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HomeMy WebLinkAbout1520 SANDALWOOD LN; ; CB022940; Permit09-30-20Q2 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No CB022940 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Valuation Reference # Project Title 1520 SANDALWOOD LN CBAD MISC 2051304500 $000 Subtype REROOF Lot# 0 EMBER RES 2800 SF REROOF SHAKE TOLTWTCONTILE Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 09/30/2002 SB 09/30/2002 09/30/2002 Applicant PIVA ROOFING, BOB 1192 INDUSTRIAL AV ESCONDIDO, CA 92029 6197454700 Owner 7449 09/30/02 0002 01 02 EMBER FAMILY TRUST 05 22 96 CGP 140-00 C/O LAURA EMBER 1266 STRATFORD LN * '- CARLSBAD CA 92008 Total Fees $14000 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees , Total Payments To Date $0 00 PERMIT FEEE Balance Due $14000 $000 i - $000 ' $14000 TOTAL PERMIT FEES $14000 Inspector FINAL APPROVAL Date Clearance( ' —— NOTICE Please take NOTICE tftat 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 FOR OFFICE USE ONLY PLAN CHECK NO 7,8EST VAL Plan Ck Deposit Validated By_ Date ?/Wo7 Address (include Bldg/Suite #)Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total # of units Assessor s Parcel #Existing Use Proposed Use Des SQ FT #of Stories # of Bedrooms 1. # of Bathrooms * Name Address City ontraotor^O Agent fo*r"CwiSSoi'*fLl] OwneF^ Q'Agent for Owner State/Zip Telephone #Fax # a Name'Address City State/Zip Telephone # Name Address City State/Zip Telephone # (Sec 7031 5 Business and Professions Code Any Crty 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 vinlationof Section 7031 5 by any applicant fora permit subjects the applicant to a civil penalty of not more than five hundred dollars [$500)) fyyo r/v? /v*o4-f>j<>\ /I9d3 Name — ' State License # '2^'^3'^C -flflk JT/VQ / y"7V£ Address License Class ^- J ' c$c&Ac(rfio cfi 920% City State/Zip City Business License # 1 2.0^ > 7 -go^t^q '% '- f 'TOO Telephone # ?/9t Designer Name State License t> Address City State/Zip Telephone Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations n 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 f>E, 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 insuraoge carrier and policy number are Insurance Company ^5~ftft& rk/tf[ Policy No V^-jf^^OQ- Expiration Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [*100] OR LESS) (21 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 DATE [DECLARATION "&!"&•'W"%.;\.. "fV ' _p t "" ~* '- ' ' > '• ' I hereby affirm that I am exempt from the Contractor s License Law for the following reason f~1 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) Q 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) [~| | 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 d 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 IFOR/WW/?£S/O£/ra^BUILDING,PERMITSONLY> te* I ' . „ < ' ! 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? D 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? l~l 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 __ ip-. T- ^ ~, , j™-^il!IlP9MT«JJ£n0ri teMiNG' 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 PiIi3fi!LlCANTs«CERTIF,ICAT10N ,2 „ "- ^"\Jl ^ 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 180 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 comrneated for a pepoa of 18p^fays (Section 106 4 4 Uniform Building Code) ^^Zg' ^r v*^ APPLICANT S SIGNATURE Vy*' ^ rf^~~^ -> DATE ' / / ~~ / S WHITE File YELLOW Applicant PINK Finance City Of Carlsbad SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING 1, JOB ADDRESS. 15^0 J^/^/WOQJ (jMe 2 TYPE OF BUILDING: RESIDENTIAL ^ COMMERCIAL 3 ROOF SLOPE RISE f inches In 12 inches 4, NUMBER OF EXISTING ROOF COVERING (circle one) Q 2 3 5 TYPE OF EXISTING ROOF COVERlNG^li^SHEATHING *6 NEW ROOF MATERIAL 4-1 fe CL AS S^gQ WEIGHT PER SQUARE 7 NUMBER OF SQUARES 8 TRADE NAME MANUFACTURER 9 ROOF SYSTEM LISTING UL No _ iCBO No 10. IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? <$E&) NO Ail 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 Dafe Contractor^ - _ Owner _ Contractor Name *6 • Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other City of Carlsbad Bldg Inspection Request For 10/21/2002 Permit# CB022940 Title EMBER RES 2800 SF REROOF SHAKE Description TO LT WT CON TILE Inspector Assignment PY 1520 SANDALWOODLN Lot 0 Type MISC Sub Type REROOF Job Address Suite Location APPLICANT PIVA ROOFING, BOB Owner EMBER FAMILY TRUST 05-22-96 Remarks Phone 7607454700 Inspector Total Time CD Description 19 Final Structural Act .Comments Requested By NA Entered By KAREN Associated PCRs/CVs Inspection History Date Description Act Insp Comments 10/09/2002 15 Roof/Reroof AP PY SHEATHING ACORa CERTIFICATE OF LIABILITY INSURANCE oTovSS PRODUCER (619)584-6400 FAX (619)584-6425 West! and Iiisuraice Brokers 3838 Camino Del Rio North #315 P 0 Box 85481 " 1 Diego, CA 92186-5481 ,co Bob Piva Roofing 1192 Industrial Avenue Escondido, CA 92029 I 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 Royal Surplus Lines Ins Co /Sterling West INSURERS Peerless Insurance Company/GEIC INSURER c State Compensation Insurance Fund INSURER D INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE FOR THE POLICY PERIOD INDICATED NOTWITHSTANDING MAY PERTAIN THE INSURANCE AFFORDED BY THE POLICIES DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH POLICIES AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS INSF LTR A B C TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY | CLAIMS MADE ( X [ OCCU GEN L AGGREGATE LIMIT APPLIES PER ~H POLICY) |jTc°T r~Koc AUTOMOBILE LIABILITY X X X ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON OWNED AUTOS GARAGE LIABILITY ANY AUTO EXCESS LIABILITY | OCCUR | [ CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS LIABILITY OTHER POLICY NUMBER K2HA120557 CBP9497628 6-11802-02 POLICY EFFECTIV DATE 1MM/DDAT 06/01/2002 06/01/2002 06/01/2002 POLICY EXPIRATIO DATE (MM/DD/YY 06/01/2003 06/01/2003 06/01/2003 LIMITS EACH OCCURRENCE FIRE DAMAGE (Any one fire) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS COMP/OPAGG COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY [Per accident) PROPERTY DAMAGE (Per accident) AUTO ONLY EA ACCIDENT DTHFRTHAW EA ACC AUTO ONLY AGQ EACH OCCURRENCE AGGREGATE V WCSTATU 1 OTHA TORY LIMITS | ER L EACH ACCIDENT L DISEASE EA EMPLOYEE L DISEASE POLICY LIMIT s 1,000,000 $ 50,000 s excluded $ 1,000,000 s 2,000,000 $ 1,000,000 $ ) $ s s 1,000,000] 1,000,000 1, OOO.OOOl 1 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS IE \S RESPECTS GENERAL LIABILITY THE CERTIFICATE HOLDER IS AN ADDITIONAL INSURED PER THE ATTACHED FORM '• 10 DAY NOTICE IN THE EVENT OF CANCELLATION FOR NONPAYMENT OF PREMIUM CERTIFICATE HOLDER ADDITIONAL INSURED INSURER LETTER CANCELLATION IJjMlW* 3M°1B3 /j.^ x~59 ISSUED AS EVIDENCE OF INSURANCE 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 AUTHORIZED REPRESENTATIVE ^~-~y , . ,/ Robert Kempa/JOYR to*ff— ACORD 25 S (7/97) ©ACORD CORPORATION 1988