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Home My WebLink About2604 COLIBRI LN; ; CB052166; Permit06-09-2005 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No CB052166 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Valuation Reference # Project Title 2604 COLIBRI LN CBAD MISC 2155340600 $7 250 00 Subtype REROOF Lot* 0 Status ISSUED Applied 06/09/2005 LSM 06/09/2005 06/09/2005 CARSTEA RES 25 SQUARES FROM , TILE TO CONCRETE Entered By Plan Approved Issued Inspect Area Applicant \ SAN DIEGO ROOFING 615NORTHAVE I VISTA, CA 92083 / 760 758 1800 Owner CARSTEA EUGENE D&JANE E 2604 COLIBRI LN CARLSBAD CA 92009 Miscelaneous Fee #1 PERMIT FEE Miscelaneous Fee #2 Additional Fees $14000 $000 $000 TOTAL PERMIT FEES $14000 Total Fees $140 00 Total Payments To Date $000 Balance Due $14000 Inspector f? I FIN Date VAL 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 APPL •! 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 PROJECT INFORMATION FOR OFFICE USE ONLY PLAN CHECK NO C&> EST VAL Plan Ck Deposit Validated By Date Address (include Bldg/Suite #)".IK Business Naraeiatthis.address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total tt of units Assessor s Parcel #Existing Use Proposed Use Description of Work SQ FT #of Stories tt of Bedrooms # of Bathrooms 2 CONTACT PERSON (if different from applicant) Name 3 APPLICANT Q Contractor -^-^ddress L^Xgent for Contractor City Owner Q Agent for Owner State/Zip Telephone Fax # Name 4 PROPERTY OWNER Address City State/Zip Telephone tt Address City State/Zip Telephone ffName 5 CONTRACTOR • COMPANY 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 lhat he is exempt therefrom and the basis for the alleged exemption Any uplation of Section 7031 5 b,y any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollar Name f*fj t State License « vCOl^O / ,n Address l) License Class /City ^ State/Zip City Business License # / ^ Telephone # 1^75- Designer Name State License # Address City State/Zip Telephone i 6 WORKERS' COMPENSATION Workers Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations fv^/l 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 H/l 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 Policy No Expiration Date (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) Q 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 a unlawful and shall subject an employer to cnminal penalties and civil fines up to one hundred thousand dollars f$4QO OOOJj in addition to the cost of compensation damages as provided for in Section 3706 of the Labor code interest and attorney s fees SIGNATURE \ ^^^^^^y^^" -. ^^t--^^ •f^-^^-^-'j!. DATE 7 OWNErtfBUILDER DECLARATION ^^ 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) 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 $ 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 Q 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 COMPLETE THIS SECTION FOR NON-RgSIDBVTIAL 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 C] NO Is the applicant or future building occupant required to obtain a permit from the air pollution control distric t or air quality management district? CD YES CD NO Is the facility to be constructed within 1 000 feet of the outer boundary of a school site? CD YES Cl 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 CONSTRUCTION LENDING AGENCY 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 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 ol 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 time after the work is commenced for a period of 180 days (Section 106 4 4 Uniform Building Code) V APPLICANT S SIGNATURE __l ^^i^^^r' < ^S^*-?> /^zs.