HomeMy WebLinkAbout2694 MEDFORD CT; ; CBR2022-0959; PermitPrint Date: 12/12/2022 Permit No: CBR2022-0959
Building Permit Finaled
Residential Permit
Job Address:
Permit Type:
Parcel #:
Valuation:
Occupancy Group:
2694 MEDFORD CT, CARLSBAD, CA 92010-2177
BLDG-Residential
1674331800
$0.00
Work Class:
Lot #:
Project #:
P/M/E
Status:
Applied:
Issued:
03/23/2022
03/23/2022
Finaled Close Out:12/12/2022
#of Dwelling Units:
Track #:
Plan #:
Closed - Finaled
Plan Check #:
Orig. Plan Check #:Bathrooms:
Final Inspection:04/29/2022Bedrooms:Construction Type:
Occupant Load:
Code Edition:
Sprinkled:
INSPECTOR:Alvarado, Tony
2694 MEDFORD CT: REPLACE & RELOCATE GAS METER (E-REVIEW)Description:
Project Title:
Applicant: CO-OWNERS BALAITY NICHOLAS AND BALAITY
TARA
2694 MEDROD CT
CARLSBAD, CA 92010(805) 305-4225
AMOUNTFEE
PLUMBING, MECHANICAL & ELECTRICAL PERMITS $193.00
Total Fees:$193.00 Total Payments To Date:$193.00 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 442-339-2719 ï 760-602-8560 f ï www.carlsbadca.gov
Building Division Page 1 of 1
{"Cityof
Carlsbad
CBR2022-0959
3/23/2022
( City of
Carlsbad
Job Address
RESIDENTIAL
BUILDING PERMIT
APPLICATION
8-1
Plan Check _______ _
Est. Value
PC Deposit
Date
CT/Project 11: ________________ Lot 11: ____ Year Built: ________ _
Fire Sprinklers: 0 EsQ NO Air Conditioning:Q YESO NO Electrical Panel Upgrade:Q YESQ NO
BRIEF DESCRIPTION OF WORK: P,(l.P/ A-c.L -72.J;./o C.~7X--6,4-;S ,4,f,Ff-. ~
0 New SF : _____ Living SF, ___ Deck SF,, ____ Patio SF, ____ Garage SF __ _
Is t his to create an Accessory Dwelling Unit? O v ON New Fireplace? O Y ON , if yes how many? __
D Remodel: SF of affected area ----Is t he area a conversion or change of use? Ov ON
□ Pool/Spa: ____ SF Additional Gas or Electrical Features? ___________ _
O solar: ___ KW, ___ Modules, Mounted:0 Roof 0 Ground, Tilt: 0 vO N, RMA: O v ON,
Battery: 0v ON, Panel Upgrade: 0v ON
O)'e,ool ~ G1' Plumbing/Mechanical~
0 Only: Other:
Name: Business Name: t .
Address: ___ ~-rf-zjt:::=~------; Address: L
City: ,_ __ Zip: ____ City: X t TJ~ __ Z1p:
Phone: _____ .__ _________ -1 Phone: ___ , __ / _______ ::~~::::_-_-_--=
Email: ________________ Email: _________________ _
Architect State License: CSLB License 11: _______ Class: ______ _
Carlsbad Busi ness License II (Required): ______ _
APPLICANT CERT/FICA TION: lcert1fythat /have read the app/1cot1onandstace tha1 the above informationiscorrect and that the
informalianon the plans is accurate. /agree to comply wrth all City ordinances and State laws I elallng to building
cot ct ,on. --r Vl , \ J. 1 -r-t/L. _
NAME PRINT . ~('\YP\ r,.i1 Vl \l':f s1GN:~ ~ oATE: \Vrl\r C
Ph 7t,().t,02 27!9F~• 71./0 t,02 II 58
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 EITHER ENTITY AN AUTHORIZATION FORM OR LETTER IS REQU IRED PRIOR TO
PERMIT ISSUANCE.
