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HomeMy WebLinkAbout1746 CATALPA RD; ; CB023248; Permit10-28-2002 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No CB023248 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Valuation Reference # Project Title 1746 CATALPA RD CBAD MISC 2155160500 $2,781 00 Subtype REROOF Lot# 0 FRODSHAM 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 Owner FRODSHAM LEE&JO L H LIVINGnT| 1746 CATALPA RD CARLSBAD CA 92009 ISSUED 10/28/2002 MDP 10/28/2002 10/28/2002 0002 Ox CGP Total Fees $7700 Total Payments To Date $000 Balance Due $7700 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES PERMIT $7700 $000 $000 $7700 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 6602Q(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 (heir 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 vou 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. VAL Plan Ck Deposit Validated By Date Address (include Bldg/Suite #)Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total # of units Assessor's Parcel H Existing Use Proposed Use Description of Work ^£f^Fi&5 ~~! SQ FT ..._J??S*nt}^iiitg|^|lfj'* "A #of Stones # of Bedrooms ft of Bathrooms Name Address City State/Zip Telephone #Fax # Name Address 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 b,y any applicant for a permit subjects the applicant to a,civil penalty of not more than five hundred dollars 15500]) $-A £.*?/£/£> e> Name State License # v>5"<2- '* Designer Name State License # ' Address ' r 2 / License Class *~- *~ O / Address City State/Zip City Business License # C City State/Zip -<+& Telephone # -\^ A^4^ Telephone is p . / // Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations Q I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued Q I have and will maintain workers' compensation, as required by Section 3700 of the Labor Coda, for the performance of the work for which this permit is issued My worker's compensation insurance earner and policy number are Insurance Company °S /f$ ffi jrTj£t-*& Policy No /£2-ij> C- /Jif Expiration Date^ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$1001 OR LESS) 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 to become subject to the Workers Compensation Laws of California WARNING Failure to secure worker*' compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100,000), In addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees SIGNATURE DATE I hereby affirm that I am exempt from the Contractor's License Law for the following reason D 1, as owner of the property or my employees with wages as their sole compensation, wilt 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 ofproving that he did not build or improve for the purpose of sale) n 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 do0s 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 I personally plan to provide the major labor and materials for construction of the proposed property improvement Q] YES FlNO 2 I thave / 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 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 G NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? t] YES D 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 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 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 1. JOB ADDRESS: / 2. TYPE OF BUILDING: RESIDENTIAL _ COMMERCIAL 3. ROOF SLOPE: RlSE^U^lnches in 12 inches / X==K4. NUMBER OF EXISTING ROOF COVERING (circle one) (3) 2 5. TYPE OF EXISTING ROOF COVERING 3/Mfa SHEATHING *6. NEW ROOF MATERIAL to^o CLASS /? WEIGHT PER SQUARE 7. -NUMBER OF SQUARES 8. TRADE NAME^//e MANUFACTURER 9. ROOF SYSTEM LISTING UL No. _ ICBO No. 10. IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? CYJj) 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 97 — • _ Date Contractor ^4— 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# CB023248 Title FRODSHAM RESIDENCE Description 27 SQUARES OF SHAKE TO COMP Inspector Assignment RF Type M1SC Sub Type REROOF Job Address 1746 CATALPA RD Suite Lot 0 Location APPLICANT HOFFMAN ROOFING Owner FRODSHAM LEE&JO L H LIVING TRUST Remarks Phone 7605057363 Inspector Total Time CD Description 19 Final Structural Act Comments Af __ 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 F-LJND CERTIFICATE OF WORKERS1 COMPENSATION INSURANCE- ISSUE DATE 03-01-02 POLICY NUMBER 1236134 - 02 CERTIFICATE EXPIRES O3-01-03 STATE CONTRACTORS LICENSE BOARD-WORKER'S COMP. BOX 26000 SACRAMENTO CA 95826 JOB LIC #352921 INCEPTION DATE- O3-O1-O2 D 0 SAN DIEGO 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 wtli also give you 39 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 a|l the terms, exclusions and conditions of such policies At^r^tZK ~1 PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS $1.000,000 00 PER OCCURRENCE_ t- STANDARD EXCLUSION INDIVIDUAL EMPLOYERS AND HUSBAND AND WIFE EMPLOYERS ARE NOT ELIGIBLE FOR BENEFITS AS EMPLOYEES UNDER THIS POLICY .ENDORSEMENT #2O65 ENTITLED CERTIFICATE HOLDERS' NOTICE EFFECTIVE 03 A> 1/02 IS ATTACHED TO AND FORMS A PART OF THIS POLICY > EMPLOYER LEGAL NAME HOFFMAN ROOFING PO BOX i\h2 ESCONOIDO CA 92033 HOFFMAN, MIKE THIS DOCUMENT HAS A BLUBPATTERNED BACKGROUND PRINTED 02-20-02 P0409 SCIF 10265 (REV. 2-01)