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Home My WebLink About1748 CATALPA RD; ; CB031302; Permit05-05-2003 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No CB031302 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Valuation Reference # Project Title 1748CATALPARDCBAD MISC 2155160600 $2,553 00 BRENGI RESIDENCE 23 SQUARES OF COMP Subtype Lot# REROOF 0 Status Applied Entered By Plan Approved Issued Inspect Area Applicant T R CONSTRUCTION 9847 PASEO MONTRIL 92129 Owner COLUCCI ROBERTJ 1748CATALPARD CARLSBAD CA 92009 ISSUED 05/05/2003 MDP 05/05/2003 05/05/2003 4258 05/05/03 0002 02 11. Miscelaneous Fee #1 PERMIT Miscelaneous Fee #2 Additional Fees $7700 $000 $000 TOTAL PERMIT FEES $77 00 Total Fees $7700 Total Payments To Date $000 Balance Due $7700 Inspector FINAL/PPRpVAL Date Clearance — NOTICE Please take NOTICE that approval of your project includes the "Imposition" of lees, 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 begn 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 ON PLAN CHECK NO EST VAL Plan Ck Deoosit Validated By Date 1 PROJECT INFORMATION Address (include Bldg/Suite #)Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Totals of units Assessor's Parcel #Existing Use Proposed Use SQ FT2-lco # of Stones # of Bedrooms it of Bathrooms 2- 2 CONTACT PERSON (if different from applicant) Name Address City State/Zip Telephone #Fax # [3 APPLICANT ffl Contractor D Agent for .Contractor D Owner Si-Lj&SSP' for Owner r* | Address City Telephone PROPERTY OWNER fcKf-S Name Address City State/Zip Telephone # 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 structure pnor to its issuance also requires the applicant for such permit to file a signed statement thai he is licensed pursuant to the provisions of the Contractors License Law [Chapter 9 commending with Section 7000 of Division 3 of the Business and Professions CodeJ or that rre is exempt therefrom, and the basis tor fna alleged exemption Any violation of Section 7031 5 by any applicant for a permit subjects the applicants a civil penalty of not mc*8 than five hundred dollars [$500]) Name State Licenses (f> Designer Name State License # 9-S2.7 9 Address ,, > &. - DLicense Class C-^O / /• O/ Address City City State/Zip j -Citv Business Licence # I /. State/Zip Telephone # Telephone # WORKER'S COMPENSATION Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations D I have and will maintain a certificate of consent to self-insure for workers compensation as provided by Section 3700 of the Later Code for the performance of the work for which this permit is issued oC 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 issuod My worker's com[>ensation insurance earner and policy number are Insurance Company _^)T'^l "T^- ^^ A-O __Policy No Expiration Date. (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] 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 wcura workers' compensation coverage la unlawful and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollarsfdOOOOO) In addition tottiecostof compensation, damagaaare providedfor in SocUon3706 of the Labor Code Interest and altorney'n fees SIGNATURE (P^M, -H^ ft d/^^^Tj' __ DATE. |7~~OWNER-BUILDER DECLARATION^ ^ ____ ___ ]; ] I hereby affirm that I am exempt from the Contractor s License Law for the following reason D I as owner of the property or my employees with wages as their sole compensation, will d the work and the structure is nol 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 tha burden of proving that he did not build or improve for the purpose of sale) D 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 Contractors 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 matenals for construction of the proposed property improvement D YES D NO 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 (induda 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 / tontractors 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 number / type of work) PROPERTY OWNER SIGNATURE DATE WHITE File YELLOW Applicant