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Home My WebLink About2382 CAMINO VIDA ROBLE; ; CB972471; Permit/ Permit No: CB972471 Project No: A9703131 Development No: BUILDING PERMIT 09/03/97 12:05 Page 1 of 1 Job Address: 2382 CAMINO VIDA ROBLE Suite: Permit Type: MISCELLANEOUS 8731 W/03/97 0001 01 02 Parcel No: Lot#: C-PRHT 254-00 Valuation: 13,632 Construction Type: NEW Occupancy Group: Reference*: Status: ISSUED Description: RE-ROOF,14,200 SF-BUILT UP Applied: 09/03/97 : Apr/Issue: 09/03/97 Entered By: RMA Appl/Ownr : PREMIER ROOFING 619 667-4565 9054 OLIVE DR SPRING VALLEY CA 91977. *** Fees Required *** Collected & Credits *** Fees: 254.00 -,''-' •', - Adjustments: .90 "',-. .Tpta2, C32«$4ts: .00 Total Fees: 254.00 / l tfotAl P«^iTi9a1fcs: .00 ' '.*•;' Balance Me: 254.00 Fee description * "Units' Fee'/Onit Ext fee Data Miscellaneous Fee #1 * MISCELLANEOUS TOTAL 254.00 254.00 PERMIT FE 254.00 CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760)438-1161 FOR OFFICE USE ONLY PLAN CHECK NO. ff "7 xJ~l If Pel 0—EST. VAL. Plan Ck. Deposit Validated By Date [ \ Address (include Bldg/Suite #1 Legal Description Assessor's Parcel t Description of Work , Business Name (at this address) Lot No. Subdivision Name/Number Unit No. Phase No. Total # of units Existing Use . Proposed Use •—, f\ — Cli SQ- FT- *°* Stories # of Bedrooms * of Bathrooms . #^c ' *"« ' Name 4, PROPERTY OVVNER Address City State/Zip Telephone 9 !,«-•;*.: (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 dollars (45001).C/*/U, cfl fr/gyr-^of eft Name State License # (fyQf /0 \£3 Address License Class City ' State/Zip City Business License * Telephone # 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 oftne work for which this permit is issued. QL_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 ere: i /\ s **\ -*. f\ i /- /* _ - r\ f> 5V "9 f"Insurance Company PolicvNo.Expiration Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS 1*1001 OR LESS) ^J~~6ERTIFICATE 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 shafl subject an employer to criminal (uoahfas and civil fines up to one hundred thousand dollars ($100,000), in addition to tpe~£oVt of compensation, damages as provided for In Section 3706 of the UKtotJC^de^teraJt and attorney's fees. SIGNATURE /vL^^"' V^ , DATE *^ O^T / !7. OWNER-BUlLbER MCURAtlON7 ' -:"" '''"' •^^^•rw^'.'-r'rwr^^:^ y^^nf?^^^^^^^ 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, 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). C] 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 wrth contractors! licensed pursuant to the Contractor's License Law). I »m 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 / heve 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 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 d 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? D 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 IS MEETING THE REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT.ivr''etiwsfmjciibK tir^ 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 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 