The URL can be used to link to this page

Home My WebLink About2614 COLIBRI LN; ; CB033176; Permit1MK . 11-18-2003 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No CB033176 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Valuation Reference # Project Title 2614COLIBRILNCBAD MISC 2155341100 $2,331 00 Subtype REROOF Lot# 0 BROWN RES-21 SQRS COMPOSITION Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 11/18/2003 RMA 11/18/2003 11/18/2003 Applicant PIVA ROOFING, BOB 1192 INDUSTRIAL AV ESCONDIDO, CA 92029 619-745-4700 Owner BROWN JAY J&MORAN LAUREL J 2614COLIBRILN CARLSBAD CA 92009 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES PERMIT FEE $7700 $000 $000 $7700 Total Fees $7700 Total Payments To Date $000 Balance Due $7700 3973 11/18/03 0002 01 COP 02 77-00 Inspector _L FINAL 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 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 ;1.:v' PROJECT; INFORMATION ; '• ~ " Oil oh* Lane. FOR OFFICE USE O PLAN CHECK NO EST VAL Plan Ck Deposit Validated By. Date Address (include Bldg/Suito i»Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total tt of units Assessor's Parcel tt Existing Use Proposed Use Descrition of Work SQ FT #of Stones tt of Bedrooms # of Bathrooms fe£cbNTACf';PERSON:.(if different from applicant)'.^ Sr<.^'.?,, f "'•','. Name [37.JJ, 'APPLICANT Address City ^Contractor', O Agent for Contractor, • 'El .Owner, D Agent for Owner State/Zip Telephone #Fax tt CA Name C5a Address City State/Zip Telephone tt Name 'Address City State/Zip Telephone tt (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 aviUjenalty of not more than five hundred dollars [4500]) State License # {*\V L^> Designer Name State License tt ~" Address><f >(S License Class Address C3? City City City State/Zip Telephone Business License tt 13(031/0 State/Zip Telephone tt r6"J^.,WbRKERS5COMPENSATIONr -.-. •': " ••' "'-. '° V.'* ,?''•?•• T?"" -"'''' ""!''" ~ '"'./"""' {' ~,, .. ,; V '-. -. Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations fj] 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 pfl | 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 carrier and policy number are Insurance Company '^/#/€ \~\AAW Policy No A<!&oOOQ.^S5\5O!5 Expiration Date_ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) |jQ. 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 nnd civil fines up to one hundred thousand dollars ($100,OOOKift,addition to the cost of compensation, damages as provided for in Section 3706 of the Labpr cocliy interest nnd attorney s fees SIGNATURE j^'ii^^ ^-°~ 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 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 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) Q 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 PINO 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) A 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? O YES C] NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? O YES l~l NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Q YES [3 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 K'^ONSTRUCTiON LENDING AGENCrJV"™'"^^,,;^ i.u \, X.Q.V.11'1" ', - •. ' • ., •-, , - 1 ,-' ' - 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 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 permit or if the building or work authorized by such permit is suspended or abandoned at any time after the work is commenced fM apenod of 180 days (Section 106 4 4 Uniform Building Code) APPLICANT S SIGNATURE ,.- =7^- '_^f^~ 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: RISE 7 inches in 12 inches 4. NUMBER OF EXISTING ROOF COVERING (circle one) (J) 2 5. TYPE OF EXISTING ROOF COVERING 5fafe. SHEATHING *6. NEW ROOF MATERIAL dO^> CLASS A WEIGHT PER SQUARE 7. -NUMBER OF SQUARES 8. TRADE NAME //.ft. ^wfeufrgf MANUFACTURER 9. ROOF SYSTEM LISTING UL No. ICBO No.. 10. IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? (fE$) 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 Date ////7/05 /\ Owner Contractor Name S>OJ3Contractor /\ Owner _ Contractor Name *6 - Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other. City of Carlsbad Bldg Inspection Request 1 For 12/23/2003 £.1 Permit* CB033176 Title BROWN RES-21 SQRS COMPOSITION Description Type MISC Sub Type REROOF Job Address 2614 COLIBRI LN Suite Lot 0 Location APPLICANT PIVA ROOFING, BOB Owner BROWN JAY J&MORAN LAUREL J Remarks Total Time CD Description 19 Final Structural Act Comment Inspector Assignment JM Phone 7608078350 Inspector JtsA- Requested By BOB PIVA ROOFING Entered By CHRISTINE Associated PCRs/CVs Inspection History Date Description Act Insp Comments 12/16/2003 15 Roof/Reroof AP JM OK TO COVER ACQffll CERTIFICATE OF LIABILITY INSURANCE | °Sw!%£gt «woC«0i t&!£)5S'-6400 FAX 0619)584-6425 West f and Insurtince Brokers 3838 Camino Del Rio North #315 P.O. Box 8S4S1 San Diego, « WM6-S481 auneo Bob Piva «x»fing Oomjiany, Inc. 1192 Industrial Avenue EscomKdo, CA 92029 TWS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND COWERS HO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES WOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE wan***. Admiral Insurance Conpany •Ksjastft Peerless Insurance Conpany WSWSRC state Compensation Ins. Fond USURER D. WSlfflERE: KAIC* 24856 I2419S £29 XW REQUIREMENT, TEMIORCONDmONdFANYCainitACTW MWPEKTAIN TIEttiStffiAH(£AnKmDEDBVTHEIXXK»ESCesCRies>MBtBNtSSUBJ^ HSR Vtff. JFMMRWKE tOOHCRALUAeUTT X ID POLICY NUMBER A03AG17262 06/03/2004 EMCHOOCUinBtQE OMMBETOREHIED PERSONAL *«3W WlURT PRODUCTS -60MMy ABB 1,000.001 50001 exclude* l.OOO.OOf 2.000.0W 1,000,001 CBP9497628 06/01/2003 06/01/2004 B AUOMMeiMITOS SCHEOUU 0 AUTOS WREDMTOS 1.000,000 (Porpannn) AUraONLV-EAACaOCMT AWAUTC OTHER THAH AWTOWU.Y- EAWC BIUWWUAUMHflYa EACHOCCURnSKE CIMBSMMg A6QRE6ME 06DOCTIBJE 285000233503 CERTIFICATES OF INSURANCE MUST BE ISSUED BY STATE FUND 06/01/Z003 06/01/2004 l.OOO.OM l.OOO.OOC ELWSaSE-POUCTtWJT 1,000,OOC OtHBt ^SUBJECT TO 10 IAY5 NOTICE OF CANCELLATION FOR NONPAYMENT OF PREHHM EVUKNCE -IF INSURANCE ««*««««** »*««*««« > BEFORE THE EHMWnQM CATC THEREOF, THE ISSUING HtSUflEft WU.atOEAVORTOilML 30* t BOTF*L«fff TO IW«L SUCH m>TireSHRU. arose WJOOUOftTKW OB IMflttlTY Cf AKyMM)UPOHTHE»ffH«gaiTSAeEHT5O«imBtgSetTATOfES. MJTHDKIZEORSVESaiTATIVE Robert Ke««/3ILL 4MCORD CORPORATIOM1S88