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Home My WebLink About2622 COLIBRI LN; ; CB002522; Permit07/06/2000 City of Carlsbad Miscellaneous Permit Permit No CB002522 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Valuation Reference # Project Title 2622 COLIBRI LN CBAD MISC Subtype REROOF 2155341500 Lot# 0 $5,830 00 SAITO RES-2200 SF LT WT CONCRE Status Applied Entered By Plan Approved Issued Inspect Area ISSUED 07/06/2000 RMA 07/06/2000 07/06/2000 Applicant SECURE ROOF INC 7356 TRADE ST SAN DIEGO CA 92121 800 338-6868 Owner SAITO ROBERT C&ALYCE R 2622 COLIBRI LN CARLSBAD CA 92009 2143 07/06/00 0001 01 02 C-PRMT 131-00 Total Fees $131 00 Total Payments To Date $000 Balance Due $131 00 Miscelaneous Fee #1 Miscelaneous Fee #2 TOTAL PERMIT FEES PERMIT FEE $131 00 $000 $131 00 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 CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 1 PROJECT INFORMATION FOR OFFICE USE ONLY PLAN CHECK NO [ P EST VAL Plan Ck Deposit. Validated By// / Date ~ 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 /-\ ExistinaJJse 'I -c/iption of Work £-/ u" ' SO FT CONTACT PERSON (if different from applicant) .„„,;: #of Stories I ,, Proposed Use tt of Bedrooms 3 tt of Bathrooms 2L Name Address City 3 APPLICANT GETContractor Q Agent for Contractor D.Owneri1 Q Agent for Owner State/Zip Telephone #Fax # Name 4 PRQPERTY OWNER Address It £2 City State/Zip Telephone # Ad"dress City State/Zip Telephone #Name 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 Codel or that he is exempt therefrom, and the basis for the alleged exemption Any violation oiVSectioiy?031JLby any applicant for aijermit subjects the applicant^ a_£ivil penalty of ncj^more^han five hundred dollars I$500)) Name State License # Address License Class c -City State/Zi| City Business License # elephone tt Designer Name Address City State/Zip Telephone State License # .6 WORKERS'COMPENSATION : :: ;: . ,...:.. ;: ¥ ::': .„> :;: ":" .....:: ;;•-*;;; j- 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 (~1 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 g^- C^A/») fl/6 JTA SJ.tfftfi' C £ Policy No gP&^WffioO Expiration Date Q I "C?l ~^> (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) f~] 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 dollarsfRyVOO 000) in addition^ the cost of compensation damages as provided for in Section 3706 of the_Labor code interest and attorney's fees SIGNATURE C/pA— jC^tf? Ig DATE ~7~fe —QO 7 OWNER-BUILDER DECLARATION ,i I hereby affirm that I am exempt from the Contractor's License Law for the following reason O 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) O If 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) 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 [~l YES flNO 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 CdlVlPLETE THIS SECTION FOR /VO/V-/?£S/Of/VrWI BUILDING PERMITS ONLY > - ... , s,/ 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? fJ 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? d YES fj MO Is the facility to be constructed within 1 ,000 feet of the outer boundary of a school site? fJ YES l~l 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 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 _ _ _ _ 9 :. APPLICANT CERTIFICATION • ,....,,.::.••• v .. " ..... ... ::i'" ,:>-'" . • "':'.••..- ~ : ;• ::v -:" • :""-. -.1 ...... "..