Loading...
HomeMy WebLinkAbout1705 CANNAS CT; ; CB030810; Permit03-19-2003 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No: CB030810 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: 1705CANNASCTCBAD MISC 2155011000 $2,664.00 Subtype: REROOF Lot #: 0 STRUBLE RES 2400 SF REROOF WD SHAKE TO COMP SHINGLE Status: ISSUED Applied: 03/19/2003 Entered By: SB Plan Approved: 03/19/2003 Issued: 03/19/2003 Inspect Area: Applicant: PIVA ROOFING, BOB 1192 INDUSTRIAL AV ESCONDIDO, CA 92029 619-745-4700 0002 01 COP 02 77-00 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES Total Fees:al Payments To Date:$0.00 Ba $77.00 Inspector: FINAL APP Date:Clearance: NOTICE: Please taka^TlCE thaflHal of your project includes the "lmposj«n" of fejf dedications, reservations, or other exactions hereafter collectively referred to as leesferactions." YouJJb 90 days from the date this permit was Issued to protest imposition of these fees/exactions. If you protest them, you must follow the protest procedures set forlffi Government Code Section 66020(a), and ie the protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section 3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their imposition. You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exacticro DC€S WT AP^ changes, rw planning, zoning, gra<$r$ or ti^ NOR DOES IT APPLY to any fees/exactions of which vou have Dreviouslv beeridven a NOTJCEslmilar toJfeor as to which the statute of limitations has Pfeylouslv otherwise expired. PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave., Carlsbad, CA 92008 FOR OFFICE USE ONLY PLAN CHECK NO.C&e&D Bf P EST. VAL. ; Plan Ck. Deposit Validated By Date S — I Addreu (include Bldg/Suite f)Business Name (at this address) Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Total # of units Assessor's Parcel #Existing Use Proposed Use *of Stories # of Bedrooms if of Bathrooms Neme Address City State/Zip Telephone *Fax* (Sec. 7031.5 Business and Professions Code: Any Crty 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 exemptin. Any violation of Section 7031.5 by any applicant for a germit subjects the applicant to a civiL penalty of not more then five hundred dollars [$5001).AW /town* /ifo xtdtakfol Ave &fe>»J,d~ <rA Name Stete License Address License Class City State/Zip City Business License * Telephone f Designer Name State License * Address City State/Zip Telephone 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 of the work for which this permit is Issued. JE~ I have and will maintain workers' compensation, es required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My worker's compwjMtioryinsurance carrierand policy number are: / / Insurance Company ^fafe fif/lrf Policy No. #T-V#*%Pjt"-Q3^ Expiration Date ff/J I&3 {THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1*100] OR LESS) ' ' -&. 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: Faflur* to secure workers' compensation coverage Is unlawful, and shall subject an employer to criminal penalties and dvH fines up to one hundred thousand dollars (UOQyOOO), In addjJfMto the cost of compensation, damages as provided for In Section 3706 of the Labor coda. Interest and attorney's fees. SIGNATURE *^T^" 'j£ ' ' V , ; 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, end who does such work himself or through his own employees, provided that such improvements are not intended or offered for sele. 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 buitd 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). n 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 / eddress / 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 la 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 25506, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? D YES Q 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 Q NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Q YES Q NO IF ANY OF THE ANSWERS ARE YES, A FINAL CERTIFICATE OF OCCUPANCY MAY NOT BE ISSUED UNLESS THE APPLICANT HAS MET OR tS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. 