(OPTION A): LICENSED CONTRACTOR DECLARATION:
1 herebyaf firm underpenal tyof per jury that I am l1censedunderprovis1onsof Chapter 9 mencing with Section 7000)of D1vis1on3
oft he ~usinessand Prof essions Code, and my license is inf ul/ force and effect. la/ firm under penalty of perjury one of the
f ollow,ng declarations (CHOOSE ONE):
D hil,e and v.ill ma nu n a cert1foca1e of cons•m 10 s~.f msure fOfv.orke,s· cor,,pe ,on prov,ded by SeCllon 3700 of the Labor Code, for the performan,e of the
work wh ch this permit is issued PohcyNo ___________ ""?"c.__ _________________________ _
-OH
DI have and w II mam1aIn worker's c0fnpensatIon, as requ red by on 3700 of the Labor Code. for the performance of the v.ork for which this perm 1Is ssued
My workers' compensation Insura,ice carr.er and pol cy number · Insurance Company Name: _____________________ _
Policy No. --------------~'.-___________ Expiration Date: __________ _
OH-
O Certif cate of E>-empuon· I cert,fy thill In the rmance of the work for which th s permI1Is Issued I sha I not employ any oerson n any manner so as to becom,,
subiPrt lo the workers' compensation Laws o al forn1a WARNING: Failure 10 secure workers compensation coverage is unlawful and shall subJecl an employer to
criminal penallles and civil fines up to S ,000,00, In addition the to the cost of compensation, damages as provided for In Section 3706 of the Labor Code,
mterest and attorney's fees.
construct,on lenchng agency for the perf0<mance of the work this permit Is issued {Sec 3097 {1J C1v1I Code)
Lender's Name: _ ___,,,_ _________________ Lender's Address: ___________________ _
CERT/FICA T/ON: /certifythat I have read the applicationandstate that the above information is correct and that
the inf or ationon the plans isaccurate. lagree to comply with all City ordinances and State laws relating t o building
construction.
NAME (PRINT}: -------------SIGNATURE: __________ DATE: ______ _
Note; If the person signing above Is an .1uthonzed agent for the contractor provide a letter of authorization on contractor letterhead.
-OR -
(OPTION 8): OWNER-BUILDER DECLARATION:
I hereby affirm that I am exempt from Contractor's License Low for the f ollowing reason:
(3 I. as owner of 1he property or my employees with wages as their sole compensatron, wlll do the work and t e structure Is not intended or offered for sa e (Sec
7044 Bus,ness and Professions Code The Contractor's License l aw does not apply to an owner of property who builds or improves thereon, and who does such
w, •~ h,-,~ f or through his own employees, provded that such improvements are not in ended or offered for sale If, however, the bu Id og or rnprovement Is sold
w1thIn one year of completron, the owner bu Ider will have t~e burden of proving that he did not build or improve for the purpose of sa e)
0 1 •
I, as ow ., of the propeny am excl,si,ely convan,ng with l<ensed contractors to construct the proJect (Sec 7044, BuS1ness and Professions Code The
Contractors L>eense Law does not apply 10 an owner of property who builds or improves thereon, and contracts for such pro;ects with contractor(s) licensed
pu"uant to the Contr•ctor's LICense Law)
-0 1(-□ I am e>t·mpt under Business and Profess10ns Code D1vis,on 3. Chapter 9, Article 3 for th<s reason
,-..u.
~ 1 •owner B01lder Acknowledgement and Verif1ca1lon Form• Is rt~J red for any µ<>rrn.t ssuo>d to a propeI t; o" ,er
'r 111'( !t,,:JtlJ~l t. I -,., I ~ "' -dgt t, • r , pt ft~ rny p,-ri'>n rt-Jt /J m \~h 'rr \l hiv rt1\1dr,d f 1r t I l itl y r pr nr t complt~t 1 oft
mr ,..,f'rr1t. t• c '-'t red by th s r r-n t, I no t lrgal .,, • stru ture that I t,J,. b It a~ an ownr,r bu ldtr 1f 1l his· ut ~ ~n con\tru t~ in at t•nt rtt\' ~YI ensed
, .11 I undnsrond I hara copy of lheoppl,coble low, Sea Ion 7044 of l he Business and Prof esslons Code, Is U1 al/able upon request when rhls oppf lea! ,on f s
submrt1t'doro1 rhe following Websl!e: hllp.l /W\<.w leglnfo.co govlcolow.hrml
OWNER CERTIFICATION: lcerufythat I have read the app/icauonandstate that theabovelnformation1scorrect and that the
information on the plans 1saccurate. /agree wcomp/y with all Clly ordinances and State laws relating to bui/dins
construction. \r
No~~~h!~::~~1g:m1~r.~n .To,~.~ !~t for the propert;!~n~r: ;~ ~~ G~rty owne~A TE: tfl~W ch 7' f / 1,0 7 i
16 ~r rildJy AveCJr b.dCA92"()8 Ph 7(,().fiOJ 2719 ra, 7V' bol ·,s8
2 REV 07121
•
I.