commewwdswithin 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 (5animenoegyfor\B period of 180 days (Section 108.4.4 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 2. TYPE OF BUILDING:RESIDENTIAL COMMERCIAL L*^- 3. ROOF SLOPE: RISE ^ inchesin 12 inches pj 4. TYPE OF EXISTING ROOF COVERING <T> U - P- SHEATHING \^(°?u^OO O 5. NUMBER OF EXISTING ROOF COVERINGS (circle one) (f^> 2 3 *6. NEW ROOF MATERIAL C^ lA £L - CLASS A WEIGHT PER SQUARE 7. NUMBER OF SQUARES 8. TRADE NAME C~cl A.MANUFACTURER O^L /W/e 9. ROOF SYSTEM APPROVAL UL No. C/AS& ^ 10. IS THE EXISTING STRUCIUJAk DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT THE PROPOSED ROOF (^/ _ NO _ If the answer is no, a roof plan must be provided with this application. 11. Fire rating of roof: Class A_J^ Class B _ I understand the following inspections are required: 1. Tear Of f/Pre- inspection prior to installing new roof covering. 2. Final Inspection I agree to provide a ladder extending at least 2 rungs above the roof for inspection SIGN DATE Contractor ^^ Owner Contractor Name Y^^f/ Ifi£t*re/t. *6 - Rolled Roofing, Tile, Shake, Shingle, Asphalt/Comp Fiberglass, Built up CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB972471 FOR 09/30/97 DESCRIPTION: RE-ROOF,14,200 SF-BUILT UP TYPE: MISC JOB ADDRESS: 2382 CAMINO VIDA ROBLE APPLICANT: PREMIER ROOFING CONTRACTOR: OWNER: REMARKS: C/DAVID/667-4565 SPECIAL INSTRUCT: LATE AM OR EARLY PM STE: PHONE: 619 667 PHONE: PHONE: INSPECTOR INSPECTOR AREA PLANCK* CB972471 OCC GRP CONSTR. TYPE NEW LOT: -4 TOTAL TIME: —RELATED PERMITS— CD LVL DESCRIPTION 15 ST Roof/Reroof PERMIT* CUP00224 CUP0224A TYPE STATUS CUP EXPIRED CUP EXPIRED ACT COMMENTS DATE DESCRIPTION ***** INSPECTION HISTORY ***** ACT INSP COMMENTS ACORD CERTIFICATE OF LIABILITY INSURANCE DUCER (619)642-0010 *A. Pearson and Associates Insurance Brokers, Inc. 6" ,. FAX (619)642-0888 THIS UtKlil-ILiAlb IS ISSUtU AS A MAI I tK Uh INhUKMAllUN ONLY AND CONFERS NO RIGHTS UPON THE CERTIFICATE HOLDER, THIS CERTIFICATE DOES NOT AMEND. EXTEND OR ALTER THE COVERAGE AFFORDED BY THE POLICIES BELOW. INSURED LUSK BlVd. 5te. B iego, CA 92121 Carin Cramer Ext Premier Roofing, Inc. Spring Valley, CA 91977-2301 COMPANY A COMPANYB COMPANY C COMPANY D C CNA CNA CNA ;OMPANI&5 AFFORDING COVERAGE - Transportation insurance Co. - Valley Forge Insurance Co. - American Casualty Co. of Reading,PA THIS ISTO CERTIFY THAT THfe PbUCIE^^^^Uf^SSTED'BELOW HAVEBEEJI ISSUED TO THE l^U^^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 SUBJECTTO ALL THE TERMS. EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. COLTR TYPE OF INSURANCE POLICY NUMBER POLICY EFFECTIVE DATE (MM/DD/YYJ POLICY EXPIRATION ! DATE (MMSDD/YY) j liurra"»••» GENERAL LIABILITY COMMERCIAL GENERAL LIABILITY ; CLAIMS MADE ! X I OCCUR OWNER'S & CONTRACTOR'S PROT $5,000 Property • GENERAL AGGREGATE f S 2 . 000 . 000> « •* '• i PRODUCTS - COMP/OP AGG C1055398208 05/01/1997 05/01/1998 | i FIRE DAMAGE (Any on. fr.) Damage Deductible : MED EXP (Any om parson) 1,000,000 1,000 ,.000 'i.'opp.'ppp 50,000 5,000 AUTOMOBILE LIABILITY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NONOWN6D AUTOS I COMBINED SINGLE LIMIT 1.000,000 BUA1055398211 05/01/1997 05/01/1998 ! 1 BODILY INJURY• (Pw parson) BODILY INJURY: (Pwaccfctonl) \ PROPERTY DAMAGE GARAGE UABIUTY ANY AUTO 1 AUTO ONLY - EA ACCIDENT • OTHER THAN AUTO ONLY: EACH ACCIDENT AGGREGATE EXCESS UAB4LTTY UMBRELLA FORM OTHER THAN UMBRELLA FORM EACH OCCURRENCE •AGGREGATE WORKERS COMPENSATION AND EMPLOYERS' LIABILITY • w ; **\>OI/MU- •: X : TORY LIMITS | THE PROPRIETOR/ PARTNERS€XECimVE OFFICERS ARE: ,WCL EXCL 1063791361 05/01/1997 05/01/1998 *| EL DISEASE - POLICY LIMIT f EL DISEASE - EA EMPLOYEE 1000000 1,000,000 1.000,000 OTHER ECRIPTION OFOPEKATlONS'LOCA'nONS/VEHICLES/SPEClALIIbllS £: Contractors State License Number - 689726. ny and All Operations of the above named insured CONTRACTORS STATE LICENSE BOARD P.O. Box 26000 Sacramento, CA 95826 SHOULD AMY OP THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF. THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 30 DAYS vmrrrew NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT. BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABIUTY OF **** KSHD UPON ™e CQWMff, rra AGENTS OR REPRESENTATIVES. AU REPRESENTATIVE 9ACQRDCQRPORATIQW 1S88 ••• — •- J — -'Tr^T ' •i-lf''-1' ^T^ ,--5*fta Isat;—TSrT.i.Ji-.ii.. EMERGENCY CONTACTS 1; <MBLIN, STEVE 15 AVENIDA ABAJO 1 CAJON, CA CORP. OFFICER 92020 619-447-1670 CORP. OFFICE rrr-^Te*i>^TrrM:ftT?asr^nrr^taEr' iBfl |tJjfl^gfcrf-^r '££. .XfJ".: ^ 'i IGEON, TOM 4580 LYONS VALLEY RD |l AMUL CA 91935 619-669-4902S NK **• LICENSE RESTRICTION: NONE PREMIER ROOFING, 9054 OLIVE DR SPRING VALLEY CA INC 91977-2301 ^jj . ..jftiyif.e.. *jj_:^i»i«ffcj.L_||^»a i Maa.. f^j-.^aiffi^- T^jL ^US^^OC^^U^L -*f-* |-"*feS,'. IS! (619) 434-2882 ,„„„ 619-667-4565 CITY OF CARLSBAD 1200 CARLSBAD VILLAGE DR., CARLSBAD, CA 92008 USINESS LICENSE N0 SUED TO (BUSINESS OWNER): <EM1ER ROOFING, INC. )?4 OLIVE DR 'RING VALLEY CA 91977 > CONDUCT THE (BUSINESS CLASSIFICATION): 'B-CONTRACTOR 17 ISINESS AS (DBA, BUSINESS NAME): EMIER ROOFING, INC. GATED AT (BUSINESS LOCATION): 54 OLIVE DR RING VALLEY CA 91977 FROM: 11/01/96 TO: 10/31/97 NOTTRANSFERABLE — POST IN A CONSPICUOUS PLACE i i ^ ir (• i i MI mi i ~> mm'< "•'j i ^•ip~J~r^» i i •P »"» i i ian~n^ria> 111 jgg;.~Ty^:*gBffar_!ia-f rW.-.-^^.^_grr ^Myt. J35lLg3ff|p'' rirlT^i^ FEE-SCHEDULE PC60 SUBJECT TO REVOCATION BY THE CITY COUNCIL OF CARLS TJ '•j''-'ffc-* T.ST.-tpftmtvj -*—*, J^^^s^ *.JT ^fjflmL»,_*^t_ LICENSE MUST BE POSTED ON BUSINESS PREMISES. NOTIFY BUSINESS LICENSE OFFICE IF YOU CHANGE LOCATION OR CEASE U OPERATION. •sJ B -flf!jf._Sr^1_xfgr :""--'gyytig;- ?TIU : ^&T" State of California CONTRACTORS STATE LICENSE BOARD ACTIVE LICENSE bSSIHb ^ CORP PREMIER ROOFING INC C39 ASB *w- 06/30/98 Any dungt d bwinm tddnufeunt must bt npoiM ta.B« RnJWnnrtWn90Ay«. 7W» fcww Is not tnnittrobJ*, and than IN nrturMd to Jht Atglilrar upon dtmutd triiw lomndtd, nvohad or (nnHMid for my nison.This podut eird U gUdttrough 0* upfntfon dctt only. It found, pbw drop bi «y ma9 box. Cortraetort State UCWM BoanJ P.O.Box 26000 Swimerto.CA 95820 Uctnut Sgnatun