HomeMy WebLinkAbout2431 UNICORNIO ST; ; 82-07; PermitII) z 0 ~ C cc C _,
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O I hereby .ft,, am licensed under
provisions of Ch\., /(commencing with
Section 7000) of Division 3 of Iha Business
and Profesalons Code, and my license Is In
lull force and effect.
L,c No _______ Class
1 hereby affirm that I am exempt from the Con·
~~o;·~~~,::: ;:w ~f~~:~c!l.~¼Ci~ county which requires a permit to construct
alter. improve. demolish. °' repair any structure,
pnor to its issuance also requires the apphcan1 for
such pemut to file a signed statemenl that he is licensed pursuant to the PfOYIStOnS of the Con· tractor's License Law (Chapter 9 commencing with
SectK>O 7(0) of 01v1s10f'I 3 of the Business and Pro-fess,ons Code) or that ,s exempt therefrom and the
basis for the alleged exemptK>O. Any violation of Sectt<>n 7031 5 by an applicant for a pennit subfects
tne apphcant to a c1v11 penaJty of not more lhan five
hundred doll= ($500)
0 I, as owner ol the property, 0< my employees
,.,th '#aQ8S as their sole compensation, will do the wotk, and the structure ,snot intended or offered for sale jSec 7044, Business and Proless,ons Code The Contractor's License Uw does not apply to an
owner or property who builds or ,mproYes the<eon and wno ooes such WM himself or througn his own
empk>yees. provtded t~t such unprovements •e not 1nteode1 or offered for sale. 11, howe:Yef. the buti<:hng or improvement 1s .sold within one yeM of
complettOn, the owner-builder will have the burden of proving that he dtd not bu1kS or improve f<>< the
purpose ol sale).
~ I. as owner of the property, am exclusively
cootrachni with licensed contr~tors to construct the proteet (See 70&,,4, Business and Professt0ns
Ccxte: The Contractor's License Law does not apply
to an owner of property who bu1kSs or improves
thereon. and who contracts tor each pro1ects with a
contractor(s) 1tcense pursuant to the Contractor·s
License Law).
0 lamexemptunderSec _____ ,B &PC
for this reason ___________ _
□ I hereby affirm that I ha'le a cert1f1cate of consent to self-insure, or a cert1f1cate ol Workers·
Compensatton Insurance, or a certified copy !hereof
(Sec 3800, Labo< Code)
POLICYNO __
COMPANY __
□ Copy IS hied with the city
D Certt11ed copy Is hereby furnished
CERTIFICATE. OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This section need not be compleled if the permll
Is fOf one hundred dollars ($100) or less)
'-. I cert,ty tha.l in the performance of the work tor
C'h1ch lh1s perm11 Is issued. I shall not employ any
person In any manner so as to become sub1ect lo !he Workers' Compensation Laws of Cahtorma
NOTICE TO APPLICANT II, alter malun~ thlS cen,
hcate of E•emphon. you shoukS beeome sut,Ject I')
the wonc.ers· Compensation prcw,s1ons of the Labor Code, you must tonhw,th comply with such ;;;~;;;~~~
0 I hereby athrm thal !here ,s a construction
Iend1no agency tor the performance ol the w~ IOf wtuch !his permit Is issued (Sec Y:l:J7. C1v1I Code)
Lenders Name ___________ _
Lender, Address __________ _
USE BALL POJNT PEN ONLY & PRESS H•RD ' CARf )D BUILDING DEPARTMENT
-.. -. ... le; APPLICATION & PERMIT ) 1200 Elm,, ~oad, Callfomla 92008 (714) 438-5525
APPLICANT TO FILL IN INFORMATION WITHIN SHADED f~1' AND DECLARATIONS
JOB ADDRESS
A~;Tr;~ o; Aq:1j1
BUSINESS LICENSE # VALUATION PERMIT NUMBER
::J. I-) ::u I J N l / /'J p /\I, J/) 6-r; l37 ~'1 -45 8Z-01 OWNER'S NAME
IIA-~le,.i/
OWNER'S PHONE PRIME CONTRACTOR CONTRACTORS PHONE • ZONE
J\t')h,t:L/ 4_,~-S'7JeJ /')/.,1JA/~L S:JMt:/
OWNER'S MAIL•NG ADDRESS CONTRACTOR'S AOORESS LICENSE NO. PLAN 1.0. # BLOG use CODE
1-1 / #,j J/4A-'51'JI IA,-A-/).,. A.IX JAG S/Jm~ ~.F.D.
