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Home My WebLink About2841 CEBU PL; ; CB052971; Permit08-16-2005 City of Carlsbad 1635 Faraday Av Carlsbad, CA 92008 Miscellaneous Permit Permit No CB052971 Building Inspection Request Line (760) 602-2725 Job Address Permit Type Parcel No Valuation Reference # Project Title 2841 CEBUPLCBAD MISC 2153202501 $570 00 Subtype REROOF Lot# 0 MAYNARD RES-500 SF COMPOSITION FING UNO REAL CA 92064 760-577-2935 Status ISSUED Applied 08/16/2005 RMA 08/16/2005 08/16/2005 Entered By Plan Approved Issued Inspect Area Owner MAYNARD JOHN 2841 CEBU PL CARLSBAD CA 92009 Misce Ian ecus Fee #1 PERMIT FEE Miscelaneous Fee #2 Additional Fees $3000 $000 $000 TOTAL PERMIT FEES $3000 Total Fees $30 00 Total Payments To Date $000 Balance Due $30 00 4854 08/16/05 0002 03 02 Inspector FINAL Date VAL Clearance NOTICE Please take NOTICE that approval of your project includes trie "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as lees/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 m connection with this project NOR DOES IT APPLY to any fees/exactions of which you have previously been qiven a NOTICE similar to this, or as to which the statute of limitations has previously otherwise_expjred PERMIT APPLICATION > CITY OF CARLSBAD BUILDING DEPARTMENT 1635 Faraday Ave , Carlsbad, CA 92008 1, Address (include Bldg/Suite ft) FOR OFFICE USE ONLY PLAN CHECK NO _ EST, VAL Plan Ck Deposit Validated Date Business Name (at this address) Legal Description Lot No Subdivision Name/Number Unit No Phase No Total # of units Assessor's Parcel #Existing Use A/A— Proposed Use Description of Work SO FT #of Stories of Bedrooms # of Bathrooms Sou Nam Address >3./} APIUCANT V' t3 Contactor,: • Q Agent for IO Owner City Agent for" Owner1* >,, '? State/Zip Telephone tt Fax # (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 otSection 7031 5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars 15500]} Uame State License # Address License Class City State/Zip Telephone # City Business License # /"2Jl/$ Designer Name State License # Address City State/Zip Telephone Workers' Compensation Declaration I hereby affirm under penalty of perjury one of the following declarations |~) I have and will maintain a certificate of consent to self-insure for workers' compensation as provided by Section 3700 of the Labor Cods, for the performance of the work for which this permit is issued 0 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 carneuind poUcy nurntoer are / Insurance Company fyjLAA $LLA£jfa<-{ (v *7\ ^ft/Ufa Policy No lAJ<£jQ<tT)}C)ty\ OOQ02~ Expiration Date^y 0JT" (THIS SECTION NEED NOT BE COMPLETED IF THE PERMITW FORGONE HUNDRED DOLLARS l$100] OR LESS) [~) 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 dollar*1{8.100,000}, urrtddition to the cost of compensation, damages as provided for In Section 3706 of the Labor code, interest and attorney's fees SIGNATURE ^iljL(A^]fty_l A\ " DATE *% ' I S'Q V 1 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) Q 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 | 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 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 fj NO Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Q YES O NO l& the facility to be constructed within 1,000 feet of the outer boundary of a school site? Q YES Q 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 OP EMERGENCY SERVICES AND THE AIR POLLUTION CONTROL DISTRICT I hereby affirm that there is a construction lending agency for the performance of the work for which this permit is issued (Sec 3097d) Civil Code) LENDER'S NAME LENDER $ ADDRESS '»wi^u^ <'..#* f .*rtji,i^"lf.1.', -%,"^^ ^tr.