HomeMy WebLinkAbout2535 Jefferson St; 3, 4, 7, 8; CBR2018-2339; PermitCcityof
Carlsbad
Residential Permit
Print Date: 02/27/2019 Permit No: CBR2018-2339
Job Address:
Permit Type:
Parcel No:
Valuation:
Occupancy Group:
# Dwelling Units:
Bedrooms:
2535 Jefferson St, 3,4,7,8
BLDG-Residential
1551704504
$0.00
Work Class: Repair
Lot#:
Reference#:
Construction Type:
Bathrooms:
Orig. Plan Check#:
Status:
Applied:
Issued:
Permit
Finaled:
Inspector:
Closed -Finaled
09/06/2018
09/06/2018
Plan Check#:
Final
Inspection: 2/27/2019 11:55:21AM
Project Title:
Description: LAGUNA DE LOS PATOS: RESIDE BUILDING (UNITS 3,4,7,8)
Owner:
LAGUNA DE LOS PATOS HOA
760-720-0900
BUILDING INSPECTION FEE
Total Fees: $234.00 Total Payments To Date: $234.00
Contractor:
PRIMECO
220 Oceanside Blvd
Oceanside, CA 92054-4903
800-881-8067
Balance Due:
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.
$0.00
1635 Faraday Avenue, Carlsbad, CA 92008-7314 I 760-602-2700 I 760-602-8560 f I www.carlsbadca.gov
$234.00
Ccityof
Carlsbad
RESIDENTIAL
BUILDING PERMIT
APPLICATION
8-1
Plan Check C()RJQI ~ -itgtJ
Est. Value -1
PC Deposit z
Date _q--'--'/----'-Lj +-'-1....,_8_
Job Add res:. _i;d--b_ ;.;DQ,Jmrn~~~~{2~I._~:..:3~•~s,
CT/Project "• __________ Lot#: ___ _
BRIEF DESCRIPTION OF WORK: ic6--':>11)f; &,11-D/rJG,rS JW1H LY '5MAfff'51Dc
0 Addition/New: ______ New SF, ____ Deck SF, ____ Patio SF, ____ Garage SF
Is this to create an Accessory Dwelling Unit? Yes/ No New Fireplace? Yes/ No, if yes how many?
D Remodel: _____ SF of affected area Is the area a conversion or change of use? Yes/ No
0 Pool/Spa: ____ SF Additional Gas or Electrical Features? ______________ _
O Solar: ___ KW, ___ Modules, Mounted: Roof/ Ground , Tilt: Yes/ Ne•, RMA: Yes/ No, Battery: Yes/ No
Panel Upgrade: Yes/ No
D Reroof: ------------------------------------
□ Plumbing/Mechanical/Electrical Only:
D Other: ---------------------------
APPLICANT (PRIMARY} PROPERTY OWNER
Name: :EPG,a& MBNP-IQit:---Z.
Address: -2:zo QCf#'rrv'51Qc Bt-vD
City: OCJ;/IN$1DE: State: CA Zip: "I-ZOS4
___. Phone: :z <,o • 4o5 -3lfk5
Email: f:MF\1YSICNCZ0 P81Mi5co COM
DESIGN PROFESSIONAL
Name: __________________ _
Address: ________________ _
City: ________ State: __ ~Zip: ____ _
Phone: _________________ _
Email: __________________ _
Architect State License: ____________ _
Name: LAetu,.,,.. DE' irs 0t:rDs lbB
Address: 21i25 1>'0""'E~SQN '21
City: C#IS)bBAQ State: CA ·zip: 92 008
Phone: ______________________ _
Email: _____________________ _
CONTRACTOR BUSINESS
Name: IBIMC:CO
Address: 7;20 oCl:n\ff,,QC )31..yQ
City: OCJfflNS10e State: CA Zip: 9:ZOS'-1
Phone: Boo. ear. Be 7
Email: i'/ZIME?IW\'l rF-IMECO. coM
State License: ,31 ?£4 Bus. License: 1191 JJ:3
(Sec. 7031.S Business and Professions Code: Any City or County which requires a permit to construct, alter, impm-1e, 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 e <empt 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 ot 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
8-1 Page 1 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 3;·00 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 perforn1ance of the work for which this permit is issued.
My workers' compensation insurance carrier and policy number are: Insurance Company Name: Cf\L)fo£.~>Jwfs: CON'T~t:126 Ni:Jr..,oBr:,
Policy No. 'H:oi!I· 01,C/ Expiration Date: QI /{}f /Zo/q
□ Certificate of Exemption: I certify that in the periormance 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: ....... ;~.,~.,1.;;,:;~· "--,...,-;:7{"-____________ □AGENT DATE: _____ _
( OPTION B ): OWNER-BUILDER DECLARATION:
I hereby affirm that I am exempt from Contractor's License Law for the following reason:
D I, as owner of the property or my employees with wages as their sole compensation, wHI do the work and the s• ructure is not intended or offered for sate (Sec.
7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who b Jllds 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, f,owever, 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 thP purpose of sale).
□ I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. i044, 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).
D 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 improvem,,nt. □ Yes □ 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 I phone/ 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/
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/ type of work):
OWNER SIGNATURE: ___________________ □AGENT DATE: ______ _
CONSTRUCTION LENDING AGENCY, IF ANY:
I hereby affirm that there is a construction lending agency for th,e 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 regist 'ation form or risk management and prevention
program under Sections 25505, 2S533 or 25S34 of the Presley-Tanner Hazardous Substance Account Act? D Ye-:. □ No.
Is the applicant or future building occupant required to obtain a permit from the air pollution control district or ai quality management district? O Yes O No
Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? □ Yes D 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 nn 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 pur:1oses. I ALSO AGREE TO SAVE, INDEMNIFY AND KEEP
HARMLESS THE CllY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND EXPENSES WHICH MAY IN ANY \/\,AV 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 cor,struction 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 aftecthe work ;s commenced for a ped=z:Un. iform Building Code).
APPLICANT SIGNATURE: ~ DATE: ora/~q !'2otB
1635 Faraday Ave Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Email: Building@carlsbadca.gov
B-1 Page 2 of 2 Rev. 06118
PERMIT INSPECTION HISTORY REPORT (CBR2018-2339)
Permit Type: BLDG-Residential Application Date: 09/06/2018 Owner: LAGUNA DE LOS PATOS HOA
Work Class: Repair Issue Date: 09/06/2018 Subdivision: CARLSBAD TCT#77-01
Status: Closed -Finaled Expiration Date: 05/29/2019 Address: 2535 Jefferson St, 3,4,7,8
Carlsbad, CA 92008-1420
IVR Number: 13736
Scheduled Actual Inspection Status Primary Inspector Reinspection Complete Date Start Date Inspection Type Inspection No.
11(2612018 11/26/2018 BLDG-18 Exterior 076894-2018 Passed Tim Frazee Complete
Lath/Drywall
Checklist Item COMMENTS Passed
BLDG-Building Deficiency Typar paper on exterior OK Yes
02/27/2019 02127/2019 BLDG-Final 084801-2019 Passed Mlchael Collins Complete
Inspection
Checklist Item COMMENTS Passed
BLDG-Building Deficiency See final notes about Unit ID Yes
February 27, 2019 Page 1 of 1
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