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HomeMy WebLinkAbout1745 CEREUS CT; ; CB023131; Permit0-17-2002 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No: CB023131 Building Inspection Request Line (760) 602-2725 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: 1745CEREUSCTCBAD MISC 2155164200 $2,664.00 Subtype: REROOF Lot #: 0 WILSON RES 2400 SF REROOF SHAKE TO COMP SHINGLES Applicant: PIVA ROOFING, BOB 1192 INDUSTRIAL AV ESCONDIDO, CA 92029 619-745-4700 Owner: Status: ISSUED Applied: 10/17/2002 Entered By: SB Plan Approved: 10/17/2002 Issued: 10/17/2002 Inspect Area: 8953 10/17/02 0002 01 02 CGP ??,00 WILSON RUSSELL S&PAULA S 230 SEEMAN DR ENCINITAS CA 92024 Total Fees:$77.00 Total Payments To Date:$0.00 Balance Due:$77.00 Miscelaneous Fee #1 Miscelaneous Fee #2 Additional Fees TOTAL PERMIT FEES PERMIT FEE $77.00 $0.00 $0.00 $77.00 Inspector: FINAL APPROVAL Date: l^/3 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 FOR OFFICE USE ONLY PLAN CHECK EST. VAL. Plan Ck. Deposit Validated C'ereus Address (include Bldg/Suite #)Business Name (at this address) Legal Description Lot No.Subdivision Name/Number Unit No.Phase No.Total tt of units Assessor's Parcel tt Existig Use Proposed Use 5.5 Description of Work . SQ. FT. #of Stories gj^^y,^^™^gg^gg^^^|.g^gj.gj^,^j r',-1,, '£.'!• t'!«• "' * • ', ,, tt of Bedrooms of Bathrooms Name Address City 3*f7APPLICANT,, JS Contractor t 'C^Agent for Contractori '[3.Owr|6r ~ df Agent for Owner Av? State/Zip Telephone if Fax # Name Address City State/Zip CA 9X& Telephone tt Name Address City State/Zip Telephone tt 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 [$5001). jSblij r/W*} KOerW/ldl Name — J . State License tt t7\lo75'o Jf?9~-3s4w£~frMi #v£ Address License Class C.37 ^ttwdftl* £n iffd^ir •7&> -7V5- ^7^0 City State/Zip Telephone # City Business License # f^O"SI 7 % Designer Name State License # Address — ' City State/Zip Telephone Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: (~1 1 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. ^6j,_ 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 ^5\C{~T^- rtSl/)w Policy No. 7& ~// oO<^ ~~ (^gj. Expiration DateJ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) ^ SL 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 Tobecome 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 additiontothe cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE ^^T^-" -^-^-^^ ' ; DATE 10/1*7/6 D* I hereby affirm that I am exempt from the Contractor's License Law for the following reason: Q 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). (~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. CD YES [~|NO 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 ijcpjyigiiji&li^^ ' * • > , - - - - 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 CU 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 O NO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Q YES d 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. reV'f CONSTRUCTION LENDING AGENCY " '"'" > „ ,'„ ^ T,~V ' „>'"' 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 _ ' LENDER'S ADDRESS _ 19™' APPLICANT 'CERTIFICATION- V , „', ,,1 ".,.,••"• ^ '"' , , ,, ,, , K tJ 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 180 days from the date of such permit or if the building or work authorized by such permit is suspended or abandoned at any lime after the work is commeoce^for a periocUjLlBO days (Section 106.4.4 Uniform Building Code). , / ft /1 7/01 _APPLICANT'S SIGNATURE DATE WHITE: File YELLOW: Applicant PINK: Finance * ' City Of Carlsbad SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING 1, JOB ADDRESS: 77^5 2. TYPE OF BUILDING: RESIDENTIAL X COMMERCIAL 3. ROOF SLOPE: RISE 7-A inches In 12 inches 4. NUMBER OF EXISTING ROOF COVERING (circle one) (J> 2 5. TYPE OF EXISTING ROOF COVERING 5^^ SHEATHING *6. NEW ROOF MATERIAL CoMf CLASS3^O WEIGHT PER SQUARE 7. NUMBER OF SQUARES. 8. TRADE NAME CP^\f /rtflg MANUFACTURER GWWS &rfi\*M 9. ROOF SYSTEM LISTING ULNo. rW ICBO No. 10. IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? ) 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. Sionatura //^^T^f^ Dafe_ / T Contraetor X Owner Contractor Name/M //V^? J^C^I/1L *6 • Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other. City of Carlsbad Bldg Inspection Request For: 11/12/2002 Permit# CB023131 Title: WILSON RES 2400 SF REROOF Description: SHAKE TO COMP SHINGLES Inspector Assignment: JE 1745 CEREUSCT Lot Type:MISC Sub Type: REROOF Job Address: Suite: Location: APPLICANT PIVA ROOFING, BOB Owner: WILSON RUSSELL S&PAULA S Remarks: Phone: 7607454700 Inspector: Total Time: CD Description 19 Final Structural Act ^Comments Requested By: BOB PIVA ROOF Entered By: CHRISTINE Associated PCRs/CVs Inspection History Date Description Act Insp Comments 10/25/2002 15 Roof/Reroof AP JE OK TO COVER a.-? - ACORZ CERTIFICATE OF LIABILITY INSURANCE PRODUCER- (61-9)584-6400 FAX (619)584-6425 West! and Insurance Brokers 3838 Camino Del Rio North #315 P,0. Box 85481 ~ g Diego, CA 92186-5481 ,.=o Bob Piva Roofing 1192 Industrial Avenue Escondido, CA 92029 I . . DATE (MM/DD/YY) 06/04/2002 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/CEIC 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 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, EXCLUSIONS AND CONDITIONS OF SUCH POLICIES. AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. INSFLTR A B "T C TYPE OF INSURANCE GENERAL LIABILITY X COMMERCIAL GENERAL LIABILITY | CLAIMS MADE | X | OCCU GEN'L AGGREGATE LIMIT APPLIES PER "H POLICY) ljpERc°f r~Uoc AUTOMOBILE LIABILITY X X X ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWN ED AUTOS JARAGE LIABILITY ANY AUTO EXCESS LIABILITY _J OCCUR | | CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OTHER POLICY NUMBER K2HA120557 CBP9497628 6-11802-02 POLICY EFFECTIVDATE (MM/DD/YY 06/01/2002 06/01/2002 06/01/2002 POLICY EXPIRATIODATE (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 4 ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGG COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY Per accident) PROPERTY DAMAGE Per accident) AUTO ONLY - EA ACCIDENT OTHFR THAN ^ ACC AUTO ONLY: AGQ EACH OCCURRENCE AGGREGATE V 1 WC STATU- 1 |OTH-A I TORY LIMITS! I ER .L. EACH ACCIDENT .L. DISEASE - EA EMPLOYEE .L. DISEASE - POLICY LIMIT $ 1,000,000 s 50,000 s excludec $ 1,000,000 $ 2,000,000 * 1,000,000 1,000,000 $ S - ) s 1,000,000 1,000,000 1,000,000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROVISIONS *E: \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 //€^^^/8^ 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 ^-p? . . ,/ Robert Kempa/DOYR to-^*— ACORD 25-S (7/97) ©ACORD CORPORATION 1988