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HomeMy WebLinkAbout1015 DAISY AVE; ; CB992800; Permit07/27/1999 City of Carlsbad Miscellaneous Permit Permit No CB992800 Building Inspection Request Line (760) 438-3101 Job Address Permit Type Parcel No Valuation Reference # Project Title 1015DAISYAVCBAD MISC 2144221700 $2,884 00 Subtype REROOF Lot# 0 HANSELL RESIDENCE 28 SQUARES OF COMP RE ROOF Status ISSUED Applied 07/27/1999 Entered By MDP Plan Approved 07/27/1999 Issued 07/27/1999 Inspect Area Applicant CUHEY, BRIAN 3048 VIA MARIPOSA CARLSBAD, CA 92009 Owner- HANSSEL JOHN E&ELIZABETH B TRS 1015 DAISY AVE "\ CARLSBAD CA , s\ 2270 07/27/99 0001 01 02 92009" 'V,':;",/ \ C-PRHT 87-00 Total Fees $87 00 /. Total Payments To'Date - ••, '* $0 00 \ V;y Balance Due $8700 Miscelaneous Fee #1 Miscelaneous Fee #2 I TOTAL PERMIT FEES $8700 $0 00 $87 00 Inspector FINAL APPROVAL 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 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 PalmasDr, 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 ONLY PLAN CHECK NO EST VAL Plan Ck Deposit Validated By Date Address (include Bldg/Suite t» ' -E* Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total # of units Assessor s Parcel #KC roo ft) Existing Use Proposed Use Description of Work SQ FT #of Stories # of Bedrooms # of Bathrooms CONTACT PERSON (if different from applicant) Name 3 ( Nar APPLICANT -^"Contractor ne Address Q Agent for Contractor Address City State/Zip Telephone f Fax # Q Owner "I OO~i ofT Q Agent for Owner )J,tA- Lu (OjJtV c\ City State ^oos ^/-J/U /Zip Telephone # H-Name 5 CONTRACTOR COMPANY NAME Address City State/Zip Telephone # (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 IChapter 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 |$500]1 C A N CH OQ^R VICJQ HQU-< Poi<x La. Coifa flOof Name State License # Address License Class G City State/Zip City Business License # Telephone # Designer Name Address City State/Zip Telephone State License # 6 WORKERS COMPENSATION Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations 0 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 _Q"^ 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 -^.T^X^t. KN^rQ Policy No Q *~( lo ' *l ff Expiration Date Iff (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($100) OR LESS) Q 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 workers compensation coverage is unlawful and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars ($100 000) in addition to the cost of compensation damages as provided for in Section 3706 of the Labor code interest and attorney s fees SIGNATURElj_^. \-< C t-*^—' . DATE ~l -2,1 - °\ °\ 7 OWNER BUILDER DECLARATION 1 hereby affirm that I am exempt from the Contractor s License Law for the following reason n ! 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) n 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) CD 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 f"l 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 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? Q YES O 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' O YES 0 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 30970) 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 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 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 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 \d \S ^ y < 2 TYPE OF BUILDING RESIDENTIAL ^ COMMERCIAL 3 ROOF SLOPE RISE S inches in 12 inches 4 NUMBER OF EXISTING ROOF COVERING (circle one) (©23 5 TYPE OF EXISTING ROOF COVERING ^KiJ:£ SHEATHING Jfc ' *6 NEW ROOF MATERIALISM? CLASS Q _ WEIGHT PER SQUARE 2 7 NUMBER OF SQUARES J0 _ 8 TRADE NAMEPrt^.t^ MANUFACTURER £)£- _ 9 ROOF SYSTEM LISTING UL No ICBO No 10 IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? ^ESJ 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 x^ >-i ^^- — _ Date ~~l Contractor _ Owner _ Contractor Name CH) '-» c ^ d *6 - Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other City of Carlsbad Inspection Request For 8/3/99 Permit# CB992800 Title HANSELL RESIDENCE Description 28 SQUARES OF COMP RE ROOF Inspector Assignment SR Type MISC Sub Type REROOF Job Address 1015 DAISY AV Suite Lot 0 Location APPLICANT CUHEY, BRIAN Owner HANSSEL JOHN E&ELIZABETH B TRS Remarks FINAL ROOF Phone 7605913123 Inspector Total Time CD Description 19 Final Structural Act Comments Requested By BRIAN Entered By ROBIN Inspection History Date Description Act Insp Comments 7/28/99 15Roof/Reroof AP SR PO BOX 420807, SAN FRANCISCO CA 94142-0807 COMPENSATION INSURANCE FUND CERTIFICATE OF WORKERS' COMPENSATION INSURANCE ' ' ' POLICY NUMBER CERTIFICATE EXPIRES r L This is to certify that we have issued a valid Workers' Compensation insurance policy in a form approved by the California Insurance Commissioner to the employer named below for the policy period indicated This policy is not subject to cancellation by the Fund except upon ten days' advance written notice to the employer We will also give you TEN days' advance notice should this policy be cancelled prior to its normal expiration This certificate of insurance is not an insurance policy and does not amend extend or alter the coverage afforded by the policies listed herein Notwithstanding any requirement, term, or condition of any contract or other document with respect to which this certificate of insurance 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 AUTHORIZED REPRESENTATIVE PRESIDENT i-^i-u' r .-^^ i.iniM1 *T ' oH" .iiscv" s - >*••-. ';"! n'-v-> - , * ir\ *'"/' '..F LL> v> ,< EMPLOYER r