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Home My WebLink About1031 DAISY AVE; ; CB972138; PermitBUILDING PERMIT 08/01/97 09 14 Page 1 of 1 Job Address 1031 DAISY AV Suite- Permit Type MISCELLANEOUS Parcel No. 214-401-21-00 Lot# • Valuation- 6,8.10 Occupancy Group- Description: REROOF 3000 SF, ICBO 5121 Permit No Project No Development No CB972138 A9702704 7&M 31 01 Referenced NATUREGAURD Appl/Ownr **Fee: • SAN DIEGO ROOFING 625 NORTH AVENUE VISTA, CA 92083 Required *** Construction Type• Status. Applied Apr/Issue Entered By •TO o 700 J-SLOQ— NEW ISSUED 08/01/97 08/01/97 JM Fees Collected & Credits Fees Adiustments . Total Fees Fee description 149.00 . 00 149.00 Total Credits . Total Payments Balance Due: Units Fee/Unit 00 00 149. 00 Ext fee Data Miscellaneous Fee #1 * MISCELLANEOUS TOTAL 149 00 149.00 PERMIT FE 149 00 PERMIT HAS'EXPIRED. IN ACCORDANCE WITH U.B.C SECTION 303 (d) .^-SIGNATURE— DATE CITY OF CARLSBAD 2075 Las Palmas Dr , Carlsbad, CA 92009 (619) 438-1161 'ERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr, Carlsbad CA 92009 (760)438-1161 1 PROJECT INFORMATION Q 3 i A FOR OFFICE USE OIML PLAN CHECK NO EST VAL Plan Ck Deposit Validated By. Date Address (include Bldg/Suite #) Legal Description Assessor s Parcel #-. r> •€_ C o ov Description of Work / Lot No Subdivisio ^4Existing Use ' " 30 SQ FT Business Name (at. this address) / — ^Name/Number / { #of Stories ^^~ "Onit No Phase No ~&y^j&^ D Mjtipij'2-' Proposed Use 3 # of Bedrooms Total # of units ^# of Bathrooms CONTACT PERSON (If different from applicant) Name Address City a APPLICANT JEJ[ Contractor O Agent fdf&ontraetbr:'-* Q Owner "'" Q Agent for Owner" '^ State/Zip Telephone # Fax # 2-<r i/. Name 4 PROP! /l/dl_ OWNER Address 031 City State/Zip Telephone ft Name Address ' City State/Zip Telephone # 5 CONTRACTOR- COMPANY NAME "•"*"-ai -" ' -" " r- "••" '•'" "' '- ' •• • •' .'i: * .. — —-.,.• •. (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 7Q31 5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500]) Name * State License # C0 QU> 3 I Q Address License Class City State/Zip Telephoni City Business License # / 7 /*> ^i"7 •<* "7 k/£^ °~~^ ' Address City State/Zip TelephoneDesigner Name State License # 6 WORKERS' COMPENSATION 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 the work for which this permit is issued 5£ 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 , /1 /I/73PInsurance Company Policy No Exp,rat,on Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS ($1001 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 eny 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 coda, interest and attorney a fees SIGNATURE /Zrf&£&£^ ^^^-^?—^« ~~?^^^ DATE &~ // /^ 7 7 OWNER-BUILDER DECLARATION ^ ! I hereby affirm that I am exempt from the Contractor's License Law for the following reason 0 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, end 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 sole) 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) 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 Q 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 BUILDING PERMITS ONLY' '' '•'-'< <<M»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 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? n YES £] NO Is the applicant or future btilding occupent required to obtain a permit from the air pollution control district or air quality management district? Q YES l~l NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? O 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 ' ~ "*"T ' -"!"