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HomeMy WebLinkAbout1027 DAISY AVE; ; CB062013; PermitCity of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 07-14-2006 ' Miscellaneous Permit Permit No CB062013 Building Inspection Request Line (760) 602-2725 Job Address 1027 DAISY AV CBAD Permit Type MISC Subtype REROOF Status PENDING Parcel No 2144011900 Lot# 0 Applied 07/14/2006 Valuation $5,040 00 Entered By MDP Reference # Plan Approved Issued Project Title DUNLAP RESIDENCE Inspect Area 20 SQUARES OF COMP RE ROOF Applicant Owner URBACH ROOFING, INC DUNLAP PAUL F&MICHELLE M STE D-7 120 N PACIFIC ST 1027 DAISY AVE SAN MARCOS CA 92069 CARLSBAD CA 92011 760471-5065 Miscelaneous Fee #1 PERMIT $11500 Miscelaneous Fee #2 $0 00 Additional Fees $0 00 TOTAL PERMIT FEES $11500 Total Fees $11500 Total Payments To Date $11500 Balance Due $000 FINAL APPROVAL Inspector *—' *-/ 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 t-UK UM-ICt USE ONLY PLAN CHECK. NO EST VAL Plan Ck Deport Validated By Date K. NO £, fl^Q ' Address (include Bldg/Soite H]Business Name (al Uus address) Description of Work i*.i..*.v..,i.Kv»i.Tvnii,9N(lt;dllf»erant»rQm applicant) , . Kn&fP_ fy&AAC(4 4ijiS&Pr>r>u<:r"U/3r<S#*JJl>{/)&frf:> &ff Name ' Address City J3;'»i.APPLICANT vSgppttafltor.f C3 Agent tor,Contractor Q Owner Q Agent for Owner. State/Zip fefephonei Name Address City State/Zip Telephone i ±-J City State/Zip Telephone #Name Address S&^MWKB^^ • • ' ' , (Sec 7031 6 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 ajjermit subjects the applicant to a civil penalty of not more than five hundredjlollars l$500l) Name State License S /Oi) ~2- 3 Address 7 X License Class £_ . ^J> 1 City State/Zip City Business License tt 1 ^ Telephone # ^OnatfQ Designer Name State License tt Address City State/Zip Telephone Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations l~) 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.'^rfiave 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 .N'/^T^ J-ZSSlS^, Policy No "25%^"^^ ~2- " *2f3Z>%& Expiration Data ///Af (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'iefcure worker*' compensation coverage, ia unlawful, and shall subject an employer to criminal penaltleg and civil fines up to one hundred thousand dollaii ($100.060). in addition to/the coc&f copfeeiwbtion. damage* as provided for in Section 3706 of the Labor code interest and attorney's fees 'SIGNATURE //}/0<^^f; /^fJ^T^^ J DATE ~7- I hereby affirm that I am exempt from the Contractor's License Law for the following reason PI 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 ottaieu toi sale (Sec 7044, Business arid Professions Coda The Contractor's License Law does not apply to an ownet of property who builds or improves thereon and who uoes such work himself or through his own employees, provided that such improvements are not intended or offered for sale It however the building or improvement is sold within one year of completion, the owner-builder will have the burden of proving that hu did not build or improve tor tha purpose ut 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) |~l 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 Q YES QNO 2 I (have / have not) signed an application for a bjilding 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 puison 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 woik indicated (include name / address / phone number / type of work) PROPERTY OWNER SIGNATURE DATE ICOMPLETETHISi SECTION FQfiflON-afflPBWAt BUILDING. PERMITS ONLY ,_. . , ,,,.,,.,.,'...., ', ,:.;;.;-IA . , .., ., 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 Q NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? d YES Q NO Is the facility to be Constructed within 1,000 feet of the outer boundary of a school site? Q YES B 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,,. i: CONSTRUCTION LENDINCPAGENCY I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sue 30970) Civil Code) LENDER S NAME LENDER S ADDRESS &. .APPUCANT CERTIFICATION! ,< I certify that I have read the application and state that the above information is conect 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 AGKEE 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 it the building or work authorized by such permit is not commenced within 180pays from the. date ot such permit or it the building or work authorized by such permit is suspended or abandoned at any time after the work is comnwced/ror a period ol 180 daysJ&fction 106 4 4 (Jniform Building Code) V|APPLICANT'S SIGNATURE ///&(//!