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Home My WebLink About1023 DAISY AVE; ; CB971906; Permit,53515 ' J BUILDIlSiGPE. R-MIT 07/15/97 09:21 Page 1 Of 1 Job Addre'ss 1023 DAISY AV Suite: Permit Type- MISCELLANEOUS 'Parcel No; 244-401-17-00 : Lot#,: Valuation: 7,290 .- . Occupancy Group;. , Reference* : -Description: REROOF.\3000 SF LITE WGHT TILE . ICBO Permit No- CB971906 Project No A9701422 Development No: Appl/Ownr : CAtfEY CUSTOM ROOFING 3043 VIA MARIPOSA- CARLSBAD, CA 92009 ;- AAA Fees R*equire.d •**•* \. 'Figfes:, Adjustments:,. , ; Total v/Fees; Fee d'e^crf pfc|on - r*f ' r^!«^ — *••'; ; Construction Type: NEW Status. ISSUE? Applied: 07/15/97 Apr/Issue 07/15/97 Entered By JM 760 591-3123 * MI|CELLAJ«eoUS TC 164 00 PERMIT 164.00 ,1'.- I'-t-v- i APPROVAL DATE. FRANCE OF CARLSfcAD 2075 Las Palmait^.r«afisbad, CA 92009 (619) 438-1161 'ERWHT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr, Carlsbad CA 92009 (760)438-1161 1 PROJECT INFORMATION ^ p: "T FOR OFFICE USE ONLY PLAN CHECK NO. EST VAL Plan Ck Deposit Validated By < Date Address (include Bldg/Suite ffl Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total * of units Assessor's Parcel # Kc r^K C- vo Existing Use Proposed Use Description of Work SQ FT #of Stories tt of Bedrooms of Bathrooms CONTACT PERSON (If different from applicant) Name Address City S3. APPLICANT Q-Corttraotor " Tl'AoefiFfoTcloTiMStoT^DI&^wnw^Tn Agent for Owner" '•" ' Name * Address 4 PROPERTY OWNEFi " " ' "= • *^»'^*<l>*m»™*>r^ t^^w^-^^T -"11 HCcW^OveiA lCsT~i $>fLoi-vf C, Name Address City f^-f I ^ H/^ City State/Zip T(J^ <itWc| State/Zip '""""" X?^^1 State/Zip Telephone # Fax tt Telephone tt ' '< ""v^^."-,^ ^ 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 five hundred dollars ($500]) Lu. foJ-ru- c, Lbn4 £~5 )- 3) 12 Name State License tt S Address License Class --> 1 City State/Zip City Business License # Telephone tt Designer Namo Address City State/Zip Telephone State License tt _ 6 WORKERS' COMPENSATION T-,,-.^--, , ..... ,., ... .,..,. 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 thework for which this permit is issued J3i ' have and wl" 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 5> "T 0^\ t- £* u O <£. _ Policy No H ^ Vn f\ "3- _ Expiration Date _ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 OR LESS) n CERTIFICATE OF EXEMPTION I certify that in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the Workers' Compensation Laws of California WARNING Failure to secure workers compensation coverage la unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollarsj$ 1 00,000). in addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees SIGNATURE \^)^ — . V-** f, t^^^- _ DATE _ 7 OWNER-BUILDER DECLARATION ..... ' - ' ':;: ' " - '"•• -•'"' -' " - ";! - '-"• '"*"" -:- •• "-'-'-r- I hereby affirm that I am exempt from the Contractor's License Law for the following reason G 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) 0 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) C] 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 O 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) .. DATEPROPERTY OWNER SIGNATURE COMPLETE THIS SECTION FOR NON-RESIDENTIAL BtllLDINQ PERMITS"ONLY'SFt' f':'-"")• ": '.' *T> 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 25S05, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? D YES Q NO Is the applicant or future buldmg 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 8. CONSTRUCTIOM LENDING AGENCY '" "" "^ ~ ,~^«w^-••*•-•««•->«—,= »-,-, -,, ,, - „,,,,.„-, ,..,.. ,;.-,:, 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* ' '"^ —^ "^' -'~-^^F^^^T-^r^. ^^~^--;:jf-fX:'^^:'^^'~. r;-, - "- ' -- 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. 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 180 days (Section 106 4 4 Uniform Building Code) APPLICANT S SIGNATURE DATE "7 •" J - C] CITY OF CARLSBAD SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFIN6 1. JOB ADDRESS /m3 D fa. i J r^ c 2. TYPE OF BUILDING: RESIDENTIAL COMMERCIAL _ 3. ROOF SLOPE: RISE M inches in 12 inches 4. TYPE OF EXISTING ROOF COVERING S ^ t^K e _ SHEATHING 5. NUMBER OF EXISTING ROOF COVERINGS (circle one) (T, 2 3 *6. NEW ROOF MATERIAL ( f UT Co ^ C CLASS ft- HEIGHT PER SQUARE 5 7. NUMBER OF SQUARES T3 0 8. TRADE NAME Trvj 1^ + ^ MANUFACTURER LI k T. I<L 9.. ROOF SYSTEM APPROVAL UL No. Other 10. IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF YES ^^ NO If the answer is no, a roof plan must be provided with this application. 11. Fire rating of roof: Class A •>/ Class B I understand the following inspections are required: 1. Tear Off/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. T- SIGN DATE Contractor / Owner _ Contractor Name Lft\^^\^ %. p n f r *6 - Rolled Roofing, Tile, Shake, Shingle, Asphalt/Corop Fiberglass, Built up. J CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB971906 FOR 07/30/97 INSPECTOR AREA TP DESCRIPTION: REROOF 3000 SF LITE WGHT TILE PLANCK* CB971906 ICBO 4660 OCC GRP TYPE: MISC CONSTR. TYPE NEW JOB ADDRESS: 1023 DAISY AV STE: LOT: APPLICANT: CAHEY CUSTOM ROOFING PHONE: 760 591-3123 CONTRACTOR: PHONE: OWNER: PHONE: REMARKS: C/MIKE/603-8711 SPECIAL INSTRUCT: INSPECTOR TOTAL TIME: CD LVL DESCRIPTION 19 ST Final Structural ACT COMMENTS DATE DESCRIPTION 071697 Roof/Reroof ***** INSPECTION HISTORY ***** ACT INSP COMMENTS AP TP COMPENSATION INSURANCE FUND r PO BOX 420807, SAN FRANCISCO, CA 94142-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE POLICY NUMBER CERTIFICATE EXPIRES OQOGZ--„ , ._> , L ~ - ~ 7'''' PAL-L CM-IS SYSTEMS ap V-.AJ DIHGO ir.-c 922'5 - F CHESAPEAKE "-RI/E SAN OIE30 CA 92123 SIB ALL OPERATIONS 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 EMPLOYER'I- LIABILITY LIMIT INCLUDING DEFENSE COSTS' $1,000=000 PER OCCURRENt EMPLOYER r CAHEY C'J-TOM ROOF IN 3 30^8 VIA MAPIFCS^ CARLSR^L' C^ "^OO0 < A BLUE PATTERNED BACKGROUND SCIF 10262 (REV. 3-95