*~^",~"~ DATE WHITE File YELLOW Applicant Pll City Of Carlsbad SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING 1. JOB ADDRESS-Ui CQKl5/vfo (A. 2. TYPE OF BUILDING RESIDENTIAL__L/_COMMERCIAL 3. ROOF SLOPE RISE M inches in 12 inches 4 NUMBER OF EXISTING ROOF COVERING (circle one) ($23 5. TYPE OF EXISTING ROOF COVERING -Kf<- SHEATHING *6 NEW ROOF MATERIAL Coftcr^fg CLASS^'^WEIGHT PER SQUARE 7. -NUMBER OF SQUARES 8. TRADE NAME MANUFACTURER 9 ROOF SYSTEM LISTING UL No ICBO NoT^/&G 10 IS THE EXISTING STRUCTURAL DESIGNSJJFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? (^EB 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-mspection 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 Signature;. Contractor _ Owner Contractor Name '~X£/L'~X/ *6 - Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other City of Carlsbad Bldg Inspection Request For 08/02/2005 Permit* CB052166 Title CARSTEA RES-25 SQUARES FROM Description TILE TO CONCRETE Inspector Assignment PC Sub Type REROOF 2604 COLIBRI LN Lot 0 Type MISC Job Address Suite Location APPLICANT SAN DIEGO ROOFING Owner CARSTEA EUGENE D&JANE E Remarks card is at left side by porch lite Phone 7602261800 Inspector f: Total : ime CD Description 19 Final Structural Act Comment Associated PCRs/CVs Requested By NEIL Entered By CHRISTINE Inspection History Date Description Act Insp Comments 06/29/2005 19 Final Structural CA PC PER PABLO 06/10/2005 15 Roof/Reroof AP <\~\\ EVIDENCE OF COVERAGE, Master Account Independent Staffing Solutions PO Box 446 Independence, CA 93526 Staffing Client San Diego Roofing 1351 Broadway El Cajon, Ca 92021 DATE {MIWDD/YY} 10-01-04 THIS EVIDENCE OF COVERAGE 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 COVERAGE BELOW ENTITY AFFORDING COVERAGE INSURER A Independent Staffing Solutions Occupation Indemnity and Medhca! Benefits Fund INSURERS INSURERC INSURER D INSURER E COVERAGES THE COVERAGES LISTED BELOW HAVE BEEN ISSUED TO THE ENTITY NAMED ABOVE FOR THE PERIOD INDICATED NOTWITHSTANDING ANY REQUIREMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCUMENT WITH RESPECT TO WHICH THIS CERTIFICATE MAY BE ISSUED OR IMAY PERTAIN, THE COVERAGE AFFORDED BY THE CERTIFICATE OF COVERAGE DESCRIBED HEREIN IS SUBJECT TO ALL THE TERMS EXCLUSIONS AND CONDITIONS OF SUCH COVERAGE AGGREGATE LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS [•Mr A TYPES OF COVERAGE GENERAL LIABILITY COHMERICAL OHNIBUl. LUilUTY ~^ ei>iw MADE [ | OCCUR OEH'L AaHREOATI UMtT APPUSU PER. AUTOMOBILE LIABILITY | ] ANT AUTO 8CMEIJU1.ED AUTOS NON-OWNED AUTOS 1 1 GARAGE LIABILITY 1 I AMY AUTO EXCESS LIABILITY \ | OCCUR | ~] CLAIMS MADE B DEDUCTIBLE USTENTIQN » OCCUPATIONAL INJURY INDEMNITY AND MEDICAL BENEFITCOVERAGE POLICY NUMBER ISS 10001 0301 POLICY EFFECTIVE DATE (MIWDDmr) 10/01/04 POLICY E> PER ATION DATE (UM/DD/YY) 10/01/05 LIMITS EACH OCCURRENCE FIRE DAMAGE (Any on« fire) MED EXP (Any ona person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/QP AGG COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Per person) BODILY INJURY ((Par accident) PROPERTY DAMAGE AUTO ONLY -EA ACCIDENT OTHER THAN AUTO ONLY EACH OCCURANCE EAACC AGO AGGREGATE EL DISEASE-EMPLOYEE EL DISEASE - LIMIT EL EACH ACCIDENT $ < > i 1 $ $ $ $ $ $ $ $ $ $ $ $ $ $1 MIL DESCKip HUN (Jh UKtKA IIUNSfLULAIIUNS/VbHICLES/EXCLUSIONS ADDED BY ENDORSEMENT/SPECIAL PROV SIGNS ~ "~ This coverage Is afforded only to the employees provided to the staffing client listed above Waiver of Subrogation is applicable to the above-mentioned coverage CERTIFICATE HOLDER X | * This document is to be used for either bid purposes or evidence of coverage purposes only Phone Fax- CANCELLATION SHOULD ANY OF THF ABOVE DESCRIBED COVERAGE BE CANC6LI SO BEFORE THE EXPIRATION DATE THEROr THE ISSUING ENTITY WILL I NOEAVOR TO MAIL 30J5AY8 WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT BUT FAILURE TO 130 30 SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KINO AUTHORED REPRESENTATIVE /3-0,^+JKXB~e»gf*-