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Home My WebLink About1011 IRIS CT; ; VARIOUS; PermitBUILDING PEE : IRIS CT . :DENTAL ADD/ALT -el No: 214-402-01-00 17,355 . -ype: VN ccuparicy Group: escripf: •. 95 SF Suites L'..t4i : Reference**: Permit No: CB Project No: A9 J . - . Developmeat No: 4092 09/29/93 OOOl 01 02 C-PRHT 211.00 Status: ISSUED Applied: Appj./uwnr : SMITH, : . 1011 IB.i. r-;T CARLSBAD, CA 32 Fees Required 619 438-179^ Adjust!;. .. . Total Fees Fee description Pennit Buil " • • Plar. ; Strong Motion Fee * BUILDING TOTAL Enter "y" for Elect Enter "Y" for.Remode ' ELECTRICAL TOTAL ed & Credits 18 9 . 0 L: dl4 . 00 • , • , . -• INSP. CLEARAPJCE mi APPROVi _DAT '1^ CITY OF CARLSBAD 2075 Las Palmas Dr,. Carlsbad. CA 92009 (619) 438-1161 PUCATION City of Carlsbad .Building Department 2075 Las Palmas Dr., Carlsbad. CA 92009 (619) 438-1161 1. PEKMlT'lVPK A-U Commercial U New Building U Tenant Improvement B - • Industrial • New Building • Tenant Improvement C - • Residential • Apartment • Condo^ja'^gle Family Dwelling^,J3^dition/Alteration • Duplex • Demolition • Relocation • Mobile Home • Electrical • Plumbing • Mechanical • Pool • Spa • Retaining Wall • Solar • Other 2. PROJECT INFORMATION PLAN CHECK NO. EST. VAL 7 3^^ PLAN CK DEPOSIT VALID. BY_ DATE J2£ /^^ UO/iO FOR OFFICE USE ONLY Building or Suite No. Address \ > -r- J . _ 10\(.4,ri.s C'T Nearest Cross Street .A U tr N6. Suf TEGAirnEscmpnoN CSF 3 on ivision Name/Number Unit No. Phase No. CHECK BELOW W yUHMlTl'EU: • 2 Energy Calcs • 2 Structural Calcs • 2 Soils Report • 1 Addressed Envelope ASSESSOR'S PARCEI. EXISTTNG USE PROPOSED USE DESCRIPTION OF WORK SQ. FT. 3. UUN TALTW I 'S # OF STORIES N (.It ditterent trom applicant; Mil NAME ADDRESS CITY STATE ZIP CODE 4. APPUCANT OCONTHACrOR—DAGENT FOU CONTRACTOR yr DAY TELEPHONE SdWVNER U AGEN T FUR UWNER NAME i>^t\cx^3v'Wi4Uv ADDRESS \oU-3: . % C-t" CITY CAirJi^.^^f^ A STATE Q A- ZIP CCDE 9 ^L^O*^ DAY TELEPHONE ^ 1 >V Q 5. PHOPKRIVO' NAME Oa\\ciS ^Wc.-^^v.^ Sv^vv r\ U ADDRESS \oa X^>2> C-V. CITY CCk^ K W tJ STATE Q\ ZIP CODE 0\ ZCXF\ DAY TELEPHONE ^ 5 % - \ Yi QONTRAgfoR ^ NAME CITY STATE STATE UC. # DESIGNER NAME CITY 0^ \ hc\^ mm? UOMPKNiiA' ADDRESS ZIP CODE UCENSE CLASS ADDRESS DAY TELEPHONE CITY BUSINESS UC. # STATE C -V ZIPCODE ^2.0>M DAY TELEPHONE 7S^-^'fcj STATE UC. # C -iS "13 "7 norr 7. WOI Workers' Compensation Ueclaration: i hereby atlirm that I have a certiticate ot consent to selt-insure issued by the Director ot Industrial Relations, or a certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified by the Director of the insurer thereof filed with the Building Inspection Department (Section 3800, Lab. C). INSURANCE COMPANY POUCY NO. EXPIRATION DATE Certificate ot Exemption: 1 certify that in the pertormance ot the work tor which this permit is issued, 1 shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of Califomia. SIGNATURE DATE Uwner-Builder Declaration: I hereby affirm that f am exempt from the Contractor's License Law tor the tollowing reason: 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 Ucense 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.). 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 Ucense 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 Ucense Law). I am exempt under Section Business and Professions Code for this reason: (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, commencing 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 ^e ap^icant t^ a civil Jpfnalty of not more than five hundred dollars [$500]). DATE SIGNATURE RESIDENTIAL BUILDING PERMITS ONLY: COMPLETE n 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? • YES • NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? • YES • NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? • YES • NO IF ANY OF TIIE ANSWERS ARE YES, A FINAL CERTmCATE OF OCCUPANCY MAY NOT BE ISSUED AFTER JULY 1, 1989 UNLESS THE APPUCANT HAS MET OR IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION OONTROL DISTRICT. 