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2011 CUMBRE CT; ; CB002538; Permit
07/10/2000 City of Carlsbad Miscellaneous Permit Permit No CB002538 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Valuation Reference # Project Title 2011 CUMBRECTCBAD MISC 2164912300 $3,224 00 Subtype REROOF Lot# 0 PERRY RES-3100 SF COMPOSITION Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 07/10/2000 RMA 07/10/2000 07/10/2000 Applicant PACIFICA ROOFING INC 1615 VALENCIA OCEANSIDE, CA 92054 760-966-2600 Owner PERRY STEVE&BARBARA M 2011 CUMBRE CT CARLSBAD CA 92009 2376 07/10/00 0001 01 02 C-PRHT 102.00 Total Fees $102 00 Total Payments To Date $000 Balance Due $10200 Miscelaneous Fee #1 Miscelaneous Fee #2 TOTAL PERMIT FEES PERMIT FEE $10200 $000 $10200 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 CITY OF CARLSBAD 2075 Las Palmas Dr., Carlsbad, CA 92009 (760) 438-1161 PERMIT APPLICATION . *V CITY OF CARLSBAD BUILDING DEPARTMENT 2075 Las Palmas Dr , Carlsbad CA 92009 (760)438-1161 PROJECT INFORMATION FOR OFFICE USE ONLY PLAN CHECJ^NO EST VAL Plan Ck Deposit {_ Validated By Date 1 __^c; . 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 Description of Wor SQ FT3; 00 #of Stories # of Bedroamy # of Bathrooms CONTACT PERSON (if different from applicant) Name Address 3 APPLICANT ^Jcontractpr ,O: Agent for Contractor Owner City Agent for Owner State/Zip Telephone #Fax Name ,4 PROPERTY OWNER Address '0// C City State/Zip Telephone # CT Name Address 5'- CONTRACTOR - COMPANY NAME 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 penaltyof not more than five hundred dollars [$500]) AboMfc ArS LJAUSMSiA P'OPT Name State License # // y/ * Address ^* Tr J License Class \^» ^^ !7 City State/Zip City Business License #X<3 1 Telephone # OS3y«5Lr Designer Name Address City State/Zip Telephone State License tt 6 WORKERS' COMPENSATION Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations l~l 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 ^S 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 ^STlyO 1 ^S t* 1/^Uj Policy No (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$1001 OR LESS) I I 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 mUnUuiito the cost of compensation damages as provided for in Section 3706 of the Labor code interest and attorney s fees SIGNATURE _^^^~^ DATE ^/ /0/OQ ^ OWNER-BUILDER DECLARATION I hereby affirm that I am exempt from the Contractor's License Law for the following reason n 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 Q YES l~lNO 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 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 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? d YES O 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 ^.J CONSTRUCTION LENDING AGENCY . " \ " •„. ' 1 I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097(0 Civil Code) LENDER'S NAME _ 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 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 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 f <^ periol^ of 180 days (Section 106 4 4 Uniform Building Code) APPLICANT'S SIGNATURE WHITE YELLOW Applicant PINK Finance DATE City Of Carlsbad SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING 1. JOB ADDRESS: -SO M CvW&jV£ ^^T 2. TYPE OF BUILDING: RESIDENTIAL Y COMMERCIAL 3. ROOF SLOPE: RISE ' inches in 12 inches 4. NUMBER OF EXISTING ROOF COVERING (circle one) Cj) 2 3 5. TYPE OF EXISTING ROOF COVERING W^ SHEATHING *6. NEW ROOF MATERIAL^ ^^ CLASS J) WEIGHT PER SQUARE ^3 O O 7. NUMBER OF SQUARES -3 I7^ 8. TRADE NAME ^jLJ<? MANUFACTURER 9. ROOF SYSTEM LISTING UL No. __ ICBO No. -S"4 / 10. IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? (^EsV 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 feast 2 rungs above the roof for inspection. Signature _ S ^^ _ Date "Contractor " Owner _ Contractor Name *6 - Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other. City of Carlsbad Bldg Inspection Request For 7/17/2000 Permit* CB002538 Title PERRY RES-3100 SF COMPOSITION Description Inspector Assignment SR Type MISC Sub Type REROOF Job Address 2011 CUMBRE CT Suite Lot 0 Location APPLICANT PACIFICA ROOFING INC Owner PERRY STEVE&BARBARA M Remarks Phone 7609662600 Inspector Total Time CD Description 19 Final Structural Act Comments Requested By JOHN Entered By CHRISTINE Associated PCRs Inspection History Date Description Act Insp Comments License Detail Page 1 of 2 rAt IFORNIA CONTRACTORSSTATF i irrrisr License Detail Contractor License # 630120 DISCLAIMER A license status check provides information taken from the CSLB license data base Before relying on this information, you should be aware of the following limitations • CSLB is prohibited by law liom disclosing complaints until they arc referred tor legal action • Per B&l'7071 17 only construction related civil judgments known to the CSLB art disclosed • Arbitrations are not listed unless the contractor fails to comply with the terms of the arbitration • Due to workload there may be relevant information that has not yet been entered onto the Board's license data base Extract Date 10/31/2001 * * * Business Information * * * A & J FOSTER INC P O BOX 2758 ELCAJON, CA92021 Business Phone Number (619) 390-4477 Entity Corporation Issue Date 10/07/1991 Expire Date 10/31/2003 * * * License Status * * * This license is current and active AH information below should be reviewed. * * * Classifications * * * Class |C36 Description [PLUMBING * * *Certifications * * Cert HIC Description HOME IMPROVEMENT CERTIFICATION A A * Bonding Information A * * CONTRACTOR'S BOND: This license filed Contractor's Bond number 1002375 in the amount of S7,500 with the bonding company http //www2 cslb ca gov/CSLB_LIBRARY/License+Detail asp?LicNum=630120 10/31/01 License Detail Page 2 of 2 SURETY COMPANY OF THE PACIFIC Effective Date 07/01/1994 Contractor's Bonding History BOND OF QUALIFYING INDIVIDUAL(l): This license filed an exemption certificate for the Responsible Managing Officer (RMO) ARLEN KEITH FOSTER certifying that he/she owns 10 percent or more of the voting stock/equity of the corporation A bond of qualifying individual is not required Effective Date 10/07/1991 * * * Workers Compensation Information * * * This license has workers compensation insurance with the STATE COMPENSATION INSURANCE FUND Policy Number 467-0000713 Effective Date 05/01/2001 Expire Date 04/01/2002 Personnel listed on this license (current or disassociated) are listed on other licenses. Personnel List Other Licenses License Number Request Contractor Name Request Personnel Name Request Salesperson Request Salesperson Name Request 0^*5? coMiACi us A puniic =P-VICT of ihp Contiac'O'S sStatc1 L cense Board Copyrght ^ 2001 Ah nqhts re«p-vpd L<isl Upcjied IO'Ob'20C1 http //www2 cslb ca gov/CSLB_LlBRARY/License+Detail asp7LicNum=630120 10/31/01 COMPENSATION INSURANCE FUND PO BOX 420807, SAN FRANCISCO, CA 94142-0807 CERTIFICATE OF WORKERS' COMPENSATION INSURANCE JflNUflRY 1, £«KW r CONTRACTORS STATE LICENSE BOARD fiTTN: WORKERS' COMP. UNIT BOX £6000 , SflCRflMENTS Cfl, 95325 L POLICY NUMBER CERTIFICATE EXPIRES £85-00 UNIT 0001489 1-1-01 JOB: LIC #7191*3 31/01:,'00-01/01/01 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 contract or other document with respect to which this 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 '£Z^l4Zj2--*^~s AUTHORIZED REPRESENTATIVE PRESIDENT EMPLOYER'S. LIABILITY LIMIT INCLUDING DEFENSE COSTS: $1,000,008 PER OCCURRENCE. r f'COFICfi ROOFINB INC 1615 VflLENCIft- STREET OCEflNSIDE CA 32©54 UP THIS [DOCUMENT HAS A BLUE PATTERNED BACKGROUND SCIF 10262 (REV. 3-95)^: