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HomeMy WebLinkAbout1770 BASSWOOD AVE; ; CB012662; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Building Inspection Request Line (760) 602-2725 07-06-2005 Miscellaneous Permit Permit No: CB012662 status.&&iZ;p Job Address: 1770 BASSWOOD AV CBAD Permit Type: MlSC Subtype: REROOF Parcel No: 2050803800 Lot #: 0 Applied: Valuation: $20,892.00 Entered By: CB Reference #: Plan Approved: Issued: Project Title: ROYCROFT RES./ INSTALL TRUSSES Inspect Area: /CHANGE ROOF PITCH, NEW COMP. ROOF Applicant: ROYCROFT PATRICK&JOYCE 1770 BASSWOOD AVE CARLSBAD CA 92008 Owner: ROYCROFT PATRICK&JOYCE 1770 BASSWOOD AVE CARLSBAD CA 92008 Miscelaneous Fee #I Miscelaneous Fee #2 Additional Fees PERMIT FEE $307.00 $0.00 $0.00 TOTAL PERMIT FEES $307.00 Total Fees: $307.00 Total Payments To Date: $1 19.85 Balance Due: $187.15 FINAL APPROVAL You are hereby FURTHER NOTIFIED that your right to protest the specified feeslexactiins 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 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 -_ FOR OFFICE USE ONLY PLAN CHECK NO&bQ/gd@S EST. VAL. Plan Ck. Deposit 4 // 4, 6 Date d Name Address City Statelzip Telephone # Name Address City Statelzip 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 Codel 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 1$5001). Name Address City StateZip Telephone P State License X License Class City Business License X Designer Name Address City Statelzip Telephone State License X CONTRACTOR - COMPANY NAME hereby affirm under penalty of per) 0 of the work for which this permit is issued. 0 issued. My worker's compensation insurance carrier and policy number are: Insurance Company Policy No. Expiration Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS IS1001 OR LESS) 0 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 aecure workers' compensation coverage ia unlawful. and shall subject an employer to criminal penakiea and civil fines up to one hundred thousand dollara (8100.0001, in addition to the cost of compensation. damages as provided for in Section 3706 of the Labor code, interest and attorney'a fee.. 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 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 SIGNATURE DATE I hereby affirm that I am exempt from the Contractor's License Law for the following reason: ERdUlLDER DECLARATION 0 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 tor 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). 0 1, 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). 0 1. 2. 3. 4. number I contractors license number): 5. I am exempt under Section I personally plan to provide the major labor and materials for construction of the proposed property improvementH YES ON0 I (have I have not) signed an application for a building permit for the proposed work. I have contracted with the following person (firm) to provide the proposed construction (include name I address I phone number I contractors license number): 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 I address I phone I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name I address I phone number I type Business and Professions Code for this reason: JXMPLETE THIS SECTMN FOR Is the applicant or future buildi program under Sections 25505 r 25534 of the Presley ous Substance Account Act? 0 YES 0 NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? 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 quired to submit , acutely hazardous materials registration form or risk management and prevention 0 YES 0 NO 0 YES 0 NO MENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. NSTRUCTION LENDING AGENCY affirm that there is a construction lending agency for the performa 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 Cit). 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 CONSEOUENCE 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 180 days from the date of such Demit or if the buildino or work authorized bv such Dermit is susoended or abandoned at any time after the work is APPLICANT'S SIGNATURE // WHITE: Fife WOW: Applicant PINK: Finance To; City of Cmlsbad Building Departmat 8/29/Q 1 I, Pat Royrrof€, wish to cancel my building pdt application.