HomeMy WebLinkAbout1744 CATALPA RD; ; CB023245; Permit10-28-2002
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Miscellaneous Permit Permit No CB023245
Building Inspection Request Line (760) 602-2725
Job Address
Permit Type
Parcel No
Valuation
Reference #
Project Title
1744 CATALPA RD CBAD
MISC
2155160400
$2,781 00
Subtype
Lot#
REROOF
0
CARROLL RESIDENCE
27 SQUARES OF SHAKE TO COMP
Applicant
HOFFMAN ROOFING
P O BOX 442
ESCONDIDO CA 92033
760741-7363
Status
Applied
Entered By
Plan Approved
Issued
Inspect Area
ISSUED
10/28/2002
MDP
10/28/2002
10/28/2002
Owner
CARROLL JAMES G&KAREN C
1744 CATALPA RD
CARLSBAD CA 92009
9853 JO/28/02 0002 01 02
CGP 77,
Total Fees $7700 Total Payments To Date $000 Balance Due $7700
Miscelaneous Fee #1
Miscelaneous Fee #2
Additional Fees
TOTAL PERMIT FEES
PERMIT $77 00
$000
$000
$77 00
Inspector
FINAL APPROVAL
Date Clearance —
NOTICE Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exat tions 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 subsecuent 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
il£&2 fcRQJECtj INFORMATION, „ Ja
FOR OFFICE USE ONLY_
PLAN CHECK NO
EST VAL
Plan Ck Deposit
Validated By
Date
Address (Include Bldg/Suite'#)/
Legal Description
Assessor's Parcel #
Description qf Work
Business Name (at this address)
Lot No Subdivision Name/Number
Existing Use
SQ FT #of Stories
Unit No Phase No
Proposad Use
# of Bedrooms
Total # of units
# of Bathrooms
2l!f4 qpfrfXfeT, PERSOTN&f, dtferenFfrom 'appliwnW'
Address City State'Zip Telephone Fax
Name Address City State/Zip Telephone
Name Address City 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 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])
Address f f
-------------
Name
State License #C y~ -3
City State/Zip Telephone #
City Business License # £T_fJA V *Ty
Designer Name
State License #
Address City State/Zip Telephone
• AmtAitr-hin «. -FIABI -•^•-•i wsi " s :* ' >' "& '•" ' , t ", vr "!' ,™ * "? * .,> r~; * •" ,; ^-^. ... *,,,™^t * , ,, , > t. : ;" .' * " "• •"•'- " > , •- f , <- ' • ' , , , > , ,'.iCQMPJEwSATIQNjSSjrff&fe &« u SwtsUih U" fe * f ?»-MM t s4s iLMsss' J44" ,K ! !i-V > 5 ,' i? !l ^! '* ",<> ^ s s s'si.',^ wAt't, 1^,^ ~ ...^ «„' *
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 3700 of the Labor Code, for the performance
of the work for 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 earner and policy number are
Insurance Company O_//? /" ^ P&'&*-*& Policy No /^2-/i C- / J*/ Expiration
(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 addif)oryto the cost of compensation damages as provided for m Section 3706 of the Labor code, interest and attorney's fees
DATE
I hereby affirm that I am exempt from the Contractor's License Law for the following reason
Q I, as owner of the property or my employees with wages as their sole compensation, will do the work and the strut ture 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)
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 contractor(s) licensed
pursuant to the Contractor's License Law)
F~] 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 CD 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
jDR^^ .
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? H YES D WO
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
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
I certify that I have read the application and state that the above information is correct and that the information on the plan'- 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 SAED 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 storms 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 it the building or work authorized b/ such permit is suspended or abandoned
at any time after the work is commenced for a period of 180 days (Section 106 4 4 Uniform Building Code) />yAtf/0^-APPLICANT'S SIGNATURE DATE 7
WHITE File YELLOW Applicant PINK Finance /
City Of Carlsbad
SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING
1. JOB ADDRESS:
2. TYPE OF BUILDING: RESIDENTIAL COMMERCIAL
3. ROOF SLOPE: RISE fj- inches in 12 inches
4. NUMBER OF EXISTING ROOF COVERING (circle one) $ 2
5. TYPE OF EXISTING ROOF COVERING S$*£&. SHEATHING
*6. NEW ROOF MATERIAL tew? CLASS ft WEIGHT PER SQUARE
7. -NUMBER OF SQUARES^^ =
8. TRADE NAME # >£ MANUFACTURER
9. ROOF SYSTEM LISTING UL No. ICBO No.
10. IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE
WEIGHT OF THE PROPOSED ROOF? (jj$) 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 7^u^ 7^^W^_^ _ Date
Contractor £, Owner _ Contractor Name
*6 - Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up,
Other.
City of Carlsbad Bldg Inspection Request
For 12/03/2002
Permit# CB023245
Title CARROLL RESIDENCE
Description 27 SQUARES OF SHAKE TO COMP
Inspector Assignment RF
Sub Type REROOF
1744 CATALPARD
Lot 0
Type MISC
Job Address
Suite
Location
APPLICANT HOFFMAN ROOFING
Owner CARROLL JAMES G&KAREN C
Remarks
Phone 7605057363
Inspector ft/
Total Time
CD Description
19 Final Structural
Act Comments
Requested By ROSE
Entered By CHRISTINE
Associated PCRs/CVs
Inspection History
Date Description Act Insp Comments
11/21/2002 15 Roof/Reroof AP RF
COMPENSATION
INSURANCE
PO BOX 807, SAN FRANCISCO,CA 94101-0807
FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE
ISSUE DATE 03-01-02
POLICY NUMBER 1236134 - 02
CERTIFICATE EXPIRES 03-O1-03
STATE CONTRACTORS LICENSE BOARD-WORKER'S COttP.
BOX 26000
SACRAMENTO CA 95826
JOB LIC "352921
INCEPTION DATE O3-01-02
D 0 SAN 01EGO
This is to certjfy 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 coverage afforded
by the policies listed herein Notwithstanding any requirement, term, or condition of any contract or other document
with 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 policiesy wQt^^^<s?\
I PRESIDENT
EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS $1,000,000 00 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 03/01/02 IS ATTACHED TO AND
FORMS A PART OF THIS POLICY
EMPLOYER LEGAL NAME
HOFFMAN ROOFING
PO BOX Mt2
ESCONDIDO CA 92033
HOFFMAN, MIKE
THIS DOCUMENT HAS A BLUPPATTERNED BACKGROUND
PRINTED 02-20-O2 P0409
SC1F 10265 (REV. 2-01)