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Home My WebLink About2090 AVENUE OF THE TREES; ; CBR2020-2223; PermitPrint Date: 11/25/2020 Permit No: CBR2020-2223 Building Permit Finaled Residential Permit Job Address: Permit Type: Parcel #: Valuation: Occupancy Group: 2090 AVENUE OF THE TREES, CARLSBAD, CA 92008-1104 BLDG-Residential 1562903000 $10,277.78 Work Class: Lot #: Project #: Reroof Status: Applied: Issued: 09/11/2020 09/11/2020 Finaled Close Out: #of Dwelling Units: Track #: Plan #: Closed - Finaled MColl Plan Check #: Project Title: Inspector:Orig. Plan Check #:Bathrooms: Description:LIFT AND RELAY 23 SQ CONCRETE TILE (E-REVIEW) Final Inspection:11/25/2020 Bedrooms:Construction Type: Property Owner: DESIREE EVANS-CLAASSEN 818 VIVA CT SOLANA BEACH, CA 92075 Contractor: SEMPER SOLARIS CONSTRUCTION INC 1805 JOHN TOWERS AVE EL CAJON, CA 92020-1116 (619) 807-1253 AMOUNTFEE BUILDING PERMIT FEE ($2000+)$123.83 BUILDING PLAN CHECK FEE (BLDG)$86.68 SB1473 GREEN BUILDING STATE STANDARDS FEE $1.00 STRONG MOTION-RESIDENTIAL $1.34 Total Fees:$212.85 Total Payments To Date:$212.85 Balance Due:$0.00 Please take NOTICE that approval of your project includes the "Imposition" of fees, dedications, reservations, or other exactions hereafter collectively referred to as "fees/exaction." 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 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 limitation has previously otherwise expired. 1635 Faraday Avenue, Carlsbad CA 92008-7314 ï 760-602-2700 ï 760-602-8560 f ï www.carlsbadca.gov Building Division Page 1 of 1 {"Cityof Carlsbad Plan Check Est. Value PC Deposit Date B-1 Page 1 of 2 Rev. 06/18 BUILDING PERMIT APPLICATION B- Job Address __________________________________________Suite: __________ APN: _________________________ CT/Project #:_________________________________________ Lot #:_________ Fire Sprinklers: Air Conditioning: Electrical Panel Upgrade BRIEF DESCRIPTION OF WORK: ________________________________________________________________________ __________________________________________________________________________________________________ APPLICANT (PRIMARY CONTACT) PROPERTY OWNER Name: ________________________________________ Name: _____________________________________________ Address: ______________________________________ Address: ____________________________________________ City: _________________ State:______Zip: _________ City: ______________________State:______Zip: ___________ Phone: _______________________________________ Phone: _____________________________________________ Email: ________________________________________ Email: ______________________________________________ DESIGN PROFESSIONAL CONTRACTOR BUSINESS Name: ________________________________________ Name: _____________________________________________ Address: ______________________________________ Address: ___________________________________________ City: _________________ State:______Zip: __________ City: _________________ State:______Zip: _______________ Phone: _______________________________________ Phone: ____________________________________________ Email: ________________________________________ Email: _____________________________________________ Architect State License: __________________________ State License:_____________ Bus. License:_______________ (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/she 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/she 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}). 1635 Faraday Ave Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Email: Building@carlsbadca.gov Addition/New: ____________Living SF, ________ Deck SF, ________ Patio SF, ________Garage SF Is this to create an Accessory Dwelling Unit? New Fireplace? if yes how many? _____ Remodel: __________ SF of affected area Is the area a conversion or change of use ? Pool/Spa: __________ SF Additional Gas or Electrical Features? _____________________________ Solar: _______ KW, ______ Modules, Mounted: Roof Ground , Tilt: Panel Upgrade: Reroof: ____________________________________________________________________________________ Plumbing/Mechanical/Electrical Only: ___________________________________________________________ Other: ______________________________________________________________________________________ _______________________________________________________________________________________________ CBR2020-2223 □ ( City of Carlsbad RESIDENTIAL 1 2090 Avenue of the Trees, Carlsbad, CA 92008 0 YES @ NO C))YES G) NO RE ROOF -REMOVE CONCRETE TILE AND RE INSTALL O v O N O v O N, 