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Home My WebLink About1761 CAPE MAY PL; ; CB983711; PermitBUILDING PERMIT 10/28/98 11:30 Page 1 of 1 Job Address: 1761 CAPE MAY PL Permit No: CB983711 Project No: A9804840 Development No: Permit Type: MISCELLANEOUS Parcel No: 207-312-10-00 Valuation: 8,050 Occupancy Group: Reference*: Description: 22 SQUARES OF SYNTHETIC SHAKE Appl/Ownr : HEATHERINGTON ROOFING 1527 COAST HIGHWAY OCEANSIDE CA 92054 Fees Reciuired *** Suite: Lot#: 2768 10/28/98 0001 01 02 C-PRMT 165-00 Construction Type: VN Status: ISSUED Applied: 10/28/98 Apr/Issue: 10/28/98 Entered By: MDP 760 721-0415 *** Fees : Adjustments: Total Fees: Fee description 1 ****!** 'Vijees Collected & Credit A * * ;!T~ ; f * Jf: : jS.'JL.-d'.' • • *,-", HI, '"v "ft*-! c,wi»L rfekr, a_ %f *~J(* •»""**•, Miscellaneous Fee * MISCELLANEOUS . 00 . 0 0 165,00 Ext fee Data 165.00 PERMIT 165.00 FINAtAPPROVAL INSP. DATE CLEARANCE, FIRE PREVENTION BUREAU 2560 ORION WAY, CARLSBAD, CA 92008-7280 (619)931-2121 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Patmas Dr., Carlsbad CA 92009 (760)438-1161 1. PROJECT INFORMATION & FOR OFFICE USE ONLY PLAN CHECK NO. EST. VAL. ^ , ~ 3 / ' Plan Ck. Deposit Validated By Date Address (include Bldg/Suite t)Business Name lit this address) J_ Legal Description Lot No.i Name/Number Unit No.Phase No.Total • ot units Assessor's Parcel *Existing Use Proposed Us. Description of Work 2. CONTACT PERSON (If drffererrt from SQ.FT.f of Stones * of Bedrooms * of Bsthrooms ~T^ Name 3. APPLICANT ^*"^TComri Addms City Stete/Zip Telepnone #Fsx * Contractor D Agent for Contractor D Owner~ O Agent for Owner Name Address City St*te/Zip Telephone * PROPERTY OWNER ~rc*Aor- n'fei '"/W Name 5. CONTRACTOR Address City Stete/Zip Telephone * COMPANY NAME "Mpi£i>\V2< X ' (Sec. 7031.5 Business end 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 tor such permit to file a signed statement that he is licensed pursuant to the previsions 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 eny applicant tor a permit subjects the appNcent to a cMI penalty ot not more then five hundred dollars 1*5001). Name State License t Address License Class City City Business Li State/Zip nse » Telephone * Designer Name Address State License * _____________ 6. WORKERS'COMPENSATION Workers' Compensation Declaration: I hereby effirm under penalty of penury one of the I City State/Zip ations: l have and will maintain a certificate ot consent to self-insure tor workers' compensation as provided by Section 3700 of the Labor Code, tor the performance of thejwork for which this permit is issued. E^l 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 Policy No. Expiration Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1*100) OR LESS) Q CERTIFICATE OF EXEMPTION: I certify that in the performance of the work for which this permit is issued, I shett 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 to unlawful, and she* subject an employer to criminal penaWae and dvD fines up to one hundred thousand dollars (t 100.000). In addition to the cost of compensation, damages as provided for hi Section 3706 of the Later cede. Interest and attorney's teas. SIGNATURE DATE 7. OWNER-BUILDER DECLARATION '-" •"' -r,-.v;-.- • ...-..• n-H I hereby affirm that I am exempt from the Contractor's License Law tor the following reason: O I. as owner of the property or my employees with wages as their sole compensation, will do the work and the structure to not intended or offered tor seta (Sec. 7044. Business end 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 ottered tor seta. If, however, the building or Improvement Is sold within one yesr of completion, the owner-builder will neve the burden of proving that he did not build or Improve tor the purpose of aeta). O i< as owner of the property, em exclusively contracting with licenced contractors to construct the protect (Sac. 7O44, Business and Professions Code: The Contractor's Licence Lew does not apply to en owner of property who builds or improves thereon, and contracts for such protects with contractorlsl Mcenead pursuant to the Contractor's License Lew). D I am exempt under Section Business and Professions Code tor this reason: 1. I personally plen to provide the major labor and materials tor construction of the proposed property improvement. Q YES QNO 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. l 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 I 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 Ot work): PROPERTY OWNER SIGNATURE COMPLETE THIS SECTION FOR /VOWWKSXOErVTM. BUtLDWQ PERMITS ONIY~ :~~— Is the applicant or future building occupant required to submit a business plen. acutely hi program under Sections 25S05, 25S33 or 25534 of the Presley-Tanner Hazardous Substan DATE rrtActr O YES O NO 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 D 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. 18. CONSTRUCTION LENDING AGENCY ~ """ -•--,-••—:-~~-,<,^.r,^—;. -- -,-,_ , ....... ...,„. 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 * APPLICANT CERTIFICATION -,-.-._.„..,„—.,_„_........ ......... ,.„.,_„. I certify that I have read the application and state that the above information is correct end 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 Ott 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 tor 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 shell expire by limitation end become null and void if the building or work authorized by such permit is not commenced within 365 days from the dste of such permit or if the building or work authorized by such permit is suspended or abandoned at any time efter 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: 1161 Ote ^ />/, C~&* & 2. TYPE OF BUILDING: RESIDENTIAL ^^ COMMERCIAL 3. ROOF SLOPE: RISE_J__inches In 12 inches 4. NUMBER OF EXISTING ROOF COVERING (circle one) Q) 2 5. TYPE OF EXISTING ROOF COVERING £M^ SHEATHING *6. NEW ROOF MATERIAL f i«e, f rte CLASS HIS WEIGHT PER SQUARE 7. NUMBER OF SQUARES > 8. TRADE NAME f Ue. EVee ^^MANUFACTURER 9. ROOF SYSTEM LISTING UL No. ISfO ICBO No. 10. IS THE EXISTING STRUCTURAL DESIGNSJ1EFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? /\ES 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 ^2^3JAJSeg===^ Dgte Contractor Owner Contractor Name *6 - Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other. CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB983711 FOR 10/29/98 DESCRIPTION: 22 SQUARES OF SYNTHETIC SHAKE TYPE: MISC JOB ADDRESS: 1761 CAPE MAY PL APPLICANT: HEATHERINGTON ROOFING CONTRACTOR: OWNER: REMARKS: C/DEAN/ SPECIAL INSTRUCT: INSPECTOR AREA PLANCK* CB983711 OCC GRP CONSTR. TYPE VN STE: LOT: PHONE: 760 721-0415 PHONE: PHONE: INSPECTOR TOTAL TIME: CD LVL DESCRIPTION 15 ST Roof/Reroof ACT COMMENTS '/<"' DATE DESCRIPTION ***** INSPECTION HISTORY ***** ACT INSP COMMENTS CdMPENSATIONINSURANCE!FUND P.O. BOX 42Q807, SAN FRANCISCO, CA 94142-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE CERTJFfCATfi EXPIRES: SIDNEY FRIEDMAN 3274 HILLIK® Clf? CA 9160S 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. This policy 1$ not subject to cancellation by the Fund except upon ten days' advance written notice CD the employer. We will also give you TEN days' advance notice should this policy be cancelled prior to its normal expiration. This certificate of Insurance is not an insurance policy arid does not amend, extend or after the coverage afforded by the poHctes 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 att the terms, exclusions and conditions of such policies. s&**>*ts>e__ AUTHORIZED REPRESS EMPLOYER'S LIABILITY LtWT IBCLUBlHfc BETEHSE COSTSs PER QCCURREHHE. r ; HETHERIiQTOH ROOFING 3263 VALLEY STREET CARLSBAD CA 92006 KRB THIS DOCUMENT HAS A BLUE PATTERNED BACKGROUND POLJCYHOLDER'S I