PINK Finance PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave, Carlsbad CA 92008 Page 2 of 2 fCOli^ErFTH7S~SECTOftrj^ORlto^ la the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration for or risk management and prevention program under Sections 25505 25533 or 55534 of the Presley Tanner Hazardous Substance Account Act? D 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' D YES Q 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 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 [6 CbNSTRUCfrONlT6NDINGA(g^C'Y __ 1^' ~ -I I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(1) Civil Code) LENDER S NAME _____^^_ LENDER S ADDRESS . [9 APPLICANT CERTIFICATION I certify that I have read the application and state that me 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 1 ALSO AGREE TO SAVE, INDEMNIFY AND KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGEMENTS, COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMH OSHA An OSHA permit is required for excavations of 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 permii or if the building or work aulhonzed by such permit is suspended or abandoned at any time after the work is commenced for a penod of 180 days (Section 10644 Uniform Building Code) APPLICANTS SIGNATURE it'tf^ >-*-rj _ DATE ft S/& 5~/ £> ^> WHITE File YELLOW Applicant PINK Finance City Of Carlsbad SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING 1. JOB ADDRESS: /7Vg/ 2. TYPE OF BUILDING: RESIDENTIAL ^ COMMERCIAL 3. ROOF SLOPE: RISE V inches in 12 inches 4. NUMBER OF EXISTING ROOF COVERING (circle one) (j) 2 3 5. TYPE OF EXISTING ROOF COVERING t<tep£> SHEATHING *6. NEW ROOF MATERIAL &w,f CLASS _ WEIGHT PER SQUARE 7. -NUMBER OF SQUARES 8. TRADE NAME _ MANUFACTURER/v^^x/s 9. ROOF SYSTEM LISTING UL No. _ ICBO No. 10. IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF?fTYE^) 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 t agree to provide a ladder extending at least 2 rungs above the roof for inspection. Signature < Date Contractor >O Owner Contractor Name, *6 - Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other. City of Carlsbad Bldg Inspection Request For 10/27/2003 Permit^ CB031302 Title BRENGI RESIDENCE Description 23 SQUARES OF COMP. Inspector Assignment PY Type MISC Job Address 1748 CATALPA RD Suite Lot Location APPLICANT T R CONSTRUCTION Owner COLUCC1 ROBERT J Remarks CAN YOU FINAL Sub Type REROOF Phone Inspector Total Time CD Description 19 Final Structural Act Comment Requested By NA Entered By CHRISTINE Associated PCRs/CVs Inspection History Date Description Act Insp Comments 06/06/2003 15 Roof/Reroof AP JM OK TO COVER SD •COMPENSATION INSURANCE POLICVHOLDER COPY PO BOX 807, SAN FRANC1SCO,CA 94142-0807 ' i 5« ' CERTIFICATE OF ^WORKERS' COMPENSATION 'INSURANCE ISSUE DATE 01-01-2O02 ! - GROUP OO0046 POLICY NUMBER 001O131-2003 H - •- „ CERTIFICATE ID . 2 ' - *v CERTIFICATE EXPIRES O1-01-20O4 * 01-01-2003/01-01-2OO4 COUNTY OF SAN DIEGO ATTN: BUILDING DEPARTMENT 5201 RUFFIN ROAD, • < ,. SAN DIEGO CA 92123 - SD'JOB. ALL OPERATIONS 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 t This policy is not subject to cancellation by the Fund except upon 30 days' advance written notice to the employer We will .also give 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 fay 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 poliCJes ^ ? AUTHORIZED .REPRESENTATIVE PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COSTS. $1,OOO,OOO 00 PER OCCURRENCE ' ' - , \ f t - *' '••' -* ? -I , t' ' ^ N ' ! "V > STANDARD EXCLUSION INDIVIDUAL EMPLOYERS'AND HUSBAND AND'WIFE EMPLOYERS ARE NOT ELIGIBLE - >, i FOR'BENEFITS AS^;EMPLOYEES UNDERj THIS POLICY ^ j. ', - <$t ""ENDORSEMENT #2035 ENTITLED CERTIFICATE-HOLDERS'.NOTICE EFFECTIVE 01-01-2003 is ATTACHED/TO AND FORMS A PART OF-THIS POLICY * U - . i" ' ' ' -* ' i ». *, ^ j ' v v I "ii* s> EMPLOVER ROSSETTJ, ANTHONY 98^7 PASEO MONTRU SAN DIEGO CA 92129 THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND ' ' 12-13-2002PRINTED P0409 SCIF 10265 (REV. 2-01)