The URL can be used to link to this page

Home My WebLink About1941 CASSIA RD; 100; CBR2024-3207; Permit• ( Cicyof Carlsbad RESIDENTIAL BUILDING PERMIT APPLICATION B-1 Job Address \q 4\ CCAS-}~ a,_ g.d Unit: l 00 ~an ChHk ________ _ Est . Value PC Deposit Date APN: _________ _ CT/Project#:. _________________ Lot#:. ____ Year Built: ________ _ BRIEr:DESCRIPTIONOFWORK: '\k~k;lco ... 0 40 5ct\\D'O ~-\cv-kx.cder: 0 New SF : Living SF, ____ Deck SF, __ --'Patio SF,. ____ Garage SF __ _ Is this to create an Accessory Dwelling Unit? O Y O N New Fireplace? O YON, if yes how many? ___ _ D Remodel:. ____ ___:SF of affected area Is the area a conversion or change of use? 0 YO N □ Pool/Spa:. ____ ....;SF Additional Gas or Electrical Features? ____________ _ □ Solar:. ___ KW, ____ Modules, Mounted:QRoof OGround, Tilt: 0 YON, RMA: 0 YO N, Battery:OYC N, Panel Upgrade: Ov ON Electric Meter number: ___________ _ Other: APPU PROP ~~~~~=-1-r-=~:::...=..Lilic.&.------Nam ._.-;.....,.r.=111a=l-!i,t..ilioc;:::;;;...w;,.a-::~-------Add :919Lf;> DESIGN PROFESSIONAL CONTRACTOR OF ECORD Name: _________________ Business • a ·n.9 9 :Dx:a, OS~- Address: Add City:. ________ .State:. ____ Zip:._____ City -..c..u.,W-1.i.:.r,,.l,l.l~;,,.: Phone:. ________________ _ Email:. ________________ _ Architect State License: __________ _ Carlsbad Business License# (Required):, _______ _ APPLICANT CERT/Ff CATION: I certify that I have read the application and state that. agree to comply with all City dinances and State laws relating to building construction. 1635 Faraday Ave Carlsbad, CA 92008 Ph: 442-339-2719 hat the information of the plans is accurate. I Email: Building@carlsbadca.gov REV. 04/22 THIS PAGE REQUIRED AT PERMIT ISSUANCE ' PLAN CHECK NUMBER: ______ _ A BUILDING PERMIT CAN BE ISSUED TO EITHER A STATE LICENSED CONTRACTOR OR A PROPERTY OWNER. IF THE PERSON SIGNING THIS FORM IS AN AGENT FOR EtTHER ENTITY AN AUTHORJZATION FORM OR LETTER IS REQUIRED PRIOR TO PERMIT ISSUANCE. (OPTION A): LICENSED C0NTAAO0R DECLARATION: I herebyaffirmunderpenaltyof perjurythatlam licensed under provisions of Chapter9 (commendngwith Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. I also affirm underpenaltyof perjury one of the following declarations (CHOOSE ONE): Ot have and will maintain a certificate of consentto self-insure for workers' compensation provided by Section 3700 of the Labor Code, for the performance of the work which this permit is issued. PolicyNo.'------------------------------------------ -OR- S(have and ~ill maintain worker's compensation, as required by Section 3700 of the labor Code, for the perf~rmance of the work for My workers' c.11'pensation!:'=':: ca: and policy number are: lnsuranceCompany Name: s::::.u.u.u..µ'4-:,:\-ipP,1¥~~11,.<!,.Ao'-:'ll~i..,;;iu.iu...l..'+~~-I Polley No . ..::>\ ffi ~ \R-tJ-\ Expiration Date: ~-l---!-+-"",__ __ -"""'.,_._,41-......_"---='t--l -OR- O 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 $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. CONSTRUCTION LENDING AGENCY. lf 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:. _____________________ l.ender'sAddress: _____________________ _ CONTRACTOR CERTTFICATION: The applfcant certifies that all documents and plans dearly and accurately show all existing and proposed buildings, structures, access roads, and utlfities/utllity easements. All proposed modifications and/or additions are clearly labeled on the site plan. Any potentially existing detail within these plans inconsistent with the site plan are not approved for construction and may be required to be altered or removed. The city's approval of the application is based on the premise that the submitted documents and plans show the correct dimensions of; the property, bwldings, structures and their setbacks from property lines and from one another; access roads/easements, and utilities. The existing and proposed use of each building as stated is true and correct; all easements and other encumbrances to development have been acrurately shown and labeled as well as all on-site grading/site preparation. All Improvements existing on the property were completed In accordance with all regulations in exlste t the time of th • construction, uni erwise noted. (OPTION B): OWNER-BUILDER OECl.ARATION: I hereby affirm that I am exempt from Contractor's License Law for the following reason: 0 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 hfmself 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). -OR- O I, as owner of the property, •m ..,. .. ,u~ivcly <-0ntra<;<ln5 with ••==eu contracmrs ro construct the project (Sec. 7044, f!USlness ana Professions cooe: TIie 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). -OR- DI am exempt under Business and Professions Code Division 3, Chapter 9, Article 3 for this reason: AND, 0 FORM 8-61 "OWner Builder Acknowledgement and Verification Form" is required for any permit issued to a property owner. By my signature below I acknowledge that, except for my personal residence in which I must have resided for at least one year prior to completion of the improvements covered by this permit, I cannot legally sell a structure that I have built as an owner-builder if it has not been constructed in its entirety by licensed contractors./ understand that a copyoftheapplicablelaw, Section 7044of the BusinessandProfessionsCode, isavailableupon requestwhen this application is submitted or at the following Website: http:l lwww.leginfo.ca.gov/calaw.hbnl. OWNER CERTIFICATION: The applicant certifies that all documents and plans dearly and accurately show all existing and proposed buildings, structures, access roads, and utilities/utility easements. All proposed modifications and/or additions are dearly labeled on the site plan. Any potentially existing detail within these plans Inconsistent with the site plan are not approved for construction and may be required to be altered or removed. The city's approval of the application is based on the premise that the submitted documents and plans show the correct dimensions of; the property, build"mgs, structures and their setbacks from property lines and from one another; access roads/easements, and utilities. The existing and proposed use of each building as stated ls true and correct; all easements and other encumbrances to development have been accurately shown and labeled as well as all on-site grading/site preparation. Ail improvements existing on the property were completed in accordance with all regulations in existence at the time of their construction, unless otherwise noted. NAME (PRINT): SIGN: __________ DATE: ______ _ Note: If the person signing above is an authorized agent for the prope owner indude form B-62 signed by property owner .. 1635 Faraday Ave Carlsbad, CA 92008 Ph: 442-339-2719 Email: Building@carlsbadca.gov 2 REV. ()4/22