10. IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? fYElp 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: -h 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. ,Signature— V ^"" Da*e, - Contractor V- Owner _ Contractor Name *Bob *6 - Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other. City of Carlsbad Bldg Inspection Request For 06/25/2003 Permits CB031689 Title WRIGHT RES-3000 SF COMPOSITION Description Inspector Assignment JE Type MISC Sub Type REROOF Job Address 1324 CYNTHIA LN Suite Lot 0 Location APPLICANT PIVA ROOFING, BOB Owner WRIGHT BENITA A TRUST 12-29-81 Remarks Phone 7607454700 Inspector Total Time CD Description 19 Final Structural Act Comment Requested By BOB Entered By CHRISTINE Associated PCRs/CVs Inspection History Date Description Act Insp Comments 06/20/2003 15 Roof/Reroof AP JE ROOF 60% COMPLETED WITH - OK TO COMPLETE City of Carlsbad Bldg Inspection Request For 06/20/2003 Permit# CB031689 Title WRIGHT RES-3000 SF COMPOSITION Description 1324 CYNTHIA LN Lot Type MISC Sub Type REROOF Job Address Suite Location APPLICANT PIVA ROOFING, BOB Owner WRIGHT BENITA A TRUST 12-29-81 Remarks AM PLEASE Inspector Assignment Phone 7607454700 Inspector Total Time CD Description 15 Roof/Reroof Act Comment Requested By KEITH Entered By CHRISTINE Associated PCRs/CVs Inspection History Date Description Act Insp Comments cS—^ T***-C.V,*-l MiOBH CERTIFICATE OF LIABILITY INSURANCE (£I$)5<<~6400 FAX C619)S84-<425 tfestland InsurtiBce Brokers 3S3* Camiixk Del Rio North #315 P.O. Box SS481 San Diego* CA )2186-S4S1 ONLY AND CONFERS NO RIGHTS WON THE CSOTFICATEHOLDER. THIS CERTIFICATE DOES HOT AMEND. EXIEttD OR INSURERS AFFORDING COVERAGE KAIC* Amoco gob Ptva roofing Company, Inc. 1192 Industrial Avenue fcfconditfo, CA 92029 WSWERA Admiral Insurance Goqpany 248% peerless JnSMrance Conpany Z4t9t State Cnqpensation ,Xns. Fund 629 MSWERO: COVERAGES _... jagJCATEO-MOTOTOtCTfflPMl MfftO&CKSIRGM&tf, IB^ORCwNOnKIHwAWCQlfniACTOROIhQlPQClJI^ IM»P^AI«11He»ISW«WWCeAR!aHDe&8yWKHJCJMGGRS^reuHnss^^ WSJR UDD1 tWtt 1FMWWKC 'jQcQMUBK ttLGBEWLUMBUrrZ3cuwsiWBE OD°ccutt Fl"* K?SIF^S3fiH^^?Sa 06/01/2004 1.0000(M SO.OW exclmie* l.OOO.OW 2.000.001 1,000,001 CBP949762S 06/01/2003 06/01/2004 MWAUfC MLOWMC scttswuo/uiras BOoavnimr IT MM»«NN3>MnOS l.OOO.OW cnmeniHMi ««CC ( I GftCHOCCURRBWX 3 285000233503 CERTIFZrAIES OF XD6UIWNCE fWST BE ISSUED BY STATE FUND 06/01/Z003 E4. DISEASE-FCUCVLMtT » 1.000.001 1.000,001 •SUBJECT TO 10 IAYS NOTICE OF CANCELLATION FOR NOWAYKEHT OF FKBOim EVIDENCE IF INSURANCE ********* t»»«aa>«aft«lft»Mlaft»»«r<rtxr» »•**«»»»» »*'»«*«i«Ji*»a<i j«m**«a«'f ETOIH£CaH)aCMEI«aU!8t BUTHWVnETDHMLSUCHHCmCeSHMJ.an^HOt CF.MfnqHDUPowmEiwuRgt.nreAGansoniaaw! ORi«aunr Robert )CORD2${2<»1flJ8}