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 commencedjor a period (}L4€Ktyavs (Section 106.4.4 Uniform Building Code). ' / / APPLICANT'S SIGNATURE DATE fa>-3 WHITE: File YELLOW: Applicant PINK: Finance City Of Carlsbad SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING 1. JOB ADDRESS: *70 S 2. TYPE OF BUILDING: RESIDENTIAL 9 COMMERCIAL 3. ROOF SLOPE: RISE_Sl_inches In 12 inches 4. NUMBER OF EXISTING ROOF COVERING (circle one) Q) 2 3 5. TYPE OF EXISTING ROOF COVERING 5/tffcg SHEATHING *6. NEW ROOF MATERIAL O^f> CLASS 33PWEIGHT PER SQUARE 7. MUMBERQF SQUARES 2H X . 8, TRADE NAMg Rim^- 5f€y?/1A MANUFACTURER 9. ROOF SYSTEM LISTING UL No, Kotl ICBO No. '. 10. IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? (f^) 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/Pro-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. Signatu Contractor_^J)wner Contractor Nam^ *6 - Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other. City of Carlsbad Bldg Inspection Request For: 04/04/2003 Permits CB030810 Title: STRUBLE RES 2400 SF REROOF Description: WD SHAKE TO COMP SHINGLE Inspector Assignment: JM 1705 CANNAS CT Lot Type:MISC Sub Type: REROOF Job Address: Suite: Location: APPLICANT PIVA ROOFING, BOB Owner: STRUBLE THOMAS D&MARY L Remarks: Phone: 7607454700 Inspector: Total Time: CD Description 19 Final Structural Act Comment Requested By: BOB Entered By: CHRISTINE Associated PCRs/CVs Inspection History Date Description Act Insp Comments 03/21/2003 15 Roof/Reroof AP JM ACORD^ CERTIFICATE OF LIABI PRODUCER (619)584-6400 FAX (619)584-6425 Westland Insurance Brokers 3838 Camirto1 Del* Rio North #315 P.O. Box 85481 -"^a Diego, CA 92186-5481 /D Bob Piva Roofing 1192 Industrial Avenue Escondido, CA 92029 i LITY INSURANCE DATE (MM/DD/YY) 06/04/2002 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER. THIS CERTIFICATE DOES NOT AMEND, EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURERS AFFORDING COVERAGE INSURERA: Royal Surplus Lines Ins. Co /Sterling West INSURERS: Peerless Insurance Company/GEIC iNsuRERC: State Compensation Insurance Fund INSURER D: INSURER E: COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED. NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR MAY PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSR LTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIV DATE (MM/OD/YY POLICY EXPIRATIODATE (MM/DD/YY LIMITS GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY <2HA120557 06/01/200!06/01/2003 EACH OCCURRENCE FIRE DAMAGE (Any one fire) CLAIMS MADE occu,MED EXP (An/ one person) PERSONAL & ADV INJURY GENERAL AGGREGATE GEN'L AGGREGATE LIMIT APPLIES PER l~~Uoc PRODUCTS - COMP/OP AGG POLICYnPRO-JECT! 1,000,000 50,000 excl udec 1,000,000, 2,000,000 1,000,000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS CBP9497628 06/01/2002 06/01/2003 COMBINED SINGLE LIMIT (Ea accident)1,000.000 BODILY INJURY (Per person) BODILY INJURYPer accident) PROPERTY DAMAGE Per accfdeni) IARAGE LIABILITY ANYAUTO AUTO ONLY - EA ACCIDENT OTHER THAN AUTO ONLY: EAACC AGG EXCESS LIABILITY OCCUR EACH OCCURRENCE DCLAIMS MADE AGGREGATE DEDUCTIBLE RETENTION S WORKERS COMPENSATION AND EMPLOYERS' LIABILITY 6-11802-02 06/01/2002 06/01/2003 TWC STATU- TORY LIMITS ER 1. EACH ACCIDENT 1,000,000 .L. DISEASE - EA EMPLOYEE 1,000,000 L DISEASE - POLICY LIMIT 1.000,000 OTHER RE: \S RESPECTS GENERAL LIABILITY THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED PER THE ATTACHED FORM. 10 DAY NOTICE IN THE EVENT OF CANCELLATION FOR NONPAYMENT OF PREMIUM CERTIFICATE HOLDER ADDITIONAL INSURED; INSURER LETTER:CANCELLATION ISSUED AS EVIDENCE OF INSURANCE SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 "f DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE Robert Kempa/HOYR ACORD 25-S (7/97)©ACORD CORPORATION 1988