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HomeMy WebLinkAbout1705 CATALPA RD; ; CB961795; PermitSuite Permit No: CB961795 Project No A9602531* Development No: -^ * * BUILDING PERMIT 10/2b/Sri 09 44 Page» i of 1 Job -V-dress: 1705 CATALPA RD Permit Type: RES1DENTAL ADD/AIT 059^ te/W96 000101 02 Parcel No: 215-512-17-00 Lot#: C-PRMT 228-00 Valuation 13,53b * Construction Type- NEW Occupancy Group. Referenced, Status ISSUED Description- RAISC ROOF LINE-144 SF AREA & Applied 05/18/96 RE-ROOF ENTIRE HOUSE W/PIRE TRTD WOOD Apr/Issue- 10/28/9C Entered By RMA Appi/Cwnr . PROVANSAL, JOSEPH 1705 CATALPA RD CARLSBAD CA 92009 619 438-9379 * * * Fees Required ** A Collected & Credits A A A Fees . Adjustments Total Fees: Fee description Building Permit Plan Check Strong Motion Fee A BUILDING TOTAL 25^.00 - .'10 _ '. F.ee/Unit 00 as uo 228 00 Ext fee Data 153.00 99 00 1 UO 253 00 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 (619) 438-1161 1 PERMIT from List 1 (see back) give code of Permit-Type For Residential Protects Only From List 2 (see back) give Code of Structure-Type Net Loss/Gam of Dwelling Units 2 PROJECT INFORMAnON PLAN CHECK NO.6/( \f)\ EST VAL - - PLAN CK DEPOSIT A A 'J-C- VALm.BY f(*T~ v " DATE O \ «) 1 Ot I.\ ^1 \ VV ( I * , 9 ."73 09/W9& 000^ 01 02 C-WT 25-00 FOR OFFICE USE ONLY Address /rf/iC" f\) Nearest Cross Street Building or Suite No ...... Lot No 'ff Subdivision Name/Number Tlnit No NoLEGAL THECK iitLOW IF D 2 Energy Calcs D 2 Structural Gales D 2 Soils Report D 1 Addressed Envelope PROPOSED USE DESCRIPTION OF WORK # OF BEDROOMS 3 LUNlAUl1 PEHSUN (it NAME (last name - ADDRESS STATE , ZIP CODE DAY TELEPHONE UA6TNT f'OH fYJNTJMLTK — DOWNED NAME (last naiefirst) S~~PROPEHTY OWNKR NAME (last name ADDRESS STATE (<^»_. ZIP CODE VJJ^TZ) <=/ DAY TELEPHONE 6 (JUN1KACTOK NAME (last name first)ADDRESS STATE ZIP CODE DAY TELEPHONE CITY BUSINESS LIC # NAMt (last name-tirst) DAY TELEPHONE 7. WU Workers Compensation Declaration I hereby affirm that I have a certificate" of consent to self-insure issued by the Director of Industrial Relations, or a certificate of Workers' Compensation Insurance by an admitted insurer, or an exact copy or duplicate thereof certified by the Director of the insurer thereof filed with the Building Inspection Department (Section 3800, Lab C) INSURANCE COMPANY,POLICY NO EXPIRATION DATE Certilicate of hxemption I certiiy that in the performance of the work tor 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 SIGNATURE DATE 8 (jWNhR-BUILDER DECLARATION Owner -.builder Declaration l nereDy attirm thatl am exempt trom the Con Erac tors License Law tor the tallowing reason D 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 ) D 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) D I am exempt under Section Business and Professions Code for this reason (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, commencing 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 S by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars [$SOOJ) SIGNATURE DATE COMPLETE THIS SECTION FOR NON-RESIDENTIAL BUILDING"PERMITS ONLY Is the applicant or future building occupant required to submit a business plan, acutely hazardous materials registration form or nsk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act' D YES D 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 n NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? D YES D NO IF ANY OF THE ANSWERS ARE YES, A FINAL GhRTmCATE OF OCCUPANCY MAY NOT BE ISSUED AFTER JULY 1,1989 UNLESS THE APPLICANT HAS MET OR IS MEETING TIIF. REQUIREMENTS OF THE