),,OT IJ'LOCK ~_,__ 1.:ueD, v ... 1 l~fb'-ZS--0 -Lt; DESIGNER STATE LICENSE# STANOARO PLAN# BIJILOINGf~· F' Tt:E
vt3 l,,(, . ....,~~ -:1A.~k' ,8t,JI~ l/'a7/B?75 ~-~/ ,JI
DESCRIPTION OF WORK ,.,n'r',-,r:i.--.,
DESIGNER'S ADDRESS DESIGNER'S PHONE _,_w,1,r ';-'-I " TI,-' --.::-·,•I.I. I
""'-·oJ()s~v~f ,~µ ~F 51u6/1=., Euc..1P1 -r1s ('}_A-,
-F/P FLR ELEV. NO OCCGP EDU
r,fmt II/ !lo mt,. ~ q1 4' tlli!c.¥:. STORIES ~-3 vO NO
CENSUS TRACT I GP LANO use I PARKING SPACE I RES UNITS I GRADING ~ERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAD FIRE SPR AREA CONSTN ""1:. It> YO ND vO NO v-v□ NN.i. Not Valid Unlt!ss Machine Certifitd
QTY. PLUMBING PERMIT -ISSUE ~,60 QTY. MECHANICAL PERMIT -ISSUE '3 .0~ SUMMARY/ACCOUNT NUMBER
If.,.. EACH FIXTURE TRAP ~,co 7 INSTALL FURN. DUCTS UP TO 100,000 BTU A-.00 BUILDING PERMIT 01-000-4??n ~/J.-~ 00
I EACH BUILDING SEWER /:... ,e:r T OVER 100.000 BTU -'--SIGN PERMIT 01-000-4221
I EACH WATER HEATER ANO/OR VENT j'f .. z::n BOILER/COMPRESSOR UPTO 3 HP PLAN CHECK~'.~ 1 -I . .JhAil•000-4806 ~4~.,;1'.