/&/ ^/^^-f^'^f^__^'^ DATE _ WHITE File YELLOW Applicant PINK Finance REROOFING SUPPLEMENTAL BUILDING PERMIT APPLICATION VJCX1. JOB ADDRESS: c v^CLJL. 2. TYPE OF BUILDING: RESIDENTIAL <>< COMMERCIAL 3. ROOF SLOPE: RISE ^f INCHES IN 12 INCHES 4. NUMBER OF EXISTING ROOF COVERING (CIRCLE ONE)l 2 3 5. TYPE OF EXISTING ROOF COVERING oajl^ SHEATHING A*6. NEW ROOF MATERIAL ^Q CLASS WEIGHT PER SQ. 7. NUMBER OF SQUARES 8. TRADE NAME oiAy^Q _ MANUFACTURER 9. ROOF SYSTEM LISTING 1UL-NO. OU\K'7O ICBO NO. 10. IS THE EXISTING STRUCTURAL-DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? X^YES J 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-lnspection 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 Contractor _ Owner _ Contractor Name \\ flTi/^L^V^Hl.^ \ ^ *6. Rolled Roofing, Standard/Lite Tile, Asphalt/Comp fiberglass, Built Up, Other • City of Carlsbad Bldg Inspection Request For 07/26/2006 Permit* CB062013 Title DUNLAP RESIDENCE Description 20 SQUARES OF COMP RE ROOF Type MISC Sub Type REROOF Job Address 1027 DAISY AV Suite Lot 0 Location APPLICANT URBACH ROOFING, INC Owner DUNLAP PAUL F&MICHELLE M Remarks Inspector Assignment Phone 7604715065 Inspecto. Total Time CD Description 19 Final Structural Act Comment Comments/Notices/Hold Requested By URBACH ROOFING Entered By CHRISTINE Associated PCRs/CVs Original PC# Inspection History Date Description Act Insp Comments 07/17/2006 15 Roof/Reroof AP JM ACORD CERTIFICATE OF LIABILITY INSURANCE „*£« PRODUCER Kettering-Rose Insurance 3545 Camino Del Rio S , Ste A San Diego CA 92108 Phone 619-291-7777 Fax 619-291-7776 INSURED Urbach Roofing, Inc 445 Production Street San Marcos CA 92078 DATE (MM/DDfYVYY) 06/06/06 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 INSURERS AFFORDING COVERAGE INSURER A Admiral Ins Co INSURERS Safeco INSURhRC INSURER 0 INSURER E NAIC# COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE DEEN ISSUED TO THE INSURED NAMED ABOVL 1 OK IHT POLICY PERIOD fWJICATED NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RL-SPFC1 TO WHICH 1HIS CERTIFICATE MAY Oil ISSUED OR MAY PERTAIN HIE INSURANCE AFFORnt:l> HY THE POLICIES DESCRIfirU HFRITN IS SUUJECT TO ALL. THE TERMS EXCLUSIONS AND CONDITIONS Of SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVt EJEI1N ML UUCEU BY PAID CLAIMS INSR LTR A A B B WDL 1 NSRD j TYPE OF INSURANCE X GENERAL LIABILITY X CGMMl-.KCIAl. GENERAL LIABILITY | ClAIMSMAnE | X^ OCCUR X Agg Per Project GENL AGGKt.GAIh J POLICY LIMI1 APPLIES PER ' PRO 1 1 ! JECT ! J LOC AUTOMOBILE LIAB LITY ANY AUTO Al.l UWNI.l) AUTOS X SCHCDULED AUTOS X HIRED AU1 03 X NON-OWNED AUTOS i GARAGE LIABILITY J ANYALITC EXCESS/UMBRELLA OCCUH DFUlJCIIHli: | RETEMTIOK LIABILITY CL AIMS MAIJI S WORKERS COMPENSATION AND EMPLOYERS LIABILITY ANYPROPHIl TOR/PARTNER/EXECUTIVr. orriCLH/MfFMBER EXCLUDED? If yi»s doscrltio uixtar SPECIAL PROVISIONS bulow OTHER Physical Damage POLICY NUMBER CA000009273-01 24CC1320461 24CC1320461 POLICY EFFECTIVE DATE (MWDD/YY) 06/01/06 06/01/06 06/01/06 POLIO EXPIRATION DA1E (MhVDD/YY) 06/01/07 06/01/07 06/01/07 LIMITS EACI I OCCURRENCE DAMAGE TO RENTED PREMISES (Ea oronence) MED rXP (Any one perBon) PERSONAL & ADV INJURY GENERAL. AGGHPGA1L PRODUCTS CUMP/DFAGG COMBINED SINGI E LIMIT (Ea accident) BODILY INJURY (for poraont BODILY INJURY (Pur atxi(lMi\) PROPERTY DAMAGE (Per accident) AUTO ONI Y f-AACClDENI raU,-,,-,M.M IAA';C AU 10 ONLY k<x. I.ACM OCCURRENCE: AGUREGAlt WC STATU I OTH 1ORYLIMIIS 1 tK L I F.ACH ACCIDENT E L DISEASI-. I1ALMPLOYEI C L DISbAbh POLICY LIMN > 1000000 > 100000 : excluded > 1000000 s 2000000 > 1000000 s 1000000 . 1 s I s 3 $ $ s i I $ s Phy Dam 500 Ded DESCRIPTION OF OPERATIONS / LOCATIONS / VEHICLES / EXCLUSIONS ADDED BY ENDORSEMENT / SPECIAL PROVISIONS *10 Days Notice of Cancellation Due to Non-payment of Premium Certificate holder listed as an additional insured CERTIFICATE HOLDER CANCELLATION EVIDENC Evidence of Insurance SHOULD ANY Of THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF THE ISSUING INSURER WILL ENDEAVOR TO MAIL 30* DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO DO SO SHALL IMPOSE NO OBLIGATION OR LIABILffY OF ANV KIND UPON THE INSURER. ITS AGENTS OR REPRESENTATIVES AUTHORIZED REPRESENTATIVE * j —*<^£ok^n £xxx**«*f ACORD 25 (2001/08)© ACORD CORPORATION 1988