OFFICE OF EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT. CONSTRUCTION LENDING AtitNUY 1 hereby affirm that therels a construction lending agency tor the performance ofthe work for which this permit is issued (Sec 3097(i) Civil Code) LENDER'S NAME LENDER'S ADDRESS TOJ APPLICANT OtJt I «• ICATKJN I certify that I have read the application and state that the above inlormation is correct I agree to comply with all City ordinances and btate laws relating to building construction I hereby authorize representatives of the City of Carlsbad to enter upon the above mentioned property for inspection AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SATO CITY IN CONStQUtNCE 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 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 303(d) Uniform Building Code'1 / ' APPLICANTS SIGNATURE /?//.,. - _XA 0 DATE **'-—*L WHITE: File YELLOW: Applicant PINK: Finance CITY OF CARLSBAD INSPECTION REQUEST PERMIT* CB961795 FOR 01/09/97 DESCRIPTION: RAISE ROOF LINE-144 SF AREA & RE-ROOF ENTIRE HOUSE W/FIRE TRTD WOOD TYPE: RAD JOB' ADDRESS: 1705 CATALPA RD APPLICANT: PROVANSAL, JOSEPH PHONE: PHONE: PHONE: INSPECTOR AREA PD PLANCK# CB961795 OCC GRP CONSTR. TYPE NEW STE: LOT: 619 438-9379 CONTRACTOR: OWNER: REMARKS: MW/JIM/728-8727 SPECIAL INSTRUCT: INSPECTO TOTAL TIME: CD LVL DESCRIPTION 19 29 39 49 ACT COMMENTS ST Final Structural PL Final Plumbing EL Final Electrical ME Final Mechanical ***** INSPECTION HISTORY ***** DATE DESCRIPTION 121796 Roof/Reroof 121396 Interior Lath/Drywall 121396 Exterior Lath/Drywall 121096 Rough Combo ACT INSP AP PD AP PD AP PD AP PD COMMENTS SHEATHING EsGil Corporation 'Engineers DATE 1O/23/96 a APPLICANT aCjURI^ Q FIRE JURISDICTION Carlsbad a PLAN REVIEWER a FILE PLAN CHECK NO 96-1795 SET II PROJECT ADDRESS 1705 Catalpa Rd. PROJECT NAME Provansal Residential Addition H The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's building codes The plans transmitted herewith will substantially comply with the jurisdiction's ********** codes when minor deficiencies identified below are resolved and checked by building department staff | | The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck The check list transmitted herewith is for your information The plans are being held at Esgil Corporation until corrected plans are submitted for recheck The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person The applicant's copy of the check list has been sent to Esgil Corporation staff did not advise the applicant that the plan check has been completed Esgil Corporation staff did advise the applicant that the plan check has been completed Person contacted Date contacted (by ) Telephone # REMARKS By CHUCK MENDENHALL Enclosures Esgil Corporation Q GA O CM O EJ D PC 10/14/96 trnsmtldot 9320 Chesapeake Drive, Suite 208 4- San Diego, California 92123 + (619)560-1468 + Fax (619) 560-1576 EsGil Corporation <ProfessionaC fCan Rtvicio 'Engineers DATE 9/26/96 j^-ARELHCANT ojypjs* a FIRE JURISDICTION Carlsbad a PLAN REVIEWER a FILE PLAN CHECK NO 96-1795 SET I PROJECT ADDRESS 17O5 Catalpa Road PROJECT NAME The plans transmitted herewith have been corrected where necessary and substantially comply with the jurisdiction's *********** codes The plans transmitted herewith will substantially comply with the jurisdiction's ********** codes when minor deficiencies identified below are resolved and checked by building department staff The plans transmitted herewith have significant deficiencies identified on the enclosed check list and should be corrected and resubmitted for a complete recheck XI