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Home My WebLink About2100 COSTA DEL MAR RD; ; CB023122; Permit10-16-2002 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No CB023122 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Valuation Reference # Project Title 2100 COSTA DEL MAR RD CBAD MISC Subtype REROOF Lot# 0 $116,55000 LA COSTA RESORT MAIN HOTEL 35000 SF RE-USE EXIST TILE W/NEW UNDERLAYMENT Owner Status ISSUED Applied 10/16/2002 Entered By RMA Plan Approved 10/16/2002 Issued 10/16/2002 Inspect Area Applicant COMMERCIAL & INDUSTRIAL ROOFING INC 9239 OLIVE DR SPRING VALLEY, CA 91977 619-465 3737 8347 10/16/02 0002 01 02 1000=00 Total Fees $1,000 00 Total Payments To Date $000 Balance Due $1,000 00 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES PERMIT FEE $1,00000 $000 $000 $1,00000 Inspector FINAL APPBOVAL 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* PROJECT INFORMATION FOR OFFICE USE ONLY PLAN CHECK NO EST VAL ? /^ Plan Ck Deposit Validated By /• . Date tPJ/L/b'. Address (include Bldg/Suite #)Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total # of units Proposed Use Name ^ 3 APPUCANCJ.T Intractor A* T Address 7" City Q Agent for Contractor :*!i (3 Owner d Agent for Owner o\.'ve Ok State/Zip Telephone # Fax # ••<:::;? ^1977 Name Address City PROPERTY OWNER....- K S U Ca*.&4-»L;Q-Kon >- .jf, „. 5"o-%S 10 en 0 A 5rate/Zip v/v Telephone # \A ^^ Address City State/Zip Telephone #Name 5 SS™ CONTRACTOR - COMPANY 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 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 dolla----- Name ""* Address State License # -j | eX_ J er\ I License Class (_ ~" ' Designer Name Address State License ff ~ S~^ City^-* S State/Zip Telephone # •O / City Business License tt f oL O U> ^ <) lp City State/Zip Telephone 6.11:1 f WORKERS COMPENSATIONJK y .. ; j •• .. Ais\ •• i' "• *!•? "•" ~ :l:::' - Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations CD 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 •&\ 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 — Insurance Company ^~\ffl& / *-? ** o Policy No^XL/-^""! /^>O~O ^~ Expiration Date Vj fr*^ t *"^O ^. (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) CD 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 securaiworkers^jbrnpensatiop-covpfaie is unlawful and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dpl|au-t$4QQ(pOOJ/in addXiorf to Jhe cpsl^fc/rnpensation damages as provided for in Section 3706 of the Labor code interest and attorney s fees SIGNATUFJE- - — --t-Xg — J -.DATE H C "T I Co — O 7 :S!OWNER BUILDER DECLARATION . I hereby affirm that I am exempt from the Contractor s License Law for the following reason [3 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) fj] 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 fj YES ONO 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 NON /?£S/0flV77/U BUILDING PERMITS ^ONLY -?i|i ^ " . J? * . ii /" .il- ls 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? CD YES CD 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 fJ No Is the facility to be constructed within 1 000 feet of the outer boundary of a school site? CD YES CD 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 : ;^ • !'.. "'-••-• ^3^;: -'H'%:: "":- : -"f^ , " '- •• I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 30970) Civil Code) LENDER S NAME _ LENDER S ADDRESS _ 9 APPLICANT CERTIFICATION1!^, W;' p.' ' :- • •: . -,' " """V^L :,.,„ .. , " ':';. . ::'" '. " """ 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_buildmg OJtaal 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 commen^eja within t60/days from the date/M such permit or if the building or work authorized by such permit is suspended or abandoned at any time after the wor^iS^bmrnSngej^JiMTa peridot 180 days?ctioXj.06 4 4 Uniform Building Code) APPLICANT S SIGNATURE DATE WHITE File*-LLOW Applicant PINK Finance City Of Carlsbad SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING 1. JOB ADDRESS- W A >'n )-Jo'4gC Q to-p COS^TA Qgj 2. TYPE OF BUILDING RESIDENTIAL _ COMMERCIAL 3. ROOF SLOPE RISE H inches in 12 inches 4. NUMBER OF EXISTING ROOF COVERING (circle one) GD> 2 5. TYPE OF EXISTING ROOF COVERING JAg^ SHEATHING *6 NEW ROOF MATERIAL 4 A e. CLASS A- WEIGHT PER SQUARE 7. -NUMBER OF SQUARES 8 TRADE NAME c/ '-e* MANUFACTURER 9 ROOF SYSTEM LISTING UL No. _ ICBO No. 10. IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF' (^ 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 ^^^C J f/LZt&i ~ Date O___.