HomeMy WebLinkAbout1011 DAISY AVE; ; CB011696; Permit05/09/2001
City of Carlsbad
1635 Faraday Av Carlsbad, CA 92008
Miscellaneous Permit Permit No CB011696
Building Inspection Request Line (760) 602-2725
Job Address
Permit Type
Parcel No
Valuation
Reference #
Project Title
1011 DAISY AVCBAD
MISC
2144221500
$9,554 00
Subtype REROOF
Lot# 0
SIKES RES-3400 SF LT WT CONCRE
Status
Applied
Entered By
Plan Approved
Issued
Inspect Area
ISSUED
05/09/2001
RMA
05/09/2001
05/09/2001
Applicant
SECURE ROOF INC
7356 TRADE ST
SAN DIEGO CA 92121
800 338-6868
Owner
SIKES WILLIAM R JR&PAMELA R
1011 DAISY AVE
CARLSBAD CA 92009
8858 05/09/01 0002 01 02
CGP 166-00
Total Fees $16600 Total Payments To Date $000 Balance Due $16600
Miscelaneous Fee #1
Miscelaneous Fee #2
Additional Fees
TOTAL PERMIT FEES
PERMIT FEE $16600
$000
$000
$16600
Inspector
FINAL APPROVAL
Date 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 capactiy
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
EST VAL
Plan Ck Deposit
Validated By f_
Date
I
/ rr
Address (include Bldg/Suo\\Business Name (at this address)
Name Address City
O, A;gent for Contractor '-^0 OwnerT/n^Agent fqr-Owner *;;:;--::J;i:" J:'7•••••••"•
State/Zip Telephone #Fax #
Name Address
iS\\ T
City State/Zip... ^ ••. ....
Telephone #
\o A - a I a- J 2 I
Name Address City State/Zip Telephone
(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])
Name
State License #
Address
License Class
City State/Zip Telephone tt
City Business License # ' <*Q~*>(e>S3
Designer Name
State License #
Address City State/Zip Telephone
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
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
My worker's compensation insurance carrier and policy number are ^ __
Insurance Company _ Q-^A-T-C- t~ (XAC- _ Policy No CX Q SJ-HfyVp O I Expiration Date / ~ | — O ^
(THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS)
f~l 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 cosuof compensation damages as provided for in Section 3706 of the Labor code, interest and attorney s fees
SIGNATURE ^A ---- ^^S~ W U ^~~IT -, f>T<^<L^\~ _ DATE JT^~O^ _
7:^!b^NERlUJU3ElhSECLARAfidN , • jftV . ' ^... :::' : ::"- :: y" ...:..." ..... '" ''..'-'"• " H^f'i-h,. ••- :"K ' V' "l':' "
I hereby affirm that I am exempt from the Contractor's License Law for the following reason
l~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)
f~) 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 contractors) licensed
pursuant to the Contractor's License Law)
l~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 f"l 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
'_"...*.: ;r.;.,^3S:i:?:' ' ":'I-;:..,.. 7:;h::::rf;::::- ":1; ""v,""" '..r*-^
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 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? 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
:8vKCONSTRUCTION LENDING AGENCY „ , ,..^.-Jifr-!'f:" ... =„"' . ' ...^^ ' ' ' ••':"
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 _
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'Q" 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 commencpd'for a period of 180 days (Sectiory 106 4 4 Uniform Building Code)
t KJki &ubf\\- DATE s~~ go
WHITEVFile YELLOW AVpficant PINK Finance
APPLICANT'S SIGNATURE
City Of Carlsbad
SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING
1. JOB ADDRESS: \ O I \ iJ°x v
2. TYPE OF BUILDING: RESIDENTIAL )C COMMERCIAL
3. ROOF SLOPE: RISE ^ inches in 12 inches
4. NUMBER OF EXISTING ROOF COVERING (circle one) \\) 2 3
5. TYPE OF EXISTING ROOF COVERINGS I\A^ SHEATHING .ir|«.-H\*. A ,
*6. NEW ROOF MATERIAL n^ CLASS ^-7 WEIGHT PER SQUARE
7 NUMBER OF SQUARES 3 H
8. TRADE NAME j\ O\ sr^c-p^ O MANUFACTURER £^A ^ 1
9. ROOF SYSTEM LISTING UL No. ICBO No.
10. IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN
THE WEIGHT OF THE PROPOSED ROOF9 (^§y 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 OffTPre-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.
*6 - Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other.
City of Carlsbad Bldg Inspection Request
For 06/04/2001
Permit# CB011696
Title SIKES RES-3400 SF LT WT CONCRE
Description
Type MISC Sub Type REROOF
Job Address 1011 DAISY AV
Suite Lot 0
Location
APPLICANT SECURE ROOF INC
Owner SIKES WILLIAM R JR&PAMELA R
Remarks
Inspector Assignment GG
Phone 8586937663
Inspector
Total Time
CD Description
19 Final Structural
Act Comments
Requested By TAMI
Entered By CHRISTINE
Associated PCRs
Inspection History
Date Description Act Insp Comments
05/10/2001 15Roof/Reroof AP GG 5 ROOF VENTS @ FINAL
PRODUCER
Michael Ehrenfeld Company
2655 Cammo Del Rio North, Suite 200
San Diego, CA 92108
(619) 683-9990 Fax (619) 683-9999
License #0537922
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
COMPANY COMPANIES AFFORDING COVERAGE
A State Compensation Insurance Fund
NSURED
Secure Roof, Inc
7356 Trade Street
San Diego, CA 92121
COMPANY
B
COMPANY
C
COMPANY
D
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
EXCLUSIONS AND CONDITIONS OF SUCH POLICIES LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS
CO
LTR TYPE OF INSURANCE POLICY NUMBER
POLICY EFFECTIVE
DATE (MM/DOIYY)
POLICY EXPIRATION
DATE (MMJDO/YY)LIMITS
GENERAL LIABILITY
COMMERCIAL GENERAL LIABILITY
~J CLAIMS MADE | [OCCUR
OWNER'S 4 CONTRACTOR'S PROT
GENERAL AGGREGATE
PRODUCTS - COMP.'CP AGG
PERSONAL S> ADV INJURY
EACH OCCURRENCE
FIRE DAMAGE (Any one fire)
MED EXP (Anyone person)
AUTOMOBILE LIABILITY
ANY AUTO
AU. OWNED AUTOS
SCHEDULED AUTOS
HIRED AUTOS
NON-OWNED AUTOS
COMBINED SINGLE UMIT
BODILY INJURY
Per Person)
BODILY INJURY
Per Accident)
PROPERTY DAMAGE
GARAGE LIABILITY
ANY AUTO
AUTO ONLY - EA ACC.CENT
OTHER THAN AUTO ONLY
EACH ACCIDENT
AGGREGATE
EXCESS LIABILITY
R UMBRELLA FORM
OTHER THAN UMBRELLA
EACH ACC.DENT
AGGREGATE
WORKERS COMPENSATION
EMPLOYERS LIABILITY
THE PROPRIETOR/
PARTNERS/EXECUTIVE
OFFICERS ARE.
<VC iTATU j
TORY LIMITS I
Gin
cp
X INCL 285 1486 01 01/01/2001 01/01/2002 L EACH ACC.DENT S1.JOO.OOO I
L DISEASE POLICY LIMIT S1.000.000
EL DISEASE-cA EMPLOYEE S1.000.000
OTHER
DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS
RE All Operations of the Named Insured performed for the Certificate Holder
^.CANCELLATION
Evidence of Insurance Coverage
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 JilND UPON THE COMPAiyY /TS AGENTS OR REPRESENTATIVE
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