The check list transmitted herewith is for your information The plans are being held at Esgil Corporation until corrected plans are submitted for recheck The applicant's copy of the check list is enclosed for the jurisdiction to forward to the applicant contact person X] The applicant's copy of the check list has been sent to Jim Leising 3591 Loshermanos Road Fallbrook CA 92027 Esgil Corporation staff did not advise the applicant that the plan check has been completed i Esgil Corporation staff did advise the applicant that the plan check has been completed Person contacted Jim Leising ( A^J^uOeo^ ^ACH/Aie j Date contacted rf<?6 (by K^) Telephone # 728-8727 X] REMARKS City to place their soils notice stamp on the plans By Glen Adamek Enclosures Esgil Corporation D GA a CM Q EJ n PC 9/19/96 tmsmtidot 9320 Chesapeake Drive, Suite 208 + San Diego, California 92123 4 (619)560-1468 + Fax (619) 560-1576 Carlsbad 96-1795 9/26/96 PLAN REVIEW CORRECTION LIST SINGLE FAMILY DWELLINGS AND DUPLEXES PLAN CHECK NO 96-1795 JURISDICTION Carlsbad PROJECT ADDRESS 1705 Catalpa Road FLOOR AREA 144 sq ft STORIES two HEIGHT 20 ft REMARKS DATE PLANS RECEIVED BY JURISDICTION 9/19/96 DATE INITIAL PLAN REVIEW COMPLETED 9/26/96 DATE PLANS RECEIVED BY ESGIL CORPORATION 9/19/96 PLAN REVIEWER Glen Adamek FOREWORD (PLEASE READ): This plan review is limited to the technical requirements contained in the Uniform Building Code, Uniform Plumbing Code, Uniform Mechanical Code, National Electrical Code and state laws regulating energy conservation, noise attenuation and access for the disabled This plan review is based on regulations enforced by the Building Department You may have other corrections based on laws and ordinance by the Planning Department, Engineering Department, Fire Department or other departments Clearance from those departments may be require'd prior to the issuance of a building permit Present California law mandates that residential construction comply with Title 24 and the following model codes 1994 UBC (effective 12/28/95), 1994 UPC (effective 12/28/95), 1994 UMC (effective 2/23/96) and 1993 NEC (effective 12/28/95) The above regulations apply to residential construction, regardless of the code editions adopted by ordinance The following items listed need clarification, modification or change All items must be satisfied before the plans will be in conformance with the cited codes and regulations Per Sec 106 4 3, 1994 Uniform Building Code, the approval of the plans does not permit the violation of any state, county or city law To speed up the recheck process, please note on this list (or a copy) where each correction item has been addressed, i.e.. plan sheet number, specification section, etc. Be sure to enclose the marked up list when you submit the revised plans. LIST NO 1, GENERAL SINGLE FAMILY DWELLINGS AND DUPLEXES WITHOUT SUPPLEMENTS (1994 UBC) rSforw dot Carlsbad 96-1795 9/26/96 PLANS 1 Please make all corrections on the original tracings, as requested in the correction • list Submit three sets of plans for commercial/industrial projects (two sets of plans for residential projects) For expeditious processing, corrected sets can be submitted in one of two ways a) Deliver all corrected sets of plans and calculations/reports directly to the City of Carlsbad Building Department, 2075 Las Palmas Drive, Carlsbad, CA 92009, (619) 438-1161 The City will route the plans to EsGil Corporation and the Carlsbad Planning, Engineering and Fire Departments b) Bring one corrected set of plans and calculations/reports to EsGil Corporation, 9320 Chesapeake Drive, Suite 