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HomeMy WebLinkAbout1013 DAISY AVE; ; CB992782; Permit07/23/1999 City of Carlsbad Miscellaneous Permit Permit No CB992782 Building Inspection Request Line (760) 438-3101 Job Address Permit Type Parcel No Valuation Reference # Project Title 1013DAISYAVCBAD MISC 2144221600 $10,60000 Subtype REROOF Lot# 0 REROOF 4000 SF -LITE TILE#4660 Status ISSUED Applied 07/23/1999 Entered By JM Plan Approved 07/23/1999 Issued 07/23/1999 Inspect Area Applicant ZAVALA ROOFING 13486 CHELAN COURT SAN DIEGO CA 92129 858-780-9732 Owner . ANSARI RASHAD&PAMELA TRUST 09-12 .1013 DAISY AVE CARLSBAD CA 92009 Total Fees $20300 Miscelaneous Fee #1 '•. Miscelaneous Fee #2 Total Payments To Date $0 00 Balance TJue' y? V, •:• •'' :V '•••••• . $20300 ; . /''••' '> :;.-f :•" . ; ."V. ," .' ' " $000 m&203-00 TOTAL PERMIT FEES $203 00 -i • !AS EXPIRED IN ACCORDANOCMf S \ J^ 106.4.4 ,/^rtK SIGNATURE. ' > 3 C. FINAL APPROVAL Inspector \ 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 capactiy 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 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 1 PROJECT INFORMATION FOR OFFICE USE DIM PLAN CHECK NO _ EST VAL Plan Ck Deposit, Validated By Date V Address (include Bldg/Suite #) 'Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No / '/ Total # of units Assessor s Parcel tt Existing Use Description of Work SO FT #of Stories tt of Bathrooms CONTACT PERSON (if different from applicant) Name 3 APPLICANT Address Contractor l~l Agent for Contractor City Owner Q Agent for Owner State/Zip Telephone tt Fax # Name 4 PROPERTY OWNER Address City State/Zip Telephone tt Name 5 CONTRACTOR COMPANY NAME Address City State/Zip Telephone tt (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 fiv& hundred dollars [$500]) .Of Name State License tt • Designer Name State License tt ?J393 2- Address License Class (~ ~ J // Address City ' State?Zip City Business License tt fh " f City State/Zip ' Telephc/fi /Qr?/|v£-£P If Telephone e#/y Tt)/ Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations JAL 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 /HT 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 I / 4 (? Q £T P Policy No \Aj C / 9 124 ?0Q <? Expiration Date^</^AitfO<3Insurance Company (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) 0 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 worket^/compemiation coverage is unlawful and shall subject an employer to cnminal penalties and civil fines up to one hundred thousand dollars ($100 000) in addition to tUe/cjv? of compensation damages as provided for in Section 3706 of the Labor code interest and attorney s fees SIGNATURE ,^~^j£cl7 DATE p2 " 2. % - ^ ^ 7 OWNER BUILDER DECU<RAtnB»I^ ^L^— 1 hereby affirm that I am exempt from the Contractor s License Law for the following reason O 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) 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) 0 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 C~l YES l~lNO 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 RESIDENTIAL BUILDING PERMITS ONLY 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? O 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' [~l YES [~1 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 8 CONSTRUCTION LENDING AGENCY I hereby affirm that there is a 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 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 stones 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 1 80 days (Section 106 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 xK 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 /vrg SHEATH ING *6 NEW ROOF MATERIAL _ CLASS _ WEIGHT PER SQUARE 7 NUMBER OF SQUARES -f 0 8 TRADE NAME E& c3 f^ r U Q MANUFACTURER 9 ROOF SYSTEM LISTING UL No ICBO (No 10 IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT KTSUSTA4N-THE' WEIGHT OF THE PROPOSED ROOF? ( YES ) 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 / 'r^^df" x*/g3/°l ^ Date Contractor S*^ Owner Contractor Name *6 - Rolled Roofmg,(^tandard/Lite file] Asphalt/Comp Fiberglass, Built up, Other City of Carlsbad Inspection Request For 7/29/99 Permit* CB992782 Title REROOF 4000 SF -LITE TILE#4660 Description Inspector Assignment Type MISC Sub Type REROOF Job Address 1013 DAISY AV Suite Lot 0 Location APPLICANT ZAVALA ROOFING Owner ANSARI RASHAD&PAMELA TRUST 09-12 Remarks Phone 6198517663 Inspector Total Time CD Description 15 Roof/Reroof Act Comments Requested By VIDAL Entered By CHRISTINE Inspection History Date Description Act Insp Comments City of Carlsbad Inspection Request For 7/28/99 Permits CB992782 Title REROOF 4000 SF -LITE TILE#4660 Description Inspector Assignment Type MISC Sub Type REROOF Job Address 1013 DAISY AV Suite Lot 0 Location APPLICANT ZAVALA ROOFING Owner ANSARI RASHAD&PAMELA TRUST 09-12 Remarks Phone 6198517663 Inspector Total Time CD Description 15 Roof/Reroof Act Comments Requested By VIDEL ? Entered By CHRISTINE Inspection History Date Description Act Insp Comments ^ORD CERTIFICATE OF LIABILITY INSURANCE Sft DATEoi™D/YY) - PRODUCER Barrow Group, LLC 636 Exchange Place, Suite 300 Lilburn, GA 30047 i INSURED Zavala Roofing 13486 Chelan Court San Diego, C A 921 29- 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 CN4 Insurance Company B Company C Company! D COVERAGES INDICATED NOTWITHSTANDING ANY REQUIREMENTS 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 POUCIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS CO LT A TYPE OF INSURANCE POLICY NUMBER GENERAL LIABILITY AU — COMMERCIAL GENERAL LIABILITY ~\ CLAIMS MADE | | OCCUR. OWNER S & CONTRACTOR S PROT TOMOBILE LIABILITY ANY AUTO ALL AUTO SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS GARAGE LIABILITY ANY AUTO EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION AND EMPLOYERS LIABILITY THE PROPRIETOR/ I I ,NCL PARTNERS/EXECUTIVE OFFICERS ARE | | EXCL OTHER WC191247009 POLICY EFFECTIVE DATE(MM/DD/YY) 04/26/1999 POLICY EXPIRATION DATE (MM/DD/YY) 04/26/2000 LIMITS GENERAL AGGREGATE PRODUCTS-COMP/OP AGG PERSONAL & ADV INJURY EACH OCCURANCE FIRE DAMAGE (Any one fire) MED EXP (Any one person) COMBINED SINGLE LIMIT BODILY INJURY (Per person) BODILY INJURY (Per accident) PROPERTY DAMAGE AUTO ONLY EA ACCIDENT OTHER THAN AUTO ONLY EACH ACCIDENT AGGREGATE EACH OCCURANCE AGGREGATE x WC STATU OTH- TORV 1 IMITS FR EL EACH ACCIDENT EL DISEASE POLICY LIMIT EL DISEASE EA EMPLOYEE $ S S $ $ S $ % S $ $ S $ $ S $ $1,000,000 $1 000 000 $1,000000 DESCRIPTION OF OPERATIONS/VEHICLES/SPECIAL ITEMS EVIDENCE OF COVERAGE PRO\ 1DED CERTIFICATE HOLDER EVIDENCE OF INSURANCE For verification of coverage Call (760) 943-2350 Ext 5 ACORD 25-S (1/95) CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 1 0 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAME 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 / Roberts Barrow '/ty^A^SC / ACORD CORPORATION 1988 /&*** JLS****/