t EACH GAS SYSTEM l TO 4 OUTLETS -~ .'E-n 80 ILER /COMPRESSOR 3-15 HP . TOTAL PLUMBING 01 ·000-4222 c:;q, Ol"l
EACH GAS SYSTEM 5 OR MORE ~., ..., ~-METAL FIREPLACE /LJ.,Ot) ELECTRICAL 01 ·000-4223 t;,[.,, n O
/ EACH INSTAl .. ALTER , REPAIR WATER PIPE I/,, VENT FAN SINGLE DUCT A-.. on MECHANICAL 01 ·000-4224 1 "'7.o~
EACH VACUUM BREAKER ME CH EXHAUST -HOOD/DUCTS MOBILEHOME 01 ·000-4225
WATER SOFTNER RELOCATION OF EA FURNACE/HEATER MOBILEHOME PARK INSP
EACH ROOF DRAIN (INSIDE) SOLAR 01 ·000-4226
TOT/.L MECHANICAL STRONG MOTION 65·640-0519 C,,f f1tl/J
TOTAL PLUMBING I ' ,:;.;9 , 0,. 11 , oo FIRE SPRINKLERS 01-000-4?27
QTY. ELECTRICAL PERMIT -ISSUE 1,,,00 QTY. SOLAR • ISSUE
PUBLIC FACILITIES FEE 25·000-4933
BRIDGE FEE
fAn NEW CONST EA AMP/SWT/BKR COLLECTORS SCHOOL FEE -DISTRICT
'1 P~.1.,t;t, /»,.9 3 PH &:;/'I ,01' STORAGE TANKS Carlsbad 65·623-0519
EXIST BLOG EA AMP/SWT/BKR ROCK STORAGE Encinitas 65-624-0519
1 PH 3 PH PUMP San Oieguito 65·625-0519 .
REMODEL/ALTER PER CIRCUIT PLAN CHECK FEE San Marcos 65-626-0519 /h~~-00
TEMP POLE 200 AMPS ,, . '
OVER 200 AMPS -:-J-~ ,. 6~4 P1AtJ t Y rn. ,~~-A,.c;'
TEMP OCCUPANCY 130 DAYSI
,. 7
TOTAL ELECTRICAL I 51, ,po TOTAL SOLAR TOTAL FEES PAYABLE I f,z5q,11 . I ... -' . . E•p1rahon. Every perm,1 Issued by theBuildtng Offlc,el under the prov,s,onsofth,s I HAVE CAREFULLY EXAMINED THE COMPLETED "i".PPLICATION AND PERMIT ' AND DO HEREBY * AN OSHA PERMIT IS RE0UIAED FOA EXCAVAllONS OVER
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Coda shall exp,re by limitation and become null and vo,d If Iha building or work 5· O" DEEP ANO 0£MOUTION OR CONSTRUCTION OF
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS suthortzed by such permit ,snot commenced w,th,n 180 days from lhe date of such STRUC'I\IMS OVER 3 STONES IN HEIGHT parm,t, or if the build•~ or work authorized by such perm,t IS suepended or ISSUED: TO COMPLY WITH ALL CITY. COUNTY ANO STATE LAWS GOVERNING BUILDING CON-abandoned a1 anv ,,,.,. a er the work IS cor,,menced for • """od of 180 davs
STRUCTION. WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND APPLICANT'S SIGNATURE Jf. M, O~NERY CONTRACTOR 0 APPROVED BY DATE KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS, COSTS AND ~?/ ~ if~Jt EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE BY PHONE 0 i ,-i1-e.z. GRANTING OF THIS PERMIT • ~ [/ ;:_ -1 _.:.,.. .,..,
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BUILDING ' -
/ FIELD INSPECTION RECORD
.fOUNDATION ; .--
REINFORCED STEEL I • V.,,,,,l" ~ REQUIRED SPECIAL INSPECTIONS
I \I REQ IF INSPECTORS MASONRY ' INSPECTION CHECKED APPROVAL
I GUNITE OR GROUT I SOILS COMPLIANCE
FLOOR & CEILING SUB FRAME 1 PRIOR TO
' FOUNDATION INSP
SHEATHING I STRUCTURAL CONCRETE
FRAME ' OVER 2000 PSI
EXTERIOR LATH lNSULATION i PRESTRESSED
CONCRETE
i POST TENSIONED INTERIOR LATH & DRYWALL \ , ·' CONCRETE
PLUMBING I' I\ FIELD WELDING --
SEWER AND BL/CO r -I t11GH STRENGTH
PLUMBING UNDERGROUND I 1 .. ../,Y' /,Ml/ • ---BOLTS ... .,,
I . SPECIAL MASONRY PLUMBING TOP OUT I
TUB AND ~HOWER PAN I
' ' GAS TEST I PILES CAISSONS
ELECTRICAL I I ~,
I TEMPORARY POWER ---' '
ELECTRIC UNDERGROUND i -
' ROUGH ELECTRIC ' _,
I
ELECTRIC SERVICE I .. ,•-, ' ' BONDING ~ I ·, .
G. F. I. -SMOKE DETECTOR I
I
I MECHANICAL I
DUCT & PLEM., REF. PIPING "", ~ ~ \J ... '" .. -, . . ··-
HEAT -AIR COND. -SOLAR SYSTaMs
"\' •L ;...
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VENTILATING SYSTEMS .. ~ . ' ~ < ' . . --...
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE = --ITEMS ABOVE HAVE BEEN APPROVED.
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JY~ PLUMBING I n. .A
ELECTRICAL I I /JI// I . ' ~
MECHANICAL ~ • -~ I
GAS I . ' rJv ✓ ' ' .. . . ,_ -
BUILDING ' ✓ I -·-
I -SPECIAL CONDITlf'I\IS I /
CERT OF OCCUPA • SUED .,
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INSPECTOR'S NOTES
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This Certificate issued pursuant to the requirements of Section 306
of the Uniform Building Code certifies that at the time of issuance
this structure complies with applicable ordinances of the City
regulating building construction use.