09/11/2020 :()YES @ NO O v Q N □ □ □ Q Y@ N, RMA: Y@)N, Battery: Y @ N, Y @ N [Z] REMOVE CONCRETE TILE AND RE INSTALL □ □ Estephany Arreola 1805 John Towers Ave El Cajon Ca 619 807-1253 Estephanyarreola@gmail.com Semper Solaris 1805 John Towers Ave 92154 Dessiree Evans 2090 Avenue of the Trees CARLSBAD (858) 342-8859 Semper Solaris 185 John Towers Ave CA 92008 El Cajon Ca 92020 El Cajon CA 92020 858 627-2027 978152 B-1 Page 2 of 2 Rev. 06/18 ( OPTION A ): WORKERS’COMPENSATION DECLARATION: I hearby 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 provided by Section 3700 of the Labor Code, for the performance of the work which this permit is issued. I have and will maintain worker’s compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers’ compensation insurance carrier and policy number are: Insurance Company Name: _______________________________________________ Policy No. _______________________________ Expiration Date: _______________________ 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 be come 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 $100,000.00, in addition the to the cost of compensation, damages as provided for in Section 3706 of the Labor Code, interest and attorney’s fees. CONTRACTOR SIGNATURE: _____________________________________________ AGENT DATE: _______________ ( OPTION B ): OWNER-BUILDER DECLARATION: I hereby affirm that I am exempt from Contractor’s License Law for the following reason: 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). 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). I am exempt under Section __________________Business and Professions Code for this reason: I personally plan to provide the major labor and materials for construction of the proposed property improvement. I (have / have not) signed an application for a building permit for the proposed work. I have contracted with the following person (firm) to provide the proposed construction (include name address / phone / contractors’ license number): 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 / contractors’ license number): I will provide some of the work, but I have contracted (hired) the following persons to provide the work indicated (include name / address / phone / type of work): OWNER SIGNATURE: ______________________________________________ AGENT DATE: _______________ CONSTRUCTION LENDING AGENCY, IF ANY: I hereby affirm that there is a construction lending agency for the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Lender’s Name: ___________________________________________________ Lender’s Address: ___________________________________________________ ONLY COMPLETE THE FOLLOWING 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? Yes No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Yes No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Yes 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. 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 representative 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 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). APPLICANT SIGNATURE: __________________________________________________ DATE: ____________________ 1635 Faraday Ave Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Email: Building@carlsbadca.gov □ □ □ □ □ 1. 2. 3. 4. 5. 978152 10/31/2020 Estephany Arreola Estephany Arreola state fund □ 09/11/2020 Q vES Q No □ Yes/ No Yes/ No Yes/ No 9/11/2020 B-50 Page 1 of 6 Revised 08/19 Development Services Building Division 1635 Faraday Avenue (760) 602-2719 www.carlsbadca.gov CLIMATE ACTION PLAN CONSISTENCY CHECKLIST B-50 PURPOSE This checklist is intended to assist building permit applicants identify which Climate Action Plan (CAP) ordinance requirements apply to their projects. The completed checklist must be included in the building permit application. It may be necessary to supplement the completed checklist with supporting materials, calculations or certifications, to demonstrate full compliance with CAP ordinance requirements. For example, projects that propose or require a performance approach to comply with energy-related measures will need to attach to this checklist separate calculations and documentation as specified by the ordinances. NOTE: The following type of permits are not required to fill out this form Patio Decks PME (w/o panel upgrade)Pool If an item in the checklist is deemed to be not applicable to a project, or is less than the minimum required by ordinance, an explanation must be provided to the satisfaction of the Building Official. Details on CAP ordinance requirements are available on