-,- '" 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 time after the work is commep^j for a pe/iod>Tl80 da^ (Sectioib 106 4 4 Uniform Building Code) ' APPLICANT'S SIGNATURE DATE WHITE File YELLOW Applicant PINK Finance City Of Carlsbad SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING 1. JOB ADDRESS: _ -S A I Tb 2. TYPE OF BUILDING: RESIDENTIAL COMMERCIAL _ , 3. ROOF SLOPE: RISE ^ inches in 12 inches 4. NUMBER OF EXISTING ROOF COVERING (circle one) (J> 2 3 5. TYPE OF EXISTING ROOF COVERING SflftKg. SHEATHING Sfr jb . ^T-fcdMQrH" inZJ***6. NEW ROOF MATERIAL TH^ CLASS5& WEIGHT PER SQUARE 7. NUMBER OF SQUARES 8. TRADE NAMEfR^Wg Srg MANUFACTURER 9. ROOF SYSTEM LISTING UL No. ICBO No. 10. IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? (YES) 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 c I agree to provide a ladder extending at least 2 rungs above the roof for inspection. Signature yU/g, gw _ Date Contractor _ Owner _ Contractor Name *6 - Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other. City of Carlsbad Bldg Inspection Request For 7/14/2000 Permit# CB002522 Title SAITO RES-2200 SF LT WT CONCRE Description Type MISC Sub Type REROOF Job Address 2622 COLIBRI LN Suite Lot 0 Location APPLICANT SECURE ROOF INC Owner SAITO ROBERT C&ALYCE R Remarks Inspector Assignment TL Phone 8003386868 EX 102 Inspector Total Time CD Description 19 Final Structural Comments Requested By TERESA Entered By CHRISTINE Associated PCRs Inspection History Date Description Act Insp Comments 7/7/2000 15Roof/Reroof AP TL Jul-O6-OO Ol : 19P Secure Roof^.Inc. ACORD, CERTIFICATE OF LIABII mooucen El CeunJ.no Insurance Lic0539016 3156 Vista Way, Ste 300 Oceans ide, CA 92056 760 721-3232 INSURED Secure Roof, Inc. 7356 Trade Street San Diego, CA 92121 i 858 693 73OO P . O2 LJTY INSURANCE ff/SfSi 1MB CERTIFICATE IS ISSUED AS A HATOR OP INFORMATION ONLY AND CONFERS NO RIGHTS UPON THE CfflTIFICATE HCXBSt THIS CERTIFICATE DOGS NOT AUCND, EXTEND OR ACTER THE COVBUOC AFFORDED HT THE POLICIES BaOW INaUnBHS ArrUHlAVIU CUVtHAUt MSUMERA. State Compensation Insurance Fund •OJjISJfr rautetc <HS&E*a •BUfE^c COVERAGES THE POLICES OF N3UWNCE LISTED BELOW HAVE BEEN ISSUED TO THE N9URH> HIUCTI ABOVE FOB THE POUCY PEflCO WDCATED NOTWTHSTANOUG ANY flEQUOEMENT TERM OR CONDITION OF ANY CONTRACT OR OTHER DOCLiefT VTTH RESPECT TO WHICH THJ3 CERmCATE MAY BE ISSUED CRMAY PERTAM. THE NSURANCE AFFORDED BY THE POUCCS OESCWED HEREM s SUBJECT TO ALL THE TERMS, EXQUSONS AND CONDITIONS OF SUCH POUCCS. AfiGF£(MTElMTSSNOVmMAYHAVE8EEN REDUCED BYPAO CLAMS. Mi A ITU A i HfEOF INSURANCE OE L- lap j AU - z, 1 NBULUAtiLITV COMMEflCIALaENEAAL LIABILITY | CLAIMS MAOEJ | OCCUR 1. AGOf MATE LIMIT APPllES P61 t>MO»iLEHAgillTY ANYAJTO All OWNEOAUTOS SCHEDULED AUTOS HIRED AUTOS NO* OWNEOAUTOS GARAGE LABILITY j - — 1 EXC 1 — ESS LIAtlLiTV occjB | | CLAIMS MADE OEDuCTIBlE WOflKEXS COMPENSATION AND OTHER KUICVNUUICft "S»T( \ | E1IMYOD/TT1 DATE(MM/pp/VY1 ' 285148600 01/01/00 01/01/01 ! 1 UNITS EACH OCCURRENCE FIR E OA MAO E !A»r on* Hr»| UED OO>EAnyan«pm<| PERSONAL & AOV INJURY UEMEMLAaaREOA-E paotxic's COUP/OP <aa COMBINED SINGLE LIMIT BOWLY INJURY BOOILYIHJ^KY P^OP=»TY DA WAG r t l i t i i s j t t AUTOONLY EAACCOENT.'l OTHF=TU»ly EAACC AUTO ONLY g EACMOCtXPREVCE AOQREQA7: X IWCSTATJ . p[H tTOBY'-LVlTS 1 . =•» t t » t s t 1 £L EACH ACS 06NT |ll,000,000 &!_0>ScASE eA£WP-J?YCSll,000,000 EL DISEASE =01 cr WIT tl, 000 ,000 DESCRIPTION OF OPERATlONS/LOCATlONS/VEHIClCS/EXClUSIONa ADD! D IT EMOORSEMElnvSPfC AL PROVISIONS *30 day cancellation notice except 10 days for non-payment of premium. CERTIFICATE HOLDER 1 ' ADOITWNAI MURED- NSURBUemH CANCSUATICN SHO Insurance Verification OAT •or urt RtP _ . L tar ACOR02S-S(7W)i of 2 f S52908 /M52907 UL3ANYOFr>1EAtOveDC9CII0COK>UCO«ECANCClLED(EPORETHEE)IP>RAnON ETMEPEOF IME, SSUINO INSURER W1LV ENOEAVOR TO MAlli3-Q- BAYS VKRinEN CrrOTME CERTIFICATE HOLDER NAMeOMTHt LEFT IUT FAILURE TO OOSOSHAU XEHOOtLOArONORLIAIIUTYOFANTKIMCI UTON THE INSUR£R.ITS AttEMTS OR HORCt ED REPRESENTATIVE JMW 9 ACORD CORPORAnON 190