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Home My WebLink About1394 KNOWLES AVE; ; CBR2020-2997; PermitPrint Date: 11/19/2020 Permit No: CBR2020-2997 Building Permit Finaled Residential Permit Job Address: Permit Type: Parcel #: Valuation: Occupancy Group: 1394 KNOWLES AVE, CARLSBAD, CA 92008-1547 BLDG-Residential 1562313200 $0.00 Work Class: Lot #: Project #: P/M/E Status: Applied: Issued: 11/18/2020 11/18/2020 Finaled Close Out: #of Dwelling Units: Track #: Plan #: Closed - Finaled PBurn Plan Check #: Project Title: Inspector:Orig. Plan Check #:Bathrooms: Description:GAS LEAK REPAIR (E-REVIEW) Final Inspection:11/19/2020 Bedrooms:Construction Type: Property Owner: THE GAYLE J HERMSEN CAHVEZ TRUST PO BOX 1307 CARLSBAD, CA 92018 AMOUNTFEE PLUMBING, ELECTRICAL, AND MECHANICAL PERMIT $175.00 Total Fees:$175.00 Total Payments To Date:$175.00 Balance Due:$0.00 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. 1635 Faraday Avenue, Carlsbad CA 92008-7314 ï 760-602-2700 ï 760-602-8560 f ï www.carlsbadca.gov Building Division Page 1 of 1 {"Cityof Carlsbad 1 REV. 08/20 __________________________________________________________________________________________________ RESIDENTIAL BUILDING PERMIT APPLICATION B-1 Plan Check Est. Value PC Deposit Date Job Address Suite: APN: CT/Project #: Lot #: Year Built: ______________________ Fire Sprinklers: YES NO Air Conditioning: YES NO Electrical Panel Upgrade: YES NO BRIEF DESCRIPTION OF WORK: This permit is to be issued in the name of the Property Owner as Owner-Builder, licensed contractor or Authorized Agent of the owner or contractor. The person listed as the Applicant below will be the main point of contact throughout the permit process. PROPERTY OWNER APPLICANT PROPERTY OWNERS AUTHORIZED AGENT APPLICANT Name: Name: Address: Address: City: State: Zip: Phone: City: State: Zip: Phone: Email: Email: DESIGN PROFESSIONAL APPLICANT CONTRACTOR OF RECORD APPLICANT Name: Address: City: State: Zip: Phone: Email: Architect State License: Name: Address: City: State: Zip: Phone: Email: State License/class: Bus. License: 1635 Faraday Ave Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Email: Building@carlsbadca.gov Solar: KW, Modules, Mounted: Roof Ground, Tilt: Y N, RMA: Y N, Battery: Y N, Panel Upgrade: Y N Reroof: Plumbing/Mechanical/Electrical Only: Other: Additional Gas or Electrical Features?Pool/Spa:SF Addition/New: _Living SF, _ Deck SF, Patio SF, Garage SF ______ Is this to create an Accessory Dwelling Unit? Y N New Fireplace? Y N , if yes how many? Remodel: SF of affected area Is the area a conversion or change of use ? Y N 1394 Knowles Ave 156-231-32-00 1951 Repair of gas leak at pipe behind stove per SDG&E service call 11/15/2020 for concern of gas smell/leak Bridget Hermsen 11422 Kaywood Circle Escondido CA 92026 760 715 6864 bridgethermsen@gmail.com bridgethermsen@gmail.com CBR2020-2997 11/18/20 □ □ □ □ □ Iii □ ( City of Carlsbad 0 ® 00 00 0 ® 0 0 0 0 00 0 0 0 0 00 00 □ □ □ OWNER PRINT: ^/'E͗ APPLICANT CERTIFICATION: SIGNATURE REQUIRED AT THE TIME OF SUBMITTAL 2 REV. 08/20 IDENTIFY WHO WILL PERFORM THE WORK BY COMPLETING (OPTION A) OR (OPTION B) BELOW: (OPTION A): LICENSED CONTRACTOR DECLARATION: I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect. I also 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 3700 of the Labor Code, for the performance of the work which this permit is issued. Policy No.___________________________________________________________________________________________________ I have and will maintain worker’s compensation, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers’ compensation insurance carrier and policy number are: Insurance Company Name: Policy No. ________________________________Expiration Date: 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, IF 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: Lender’s Address: DATE: CONTRACTOR PRINT͗ (OPTION B): OWNER-BUILDER DECLARATION: I hereby affirm that I am exempt from Contractor’s License Law for the following reason: 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 himself 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). 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). I am exempt under Business and Professions Code Division 3, Chapter 9, Article 3 for this reason: _____________________________________________________________________________________________________________________________________ “Owner Builder acknowledgement and verification form” has been filled out, signed and attached to this application. Owners “Authorized Agent Form” has been filled out, signed and attached to this application giving the agent authority to obtain the permit on the owner’s behalf. 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 DATE: 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. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this application is submitted or at the following Web site: http://www.leginfo.ca.gov/calaw.html. By my signature below, I certify that: I am the property owner or State of California Licensed Contractor or authorized to act on the property owner or contractor’s behalf. 