9. coNi;mucnoN LENDINC A^KNCV 1 hereby affirm ttiat there is a construction lending agency tor the pertormance of the work for wtiicti this permit is issued (Sec 30V710 Civil Code). LENDER'S ADDRESS LENDER'S NAME 10. APPLICANT CKHTMCA'nON . . . ~ 1 certify that f have read the application and state that the above information is correct, t 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 INDEIWBiraTf AND KEEP IIARMLESS THE CTIY OF CARISBAD AGAmST ALL I^ AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID OTY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT. OSHA: An OSHA permit is required for excavations over S'O" deep and demolition or construction of structures over 3 stories in height. Expiration. Every pennit 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 303(d) Unifonn Building Code). DATE: 9-] T-'l 3 WHITE: FOe YELLOW: pplicant PINK: Finance PERMIT*. CB930993 DESCRIPTION: 195 SF CITY OF CARLSBAD INSPECTION REQUEST FOR 05/27/94 TYPE: RAD JOB ADDRESS; APPLICANT: CONTRACTOR: •OWNER: 1011 IRIS SMITH, DALLAS CT REMARKS: MW/DALLAS/438-1790 SPECIAL INSTRUCT: TOTAL TIME: PHONE: PHONE: PHONE: INSPECTOR AREA PY PLANCK# CB930993 OCC GRP CONSTR. TYPE VN STE: LOT: 619 438-1790 INSPECTOR CD LVL DESCRIPTION ACT COMMENTS 19 29 39 49 ST Final Structural PL Final Plumbing EL Final Electrical ME Final Mechanical ***** INSPECTION HISTORY ***** DATE DESCRIPTION ACT INSP 113093 Frame/Steel/Bolting/Welding AP PY 110493 Interior Lath/Drywall AP PY 110193 Frame/Steel/Bolting/Welding AP PY 110193 Roof/Reroof AP PY 110193 Rough Electric AP PY 110193 Rough/Ducts/Dampers AP PY 100693 Ftg/Foundation/Piers AP PY COMMENTS SECURE HEADER W/CHIPS OK TO POUR ESGIL CORPORATION 9320 CHESAPEAKE DR., SUITE 203 SAN DIEGO. CA 92123 (619) 560-1-^63 JUP.ISDICTIOS: rT) C*KI:^UAA PLAN CHECK KO: Cf~> a.^^ Q^p SZT: > ??.OJZC? .-.DDRSSS: (M\ CX . j?L.^>3 CHECKER QrlLE COPY QUPS • DESIGNER • Sp^g. (Pi>^^- -STsrv^ The plans trsr.s-iittea herewith have been corrected vhere necessary and s-i:bstantially co-iply -^-ith the j-^irisciction' s building codes. ••he plans transmitted herewith vill substantially cc-oly vith uhe jurisdict i.on' s buildina codes vhen ninor deficien- cies icenuiiiea are resolved and checked by building department sraff. • The plans transmitted herewith have significant deficie.ncies identified on the enclosed check list and should be corrected and resubmitted for a. comolete recheck. The check list transmitted herevitb is for your information, e plans are being held at Sscil Corp. until corrected plans are submitted for recheck. j j Ths applicant's copy cf the check list is enclosed for th jurisdiction to return to the applicant contact person. \ \ } The applicant's copy cf the check list has been sent to: Escil staff did not advise the applicant contact person that plan check has been completed. Q Escil staff did advise applicant that the plan check h been conioleted. Person contacted: ,» / as >ate contacted: Telethons nl 3y: ESGIL CORPO.^TIOS t n c lo s u r e s : __,JJQJ2^ •GA DCM 2-0 Prepared byj Jurisdiction VALUATION AND PLAN CHECK FEE • Bldg. Dept, B^Esgil PLAN CHECK NO. Cl? - Ci^'> BUILDING ADDRESS 11 ^r^t. CT , APPLICANT/CONTACT S^r^ BUILDING OCCUPANCY PHONE NO. 7<^-'?