the city’s website. A CAP Building Plan template (form B-55) shall be added to the title page all building plans. This template shall be completed to demonstrate project compliance with the CAP ordinances. Refer to the building application webpage and download the latest form. Applicant Signature: ___________________________________ Date: ___________________ Application Information Project Name/Building Permit No.: BP No.: Property Address/APN: Applicant Name/Co.: Applicant Address: Contact Phone: Contact Email: Contact information of person completing this checklist (if different than above): Name: Contact Phone: Company name/address: Contact Email: C cityof Carlsbad I •:• I •:• I •:• City of Carlsbad Climate Action Plan Consistency Checklist Updated 8/15/2019 2 Use the table below to determine which sections of the Ordinance Compliance checklist are applicable to your project. For alterations and additions to existing buildings, attach Building Permit Valuation worksheet. Building Permit Valuation (BPV) from worksheet: $_______________ Construction Type Complete Section(s)Notes: Residential Low-rise High-rise A high-rise residential building is 4 or more stories, including a mixed-use building in which at least 20% of its conditioned floor area is residential use New construction 2A, 3A, 4A 1B, 2B, 3B, 4A Additions and alterations: BPV < $60,000 N/A N/A All residential additions and alterations BPV Electrical service panel upgrade only 1A, 4A 4A 1-2 family dwellings and townhouses with attached garages only BPV 1A, 4A* 1B, 4A* *Multi-family dwellings only where interior finishes are removed and significant site work and upgrades to structural and mechanical, electrical, and/or plumbing systems are proposed Nonresidential New construction 1B, 2B, 3B, 4B and 5 Alterations: BPV or additions 1,000 square feet 1B, 5 BPV $1,000,000 1B, 2B, 5 Building alterations of 75% existing gross floor area 2,000 sq. ft. new roof addition 2B, 5 1B also applies if BPV $200,000 CAP Ordinance Compliance Checklist Item Check the appropriate boxes, explain all not applicable and exception items, and provide supporting calculations and documentation as necessary. 1. Energy Efficiency Please refer to Carlsbad Municipal Code (CMC) sections 18.21.155 and 18.30.190, and the California Green Building Standards Code (CALGreen) for more information when completing this section. A. See CMC section 18.30.190. N/A _______________________________ (attach certification) Single-family -family Select one: Duct sealing Attic insulation Cool roof Attic insulation later Select one: Lighting package Water heating Package 1 Select one: Duct sealing Attic insulation Cool roof 1992 and later Select one: Lighting package Water heating package B. or additions . N/A _______________________________ □ □ □ □ □ ~ $60,000 □ □ ~ $200,000 □ I □ □ □ ~ $200,000 ~ □ ~ ~ □ ~ ~ A D Residential addition or alteration i2: $60,000 building permit valuation. □ □ Exception: Home energy score 2: 7 Year Built Requirements Multi Requirements □ Before 1978 □ □ □ □ □ 1978 and □ □ □ Between 1978 and 199 □ □ □ □ □ □ D Nonresidential* new construction or alterations i2: $200,000 building permit valuation, i2: 1,000 square feet □ City of Carlsbad Climate Action Plan Consistency Checklist Updated 8/15/2019 3 See CAL – Energy Efficiency. A5.203.1.1 Choose one:.1 Outdoor lighting .2 Warehouse dock seal doors .3 Restaurant service water heating (comply with California Energy Code section 140.5, as amended) .4 Daylight design PAFs .5 Exhaust air heat recovery N/A_______________________________ A5.203.1.2.1 Choose one as applicable:.95 Energy budget .90 Energy budget N/A _______________________________ A5.211.1** On-site renewable energy N/A_______________________________ A5.211.3** Green power (if offered by local utility provider, 50% minimum renewable sources)N/A_______________________________ A5.212.1 Elevators and escalators N/A_____________________________ A5.213.1 Steel framing N/A _____________________________ * Includes hotels/motels and high-rise residential buildings , or alterations that add 2,000 square feet of new roof addition: comply with CMC 18.30.130 instead. A. low-rise residential ) s: 1) High- MC -rise residential) or 18.30. -rise residential) Floor Plan ID (use additional sheets if necessary) CFA #d.u.Calculated kWdc* Exception __________________________________ ______________________________________________ ______________________________________________ ______________________________________________ Total System Size:kWdc kWdc =1,000 + (1.15 x #d.u.) *Formula calculation where CFA = conditional floor area, #du = number of dwellings per plan type If proposed system size is less than calculated size, please explain. B. ases roof CMC section 18.30.130 when completing this section. Note: This section also applies to high- Choose one of the following methods: GFA: __________________ Min. System Size: ______ kWdc If < 10,000s.f. Enter: 5 kWdc kWdc x (GFA/10,000) ** **Round building size factor to nearest tenth, and round system size to nearest whole number. Time- □ □ □ □ □ □ CMC 18.21.155 and □ □ □ Green Appendix AS, Division AS.2 □ □ ... For alterations ~ $1,000,000 BPV and affecting > 75% existing gross floor area 2. Photovoltaic Systems □ □ □ □ □ □ D Residential new construction (for building permit applications submitted after 1/1/20 . Refer to 2019 California Energy Code section 150.1(c)14 for requirements. Note rise residential buildings are subject to nonresidential photovoltaic requirement (28 below) instead. 2) If project includes installation of an electric heat pump water heater pursuant to C 18.30.150(8) (high 170(8) (low , increase system size by .3kWdc if PV offset option is selected. □ □ □ □ (CFAx.572) / D Nonresidential new construction or alterations ~$1,000,000 8PV and affecting ~75% existing floor area, or addition that incre area by ~2,000 square feet Please refer to rise residential and hotel/motel buildings. □ Gross Floor Area (GFA) Method □ □If.:: 10,000s.f. calculate: 15 □ Dependent Valuation Method City of Carlsbad Climate Action Plan Consistency Checklist Updated 8/15/2019 4 Annual TDV Energy use:*** ______________ x .80= Min. system size: ____________ kWdc ***Attach calculation documentation using modeling software approved by the California Energy Commission. A. Please refer to CMC sections 18.30.150 and 18.30.170 when completing this section. For systems serving choose one: Heat pump water heater AND Compact hot water distribution AND Drain water heat recovery (low-rise residential only) Heat pump water heater AND PV system .3 kWdc larger than required in CMC section 18.30.130 (high rise residential hotel/motel) or CA Energy Code section 150.1(c) 14 (low-rise residential) Heat pump water heater meeting NEEA Advanced Water Heating Specification Tier 3 or higher Solar water heating system that is either .60 solar savings fraction or 40 s.f. solar collectors Exception: ______________________________________________________________________________ For systems serving units, install a central water-heating system with all of the following: Gas or propane water heating system Recirculation system per CMC 18.30.150(B) (high-rise residential, hotel/motel) or (low- rise residential) Solar water heating system that is either: .20 solar savings fraction .15 solar savings fraction, plus drain water heat recovery Exception: ______________________________________________________________________________________ B. CMC section 18.30.150 when completing this section. Water heating system derives at least 40% of its energy from one of the following (attach documentation): Solar-thermal Photovoltaics Recovered energy Water heating system is (choose one): Heat pump water heater Electric resistance water heater(s) Solar water heating system with .40 solar savings fraction Exception: ______________________________________________________________________________________ 3. Water Heating A D Residential and hotel/motel new construction □ □ □ □ □ □ □ □ □ □ □ □ □ individual dwelling units multiple dwelling 18. D Nonresidential new construction Please refer to Carlsbad Ordinance □ □ □ □ □ □ □ □ CMC 18.30.170(6) □ City of Carlsbad Climate Action Plan Consistency Checklist Updated 8/15/2019 5 Calculations: Total EVSE spaces = .10 x Total parking (rounded up to nearest whole number) EVSE Installed = Total EVSE Spaces x .50 (rounded up to nearest whole number) EVSE other= Total EVSE spaces – EVSE Installed (EVSE other may be “Capable,” “Ready” or “Installed.”) *Major alterations are: (1) for one and two- or include an electrical service panel upgrade; (2) for multifamily dwellings (three units or more without attached garages), alterations have a building permit trical, and/or plumbing systems are proposed. B. Nonresidentia Exception : ______________________________ Total Parking Spaces Proposed EVSE Spaces Capable Ready Installed Total Calculation: Refer to the table below: Total Number of Parking Spaces provided Number of required EV Spaces Number of required EVSE Installed Spaces 0-9 1 1 10-25 2 1 26-50 4 2 51-6 3 -100 9 5 101-150 12 6 151-200 9 201 and over 10 percent of total 50 percent of Required EV