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HomeMy WebLinkAbout1734 CEREUS CT; ; CB992720; Permit07/20/1999 City of Carlsbad Miscellaneous Permit Permit No:CB992720 Building Inspection Request Line (760) 438-3101 Job Address: Permit Type: Parcel No: Valuation: Reference #: Project Title: 1734CEREUSCTCBAD MISC 2155022200 $7,155.00 Subtype: REROOF Lot #: 0 REROOF LITE WEIGHT TILE 2700SF Status: ISSUED Applied: 07/20/1999 Entered By: DT Plan Approved: 07/20/1999 Issued: 07/20/1999 Inspect Area: Applicant: SECURE ROOF INC 2210 MEYERS ESCONDIDOCA 92029 760-432-9084 S -Owner-f BARRINGER^JERRY L&DORTS ,1734 CEREUS CT 'CARLSBAD ^CA^ V92009~ C-PRMT 02 160-00 Total Fees: $160.00 fotai Payments To^ateK"1 " $O.OQX-X Vi'" Balance Due: $160.00 Miscelaneous Fee #1 Miscelaneous Fee #2 TOTAL PERMIT FEES $160.00 $0.00 $160.00 Inspector:.SR 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 2075 Las Palmas Dr., Carlsbad CA 92009 (760)438-1161 1. PROJECT INFORMATION FOR OFFICE USE ONLY PLAN CHECK EST. VAL. "7/5T Plan Ck. Deposit Validated By ~~[ Date Address (includeBldg/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 Work SQ. FT.#of Stories APPLICANT f~J Contractor Address oent for Contractor City Owner Q Agent forpwner # of Bedrooms State/Zip # of Bathrooms Telephone tt Fax # Address City State/Zip Telephone Address City State/Zip Telephone # 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 of Section 7031.5 by any applicant for a permit subjects the applicant to a civil penalty of not more than five hundred dollars ($5001). Name State License # Address License Class City State/Zip City Business License tt Telephone / / / ** (f * Designer Name Address City State/Zip Telephone State License # 6. WORKERS'COMPENSATION Workers' Compensation Declaration: I hereby affirm under penalty of perjury one of the following declarations: O ' 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. (OO 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 rA~°7~j&J~l^~ /^L/S\J~L^ __ Policy No. Gr~i§ ^/^S&^&^Q Expiration Date_ (THIS SECTION NEED NOT BE COMPLETED IF THE PERMIT IS FOR ONE HUNDRED DOLLARS [$100] OR LESS) l~l 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 ($109,000)Jn addition to the cost of compensation, damages as provided for in Section 3706 of the Labor code, interest and attorney's fees. SIGNATURE ^b*0-l/L4j(!U£^- S$-~7'^ ~ / —"\ DATE 7?/ da/Cffi t. OWNER-BU/DER DECLARATION ,. ^ *\ / ] ' ' , ' t hereby affirm tnat I am exempt from the Contractor's License Law for the following reason: D I, as ow/er 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. |f, 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 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). 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. l~l YES I~|NO 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 ^COMPLETEfTHlS SECTIONIFOR 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? O 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? O YES D MO Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? fj 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. flVs CONSTRUCTION LENDINGI 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. APPLlCANfCERTIFiCATlON , ,„ / 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 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 for a period of 180 days (Section 106;4.4 Uniform Building Code). /] f £.