208, San Diego, CA 92123, (619) 560-1468 Deliver all remaining sets of plans and calculations/reports directly to the City of Carlsbad Building Department for routing to their Planning, Engineering and Fire Departments NOTE Plans that are submitted directly to EsGil Corporation only will not be reviewed by the City Planning, Engineering and Fire Departments until review by EsGil Corporation is complete 2 Indicate on the Title Sheet of the plans the name of the legal owner and name of the person responsible for the preparation of the plans Section 106 3 2 3 All sheets of plans must be signed by the person responsible for their preparation (California Business and Professions Code) 4 Plans, specifications and calculations shall be signed and sealed by the California state licensed engineer or architect responsible for their preparation, for plans deviating from conventional wood frame construction Specify expiration date of license (California Business and Professions Code) 5 Provide a statement on the Title Sheet of the plans that this project shall comply with Title 24 and the 1994 UBC, UMC and UPC and the 1993 NEC 6 Show location of permanently wired smoke detectors with battery backup Inside new bedroom • ROOFING 7 Specify roof slope 8 Roof slope is not adequate for roof type specified Chapter 15 Carlsbad 96-1795 9/26/96 FRAMING 9 Bearing partitions, perpendicular to joists, shall not be offset from supporting girders, beams, walls or partitions, more than the depth of the joist Section 2326 8 5 10 Show double top plate with minimum 48" lap splice Section 2326 112 11 Provide complete existing roof framing plan for roof support over stairs Section 10633 12 Provide framing sections through the existing ridge support system Section 10633 13 Provide calculations for main vertical and horizontal framing members and footings Section 106 33 14 Provide calculations for lateral loads, shear panels, shear transfer and related Section 10633 15 In Seismic Zones 3 and 4, the allowable shear wall values for drywall in Table 25-I must be reduced 50 percent when considering earthquake loads This does not apply to wind loads Footnote 1 16 Show wall bracing Every exterior wood stud wall and mam cross-stud partition shall be braced at each end at least every 25 feet of length Section 2326 113 and Table 23-l-W 17 In 2-story buildings, shear panels at the first story (at least 48 inches in width) shall be located at each end or as near thereto as possible and comprise at least 25 percent of the linear length of the wall, or provide design Section 2326 113 and Table 23-l-W 18 Detail shear transfer connections, including roof and floor diaphragms, to shear walls Section 2314 19 Specify nail size and spacing for all shear walls, floor and roof diaphragms Indicate required blocking Maintain maximum diaphragm dimension ratios Sections 2314 and 2513 20 The existing section on sheet 2 shows the existing ridge being supported by the existing rafters cantilevered over the existing stairs The new section removes the rafters supporting the ridge without showing a new support system for the existing ridge Provide engineers design for the support of the existing ridge Carlsbad 96-1795 9/26/96 21 Show the existing floor joist size and spacing 2 x 10 @ 24 inches of center? 