-?i^3 DESIGNER PHONE — TYPS OF CONSTRUCTION CONTRACTOR PHONE — BUILDING PORTION BUILDING AREA VALUATION MULTIPLIER VALUE sJ • Air Conditionine Commercial Residential @ Res. or Comm. Fire Siarinklers @ Total Value Building Permit Fee $, Plan Check Fee S COM HE NTS: SHEET fp) OF tT) 12/87 Citv of Carlsbad DATE: ^/^hs Engineering Department BUILDING PLANCHECK CHECKLIST ^ PLANCHECK NO. V^-^ BUILDING ADDRESS: /^// jti/S ^ PROJECT DESCRIPTION: ASSESSOR'S PARCEL NUMBER: ^1 "{^^01^-0J EST. VALUE ENGINEERING DEPARTMENT APPROVAL The item you have submitted for review has been approved. The approval is based on plans, information and/or specifications provided in your submittal; therefore any changes to these items after this date, including field modifications, must be reviewed by this office to insure continued conformance with applicable codes. Please review carefully all comments attached, as failure to comply with instructions in this report can result in suspension of permit to build. DENIAL Please see the attached report of deficiencies marked with CH. Make necessary corrections to plans or specifications for compliance with applicable codes and standards. Submit corrected plans and/or specifications to this office for review. By:. Date: By:. Date: By:. Date: 8Y_ FOR OFFICAL USE ONLY ENGINEERING AUTHORIZATION TO ISSUE BUILDING PERMIT: ^ OATE:_ ATTACHMENTS Dedication Application O Dedication Checklist D Improvement Application n Improvement Checklist D Future Improvement Agreement CONTACT PERSON NAME: ADDRESS: PHONE: P:\docs\chklst\bp0001 .frm REV 6/5/92 2075 Las Palmas Dr. • Carlsbad, CA 92009-1576 - (619) 438-1161 • FAX (619) 438-0894 BUILDING PLANCHECK CHECKLIST SITE PLAN 1st/2ndv/ 3rdv/ • • • 1. Provide a fully dimensioned site plan drawn to scaie. Show: A. North Arrow D. Property Lines Easements B. Existing & Proposed Structures E. Easements C. Existing Street Improvements F. Right-of-Way Width & Adjacent Streets • G 2. Show on site plan: A. Drainage Patterns C. Existing Topography B. Existing & Proposed Slopes n 3. Show on a section drawing or include a note stating that there is a minimum of 6" difference between the finished floor and the finished grade elevation adjacent to the structure. • 4. Include note: "Surface water to be directed away from the building foundation at a 2% gradient for no less than 5' or 2/3 the distance to the property line (whichever is less)." On graded sites, the top of any exterior foundation shall extend above the elevation of the street gutter at point of discharge or the inlet of an approved drainage device a minimum of 12 inches plus two percent" (per 1990 UBC 2907(d)5.). 5. Include on title sheet A. Site address B. Assessor's Parcel Number C. Legal Description For commercial/industrial buildings and tenant improvement projects, include: Total building square footage with the square footage for each different use, existing sewer permits showing square footage of different uses (manufacturing, warehouse, office, etc.) previously approved. EXISTING PERMIT NUMBER DESCRIPTION P:\(locs\chldst\bp0001.fnn Page 1 Of 4 REV 6/5/92 BUILDING PLANCHECK CHECKLIST DISCRETIONARY APPROVAL COMPLIANCE 1 sW 2nd'/ 3rdV • • 6. Project does not comply with the following Engineering Conditions of approval for Project No. Conditions were complied with by: Date: DEDICATION REQUIREMENTS • 7. Dedication for all street Rights-of-Way adjacent to the building site and any storm drain or utility easements on the building site is required for all new buildings and for remodels with a value at or exceeding $ -pursuant to Code Section 18.40.030. Dedication required as follows: Attached please find an application form and submittal checklist for the dedication process. Provide the completed application form and the requirements on the