}--/ f APPLICANT'S SIGNATURE j&TP^lSL^e^2-— ^/ff"* \ ) DATE WHITE: File YELLOW: Applicant PINK: Finance ^ City Of Carlsbad SUPPLEMENTAL BUILDING PERMIT APPLICATION FOR REROOFING 1. JOB ADDRESS: 2. TYPE OF BUILDING: RESIDENTIAL COMMERCIAL 3. ROOF SLOPE: RISE -V inches in 12 inches 4. NUMBER OF EXISTING ROOF COVERING (circle one) (j) 2 t€S??&g> 5. TYPE OF EXISTING ROOF COVERING JS^^^ SHEATHING- *6. NEW ROOF MATERIALITY CLASS /?- WEIGHT PER SQUARE 1. NUMBER OF SQUARES 8. TRADE NAME £t/&£/T7 MANUFACTURER 9. ROOF SYSTEM LISTING UL No. _ ICBO No. 10. IS THE EXISTING STRUCTURAL 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: (£? Tear Off/Pre-inspection prior to install new roof covering. Q Final Inspection I agree to provide a ladder extending at least 2 rungs above the roof for inspection. Contractor NameContractor *6 - Rolled Roofing, Standard/Lite Tile, Asphalt/Comp Fiberglass, Built up, Other. City of Carlsbad Inspection Request For: 8/4/99 Permit# CB992720 Title: REROOF LITE WEIGHT TILE 2700SF Description: Inspector Assignment: SR Type:MISC Sub Type: REROOF Job Address: 1734CEREUSCT Suite: Lot 0 Location: APPLICANT SECURE ROOF INC Owner: BARRINGER JERRY L&DORIS L Remarks: Phone: 8003386868 Inspector:O-O: Q\\ Total Time: CD Description 19 Final Structural Act Comments V\V Requested By: TERESA Entered By: CHRISTINE Inspection History Date Description Act Insp Comments 7/27/99 15Roof/Reroof AP SR SECURROQ Attlimi* CERTrFICATE OF INSURANCE ST/™9 PRODUCER El Camino Insurance License # 0539016 3156 Vista Way, Suite 300 Oceans ide, CA 92056 INSURED . Secure Roof, Inc. 7356 Trade Street San Diego, CA 92.121 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. COMPANIES AFFORDING COVERAGE COMPANY A state Compensation Insurance Fund COMPANY B COMPANYc COMPANY D COVERAGES THIS IS TO CERTIFY THAT THE POLICIES OF INSURANCE LISTED BELOW HAVE BEEN ISSUED TO THE INSURED NAMED ABOVE 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. LIMITS SHOWN MAY HAVE BEEN REDUCED BY PAID CLAIMS. j^fp TYPE OF INSURANCE 1 GENERAL LIABILITY I 1! tOMMERCIAL GENERAL LIABILITY 1 ' 1 | CLAIMS MADE | 1 OCCUR 3WNER-S & CONTRACTOR'S PROT AUTOMOBILE LIABILITY l__ ANY AUTO 1 ALL OWNED AUTOS I SCHEDULED AUTOS i 1 HIRED AUTOS I NON-OWNED AUTOS i 1 1 GARAGE LIABILITY ! ANY AUTO -' 1 • ' , ! EXCESS LIABILITY j i UMBRELLA FORM j OTHER THAN UMBRELLA FORM A : WORKERS COMPENSATION AND EMPLOYERS' LIABILITY THE PROPRIETOR/ INCL i OFFICERS ARE: EXCL [ OTHER POLICY NUMBER 285148699 POLICY EFFECTIVE DATE (MM/DD/YY) 01/01/99 POLICY EXPIRATION DATE (MM/DD/YY) 01/01/00 LIMITS GENERAL AGGREGATE PRODUCTS-COMP/OP AGG PERSONAL & ADV INJURY EACH OCCURRENCE FIRE DAMAGE (Any one fire) MED EXP (Any one person) COMBINED SINGLE LIMIT BODILY INJURY(Per person) BODILY INJURY(Per accident) PROPERTY DAMAGE AUTO ONLY-EA ACCIDENT OTHER THAN AUTO ONLY: EACH ACCIDENT AGGREGATE EACH OCCURRENCE AGGREGATE X j STATUTORY LIMITS EACH ACCIDENT DISEASE-POLICY LIMIT DISEASE- EACH EMPLOYEE $ $ $ $ $ $ .-,. , $ s $ $ $ $ $ $ $ $ $1,000, 000 $1,000, 000 $1, 000, 000 DESCRIPTION OF OPERATIONS/LOCATIONS/VEHICLES/SPECIAL ITEMS CERTIFICATE HOLDER Insurance Verification ACdRi25-S (3/93)1 of 1 #M8752 CANCELLATION SHOULD ANY OF THE ABOVE DESCRIBED POLICIES BE CANCELLED BEFORE THE EXPIRATION DATE THEREOF, THE ISSUING COMPANY WILL ENDEAVOR TO MAIL 10 DAYS WRITTEN NOTICE TO THE CERTIFICATE HOLDER NAMED TO THE LEFT, BUT FAILURE TO MAIL SUCH NOTICE SHALL IMPOSE NO OBLIGATION OR LIABILITY OF ANY KIND UPON THE COMPANY, ITS AGENTS OR REPRESENTATIVES. AUTHORIZED REPRESENTATIVE £&+<t&Z^ -><3CfLpc*s* ' JMW © ACORD CORPORATION 1993