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HomeMy WebLinkAbout1350 CHESTNUT AVE; ; CB981201; PermitB U I L. D I N G PERM I 04/24/98 11:32 Page 1 of 1 Job Address: 1350 CHESTNUT AV Suite Permit Type: MISCELLANEOUS Parcel No: 205-120-15-00. ' Lot*: Valuation: 3,120 Occupancy Group: Reference*: Description: RE-ROOF,3000 SF-COMPOSITION Permit No: CB981201 Project No: A9801582 Development No: .Construction Type: NEW Status: ISSUED : Applied: 04/24/98 Apr/Issue: 04/24/98 .Appl/Ownr Entered By: RMA * ** DILS ROOFING 2230 LA MIRADA DR VISTA CA 92083 Fees Required *** 760 727-6000 Fees Miscellaneous Fee #1 * MISCELLANEOUS TOTAL 10-2, 00 01 <&** . Fees: Adjustments : Total Fees : Fee description 102. • ' ". 102. 00 -• .' '00 "- ' 00 Total Credits.: Total Payments:- Balance Due.: .-'. . . Units ' Fee/Unit "trTKfTr " . 00 .00 102 .00 Ext fee JA Data 102. 00 PERMIT FEE. 102.00 HNAUAPPROVAL I; CLEARANCE. CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (619) 438-1161 PERMIT APPLICATION CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr., Carlsbad CA 92009 (760)438-1161 1. PROJECWiNFORMATION FOR OFFICE USE ONLY PLAN CHECK NO. EST. VAL. Plan Ck. Deposit Validated Date 1 ^ ( Address (include Bldg/Suite #)Business Name (at this address) Legal Description Assessor's Parcel # lf^£./nov£- Kvo-f-f/uG* Description of Work Lot No. Subdivision Name/Number Existing Use £ fepn-cz. 3ooo / SQ. FT. #of Stories Unit No. Phase No. Proposed Use 2. # of Bedrooms Total ff of units / ff of Bathrooms 2. CONTACT PERSON (if different from applicant) -*-V/STA CA Name Address ' City 3. APPLICANT J8[ Contractor Q Agent for Contractor . CD Owner Q Agent for Owner f*7s 1 i s* f) * « /~ t * i s* *^~ A . * — State/Zip Telephone Fax # Name 4. PROPERTY OWNER Address \5O City State/Zip Telephone # Name Address City State/Zip Telephone 5. CONTRACTOR - COMPANY NAME (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)1. , Name Address State License ff ^ _5 y V (3 f License Class ^- ~- City State/Zip Telephone ff3 ^-? i j fy s &'&' c*J / '• City Business License # // ^7 (*"? r% Q ^ J Designer Name Address state License t "~ City State/Zip Telephone 6. WORKERS' COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: CD 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. ^ 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 &) LX>£~ti ^ A-&> Ifc. _ Policy NoHWC ^(^O \ - Q 1_ Expiration DateA(l6. I 9 # (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) CD 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^ttKsecure uforkers'jeoinpensation coverage is unlawful, and shall subject an employer to criminal penalties and civil fines up to one hundred thousand dollars relOOjOOoMn addition tojthe cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE ~7£ f l _ DATE 7. OWNER-BUI^R pE|tARAf ION I hereby affirm that I am exempt from the Contractor's License Law for the following reason: CD 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). 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). 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. CD YES CDN0 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 TOR 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, 2B533 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? CD YES CD NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? CD YES CD 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(i) Civil Code). LENDER'S NAME NO A/£- ' 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 CitV 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 wopKTJj commenced forjj^Jerioljl of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT'S SIGNATURE WHITE: File YELLOW: Applicant PINK: Finance City Of Carlsbad SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING 1. JOB ADDRESS:. 