HomeMy WebLinkAbout1009 DAISY AVE; ; CB984362; PermitBUILDING PERMIT Permit No CB984362
12/14/98 13 13 Project No A9805645
Page 1 of 1 Development No
Job Address 1009 DAISY AV Suite
Permit Type MISCELLANEOUS m2 12/14/98 0001 01 02
Parcel No 214-422-14-00 Lot# C-PRMT 203-00
Valuation 10,b42 Construction Type NEW
Occupancy Group Reference* Status ISSUED
Description RE-ROOF,3400 SF-LT WT CLAY Applied 12/14/98
Apr/Issue 12/14/98
Entered By RMA
760 432-9084Appl/Ownr
***
SECURE ROOFING
2210 MEYERS AV
ESCONDIDO CA
Fees Required ***
92029
^ Collected & Credits
Total vP/avmen-tc :
Fees
Adjustments
Total Fees
Fee description
Miscellaneous Fee #
•* MISCELLANEOUS TOT
00
00
203 00
Ext fee Data
203 00 PERMIT FEE
203 00
FINALAPPROVAL
nor
CLEARANCE.
' /
CITY OF CARLSBAD
2075 Las Palmas Dr, Carlsbad, CA 92009 (760) 438-1161
PERMIT APPLICATION
CITY OF CARLSBAD BUILDING DEPARTMENT
2075 Las Palmas Dr, Carlsbad CA 92009
(760)438-1161
ROJECT INFORMATION,
FOR OFFICE USE ONLY
PLAN CHECK NO
EST VAL [D. PA
Plan Ck Deposit '
Validated
Date
'Address (include Blag/Suite »}Business Name (at this address)
Legal Description Lot No Subdivision Name/Number Unit No Phase No Total # of units
Assessor s Parcel #Existing Useing Use,. s
% v t&
Proposed Use
/Description of Worj'/\p~'?0-J£:> *
2 CONTACT PERSON (If different from applicant)
SO FT #of Stones * of Bedrooms 9 of Bathrooms
Name
,3 APPLICANT D Contractor
Address City
,gent for Contractor Q Owner Q Agent for Owner
State/Zip Telephone * Fax #
*~fjame
4 PROPERTY OWNER
Address City State/Zip Telephone 9
Name Address City State/Zip Telephone 0
CONTRACTOR COMPANY NAME
(Sec 7031 5 Business and Professions Code Any City or County which requires a permit to construct alter improve demolish or repeir 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 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($5001)
"Nfime
State License t^^Oft^
, Address
V License Class L^^if
City State/Zip
City Business License t/2?~(.
Telephone f
?3^S£>-
Designer Name
State License #
Address City State/Zip Telephone
6 WORKERS COMPENSATION " " ----,,--- ,
Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations
Q I have end 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
O> 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
issued My worker s compensation insurance carrier and policy number are . .
~2-£> S "> "t ' Q>ts?eJ& Expiration Date ////*?cSInsurance Company Policy No
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS) ( '
Q 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 and civil fines up to one hundred
thousand dollars ($1(XLOOO) In addition to the cost of compensation damages as provided for hi Section 3706 of the Labor code Interest and attorney » fees
SIGNATURE ---/^&£fa^L&S^*-^^^y^——f—v /&Z=r£~7U7~ DATE /S //4Y 1^
7 OWNER BUfkOER DECLARATION 1 J" ~f "".,/, •"' < '*r'~ ~
I hereby affirm/hat I am exempt from the Contrector s License Lawfor 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)
l~l 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)
I am exempt under Section Business end 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 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 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 / contrectors 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
COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING PERMITS ONLY r ""*" "*""" '•*~--~*rr,-*r-~~«~rr^-».<~-,l* •• ,-
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 Q NO
Is the applicant or future building occupant required to obtain a permit from the eir pollution control distnct or air quality management district? Q 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
i8 CONSTRUCTION LENDING AGENCY " ~" " " "" ""••"• ~r- «•--.•"- --- — •• — -•
I hereby affirm that there is e construction lending agency for the performance of the work for which this permit is issued (Sec 3097(0 Civil Code)
LENDER S NAME LENDER S ADDRESS
9 APPLICANT CERTIFICATION ~ "' -——----- - -- --,-„-.»,-, r ,.~T,-t,,
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 City 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 365 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)
faZs^^*— .XZ"//-, i^-^ &2j£*J7— DATEAPPLICANT S SIGNATURE
Applicant PINK Finance
Inspection List
Permit* CB984362 Type MISC RE-ROOF.3400 SF-LT WT CLAY
Date Inspection Item Inspector Act Comments
1/29/99 19 Final Structural DH AP
12/16/98 15 Roof/Reroof DH AP
Wednesday June 16 1999 Page 1 of 1
City of Carlsbad Inspection Request
For 1/29/99
Permit# CB984362
Title RE-ROOF.3400 SF-LT WT CLAY
Description
Type MISC Sub Type
Job Address 1009 DAISY AV
Suite Lot
Location
APPLICANT SECURE ROOFING
Owner ZAWISTOWSKI RONALD&DIANE
Remarks
Inspector Assignment DH
Phone
Inspector
Total Time
CD Description
19 Final Structural
Requested By JAMIE
Entered By CHRISTINE
Act CommentsM
InspectionHistory
Date Description Act Insp Comments
12/16/98 15Roof/Reroof AP DH
City Of Carlsbad
SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING
1 JOB ADDRESS
2 TYPE OF BUILDING RESIDENTIAL > COMMERCIAL
3 ROOF SLOPE RISE 4^/y>inches in 12 inches
4 NUMBER OF EXISTING ROOF COVERING (circle one) <£) 2 3
5 TYPE OF EXISTING ROOF COVERING~0#?££fSHEATHING
*6 NEW ROOF MATERIAL V7t-g CLASS Jh' WEIGHT PER SQUARE 3"-£>
1 NUMBER OF SQUARES
8 TRADE NAME MANUFACTURER
9 ROOF SYSTEM LISTING UL No _ ICBO No
10 IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE
WEIGHT OF THE PROPOSED ROOF? ^§§1^ 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-mspection 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.
Contractor Owner Contractor Name
*6 - Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up,
Other