~ ~ ~ Use Classification __ S_in__;cg_l_e_F_a_m_i _l ..:,_y_D_w_e_l_l _i _n.:::g:__ ___ Bldg. Permit Na. __ 8_2_-_o_7 __ _
~ Graup _____ Type Construction _____ Fire Zone ______ Use Zone _____ _
~ Occupant Load ______________________________ _ < Owner of Buildin, .Robert Hadley ~ _2431 Unicornio <e Building Address_o--------..----~-
<P
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Address --::2::-4_3_,1=-='-U_n....,i,...c_o_r,,..n,-;c.i ~0..,,...,,---:--:-=----
C rlsbad, CA . 92008
~ ~ ~
NOTE: Alterations, changes, addition, or chong•• of occuponc
(Post in conspicuous place)
){YYWW M
INSULATIOi'l CERTIFICATION
COMPLETE, SIGN AND POST AT A CONSPICUOUS LOCATION WITHIN THE BUILDING
WITH THE INSPECTION RECORD CARD AT THE TIME OF FINAL INSPECTION.
This is to certify that, in accordance with the current energy regulations (California Adminis-
trative Code, Title 25, State of California) and approved plans, insulation has been installed in
the building located at:
SITE ADDRESS
EXTERIOR WALLS
'\ £ I -. I ·"-I .:,
Number
LA C0~TA
Street City
.
Manufacturer _C_£ .... R .... I ..... A .... ( .... A ___ l_n_,=; .... £ ...... (_~----Thickness/Type __ 0 ..... ·?---~--R Value
CEILINGS
If
Batts: Manufacturer John 5 -fn ~"{.~I {I e., Thickness/T ype C,~ R Value J1_
Blown: Manufacturer Thickness/T ype No. Bags
Wt./Bag Sq. Ft. Covered R Value ,
G "'l"l Pt G.i..
:S vf3-FLOORS
Manufacturer CE-R f t'fl f'( 1£ £/) Thickness/Type • -g¾_ R Value (( , •
SLAB ON GRADE
Manufacturer Th ickness/Tvpe R Value
Width of Insulation Inches
FOUI\JDATION 1NALLS
Manufacturer _____________ Thickness/Type ______ R Value __ _
GENERA L CONTRACTOR _____________ LICENSE NUMBER _____ _
BY TITLE _________ DATE _____ _
INSULATION COl'JTRACTOR *Ins-v/;t io;, LICENSE NUMBER __._Yt--~_.y'.___._7i-=-'d ..... CJ'---
BY mcvJ_~ -TITLE u wo ~"° DATE /lfl,.; 1 ,) 1<tF2-
LUE A No. 121 Revisod 11 /3/76
i~-07
7L' Se:1-
ESGIL CORPORATION
9320 CHEt-;APEAKE DR .• fi,{TJTE U.?2
HAN DIEGO, CA 0212H
(T14) R60-146M
IJ /VIC r.1~1 cJ
;}lf ~ I
Prepared by1
~J ()
Jurisdiction CA RLS f3 A D
VALUATION AND PLAN CHECK FEE
PLAN CHECK NO. 8 2 -0 -;
BUILDING ADDRESS _ __,;;;,,2_L.:.,;/ ,~3..;..l __ u_~....;' ,'-c'--o _P_tv_l_D __ s;;;;..._-r_. ---------
APPL! CANT/ CONTACT ___._.R..;;;..u..._e ..._l .._t _._J _--'f-/_A"""'J)---t"""'r .... Y_ PHONE NO. ___ '-1 __ 3"""''1'---..;..S-''7-'t--'9~-
BUILDING OCCUPANCY --~R.;_..;;5'-----DESIGNER PHONE ------TYPE OF CONSTRUCTION \/-,1., -------CONTRACTOR PHONE -----
BUILDING PORTION BUILDING AREA VALUATION VALUE
MULTIPLIER
L Ii/it(, I\ I~ EA 3 I 2 3 ¢' 42.. -I ?, I /0(,, ,...
