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'1 STHUCTION, WHETHER SPECIFIED HEREIN OR NOT. 1 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 CONSEQUiNCE OF THE1 GRANTING OF THIS PERMIT.V 3
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fE CAREFULLY EXAMINED THE COMPLETED "APPUGATIQN AND PERMIT*IFY UNDER PENALTY OF PERJURY THAT ALL .INFORMATION HEREON.ARATfONS ARE TRUE AND CORRECT AMD 1 FURTHER CERTIFY AND AGRED; TO. COMPLY WITH ALL CiTY, COUNTY AND STATE LAWS GOVERNfNAN 0 DO HEREBYINCLUDING THEEE IF A PERMIT IS3 BUILDING CON^Expf ration. Every permit issued by the 8uil<Code shaH expire by limitation artel becomeauthorized by such permit is not commencepermit or if the buiktmp or wprk author)abandoned at any time after the 'work is corling Official under thenut! and void. Jf tfte3 within 180 days fromzed by such atermitnmen^ed for aioetiodjrovtsions of this)uf!ding or workthe date of suchs suspended orof ISO davs.* AN OSHA PERMIT IS INQUIRED5" 0" DEEP AND DEMOLITION OlSTRUCTURES OVER 3 STORIES/FOR EXCAVATIONS OVERR CONSTRUCTION OfN HEIGHT/o
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DEVELOPMENTAL .. _ B" » 1200 ELM AVENUE
SERVICES • ^&r m CARLSBAD, CALIFORNIA 92008-1989
BUILDING DEPARTMENT m^!^Ji (619)
Cttp of Carlsbad
Dear Property Owner:
An application for a building permit has been submitted in your name listing yourself
as the builder of the property improvements specified. For your protection you should be
aware that as "owner-builder" you are the responsible party of record on such a permit.
Building permits are not required to be signed by the property owners unless they are
personally performing their own work. If your work is being performed by someone 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 bonded 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 work, 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 immediate family,
and the work (including material and other costs) is $200 or more for the entire project,
and such persons are not licensed as contractors or subcontractors, then you may be an
employer. If you are an employer, you must register with the state and federal government
as an employer and you are subject to several obligations including state and federal
income withholding, federal social security taxes, workers' compensation insurance,
disability 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 workers' compensation insurance.
For specific information about your obligations under federal law, contact the Internal
Revenue Service (and, if you wish, the U.S. Small Business Administration). For more
specific information about your obligations under state law, contact 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 perform their work 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 performing their own work personally. Informa-
tion about licensed contractors may be obtained by contacting the Contractors State
License Board in your community, or at 1020 N Street, Sacramento, CA 95814.
PLEASE COMPLETE AND RETURN THE ENCLOSED OWNER-BUILDER VERIFICATION FORM SO THAT WE CAN
CONFIRM THAT YOU ARE AWARE OF THESE MATTERS. THE BUILDING PERMIT WILL NOT BE ISSUED
UNTIL THE VERIFICATION IS RETURNED.
Very truly yours,
Building Department
City of Carlsbad
ATTENTION PROPERTY OWNER":
An "owner-builder" building permit has been applied for 1n your name and bearing your
signature.
Please complete and return this Information In the envelope provided at your earliest
opportunity to avo1d~unnecessary delay 1n processing and Issuing your building permit.
No building permit will be Issued until this verification 1s received.
1. I personally plan to provide the major labor and materials for construction of
the proposed property improvement (yes or no)
2. I (have/have not) A&&& ._\nfj^-. s^9ne£l tne application for a building permit.
3. I have contracted with the following person (firm) to provide the proposed construction.
Name /[/ «JTT— Phone
Address Contractors License No.
City
4. I plan to provide portions of the work, but I have hired the following person to
coordinate, supervise and provide the major work.
Name /\£ r^ / . Phone
Address Contractors License No. . .
City
5. I will provide some of the work but I have contracted (hired) the following persons
to provide the work indicated:
Name XT/v Xv . Address Phone Type of Work
Signed: Property Owner r*
Social Security Number & J~S~ '- a ja - /
Date:
EACH SUBCONTRACTOR WILL BE INSTRUCTED TO OBTAIN A CITY OF CARLSBAD BUSINESS LICENSE
AND FURNISH A CERTIFICATE OF WORKMAN'S COMPENSATION TO THE CITY OF CARLSBAD.
Initials