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 representative of the City 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. APPLICANT PRINT: DATE: 1635 Faraday Ave Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Email: Building@carlsbadca.gov ^/'E͗ ^/'E͗ Bridget Hermsen Digitally signed by Bridget HermsenDN: C=US, E=bridgethermsen@gmail.com, CN=Bridget HermsenReason: I am approving this documentDate: 2020.11.17 07:51:10-08'00'11/17/2020 Bridget Hermsen Digitally signed by Bridget HermsenDN: C=US, E=bridgethermsen@gmail.com, CN=Bridget HermsenReason: I am approving this documentDate: 2020.11.17 07:51:29-08'00'11/17/2020 Bridget Hermsen Bridget Hermsen □ □ □ □ □ Iii □ 1 OWNERS AUTHORIZED AGENT FORM B-62 Development Services Building Division 1635 Faraday Avenue 760-602-2719 www.carlsbadca.gov OWNER’S AUTHORIZED AGENT FORM Only a property owner, contractor or their authorized agent may submit plans and applications for building permits. To authorize a third---party agent to sign for a building permit, the owner’s third party agent must bring this signed form, which identifies the agent and the owner who s/he is representing, and for what jobs s/he may obtain permits. The form must be completed in its entirety to be accepted by the City for each separate permit application. Note: The following Owner’s Authorized Agent form is required to be completed by the property owner only when designating an agent to apply for a construction permit on his/her behalf. AUTHORIZATION OF AGENT TO ACT ON PROPERTY OWNER’S BEHALF Excluding the Property Owner Acknowledgement, the execution of which I understand is my personal responsibility, I hereby authorize the following person(s) to act as my agent(s) to apply for, sign, and file the documents necessary to obtain an Owner-Builder Permit for my project. Scope of Construction Project (or Description of Work): ________________________________________________ Project Location or Address: ______________________________________________________________________ Name of Authorized Agent: __________________________________________Tel No. ______________________ Address of Authorized Agent:_____________________________________________________________________ _____________________________________________________________________ I declare under penalty of perjury that I am the property owner for the address listed above and I personally filled out the above information and certify its accuracy. Property Owner’s Signature: _______________________________________________ Date: _________________ Repair gas leak in kitchen pipe 1394 Knowles Ave Carlsbad CA 92008 Bridget Hermsen 760 715 6864 11422 Kaywood Circle Escondido, CA 92026 Bridget Hermsen Digitally signed by Bridget HermsenDN: C=US, E=bridgethermsen@gmail.com, CN=Bridget Hermsen Reason: I am approving this documentDate: 2020.11.17 07:50:57-08'00' 11/17/2020 ( City of Carlsbad 1 REV. 08/20 OWNER-BUILDER ACKNOWLEDGEMENT FORM B-61 Development Services Building Division 1635 Faraday Avenue 760-602-2719 www.carlsbadca.gov OWNER-BUILDER ACKNOWLEDGMENT FORM Pursuant to State of California Health and Safety Code Section 19825---19829 To: Property Owner An application for construction permit(s) has been submitted in your name listing you as the owner---builder of the property located at: Site Address ______________________________________________________________________________ The City of Carlsbad (“City”) is providing you with this Owner---Builder Acknowledgment and Verification form to inform you of the responsibilities and the possible risks associated with typical construction activities issued in your name as the Owner-Builder. The City will not issue a construction permit until you have read and initialed your understanding of each provision in the Property Owner Acknowledgment section below and sign the form. An agent of the owner cannot execute this notice unless you, the property owner, complete the Owner’s Authorized Agent form and it is accepted by the City of Carlsbad. INSTRUCTIONS: Please read and initial each statement below to acknowledge your understanding and verification of this information by signature at the bottom of the form. These are very important construction related acknowledgments designed to inform the property owner of his/her obligations related to the requested permit activities. I. _____I understand a frequent practice of unlicensed contractors is to have the property owner obtain an “Owner- --Builder” building permit that erroneously implies that the property owner is providing his or her own labor and material personally. I, as an Owner---Builder, may be held liable and subject to serious financial risk for any injuries sustained by an unlicensed contractor and his or her employees while working on my property. My homeowner’s insurance may not provide coverage for those injuries. I am willfully acting as an Owner---Builder and am aware of the limits of my insurance