C:.AI\A GF
,
,;-LO I /, -{p /C,,o. -
DE ~ K C)/ (r,, 80 G,/ CJ, -
Air Conditionin~
Commercial
Residential
Fire Sprinklers
Total Value / 3 7 '1 l-ls )
Building Fermit Fee ____ S-;;;;.....;;.._7 ~i~----· _____ _
Plan Check Fee 3 '--I 3 , 2 ~ _____ ___::;;......:...:::;;...:..;_ ______ __
C Ot/.M ENTS 1 _____ .........._r .... s ____ ,1. ___ ,'--', ''--'-. ___.f ...... J.'----l _____ 2_· __ 1 __ 4 ...... _~_~ ______ _
/··
BUILDING DEPARTMENT
INTERDEPARTMENTAL INFORMATION
SHEET "' cEIVED
DATE, _______ _
iUILDING ADDRESS: dl YJI ~~
~d\ng oepartment
PLANNING DEPARTMENT
ZONE &/-7.,S-()() LOT SIZE ___ ,_~_,_/cLt.'!~~-..___LOT WIDTH __ 7~,S __ I ____ _
UNITS ALLOWED / UNITS PROVIDED I ------------------------
PARKING SPACES REQUIRED .,;1_ PROVIDED _ _._<:$__,__----..--.------
% COVERAGE ALLOWED <f0 7'o PROVIDED <'.J t:
BUILDING HEIGHT ALL_O_W_E_D ___ 3-'--~--C.-~/----PROVIDED =====~===&==/4=c:9--=="=======
FRONT SETBACK:
~ ;"'\ ( ALLOWED ----=o<--:::.__::_~~.c_-_\-f\
PROVIDED , 3o"' CJ IC
SIDE REAR SETBACK:
/~;;y f,,)
-3=--7-,,--+++f) ~
INTRUSIONS ____ _
,ANDSCAPE & IRRIGATION PLAN COMMENTS: ~tJUL._~/JL__ ____________ _
ENVIRONMENTAL PROTECTION REQ: ~
ADDITIONAL COMMENTS:
OK TO ISSUE:
ENGINEERING DEPARTMENT SfD.
R.O.W. INDUSTRIAL WASTE IMPROVEMENTS ------------------
SEWER CONNECTION _______ DRIVEWAY LOCATIONS ___________ _
GRADING PERMIT EASEMENTS _________ DRAINAGE ____ _
LEGAL DESCRIPTION ~ '3 ;;(: c.-~ ·# 1
ADDITIONAL COMMENTS _________________ ..,,__ _________ _
OK TO rssuE~ATE J -/3 -fJ;;r ___ oK TO FINALJtllt; DATES/7·/c,
FIRE DEPARTMENT
SPRiliKLING SYSTEM ___________ FIRE PROTECTION EQUIP. ______ _
FIRE ALARMS EXITS _______________ _
FIRE HYDRANTS LOCATION _________________ _
ADDITIONAL COMMENTS ___________________________ _
OK TO ISSUE: _____ DATE. _______ OK TO FINAL ______ DATE ____ _
WATER DEPARTMENT
R~QUIREMENTS OF APPROPRIATE DISTRICTS MET ________ DATE _______ _
8J..o1
ALPHA LABORATORIES, INC.
SOIL & FOUNDATION ENGINEERING
M r • F: o L, H ,:, d 1 (·? u
? :L tt ;>. \,,1 i a !:1 on o r a
OccmnsideY CA 92054
i::·ro.H}C t ::l'.:l/i'.:l
:l ~·1,,121 ,1::1 :I
SLJ8J[CT: Lot 63 of La Cost a Meadows , Carlsbad, Ca l1for n 1a.
l h:i. i;;
tc-?s t i;;
:i.i,; to r01p ort
r:,c-:ir for mc,i d on
thf? r <·?l:;u l ti,; of CJb i;;er vat :i. ans
s ubGrade soils at the subJect
a nd
r:; :i. tri .