2. TYPE OF BUILDING: RESIDENTIAL X COMMERCIAL 3. ROOF SLOPE: RISE 2*-5inches in 12 inches 4. NUMBER OF EXISTING ROOF COVERING (circle one) (^T)2 3 5. TYPE OF EXISTING ROOF COVERING//fff SHEATHING *6. NEW ROOF MATERIAL CQffr P CLASS A WEIGHT PER SQUARE 2 SO -* 7. NUMBER OF SQUARES. 8. TRADENAME)(Mf^5io^A^ MANUFACTURER 9. ROOF SYSTEM LISTING UL No._ _ ICBO No. 10. IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? YESr 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-inspection 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. Date Contractor \ Owner Contractor Name J^M-J) rt.QO 6 - Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other. CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB981201 FOR 05/13/98 DESCRIPTION: RE-ROOF,3000 SF-COMPOSITION TYPE: MISC JOB ADDRESS: 1350 CHESTNUT AV APPLICANT: OILS ROOFING CONTRACTOR: OWNER: REMARKS: C/BRENT/727-6000 AM PLEASE INSPECTOR AREA PD PLANCKf CB981201 OCC GRP CONSTR. TYPE NEW STE: LOT: PHONE: 760 727-6000 PHONE: PHONE: INSPECTO SPECIAL INSTRUCT: WANTS TO MEET INSPECTOR AT THE JOB IN THE AM - HAS LADDER. TOTAL TIME: CD LVL DESCRIPTION 19 ST Final Structural ACT COMMENTS ***** INSPECTION HISTORY ***** DATE 050898 050798 050698 050598 050498 DESCRIPTION Roof/Reroof Roof/Reroof Roof/Reroof Roof/Reroof Roof/Reroof ACT INSP AP PD CA PD CA CA CA PD PD PD COMMENTS ^AGGBQ. CERTIFICATE OF INSURANCE ISSUE DAT^^DD/YY) PRODUCER MARK RUBIN MARK RUBIN INSURANCE / ALL COM SERVICES 6313 NANCY RIDGE DRIVE SAN DIEGO CA 92121 619/642-0200 619/642-0205 INSURED OILS ROOFING 2230 LA MIRADA DRIVE VISTA, CA 92083 THIS CERTIFICATE IS ISSUED AS A MATTER OF INFORMATION ONLY AND WERCIAL INSURANCE 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 ADMIRAL INSURANCE COMPANY COMPANY B GOLDEN EAGLE INSURANCE CORPORATION COMPANY C COMPANY D (XJtflRftGlS '•- ' . -\ ,"-, .;•"'„•.",' .. • ^ >. £ >""!...." .- . . ' , THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE E . NOTWITHSTANDING ANY REQUIREMENT, TERM OR CONDITION OF ANY CONTRA PERTAIN, THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS MAY HAVE BEEN REDUCED BY PAID CLAIMS. CO * TF A '^ rf B ' B '- .- TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY fcLAIMSMADE [~j(1 OCCUR. OWNER'S & CONTRACTOR'S PROT. AUTOMOBILE LIABILITY X X X ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS GARAGE LIABILITY ANY AUTO EXCESS LIABILITY UMBRELLA FORM OTHER THAN UMBRELLA FORM WORKER'S COMPENSATION AND EMPLOYERS' LIABILITY THEPART OFF! PROPRIETOR/ iNCL :ERS ARE: X &&• OTHER POLICY NUMBER A97AG03125 CCP431901-00 NWC319301-02 EEN ISSUED TO THE INS CT OR OTHER DOCUMEN SUBJECT TO ALL THE TE POLICY EFFECTIVE DATE (MM/DD/YY) MAY 197 MAY 1 97 AUG197 LJRED NAMED ABOVE FOR T WITH RESPECT TO WHIG •RMS, EXCLUSIONS AND C POLICY EXPIRATION DATE (MM/DD/YY) MAY 1 98 MAY 198 AUG 1 98 H THIS CERTIFICATE MAY BE ISSUED OR MAY ONDITIONS OF SUCH POLICIES. LIMITS SHOWN LIMITS GENERAL AGGREGATE PRODUCTS-COMP/OP AGG. PERSONAL & ADV INJURY EACH OCCURRENCE FIRE DAMAGE(Any One Fire) MED. EXPENSE(AnyOne Persor 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 STATUTORY LIMITS EACH ACCIDENT DISEASE-POLICY LIMIT DISEASE-EACH EMPLOYEE * 1,000,000 * 1,000,000 * 1,000,000 S 1,000,000 $ 50,000 s Excluded « 1,000,000 $ $ $ s , - ' **«v" s $ $ % .,.,- ••„ *• « 1,000,000 $ 1,000,000 $ 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS •> CERTIFICATE HOLDER, OCEAN HILLS COUNTRY CLUB AKA LEISURE VILLAGE & ALL SUB ASSOCIATIONS ARE NAMED ADDITIONAL -; INSUREDS. ALL OPERATIONS OF THE NAMED INSURED. PROJECT: 4600 LEISURE VILLAGE WAY OCEANSIDE, CA 92056 l^f^^flP^E^V^r^.^'4^^p.i', , _vr ^..".£ ^£&**J$*:^SJS£ , OILS ROOFING \ 2230 LA MIRADA DRIVE % VISTA, CA 92083 Attention: SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED 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. MJTHORIZED REPRESENTATIVE •••M9R^i^v:^M0^^^«a* «" -;:?. ••'-•< - -- i .** ^*-."»\ . .':-- •- - /: ^ S.-J V 1 *« * *. X, -