+,<.- Contractor ^X. Owner _ Contractor Name *6 - Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other City of Carlsbad Bldg Inspection Request For 01/06/2003 Permit* CB023122 Title LA COSTA RESORT-MAIN HOTEL Description 35000 SF RE-USE EXIST TILE W/NEW UNDERLAYMENT Inspector Assignment RF 2100 COSTA DEL MAR RD Lot 0 Type MISC . Sub Type REROOF Job Address Suite Location APPLICANT COMMERCIAL & INDUSTRIAL ROOFING INC Owner Remarks Phone Inspector, Total Time CD Description 19 Final Structural Associated PCRs/CVs Requested By C & R ROOFING Entered By CHRISTINE Act Comment Inspection History Date Description Act 11/25/2002 21 Underground/Under Floor NR 11/22/2002 15 Roof/Reroof AP 11/21/2002 15 Roof/Reroof CA 11/20/2002 15 Roof/Reroof AP 11/13/2002 15 Roof/Reroof AP 11/05/2002 15 Roof/Reroof AP 11/04/2002 17 Interior Lath/Drywall AP 11/01/2002 15 Roof/Reroof AP 10/31/2002 15 Roof/Reroof AP 10/30/2002 15 Roof/Reroof AP 10/28/2002 15 Roof/Reroof PA 10/25/2002 15 Roof/Reroof AP 10/23/2002 15 Roof/Reroof AP Insp Comments RF RF BLDG H NORTH RF RF BUILD G SOUTH RF BUILD H SOUTH RF BUILD G NORTH RF BLDG A WEST RF BUILD E WEST RF BLDG B WEST RF BUILD C, D F (WEST) RF C EAST RF BUILDING A B D RF City of Carlsbad Bldg Inspection Request For 10/28/2002 Permit# CB023122 Inspector Assignment RF Title LA COSTA RESORT-MAIN HOTEL Description 35000 SF RE-USE EXIST TILE W/NEW UNDERLAYMENT Type MISC Sub Type REROOF Phone 6193008526 Job Address 2100 COSTA DEL MAR RD Suite Lot 0 ~ f- Location Inspector /f/" APPLICANT COMMERCIAL & INDUSTRIAL ROOFING INC Owner Remarks Total Time Requested By GARY Entered By CHRISTINE CD Description Act Comments 15 Roof/Reroof PA VC'" £^yf Associated PCRs/CVs Inspection History Date Description Act Insp Comments 10/23/2002 15 Roof/Reroof AP RF ? 7S £ 5 £p ACOPD CERTIFICATE OF LIABILITY INSURANCE ^MAY^ PRODUCES ALL COMMERCIAL INSURANCE SERVICES, LLC 6790 TOP GUN STREET #3 SAN DIEGO CA 92121 PHONE 858/642-0200 FAX 858/642 0205 Agency Lic# OC64552 INSURED COMMERCIAL & INDUSTRIAL ROOFING 9239 OLIVE DRIVE SPRING VALLEY CA 91977 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 COMPANIES AFFORDING COVERAGE COMPANY A ADMIRAL INSURANCE COMPANY COMPANY B GOLDEN EAGLE CORPORATION COMPANY C STATE FUND COMPANY D COMPANY E COVERAGES THIS IS TO CERTIFY THAT 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 POLICIESLIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS TYPEOF.NSURANCE POLICY NUMBER I >$*»*S§§f% 'V&SSSSR UMITS GENERAL LIABILITY A02AG1 3505 X COMMERCIAL GENERAL LIABILITY : | ; CLAIMS MADE X OCCUR MAY 102 ; MAY 1 03 EACH OCCURRENCE FIRE DAMAGE (Any One Fire) MED EXP (Any One Person) PERSONAL & ADV INJURY ! GENERAL AGGREGATE j GEN L AGGREGATE LIMIT APPLIES PER 'POLICY PROJECT I 'LOG AUTOMOBILE LIABILITY CCP548685-03 l ANY AUTO X | ALL OWNED AUTOS ! SCHEDULED AUTOS X ' HIRED AUTOS X NON OWNED AUTOS ' GARAGE LIABILITY : ' ANYAOTO PRODUCTS-COMP/OP AGG $ 1 000,000 $ 100,000 $ EXCLUDED $ 1,000,000 S 2,000,000 $ 1,000,000 MAY 1 02 MAY 1 03 ! COMBINED SINGLE LIMIT ; (Ea accident) ; BODILY INJURY(Per person) BODILY INJURY(Per accident) \ PROPERTY DAMAGE | AUTO ONLY EA ACCIDENT ! OTHER THAN Er,ACC ;AUIOONLY .__I AGG EXCESS LIABILITY i , \ EACH OCCURRENCE OCCUR : . CLAIMS MADE 1 i DEDUCTIBLE : i AGGREGATE RETENTION $ ; WORKERS COMPENSATION AND 285-1 753-02EMPLOYERS LIABILITY j C OTHER JAN 1 02 JAN 103 i ' wc STATU l OTHERJ«I1 1 \1L JMN 1 UO | T0f(r LIMITS E L EACH ACCIDENT i ! E L DISEASE EA EMPLOYEE E L DISEASE POLICY LIMIT ,$ 1,000,000 $ $ $ •$ s$ ,$ !$ s s $ S 1,000,000 !$ 1,000,000 S 1,000,000i DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS FOR INFORMATINAL PURPOSES ONLY CERTIFICATE HOLDER ADDITIONAL INSURED INSURER LETTER CANCELLATION FOR INFORMATIONAL PURPOSES ONLY Attention SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUTFAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THEINSURER IT S AGENTS OR REPRESENTATIVES AUTHORIZED REPRESENTATIVE -<? ^^/7?^£ ^L^^- ACORD 25-S (7/97)Certificate* 23414 Mark Rubin