F :i. f"' 1 d C-:):: F·· l o T' at i c> n 1;; 1,J £:) r <·? r11 ad f,) t CJ r f:) tr i e v fi'! 1;; Di 1 i,; a m P 1 f? i,; i n
the center of the buildinG pad. Test pits were duG tD a
depth of a t l east 2 f e et bel ow finish Grade and mDi stu re
samPles were Dbta ined a t intermediate levels. We found t h e
f:if,ild mc>:i.stur r.1 t.D bri in f:)>:Cf:)!;;l:, c:>f 20. :I. P<~T'Cf?n t .
drs de nsit s determinat:i.Dn was
with ASTM 0:1.557 to ascertain
r--erfoT'ITlf?d in
·Lhf.·! CJ Pt :i mum
A ma:-::i.mum
i:lCCDrda nce
mo :i. !,; t u r f:-:,
war:, found
mo'i.<;;t1..11 c,:.:,.
content of the s ubJect
1 l 9, 0 PCll..ll"ld!;; P<·?T'
soil. The maximum densits
cubic fDot a t 14 ,9 Percent
In cc,nc l L.tl:, :i. on, W€~ f :i. nd the-? f :i. c-:-i ·1 d mo .i 1;; turf" r-i:-:c endi,; thf,)
cn-t·1.1111.1m b\,I .,d, lc-:-:,ast ~.'i,2 r:·f,irc<•?l"1t which lltf?<•?t i; t.l H,i m:t.nimum
reau:irements for presaturation of e x r:·a n s:ive s oils ,
If sou have a n s auestiDHs, please
contact thi s office. Thi s OPP<:>rtunit~
i,; :i. nee::! r f? l \J i;lF'F· T' <·,)C :i. a tfid .
ResPectfulls s ubmitted,
ALP HA LABORATO RIES , INC.
C. H . Woodf RCE 1U 778
TD! r:ih
do n o t
to b<?
hf:i!., J. t ate to
0 f !,; C' T • V :1. C e i S
7895 Convoy Court • San Diego • California 92111 -71 4 / 292-0660
...
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LEUCADIA COUNTY WATER DISTRICT
APPLICATION FOR SEWER SERVICE
Owner I s Name Robert & Ruth Hadley Phone No. 439-5719 ------
Mailing Address 2142 Via Sonora
Oceanside, Ca 92054
Service Address: ~'i. 3 I Unicorn,-'-i'--"o _____ _
Tract Description: lot 63 Meadows 1
Assessor's Parcel No. --------------
Type of Building -----=s~.--'--f~---No. Units 1 Connection Fee $ 15QQ an
Lateral Size: 411 611 811 Saddl e Easement Connection
Extra Footage : __ @$ __ _
Amount Rec 1d $-1500 no
Ck. No/Cash1 -4=4~--
Extra Depth: _ __ @ $ __ _
Lateral Fee
Prorated Sewer
Service Fee Date 1-4-........ 8 ..... J __
Rec'd By g.franklin Total $ 1500.00
The application must be signed by the owner (or his authorized representative) of
the property to be served. The total charges must be paid to the District at the
time the application is submitted.
If a service lateral is required, it will be installed by the Leucadia County Water
District. The service lateral is that part of the sewer system that extends from
the main collection line in the street (or easement) to the point in the street (at
or near the applicant's property line) wh ere the service lateral is connected to
the applicant's building sewer. The applicant is responsible for the construction,
at the applicant's expense, of the sewer pipeline (building sewer) from the appli-
cant's plumbing to the point in the street (or easement) where a connection is made
to the service lateral.
The connection of the applicant's building sewer to the service lateral shall be
made by the applicant at his expense. The connection must be made in conformity
with the District's specifications, rules and regulations; and IT MUST BE INSPECTED
AND APPROVED BY THE DISTRICT BEFORE THE SEWER SYSTEM MAY BE USED BY THE APPLICANT.
THE APPLICANT, OR HIS AUTHORIZED REPRESENTATIVE, MUST NOTIFY THE DISTRICT AT THE
TIME INSPECTION IS DESIRED. ANY CONNECTION MADE TO THE SERVICE LATERAL OR COLLEC-
TION LINE WITHOUT PRIOR APPROVAL AND INSPECTION BY THE DISTRICT WILL BE CONSIDERED
INVALID AND WILL NOT BE ACKNOWLEDGED.
The prorated sewer service fee is based upon the date the District estimates that
service will begin and covers the balance of the fiscal year. There will be no
additional fee or refund if service actually conmences on a different date. For
succeeding fiscal years, the sewer service fee will be collected on the tax roll
in the same manner as property taxes.
