HomeMy WebLinkAbout1712 CANNAS CT; ; CB992384; Permit06/28/1999
City of Carlsbad
Miscellaneous Permit Permit No:CB992384
Building Inspection Request Line (760) 438-3101
Job Address:
Permit Type:
Parcel No:
Valuation:
Reference #:
Project Title:
1712CANNASCTCBAD
MISC
2155011800
$2,912.00
Subtype: REROOF
Lot #: 0
LARSEN RES-2800 SF COMPOSITION
Status: ISSUED
Applied: 06/28/1999
Entered By: RMA
Plan Approved: 06/28/1999
Issued: 06/28/1999
Inspect Area:
Applicant:
HOFFMAN ROOFING
P 0 BOX 442
ESCONDIDO CA 92033
760741-7363
Y A&SUESAN E TRS
06/28/99 OOOi 01 02
C-PKHT
Total Fees:$87.00 ce Due: $87.00
Miscelaneous Fee #1
Miscelaneous Fee #2
TOTAL PERMIT FEES
Inspector:
FINAL APPROVAL
Date:Clearance:
NOTICE: Please take NOTICE that approval 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 capactiy
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 previouslyjjeen given a NOTICE similar to this, or as to which the statute of limitations has previously otherwise expired.
CITY OF CARLSBAD
2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
2075 Las Palmas Dr., Carlsbad CA 92009
(760)438-1161
1,
FOR OFFICE USE ONLY
PLAN CHECK NO r/
EST. VAL.
Plan Ck. Deposit
Validate
Date
I
Address (include Bldg/Suite #)Business Name (at this address)
Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Total # of units
Proposed Use
Description of Work /
2. CONTACT PERSON (H dtffmnl from applicant)
A
# of Bedrooms # of Bathrooms
Name
5. CONTRACTOR - COMPANY NAME
(Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure1, pTidT ttTTts
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 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]).
Name
State License #/
Address
License Class 3*7
City State/Zip
City Business License #
Telephone #
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:
Q I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 37OO of the Labor Code, for the performance
of the work for which this permit is issued.
jS—l~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 earner and policy number are: *
Insurance Company sTiQ f JL /*tx>w/ Policy No.f'^-jG/ 3 y Expiration
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 19100] 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 it unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred
thousand dollars ($100,000), in addrtjpnto the cost of compensation, damages a* provided for in Section 3706 of the Labor code, interest and attorney's fees.
.—** f J*\ ^ f f — * - — ' •
j£^%**j'^^^^m—•jfn>ffyTjja^i^^^BBBaB1i - ——_^^^ Un t. _
7.fOWNErVBUILDER DC
I hereby affirm that I am exempt from the Contractor's License Law for the following reason:
Q 1, 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 he did not build ot improve for the purpose of sale).
Q 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 contractors! licensed
pursuant to the Contractor's License Law).
0 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 QNO
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
COMPLETE THIS SECTION FOR NQN-RES1DENTJAL 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 Hazardous Substance Account Act? [U YES Q NO
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Q YES Q NO
Is the facility to be constructed within 1 ,000 feet of the outer boundary of a school site? Q YES Q 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.
8. CONSTRUCTION LENDING AGENCY
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. 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 City 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 stories 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 365 days from the date of such permit or if the building or work authorized by such permit is suspended
or abandoned at anytime after thejwork is 9ommenceo^for a opriod of 180 days (Section 106.4.4 Uniform Building Code).
APPLICANT'S SIGNATURE DATE
WHITE: File YELLOW: Applicant PINK: Finance
City Of Carlsbad
SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING
i. JOB ADDRESS:
2. TYPE OF BUILDING: RESIDENTIAL y~ COMMERCIAL
3. ROOF SLOPE: RISE 4 inches in 12 inches
4. NUMBER OF EXISTING ROOF COVERING (circle one) (\} 2
5. TYPE OF EXISTING ROOF COVERING _ SHEATHING
*6. NEW ROOF MATERIAL A- CLASS3 ^ WEIGHT PER SQUARE
7. NUMBER OF SQUARES 2- §
8. TRADE NAME ^/c. MANUFACTURER
9. ROOF SYSTEM LISTING UL No. _ ICBO No.
10. IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE
WEIGHT OF THE PROPOSED ROOF? (^P 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.
Signature l. f»~-^ Date
Contractor fr— Owner _ Contractor Name
*6 - Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up,
Other.
City of Carlsbad Inspection Request
For: 7/1/99
Permit# CB992384
Title: LARSEN RES-2800 SF COMPOSITION
Description:
Inspector Assignment: SR
Type:MISC Sub Type: REROOF
Job Address: 1712 CANNAS CT
Suite: Lot 0
Location:
APPLICANT HOFFMAN ROOFING
Owner: LARSEN JEFFREY A&SUESAN ETRS
Remarks:
Phone: 7607417363
Inspector:
Total Time:
CD Description
19 Final Structural
Act Comments
Requested By: MIKE
Entered By: CHRISTINE
Inspection History
Date Description Act Insp Comments
6/29/99 15Roof/Reroof AP SR
COMPENSATION
I N SURANCE
FUND
P.O. BOX 807, SAN FRANCISCO.CA 94101-0807
CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
ISSUE DATE: 03-O1-99
POLICY NUMBER: 1238134 - 99
CERTIFICATE EXPIRES: O3-Q1-00
STATE CONTRACTORS LICENSE BOARD-WORKER'S COMP.
BOX 26000
SACRAMENTO CA 95826
JOB: LZC #352921
INCEPTION DATE: 03-O1-99
D.O.: SAN DIEGO
This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the
California Insurance Commissioner to the employer named below for the policy period indicated.
This policy is not subject to cancellation by the Fund except upon 30 days' advance written notice to the employer.
We will also give you 30 days' advance notice should this policy be cancelled prior to its normal expiration.
This certificate of insurance is not an insurance policy and does not amend, extend or alter the co\ erage afforded
by the policies listed herein. Notwithstanding any requirement, term, or condition of any contract or other documentwith respect to which this certificate of insurance may be issued or may pertain, the insurance afforded by the
policies described herein is subject to all the terms, exclusions and conditions of such policies
PRESIDENT
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,OOO,OOO.OO PER OCCURRENCE.
STANDARD EXCLUSION: INDIVIDUAL EMPLOYERS AND HUSBAND AND WIFE EMPLOYERS ARE NOT ELIGIBLE
FOR BENEFITS AS EMPLOYEES UNDER THIS POLICY.
ENDORSEMENT #2065 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE O3/01/99 IS ATTACHED TO AND
FORMS A PART OF THIS POLICY.
EMPLOYER LEGAL NAME
HOFFMAN ROOFING
P.O. BOX M2
ESCONDIOO CA 92033
HOFFMAN, MIKE
PRINTED: 02-18-99 PQ409
THIS DOCUMENT HAS A BLUE* PATTERNED BACKGROUND SCIF 1O265 (REV. 2-95)