22 The 2x6 rafters @ 16 inches on center are over spaned Please correct • MECHANICAL (UNIFORM MECHANICAL CODE) 23 Show the size, location and type of all heating and cooling appliances or systems • ELECTRICAL (NATIONAL ELECTRICAL CODE) All wiring shall comply with the National Electrical Code 24 Show on the plan the amperage of the electrical service, the location of the service panel and the location of any sub-panels If service is over 200 amps, submit single line diagram, panel schedule and load calculations . PLUMBING (UNIFORM PLUMBING CODE) 25 Show water heater size, type and location on plans UPC, Section 501 0 26 Note on the plans that "combustion air for fuel burning water heaters will be provided in accordance with the Uniform Plumbing Code" 27 Show that water heater is adequately braced to resist seismic forces Provide two straps (one strap at top 1/3 of the tank and one strap at bottom 1/3 of the tank) UPC, Section 5100 • ENERGY CONSERVATION 28 The energy design does not match the plans The plans shows a slab on grade building addition The energy design is for a raised floor building addition Please correct 29 Provide plans, calculations and worksheets to show compliance with current energy standards 30 All energy items shown on the plans must be in agreement with the information shown on the properly completed Form CF-IR 31 For room additions, show compliance with the energy standards See attached 32 Provide a note on the plans stating "All new glazing (fenestrations) will be installed with a certifying label attached, showing the U-value " Carlsbad 96-1795 9/26/96 MISCELLANEOUS 33 To speed up the review process, note on this list (or a copy) where each correction item has been addressed, i e , plan sheet, note or detail number, calculation page, etc 34 Please indicate here if any changes have been made to the plans that are not a result of corrections from this list If there are other changes, please briefly describe them and where they are located in the plans • Have changes been made to the plans not resulting from this correction list1? Please indicate Yes Q No Q The jurisdiction has contracted with Esgil Corporation located at 9320 Chesapeake Drive, Suite 208, San Diego, California 92123, telephone number of 619/560-1468, to perform the plan review for your project If you have any questions regarding these plan review items, please contact Glen Adamek at Esgil Corporation Thank you Carlsbad 96-1795 .9/26/96 VALUATION AND PLAN CHECK FEE JURISDICTION Carlsbad PREPARED BY Glen Adamek BUILDING ADDRESS 1705 Catalpa Road BUILDING OCCUPANCY R-3/U PLAN CHECK NO 96-1795 DATE 9/26/96 TYPE OF CONSTRUCTION Vn BUILDING PORTION SFD Addition Air Conditioning Fire Sprinklers TOTAL VALUE BUILDING AREA (ft2) 144 VALUATION MULTIPLIER $9400 VALUE ($) $ 13,53600 $13,53600 [X] 1994 UBC Building Permit Fee G Bldg Permit Fee by ordinance $ 15300 [X] 1994 UBC Plan Check Fee G Plan Check Fee by ordinance $ 9945 Type of Review G Complete Review G Structural Only G Hourly G Repetitive Fee Applicable n Other Esgil Plan Review Fee $ 79 56 Comments Fire Services Review G Fire Alarm G Complete Review n Other Suppression System Esgil Fire Services Review Fee Comments $ Sheet 1 of 1 macvalue doc 5196 PLANNING/ENGINEERING APPROVALS PERMIT NUMBER ADDRESS / 7 V ^>DATE / ~~ / ^ RESIDENTIAL ADDITION MINOR (< $10,000.00) TENANT IMPROVEMENT PLAZA CAMINO REAL VILLAGE FAIRE COMPLETE OFFICE BUILDING OTHER PLANNER DATE ENGINEER DATE C.