The undersigned hereby agrees that the above information given is correct and agrees
to the conditions as stated.
1-4-81 15228
Date Account No.
A'ITENTION PIDPERTY OWNER:
An "owHa-builder" building pennit has been applied for in your name and bearing your
signature.
Please complete and return this infonnation.in the envelope provided at your earliest
opportunity to avoid unnecessary delay in processing and i ssuing your building pennit.
No building pennit will be issued until this verification is received.
1.
2.
3.
I personally plan t o provide the major laror and mat ial s fr construction of
the proposed property improvement (yes or no) _ _.,q,,c;. ______ •
I (have/have not) ~signed the applicati for a building permit.
I have contracted ~following person (firm) to provide the proposed construction.
Name ------------~ Phone -------------
Address ------------Contractors License No. -----
City -------------
4. I plan to provide portions of the ~rk, _but I have hired the following person to
coordinate, supervise and provide the major ~rk.
Name -------------Phone -------------
Address ------------Con tractors License No. -----
City -------------
5. I will provide sorre of the work but I have contracted (hired) the following persons
to provide the work indicated:
Name Address Phone
Signed: Property Owner ~~
Social Security Number 5 5.-(,I 2 b z".'O ?')
Date: / ./ 2--5--: ~
Type of Work
....
1200 ELM AVENUE
CARLSBAD, CALIFORNIA 92008
Dear Property Owner:
<ttitp of Qtarlsbab
TELEPHONE:
714-438-5525
An application for a building F€ll(lit has been sul:mitted in your narre listing yourself
as the builder of the propertJ i.mprovements specified. :i:'or your protection you should be
aware that as "owner-builde:c': you are the responsible part.1 of re.:::ord on such a permit.
Building permits are not ;:-equired to be signed by the property _owners unless they are
personally _performing tbeir own 'M'.:>rk. If your "vvt>rk is being perfo.rrred by sareone other
than yourself, you may protect yourself from possible liability if that person applies for
the proper permit in his or her name.
Contractors are required by law to be licensed and l:xmded by the State of California and
to have a business license from the City of Carlsbad. They are also required by law to
put their license number on all permits for which ·they apply.
If you plan to do your own 'M'.:>rk, with the exception of various trades that you plan to
subcontract, you should be aware of the following information for your benefit and pro-
tection. If you employ or otherwise engage any persons other than your irrrnediate family,
and the "M)rk (including material and other costs) is $200 or Irore for the entire project,
and such persons are not licensed as contractors or subcontractors, then you may be an em-
ployer. If you are an employer, you must register with the state and federal governrrent
as an employer and you are subject to several obligations including state and federal
incane withholding, federal social security taxes, 'M'.:>rkers' compensation insurance, dis-
ability insurance costs, and unemployment contributions. There may be financial risks
for you if you do not carry out these obligations, and these risks are especially serious
with respect to 'M'.:>rkers ' corrpensation insurance.
For specific information about your obligations under federal law, contact the Internal
Revenue Service (and, if you wish, the U. S. Snail Business Mmi.nistration). For :rrore
specific information about your obligations under state law, oontact the Department of
Benefit Payments and the Division of Industrial Accidents.
If the structure is intended for sale, property owners who are not licensed contractors
are allowed to perfonn their "M)rk personally or through their own employees, without
a licensed contractor or subcontractor, only under limited conditions.
A frequent practice of unlicensed persons professing to be contractors is to secure an
"owner-builder" building permit, erroneously implying that the property owner is providing
his or her own labor and material personally. Building permits are not required to be
signed by property owners unless they are perfonning their CMn WJrk personally. Inforrra-
tion about licensed contractors may be obtained by contacting the Contractors State
License Peard in your ccmnunity or at 1020 N Street, Sacramento, CA. 95814.
PIBASE COMPLETE AND RETURN THE ENCIDSED OWNER-BUIIDER VERIFICATIQ.\l FORM SO THAT WE CAN
CONFIRM THAT YOU ARE AWARE OF THESE MA'.ITERS. THE BUIIDING PERMIT WILL NOI' BE ISSUED
UNTIL THE VERIFICATION IS REI'URNED.
Very truly yours,
Building Departrrent
City of Carlsbad
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