checklist at the time of resubmittal. Dedication completed by Date: IMPROVEMENT REQUIREMENTS D n D 8a. All needed public improvements upon and adjacent to the building site must be constructed at time of building construction whenever the value of the construction exceeds $ -pursuant to Code Section 18.40.040. Public improvements required as follows: Please have a registered Civil Engineer prepare appropriate improvement plans and submit them together with the requirements on the attached checklist for a separate plancheck process through the Engineering Department. Improvement plans must be approved, appropriate securities posted and fees paid prior to issuance of permit. Attached please find an application form and submittal checklist for the public improvements requirements. Provide the completed application form and the requirements on the checklist at the time of resubmittal. Improvement Plans signed by: Date: P:\docs\chktet\bp0001.frm Page 2 Of 4 REV 6/5/92 BUILDING PLANCHECK CHECKLIST isty 2ndv/ 3rdv/ DDD 8b. Construction of the public improvements may be deferred pursuant to code Section 18.40. Please submit a recent property title report or current grant deed on the property and processing fee of $ so we may prepare the necessary Future Improvement Agreement. This agreement must be signed, notarized and approved by the City prior to issuance of a Building Permit. Future public improvements required as follows: DDD 8c. Enclosed please find your Future Improvement Agreement. Please return signed and notarized Agreement to the Engineering Department. Future Improvement Agreement completed by: Date: • 8d. No Public Improvements required. SPECIAL NOTE: Damaged or defective improvements found adjacent to building site must be repaired to the satisfaction of the Citv Inspector prior to occupancy. GRADING PERMIT REQUIREMENTS The conditions that invoke the need for a grading permit are found in Section 11.06.030 of the Municipal Code. • • • 9a. Inadequate information available on Site Plan to make a determination on grading requirements. Include accurate grading quantities (cut, fill import, export). • • • 9b. Grading Permit required. A separate grading plan prepared by a registered Civil Engineer must be Submitted together with the completed application form attached. NOTE: The Grading Permit must be issued and rough grading approval obtained prior to issuance of a Building Permit. Grading Inspector sign off by: Date: • • 9c. No Grading Permit required. BUILDING PLANCHECK CHECKLIST P:\docs\chklst\bp0001.frin Page 3 Of 4 REV 6/5/92 MISCELLANEOUS PERMITS Isty 2ndN/ 3rdy • • 10. A RIGHT-OF-WAY PERMIT is required to do work in City Right-of-Way and/or private work adjacent to the public Right-of-Way. Types of work include, but are not limited to: street improvements, trees, driveways. A separate Right-of-Way permit issued by the Engineering Department is required for the following: Please complete attached Right-of-Way application form and return to the Engineering Department together with the requirements on the attached Right-of-Way checklist, at the time of resubmittal. 4 1 • • II.A SEWER PERMIT is required concurrent with the building permit issuance. The fee is noted in the fees section on the following page. • • 12. INDUSTRIAL WASTE PERMIT is required. Applicant must complete Industrial fj) Waste Permit Application Form and submit for City approval prior to issuance of a Permit. Industrial waste permit accepted by: Date: P:\docs\chldst\bp0001.frm Page 4 of 4 REV 6/5/92 CALCULATIONS WORKSHEET EDU CALCULATIONS: EDU's: ADT CALCULATIONS: ADT's: '/r y,. FEES REQUIR WITHIN CFD: \ AJCHGROtJGH • YES (NO BRIDGE_&JCHQROUGHFARE