\WP51\FILES\BLDG.FRM Rev 11/15/90 £ Si £CO CD TOD Q Q >. >. >i •- C\J C-3^ =tt ft . _ .o o o Q. . O. Q- D PLANNING DEPARTMENT BUILDING PLAN CHECK REVIEW CHECKLIST Plan Check No CB J±L Address fOO ^ (\ & VcA Planner (Name) Phone (619) 438-1161 ext APN Type of Project and Use Zone _Y^-~' \ Facilities Management Zone CFD fii rJ<x ( (If property in, complete SPECIAL TAX CALCULATION WORKSHEET provided by Building Department) Legend s3 Item Complete Item Incomplete - Needs your action Environmental Review Required: YES DATE OF COMPLETION- • TYPE Compliance with conditions of approval9 If not, state conditions which require action Conditions of Approval Discretionary Action Required: YES APPROVAL/PESO NO PROJECT NO NO TYPE DATE OTHER RELATED CASES Compliance with conditions or approval9 If not, state conditions which require action Conditions of Approval California Coastal Commission Permit Required: YES i^__ NO DATE OF APPROVAL San Diego Coast District, 3111 Cammo Del Rio North, Suite 200, San Dtego, CA 92108 (619) 521-8036 Compliance with conditions of approval9 If not, state conditions which require action. Conditions of Approval n n n n Q Inclusionary Housing Fee required: YES (Effective date of Inclusionary Housing Ordinance - May 21, 1993}• \ Site Plan: 1. Provide a fully dimensioned site plan.drawn to scale Show North arrow, property lines, easements, existing and proposed structures, streets, existing street '• improvements, right-of-way width, dimensioned setbacks and existing topographical lines 2 Provide legal description of property, and assessor's parcel number Zoning: 1 Setbacks. * ' ' - " - '*'" ^ • / Front Int. Side. Street Side. Rear 2. Lot Coverage 3 Height- 4 Parking Guest Additional Comments Required ZfO Required 6'^, Required \- Q & Required /"*?' Required /\J&V~~7 So? Required ~':" " 2C Spaces Required L — Spaces Required Shown 3 o 6 Shown H ' (? Shown 1 8 ' Shown -3O' '•> Shown /OoV ~7 S 0 9^ >' Shown 7\ Shown /— Shown OK TO ISSUE AND ENTERED APPROVAL INTO COMPUTER DATE K \ADMIN\COUNTER\PLANCK FRM 1-17-96 01 Ol O.C M -X.O J= 4V 4V •- CO MC 4v — C 01 0} Z O L. o o o— • c ra ra»+- — (0 to 4-* oi I_ 4J 3 - C U-Q) NO ra TJ — • 0* TJ TJ D) •- 5 O *-C C OITJ 0 0ra ra t- c at o> M M- Q.WOn- 01 O —I- > 0) 4V 3 CO — -E 01 — • 41 ra (- ra ra E vat ra L. >*o*- Q. 4V J2 — C C CO H- — —m »••- TJ i-C *± C 01 4v 4v TJ— (M — c c_ — • atTJ ' E ro 01 "~ <v— • 01 TJ •- U 3 OJ— — • CO W -Q U3 4J ,M^ — C — OTJI— 01 41 .C jQ C41 .C 41 4v — .C.C: 4v _fi 04V 4V C 4V M •- TJ <0 41 •-M 2 c ra-c C4J eo.c 3 rat? 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COUNTY OF SAN: DIE-30 ATTN BUILDING JD€P SAN C-IE*30 CA -.92123 , ..... - 5 - 229H96 UNIT 000825&i'vk> ^POUCY^NUMBER^ ^^07-CERTIFICATE'EXPIRES^ ** ^-~(- "'' ATTN BUILDING DEPARTMENT- £|. , * * i- 5201 RUFFIN^ROADV '^-"l-Sk^^ '"*"- '^'~', „ v v / 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 contractor other document with respect to which thjs^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 - &- - * *- • f * * -.V •*• .- * i1 , .v EMPLOYER'S LIABILITY LIMIT INCLUDING 'DEFENSE COSTS ,pOO<,000 PER OCCURRED ri EMPLOYERK^.^^'^^st< ' I7 - $* w " x *>% „ * ^j! , /X JiB BUILDES - LOS HERMANOS =?OAD LLBROQK CA 92023 NR THISf DOCUMENT HAS; A-BLUE: PATTER NED BACKGROUND^SCtF-102S2(REV. 12- 08 '95 02-S3R-L P 2/2 COMPENSATION I M & U R A NCe P.O. BOX 420807, SAN FRANCISCO, CA 94142-0807 P WJ N D CERTIFICATE OF WORKERS' COMPENSATION INSURANCE MAY 6, \995 POUICY NUMBER 229-95 UNIT 82-36 CERTIFICATE EXPIRES CirYOFCARLSSADATTN BUILDING DEPARTMENT 2075 LAS PALMAS DRIVE CARLSBAD, CA 92009 u 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 b> 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 poiolea described herein is subject to all the terms, exclusions and conditions of such policies JOB ALL OPERATIONS ik, ^*^~ ' S PRESIDENT EMPLOYER'S LIABILITY LIMIT INCLUDING DEFENSE COST 5^,000,000 PER OCCURRENCE EMPLOYER r LEISING BUILDERS 3591 LOS HERMANQS RD FALL3ROOK CA 92028 NR THIS DOCUMfcMT HAS A BLUE PATTERNED BACKGROUND