~••Ml'""•'"*-<"•••*- •• , .., , 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 ADDRESSLENDER'S NAME •9 APPLICANT CERTIFICATION"" '"' "'" .-""- .."•:•" "if - . ;• :r-' 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, 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 CITY OF CARLSBAD SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING 1. JOB ADDRESS IP 3 I D&.\S-, A^^~ 2. TYPE OF BUILDING:RESIDENTIAL X COMMERCIAL 3. ROOF SLOPE: RISE tf inches in 12 inches 4. TYPE OF EXISTING ROOF COVERING 4l^* k *~ SHEATHING 5. NUMBER OF EXISTING ROOF COVERINGS (circle one) (^> 2 3 *6. NEW ROOF MATERIAL /U« k*_ £ t~>\y . CLASS _ WEIGHT PER SQUARE d &> ( 7. NUMBER OF SQUARES 8. TRADE NAME & ^r^ ^c^r- MANUFACTURER 9. ROOF SYSTEM APPROVAL UL No. Other £~ (2- /— X c. G c=. 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__£f£ 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. SIGN DATE Contractor ^ Owner Contractor Name J?<=\o *6 - Rolled Roofing, Tile, Shake, Shingle, Asphalt/Comp Fiberglass, Built up. ' ACORD CE PRODUCER Murria & Frick Ir 380 Stevens Ave . , Solana Beach CA S Mark Guss Pt,,,,eNo 619-259-58 ERTIFICATE OF LIABS isurance First Floor 2075 DO FaxNo 619-259-6069 INSURED San Dxego Roofing Inc. 625 North Avenue Vista CA 92083 UT V 1 1\\ Cl 1 I S3 / U V! p C CSR TV DATE |MM/DD/YY>1 Y LMoUKAtlMlrt s^biY.3 05/22/97 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 A Western Specialty Insurance Co COMPANY B State Compensation Ins Fund COMPANYc COMPANY D COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED 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 SUBJECT TO ALL THE TERMS EXCLUSIOMS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS COLTR A B TYPE OF INSURANCE GENERALbABlUfY X COMMERCIAL GENERAL LIABILITY j CLAIMS MADE | X | OCCUR X | OWNER S &. CONTRACTOR S PROT { AUTOMOBILE UABIUTY 1 ANY AUTO 1 ALL OWNED AUTOS SCHEDULED AUTOS I HIRED AUTOS | NON OWNED AUTOS GARAGE LIABILITY ANY AUTO EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKERS COMPENSATION EMPLOYERS UABIUTY THE PROPRIETOR/ PARTNERS/EXECUTIVE OFFICERS ARE UNO INCL EXCL OTHER POUCY NUMBER WGL005254 WC145283497 POUCY EFFECTIVE DATE (MM/DO/YYI 04/28/97 01/01/97 POUCY EXPIRATION DATE (MM/DD/YY) 04/28/98 01/01/98 UMITS GENERAL AGGREGATE PRODUCTS COMP/OPAGG PERSONAL & ADV INJURY EACH OCCURRENCE 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 OCCURRENCE AGGREGATE $2, 000, 000 * 1,000,000 * 1,000,000 s 1,000,000 * 50,000 * 5,000 $ $ $ $ > * S s $ $ 1 WC S'ATU ; OTH !I TORY LIMITS 1 ER EL EACH ACCIDENT s 1,000,000 EL DISEASE POLICY LIMIT $1,000,000 EL DISEASE EA EMPLOYEE !$ 1,000, 000 DESCRIPTION OF CPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS Operations of named insured in the State of California. N.O.C. is 10 days for non-payment of premium. CERTIFICATE HOLDER CANCELLATION XXXXXXX SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF THE ISSUING COMPANY WILL ENDEAVOR TO MAIL XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT xxxxxxxxxxxxxxxxxxxxxxxxxxxxxc BUT — T0 M- SUCH Non« •"*"• """« - °— °R u— XXXXXXXXXXXXXXXXXXXXXXXXXXXXXX OF AMY K1ND UPON THF COMPANY ITS PGE'.TS Of, REPRESENTATIVES XXXXXXXXXXXXXXXXXXXXXX XX XXXXXXXXXX ACORD 25-S (1/95) AUTHORIZED REPRESENTATIVE Mark Guss T?/^/ £ ,,</,,., J ' ^ ^ ^ACORCLCORPORATiON 1988