FEE, REDUCED TRAFFIC IMPACT FEE) • NO • 1. PARK-IN-LIEU FEE PARK AREA: FEE/UNIT: • 2.TRAFFIC IMPACT FEE ADT's: FEE/ADT: • 3. BRIDGE AND THOROUGHFARE FEE ADT's: FEE/ADT: • 4. FACILITIES MANAGEMENT FEE ZONE: FEE/EDU: • 5. PUBLIC FACILITIES FEE • 6. SEWER FEES PERMIT No. EDU's: FEE/EDU: $_ BENEFIT AREA: FEE: $. • 7. SEWER LATERAL REQUIRED (2,500 DEPOSIT) REMARKS: P:\cloc«\chklst\bp0001 .frm REV 6/5/92 (V I- PLANNING CHECKLIST Plan Check No. Address Planner W\if>fj Qii/Aj Phone 438-1161 ext. ^$7^ APN: (Name) Type of Project and Use . Zone FaciHties Management Zone a. a. a. Legend • Item Complete Item Incomplete - Needs your action 1, 2, 3 Number in circle indicates plancheck number where deficiency was identified D D Enviromnental Review Required: YES DATE OF COMPLETION: NO TYPE Compliance with conditions of approval? If not, state conditions which require action. Conditions of Approval • • Discretionary Action Required: YES NO DATE: TYPE APPROVAL/RESO. NO. PROJECT NO. OTHER RELATED CASES: Compliance with conditions of approval? If not, state conditions which require action. Conditions of pproval • Califomia Coastal Commission Permit Required: YES )^ NO DATE OF APPROVAL: San Diego Coast District, 3111 Camino Del Rio North, Suite 200, San Diego, CA. 92108-1725 (619) 521-8036 Compliance with conditions of approval? If not, state conditions which require action. Conditions of Approval • • Landscape Plan Required: YES NO • • • [/• • o/c • • See attached submittal requirements for landscape plans Site Plan: Zoning: 2. 3. 4. 2. 3. 4. Provide a fully dimensioned site plan drawn to scale. Show: North arrow, property lines, easements, existing and proposed structures, streets, existing street . improvements, right-of-way v^dth and dimensioned setbacks. Show on Site Plan: Finish floor elevations, elevations of finish grade adjacent to building, existing topographical lines, existing and proposed slopes and driveway. Provide legal description of property. Provide assessor's parcel number. Setbacks: Front: Int. Side: Street Side: Rear: Lot coverage: Height: Parking: Required Required Required Required Required Required Spaces Required Guest Spaces Reqtiired Shown Shown Shown Shown Shown Shown. Shown Shown ^J[Z(D Additional Comments /^W/ /V2^4>^^/ pen/Ti/^ 4/T e^i^lwn OK TO ISSUE AND ENTERED APPROVAL INTO COMPUTER DATE _5:i2^ll3_ PLNCK.FRM A 11 i- (J R IA CO A ST'A L, CO My\A i S S i C) r^l .••J OiGC-.O. CA S'2 103-1725 EXFAPTJON LETTER DATE; ?^?(-r5if-a.i.lc>sr !5 O -..^ . NAME: Zy^-^ne'S C-UUA.^ J LOCATION: |0\\ "ITn's r.ot^r^1~ AtrltblogLcl. PROJECT: (!!2oKi.S-Vruc-li'oO a^pnDy-ina:ie-iw 1S.s<>. j^-l'. 'SiVi.i^le-s-l'ory^, oMAcWfi rjen acid i \-iors +D QO e)6<&4-7't^^ on^.-S-^gr c| , S.^OO^g.-pf: ^, ^^O lot. A This is to certify that this location and/or proposed project has been reviewed by the staff of the Coastal Commission. A coastal development permit is not necessary for the reasons checked below. The site is not located within the coastal zone as established by the California Coastal Act of 1976, as amended. The proposed development is included in Categorical Exclusion No. adopted by the California Coastal Commission. The proposed development is judged to be repair or maintenance activity not resulting in an addition to or enlargement or expansion of the object of such activities (Section 30610(d) of Coastal Act). The proposed development is an improvement to an existing single family residence (Section 30610(c) of the Coastal Act) and not located in the area between the sea and the first public road or within 300 feet of the inland extent of any beach (whichever is greater) (Section 13250(b)(4) of 14 Cal. Admin. Code. The