^ '**>*, i .."' '» <<ov *- 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 1 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 180 days from the date ol such permit or if the building or work authonzed by such permit is suspended or abandoned at any time after the work is commented/for a period oL180 days (Section 106 4 4 Uniform Building Code) APPLICANT'S SIGNATURE DATE WHITE File YEULOW Applicant PINK Finance City Of Carlsbad SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING 1. JOB ADDRESS:_/9ff*J 1 (khu 2. TYPE OF BUILDING: RESIDENTIAL ^ COMMERCIAL 3. ROOF SLOPE: RISE t (9 inches in 12 inches 4. NUMBER OF EXISTING ROOF COVERING {circle one) X) 2 3 5. TYPE OF EXISTING ROOF COVE RING ffikJlP SHEATHING *6. NEW ROOF MATERIAL/fryVlp S\\in4&LASS^_WElGHT PER SQUARE 7. «M»MBgR OF SQUARES <T 8. TRADE NAMEj^4M4 MANUFACTURER. 9. ROOF SYSTEM LISTING UL No. ICBO No. . 10. IS THE EXISTING STRUCTURAL DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? XES) 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: -f 1. Tear Off/Pre-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. Signature M [k^$ Pate Contractor Owner Contractor Name—• 11... i( *6 - Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other. City of Carlsbad Bldg Inspection Request For 09/06/2005 Permit* CB052971 Title MAYNARD RES-500 SF COMPOSITION Description Type MISC Sub Type REROOF Job Address 2841 CEBU PL Suite Lot 0 Location APPLICANT PATRIOT ROOFING Owner MAYNARD JOHN Remarks Inspector Assignment JM Phone 7608456191 Inspector Total Time CD Description 19 Final Structural Act Comment Requested By EILEEN Entered By JANEAN Associated PCRs/CVs Inspection History Date Description Act Insp Comments 08/23/2005 15 Roof/Reroof AP JM OK TO COVER ACORD^ CERTIFICATE OF LIABILITY INSURANCE oft^ooT"1 PRODUCER Gaslamp Insurance Services 739 4th Avenue, suite 206 San Diego, CA 92 101 INSURED Patriot Roofing, Inc 2131 Las Palmas Drive Suite E Carlsbad, CA 92009 i (619)238-4367 (61 9) 238-4387 fax License #716994 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 ProBuilders Specialty Insurance Company, RRG INSURER B Reinsurance Company of America, Inc INSURER C INSURER D INSURER E COVERAGES THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABQVE 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 IN3R LTR A B TYPE OF INSURANCE GENERAL LIABILITY y COMMERCIAL GENERAL LIABILITYmnr~iCLAIMS MADE l^ | OCCUR GEN L AGGREGATE LIMIT APPLIES PER7i poucv n^ rue AUTOMOBILE LJABIL/TY ANY AUTO ALL OWNED AUTOS SCHEDULED AUTOS HIRED AUTOS NON-OWNED AUTOS OARAGE LIABILITY ANY AUTO EXCESS LIABILITY J OCCUR j j CLAIMS MADE DEDUCTIBLE RETENTION $ WORKERS COMPENSATION AND EMPLOYERS' LIABILITY OTHER POLICY NUMBER CIWS 5004775 WC0501040100002 POLICY EFFECTIVEHATE IMMmn/YY) 06/17/2005 05/01/2005 t>OLICY EXPIRATION_ DATE IMMIDD/YYl 06/17/2006 09/30/2005 LIMITS EACH OCCURRENCE FIRE DAMAGE [Any ona tire) MED EXP (Any one person) PERSONAL & ADV INJURY GENERAL AGGREGATE PRODUCTS - COMP/OP AGO COMBINED SINGLE LIMIT (Ea accident) BODILY INJURY (Por person) BODILY INJURY{Per accident) PROPERTY DAMAGE(Per accident) AUTO ONLY - EA ACCIDENT AUTO ONLY AQG EACH OCCURRENCE AGGREGATE _/ WCSTATU- 1 OTH-» TORY LIMITS! ER E L EACH ACCIDENT EL DISEASE EA EMPLOYEE E L DISEASE - POLICY LIMIT j 1,000,000 $ excluded , 5,000 , 1,000,000 $ 1,000,000 $ 1,000,000 $ $ $ * s s $ $ *$ $ s , 1,000,000 $ 1,000,000 s 1,000,000 DESCRIPTION OP OPERATIONS/LOCATIONS/VEHICLES/EXCLUSIONS ADDED BY EN DORS EMEN ESPECIAL PROVISIONS CERTIFICATE HOLDER ! ADomoNAL INSURED, INSURER LETTER Patriot Roofing, Inc 2131 Las Palmas Drive Suite E Carlsbad, CA 92009 License # 7 1 6994 i CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED B DATE THEREOF, THE ISSUING INSURER WILL ENDEAVOR TO MAIL NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FA IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE IN REPRESENTATIVES EFORE THE EXPIRATION 30 DAYS WRITTEN ILURE TO DO SO SHALL SURER ITS AGENTS OR AUTHORIZED REPRESENTATIVE Brenda Jo Robyn ACORD 25-S (7/97)Q ACORD CORPORATION 1988