Spaces A. when completing this section. One and two-family residential dwelling or townhouse with attached garage: One EVSE Ready parking space required Exception : _______________________________ Multi-family residential: Exception : ______________________________ Total Parking Spaces Proposed EVSE Spaces Capable Ready Installed Total 4. Electric Vehicle Charging A D Residential New construction and major alterations* Please refer to Carlsbad Ordinance CMC section 18.21.140 □ □ □ □ family dwellings and townhouses with attached garages, alterations have a building permtt valuation ~ $60,000 valuation ~ $200,000, interior finishes are removed and significant site work and upgrades to structural and mechanical, elec R 0 I new construction (includes hotels/motels) □ 10 2 5 8 □ □ □ □ 75 □ 76 --17 - City of Carlsbad Climate Action Plan Consistency Checklist Updated 8/15/2019 6 An approved Transportation Demand Management (TDM) Plan is required for all nonresidential projects that meet a threshold of employee-generated ADT. City staff will use the table below based on your submitted plans to determine whether or nor your permit requires a TDM plan. If TDM is applicable to your permit, staff will contact the applicant to develop a site-specific TDM plan based on the permit details. Use Emp ADT for first 1,000 s.f. Emp ADT/ 1000 s.f.1 Office (all)2 20 13 Restaurant 11 11 Retail3 8 4.5 Industrial 4 3.5 Manufacturing 4 3 Warehousing 4 1 1 Unless otherwise noted, rates estimated from ITE Trip Generation Manual, 10thEdition 2 For all office uses, use SANDAG rate of 20 ADT/1,000 sf to calculate employee ADT 3 Retail uses include shopping center, variety store, supermarket, gyms, pharmacy, etc. Other commercial uses may be subject to special consideration Office: 20,450 sf 1. 20,450 sf / 1000 x 20 = Retail: 9,334 sf 1. First 1,000 sf = 8 ADT 2. 9,334 sf - 1,000 sf = 8,334 sf 3. (8,334 sf / 1,000 x 4.5) + 8 = Acknowledgment: I acknowledge that the plans submitted may be subject to the City of Carlsbad’s Transportation Demand Management Ordinance. I agree to be contacted should my permit require a TDM plan and understand that an approved TDM plan is a condition of permit issuance. Applicant Signature: ______________________________________________________ Date: ___________________ Person other than Applicant to be contacted for TDM compliance (if applicable): Name (Printed): _________________________________________________________ Phone Number: ________________ Email Address: _________________________________________________________ 5. : Nonresidential ONLYD Transportation Demand Management (TDM) Employee ADT Estimation for Various Commercial Uses Sample calculations: 409 Employee ADT 46 Em lo ee ADT Building Permit Inspection History Finaled PERMIT INSPECTION HISTORY for (CBR2020-2223) BLDG-Residential 09/11/2020Application Date:Permit Type:Owner:DESIREE EVANS-CLAASSEN Reroof 09/11/2020Work Class:Issue Date:Subdivision:CARLSBAD TCT#72-11 05/12/2021Expiration Date:Status: IVR Number: 28641 Closed - Finaled 2090 AVENUE OF THE TREES CARLSBAD, CA 92008-1104 Address: Scheduled Date Inspection Type Inspection No. Inspection Status Primary Inspector Reinspection InspectionActual Start Date 11/13/2020 11/13/2020 BLDG-15 Roof/ReRoof (Patio) 143788-2020 Passed Chris Renfro Complete COMMENTS PassedChecklist Item BLDG-Building Deficiency Yes 11/25/2020 11/25/2020 BLDG-Final Inspection 144825-2020 Passed Peter Dreibelbis Complete COMMENTS PassedChecklist Item BLDG-Structural Final Yes Wednesday, November 25, 2020 Page 1 of 1 {cityof Carlsbad 6-10 REROOFING SUPPLEMENTAL BUILDING PERMIT APPLICATION 1. JOB ADDRESS: 2Lfl0 f'\\J (Y)J{, ()y M tr: -e_c.,~ 2. TYPE OF BUILDING: RESIDENTIAL )I} •__,;. __ _ COMMERCIAL~-- 3. ROOF SLOPE: RISE.J.....l.L.. INCHES IN 12 INCHES 4. NUMBER OF EXISTING ROOF COVERING (CIRCLE ONEG 2 3 5. TYPE OF EXISTING ROOF COVERING (JJ{Y,{(K f\\( SHEATHING NI IPr *6. NEW ROOF MATERIAL Cll:orte,'\-e. 1\ \-t CLASS __ WEIGHT PER SQ.~ 7. NUMBER OF SQUARES 1, l -:>) 8. TRADE NAME Coro:::-cic, -h\--c, MANUFACTURER MO.\\l?V S 9. ROOF SYSTEM LISTING: UL NO. _____ 1.C.C.E.S. Report# _____ _ AS™ c~C:-:t=r M 1 ~r OL)S' 3 10. IS THE EXISTING STRUC~ DESIGN SUFFICIENT TO SUSTAIN THE WEIGHT OF THE PROPOSED ROOF? ~ 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 least 2 rungs above the roof for inspection. Signature.::-1: ...... z:--A:~ _________ .Date 11 l I\ ) Tu lD Conn~_~ ___ Owner ____ Con~~ Name 1fk¢'4D-j 'Pro::(() l0\ *6. Rolled Roofing, Standard/Lite Tile, AsphalVComp fiberglass, Built Up, Other Page 6 of 6 Rev. 04f14 Scanned with CamScanner