proposed development is an improvement to an existing single family residence and is located in the area between the sea and the first public road or within 300 feet of the inland extent of any beach (whichever is greater) but is not a) an increase of 10% or more of internal floor area, b) an increase in height over 10%, or c) a significant non-attached structure (Sections 30610(a) of Coastal Act and Section 13250(b)(4) of Administrative Regulations). (QVE.R) rail The proposed development is an interior modification to an existing use with no change in the deiisity or intensity of use (Section 30106 of Coastal Act). The proposed development involves the installation, testing and placement in service of a necessary utility connection between an existing service facility and development approved in accordance with coastal development permit requirements, pursuant to Coastal Act Section 30610(f). The proposed development is an improvement to a structure other than a single family residence or public works facility and is not subject to a permit requirement (Section 13253 of Administrative Regulations). The proposed development is the rebuilding of a structure, other than a public works facility, destroyed by natural disaster. The replacement conforms to all of the requirements of Coastal Act Section 30610(g). Other: Please be advised that only the project described above is exempt frora the permit requirements of the Coastal Act. Any change in the project may cause it to lose its exempt status. This certification is based on infonnation provided by the recipient of this letter. If, at a later date, this information is found to be incorrect or incomplete, this letter will become invalid, and any development occurring at that time must cease until a coastal development permit is obtained. Truly yours. Title: 6630A Suite: .'I BUILDING PERMIT 11/16/38 09:28 Paae 1 of i Job Address: 1011 IRIS CT Permit Type: MISCELLANEOUS Parcel No: 214-402-50-00 Lot#: Valuation: 7,950 Construction Type: KEW Occupancy Group: Reference*: Status: ISSUED Description: REROOF 3000 SF LIGHT TILE Applied: 11/16/9B : Apr/Issue; 11/16/9^ Entered By: BT 940-9474 Permit No: CB'.^6^•.^2|1 Project No: A9805119 Development No: 3420 11/16/98 OOOl 01 02 C-PftMT 160-001 Appl/Ownr * * * SPECIALITY ROOFING 131 S INDIANA AV VISTA CA 92084 Fees Required * * * Collected & Credits Fees: Adjustments: Total Fees: Fee description Miscellaneous Fee * MISCELLANEOUS T . 00 . 00 160.00 Ext fee Data 160.00 PERMIT F'T 160.00 APPROVAL DATE, 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 FOR OFFICE USE ONi,Y/ PLAN CHECK NO. EST. VAL Plan Ck. Deposit Validated By. Date 1. PROJECT INFORMATION JO 11 d::<Lis. Address (include BIdg/Suite #1 Business Name lat this address) Legal Description Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Assessor's Parcel # Description Parcel # Existing Use . Propos' ofWftrk SQ. FT. '#of Stories # of Bed Proposed Use Bedrooms # of Bathrooms Z.^COWMC'I^PERSONififw^^ i / * ,/ / ' • '^^^ -^^ ^ ^ ^ Name Address City State/Zip Telephone It Fax # Ndme • • Address City State/Zip Telephone # «ame Address City State/Zip Telephone # 6, CONTiUCTOR -COMPANV 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, 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 exgjgnption. Any i/lbiatlpn at^ectionJZ031 S> by any applicant for a permit subjects the applicant to .a divil Penalty of not more than five hundred dollars ($5001). State License # 73 <// Address License Class City State/Zip Telephone # City Business License # / '2—'C^C/~^/^i^ Address City State/Zip Telephone Designer Name State License # 6. WORKERS^ COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: Q 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 orihe work for which this permit is issued. Y)/ 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'sxompensation insurance carrier and policy number are: . > Insurance CompanN^T^ / ^gi^ Pfl h /lAuZtfVt A >C Policy Ho.Q'ZJlCf^ H lS^7 1/^ Expiration Date ^ - ^"rf (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100] OR LESS) n 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 tajthe Workers' Compensation Laws of California. WARNING: Failur/ta secure worker*' compnisatlon coverage is unlawful, and shall subject an employar to criminal penalties and civil fines up to one hundrad thousand doiiars (>1yO,000), in additioiytatnacost^MaflgBfluation, damages as provided for in Section 3706 of tha Lab^cod^^jmprest and attomey's fees. SIGNATURE f{//,(£^Q R^Mg^ DATE /C7/((>/9^ 7. OWNER.BUItDER DECWRATION ' f I hereby affirm that I am exempt from the Contractor's License Law for the following reason: • I, as owner ot 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), 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 contractor(s) licensed pursuant to the Contractor's License Law). n 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 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 / 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 COMPLETE THIS SECTION FOR/VOAMESWainm BUILDINQ PE Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or risk management and preventton program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? • YES • 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? O YES • 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, 8. CONSTRUCTION LENDING AGENCY^^^^^^ A 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 9. APPLICANT CERTIFICATION , 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 ali 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 UABiUTlES, 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 B'O" deep and demolition or construction of structures over 3 stories in height. EXPiRATiON: Every permit issuad 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 permjf id not commenced within 365 days^om the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any time aft/r thp work is coijifnenc^d/q^a puiaSef KQ^days (Section 106.4.4 Uniform Building Code). / y O DATE /Cf/^/?S WHITE: File YELLOW: Applicant PINK: Finance APPLICANT'S SIGNATURE i I City Of Carlsbad SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING 1. JOBADDRESS: /0//l?^j 2. TYPE OF BUILDING: RESIDENTIAL COMMERCIAL , 3. ROOF SLOPE: RISE ^ inches In 12 Inches 4. NUMBER OF EXISTING ROOF COVERING (circle one) (^) 2 3 5. TYPE OF EXISTING ROOF COVERING ^keJu^ SHEATHING p . *6. NEW ROOF MATERIAL/^ VMJ CLASS WEIGHT PER SQUARE 7. NUMBER OF SQUARES "^T) 8. TRADE NAME U/Z/V MANUFACTURER 9. ROOF SYSTEM LISTING ULNo. ICBO No. 'ZQ fJ 10. IS THE EXISTING STRUCTURAL DESIGNSJJ^CIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOFTr^YES J 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. S\anaturB/jCmJ? /{m^A^^ Date ^^^/ff Contractor Owner Contractor Name 5pcCifiJx^ ^60/94^ *6 - Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other. CITY OF CARLSBAD INSPECTION REQUEST PERMIT# CB983921 FOR 11/25/98 DESCRIPTION: REROOF 3000 SF LIGHT TILE TYPE: MISC JOB ADDRESS: 1011 IRIS CT APPLICANT: SPECIALITY ROOFING CONTRACTOR: OWNER: REMARKS: TAMMY/940-9474 SPECIAL INSTRUCT: STE: PHONE: 940-9474 PHONE: PHONE: INSPECTO INSPECTOR AREA PD PLANCK* CB983921 OCC GRP CONSTR. TYPE NEW LOT: TOTAL TIME: CD LVL DESCRIPTION 19 ST Final Structural ACT COMMENTS DATE DESCRIPTION 111798 Roof/Reroof ***** INSPECTION HISTORY ***** ACT INSP COMMENTS AP PD