coverage for injuries to workers on my property. II. _____I understand building permits are not required to be signed by property owners unless they are responsible for the construction and are not hiring a licensed contractor to assume this responsibility. III. _____I understand as an “Owner---Builder” I am the responsible party of record on the permit. I understand that I may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed in his or her name instead of my own. IV. _____I understand contractors are required by law to be licensed and bonded in California and to list their license numbers on permits and contracts. V. _____I understand if I employ or otherwise engage any persons, other than California licensed contractors, and the total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be considered an “employer” under state and federal law. 1394 Knowles Ave Carlsbad CA 92008 BH BH BH BH BH ( City of Carlsbad Owner-Builder Acknowledgement Continued 2 REV. 08/20 VI. _____I understand if I am considered an “employer” under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers’ compensation disability insurance, and contribute to unemployment compensation for each “employee.” I also understand my failure to abide by these laws may subject me to serious financial risk. VII. I understand under California Contractors’ State License Law, an Owner---Builder who builds single--- family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and the number of structures does not exceed four within any calendar year, or all of the work is performed under contract with a licensed general building contractor. VIII. I understand as an Owner---Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) which result from any latent construction defects in the workmanship or materials. IX. I understand I may obtain more information regarding my obligations as an “employer” from the Internal Revenue Service, the United States Small Business Administration, the California Department of Benefit Payments, and the California Division of Industrial Accidents. I also understand I may contact the California Contractors’ State License Board (CSLB) at 1---800---321---CSLB (2752) or www.cslb.ca.gov for more information about licensed contractors. X. _____I am aware of and consent to an Owner---Builder building permit applied for in my name, and understand that I am the party legally and financially responsible for proposed construction activity at the following address: ___________________________________________________________________________________________ XI. _____I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by all applicable laws and requirements that govern Owner---Builders as well as employers. XII. _____I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on this form. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractor’s State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is injured while working on your property, you may be held liable for damages. If you obtain a permit as Owner--- Builder and wish to hire contractors, you will be responsible for verifying whether or not those contractors are properly licensed and the status of their workers’ compensation coverage. Before a building permit can be issued, this form must be completed, signed by the property owner and returned to the City of Carlsbad Building Division. I declare under penalty of perjury that I have read and understand all of the information provided on this form and that my responses, including my authority to sign this form, is true and correct. I am aware that I have the option to consult with legal counsel prior to signing this form, and I have either (1) consulted with legal counsel prior to signing this form or (2) have waived this right in signing this form without the advice of legal counsel. Property Owner Name (PRINT) Property Owner Signature Date 1394 Knowles Ave Carlsbad CA 92008 Bridget Hermsen Bridget Hermsen Digitally signed by Bridget HermsenDN: C=US, E=bridgethermsen@gmail.com, CN=Bridget HermsenReason: I am approving this documentDate: 2020.11.17 07:52:07-08'00' 11/17/2020 BH BH BH BH BH BH BH Building Permit Inspection History Finaled PERMIT INSPECTION HISTORY for (CBR2020-2997) BLDG-Residential 11/18/2020Application Date:Permit Type:Owner:TRUST THE GAYLE J HERMSEN CAHVEZ TRUST P/M/E 11/18/2020Work Class:Issue Date:Subdivision: 05/18/2021Expiration Date:Status: IVR Number: 30032 Closed - Finaled 1394 KNOWLES AVE CARLSBAD, CA 92008-1547 Address: Scheduled Date Inspection Type Inspection No. Inspection Status Primary Inspector Reinspection InspectionActual Start Date 11/19/2020 11/19/2020 BLDG-23 Gas/Test/Repairs 144122-2020 Passed Paul Burnette Incomplete COMMENTS PassedChecklist Item BLDG-Building Deficiency Yes BLDG-Final Inspection 144123-2020 Passed Paul Burnette Complete COMMENTS PassedChecklist Item BLDG-Building Deficiency No BLDG-Plumbing Final Yes BLDG-Mechanical Final No BLDG-Structural Final No BLDG-Electrical Final No Thursday, November 19, 2020 Page 1 of 1 {cityof Carlsbad