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HomeMy WebLinkAbout165 CHESTNUT AVE; ; CB111973; Permit09-13-2011 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No: CB111973 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: PC#: Project Title: 165 CHESTNUT AV CBAD MISC 2042341600 $0.00 Subtype: REROOF Lot #: 0 KAUFMAN RES 20 SQUARES COMP TO COMP RE-ROOF Applicant: URBACH ROOFING, INC. 445 PRODUCTION AVE SAN MARCOS CA 92075 760471-5065 Status: ISSUED Applied: 09/13/2011 Entered By: KG Plan Approved: 09/13/2011 Issued: 09/13/2011 Inspect Area: Owner: KAUFMAN JAN REVOCABLE TRUST 06-02-01 C/O PHILLIP BLANEY 411 E CARMEL ST SAN MARCOS CA 92078 Miscelaneous Fee #1 PERMIT FEE Miscelaneous Fee #2 Additional Fees $101.00 $0.00 $0.00 TOTAL PERMIT FEES $101,00 Total Fees:$101:00 Total Payments To Date:$101.00 Balance Due:$0.00 Inspector: FINAL A Date: 'AL Clearance: NOTICE: Please take NOTICE tharapproval of your project includes the "Imposition" 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 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. CITY OF CARLSBAD Building Permit Application 1635 Faraday Ave., Carlsbad, CA 92008 760-602-2717 / 2718 / 2719 Fax: 760-602-8558 ww w.ca rlsbadca .eov Plan Check No. Est. Value Plan Ck. Deposit JOB ADDRESS S . PHASIE* ' I#OF UNITS I#BEDROOMS SUITE#/SPACE#/UNIT# # BATHROOMS (TENANT BUSINESS NAMECT/PRDJECTlT CONSTR7TYPE I OCC. GROUP DESCRIPTION OF WORK: Include Square Feet of Affected Area(s) CONTACT NAME (If Different Fom Applicant) ADDRESS CITY STATE ZIP CITY PHONE STATE.,CA- PHONE FAX FAX EMAIL "ROPERTY OWNER NAME ?>a>v Ko CONTRACTOR BUS. NAME ADDRESS ADDRESS CITY San Marcos, (760) 471-5065, FAX^60)4719610FAXPHONE EMAIL RCH/DESIGNER NAME & ADDRESS STATE IJC.#CITY BUS. LICJ (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 theapplicant 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 theBusiness and Professions Code) or that 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 acivil penalty of not more than five hundred dollars ($500)). Workers' Compensation Declaration: / hereby affirm under penalty of perjury one of the following declarations: \ 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 perm it is issued. I have and will maintain workers' compensation, as required bisection 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensatton/nsura/ice carrier and policy number are: Insurance Co. [^jim O-ftr/7? tg/2f (JnJ>f>irrjuinT\na Policy No. *~tJ (,£> ^jfj *? Expiration Date. This section need not be completed if the permit is for one hundred dollars ($100) or less. L") 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 securewstckeK' compensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars (4100,000), in addition to the cost of compensation.4amag,es as provided for in Section 3706 of the Labor code, interest and attorney's fees. CONTRACTOR SIGNATU .* / f T/J3/// / hereby affirm that I am exempt from Contractor's License Law for the following reason: O I, as owner of the properly 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). O 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 Business and Professions Code for this reason: 1.1 personally plan to provide the major labor and materials for construction of the proposed properly improvement. O Yes Q No 2.1 (have / have not) signed an application for a building permit for the proposed work. 3.1 have contracted with the following person (firm) to provide the proposed construction (include name address / phone /contractors' license number): 4.1 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 / contractors' license number): 5.1 will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone / type of work): jgfpROPERTY OWNER SIGNATURE dAGENT DATE 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? DYes 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? O Yes D 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 OCCUPAN" EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender's Name Lender's Address I hereby authorize representative of Ihe City of Carlsbad to enter upon the above mentioned properly for inspection purposes. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD OSH A: An OSKA permit is required for excavations over 5'G" deep and demolition or construction of structures over 3 stories in height. EXPIRATION: Every permit issued by the BuMngOffcial under the provisions of this Code shall expire by limitation and become nullandvoidifthebuildingor work auBiorized by such permit is not commenced wtiin 180 days from the date of such permit oyf*eTHJSc%g or work authorized by such permit is suspended or abandoned at any lime after Ihe work is commenced for a period of 180 days (Section 106.4.4 Uniform Building Code). ^APPLICANT'S SIGNATURE ^^ Ls/ * j2L^\ DATE 9//J/// REROOFING SUPPLEMENTAL BUILDING PERMIT APPLICATION .A.&1. JOB ADDRESS:. 2. TYPE OF BUILDING: RESIDENTIAL ^f COMMERCIAL 3. ROOF SLOPE: RISE ^ INCHES IN 12 INCHES 4. NUMBER OF EXISTING ROOF COVERING (CIRCLE ONEJ 3 iJ / 5. TYPE OF EXISTING ROOF COVERING ^(jf/Mu SHEATHING *6. NEW ROOF MATERIAL f\nAM? CLASST WEIGHT PER SQ.-— 7. NUMBER OF SQUARES 8. TRADE NAME /7/K^£> MANUFACTURER>— ^ ' / 9. ROOF SYSTEM LISTING: UL NO. _ I.C.C.E.S. Report # ASTM 10. IS THE EXISTING STRUCTURAL DESKaN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? /YEsJ) 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-lnspection 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. / y/y S^^?SignatureC^j^^fC^^^^T Date_ ^\Contractor ^<^ Owner Name_ *6. Rolled Roofing, Standard/Lite Tile, Asphalt/Comp fiberglass, Built Up, Other B-10 Page 5 of 5 Rev. 03/09 City of Carlsbad Bldg Inspection Request For. 09/16/2011 Permit* CB111973 Title: KAUFMAN RES 20 SQUARES COMP Description: TO COMP RE-ROOF Inspector Assignment: PY 165 CHESTNUT AV Lot: 0 Type:MISC Sub Type: REROOF Job Address: Suite: Location: APPLICANT URBACH ROOFING, INC. Owner: Remarks: Phone: 7604715065 Inspector: Total Time: CD Description 19 Final Structural Act Comments Requested By: AMBER Entered By: CHRISTINE Comments/Notices/Holds Associated PCRs/CVs/SWPPPs Original PC# Inspection History Date Description Act Insp Comments 09/14/2011 15 Roof/Reroof AP PY EXISTING SHEATHING