ii
( City of
Carlsbad
OWNER-BUILDER
ACKNOWLEDGEMENT
FORM
8-61
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: J (\ C
Site Address ___.L,1 ....:...,_w ~...._._Y~M_,_£........,_O\i}......,__.)(->U-~ __,\t<-.:...:..OV\-"-'--Y ~~Gf\'-'-'-r ls-"---"-'lw ......... J -+-, _,_.._,_A _~L.,C......CZ,0--L-"-f I) __ I
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 in1t1aled your understanding of each
prov1s1on 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 understand a frequent practice of unlicensed contractors is to have the property owner obtain an "Owner
Builder" building permit that erroneously 1mpl1es 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 lim ts of my insurance coverage for injuries to workers on my property
\ ~ 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 respons1bil1ty
ill \ B · I understand as an •owner Builder• I am the responsible party of record on the permit I und rstand that I
may protect myself from potential financial risk by hiring a licensed contractor and having the permit fil d in his
or her name instead of my own
IV T~-I understand contractors arc required by law to be licensed and bonded in California and to 11st their license
numbers on permits and contracts.
V. T.\'.21 understand If I employ or oth rwtse engage any persons, other than Californ1n licensed contractors. and
the total value of my construction 1s at least live hundred dollars ($500), 1ncludinu l.ibor and matcrrnl\, I ma\ bl'
considered an ~employer• under state and federal law.
RE 0~ 10
,
iwner-Builder Acknowledgement Continued
VI \:~ • 1 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
law~ may sub1ect me to serious financial risk
VII Th I understand under California Contractors' State License Law, an Owner Builder who builds single-family
res dent al structures cannot legally build them with the intent to offer them for sale, unless all work s performed
by licensed subcontractors and the number of structures does not exceed four w1th1n any calendar year, or all of
the wor Is performed under contract with a licensed general building contractor.
VIII T.\, I understand as an Owner-Builder 1f I sell the property for which this permit Is issued, I may be held liable
for any financial or personal m1uries sustained by any subsequent owner(s) which result from any latent
construction defects in the workmanship or materials.
IX. \ •'\>J• I understand I may obtain more information regarding my obligations as an "employer" from the Internal
Revenue Service, the United States Small Business Administration, t he California Department of Bene It
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
X
ab~t licensed contractors.
\\?-__ I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand
th I am the party I ally and financially responsible for rap sed construction activity at the following address ~ \) c; C 0\
Tu._1 agree that, as the party legally and financially responsible for this proposed construction act1v1ty, 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 1mmedlately of any add1t1ons, deletions, or changes o 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 1f an unlicensed Contractor or employee of that Individual or firm
1s in1urcd 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 bwld,ng permit can be Issued, this form must be completed, signed by the property owner and returned
to che C1ry of Carlsbad Bwld,ng Drv,s1on
I dt<lart undtt ~oo•ryof Ptr1>"t lhol I ho~ ttad and undtrsiond a• of I~ ,ofo,mor,on pro,dtd on rh1> /u1m ood rhor ,r, '"IX'=• orocl<xing M;
our"-Or1t~ [0 s,g11 rM11 /01m, IS trut arid COffttl I o,n OWO!t that I ho~'t tnt opt.on 10 COl'ISVll ...... th w-go COu'Utl pr,ot ,~ Si-J1'1tt19 th.is for and I /'ta-~
t 11><,, (J) con,ulltd-. rh 1,9,lcouos,1 pr,or 10 ''ll"'"• rt>,s/orrn or /1) ha.~ waNtd rh,s r,ghr 1n s,gn1nq rho!/ rm"' 1'1a,r 11><, 01'. t of~ co.i,-,L
r,;1\ ~,._
Property Owner Signature
Building Permit Inspection History Finaled
PERMIT INSPECTION HISTORY for (CBR2022-0959)
BLDG-Residential 03/23/2022Application Date:Permit Type:Owner:
P/M/E 03/23/2022Work Class:Issue Date:Subdivision:CARLSBAD TCT#74-04
09/21/2022Expiration Date:Status:
IVR Number: 39494
Closed - Finaled 2694 MEDFORD CT
CARLSBAD, CA 92010-2177
Address:
Scheduled
Date
Inspection Type Inspection No. Inspection
Status
Primary Inspector Reinspection InspectionActual
Start Date
03/25/2022 03/25/2022 BLDG-23
Gas/Test/Repairs
179059-2022 Passed Tony Alvarado Complete
COMMENTS PassedChecklist Item
BLDG-Building Deficiency March 25, 2022:
1. Existing gas pipe, under air pressure
leak test, upgrading gas meter, to
accommodate new pool and gas barbecue,
scope of work-approved.
Yes
BLDG-Final Inspection 179061-2022 Failed Tony Alvarado Reinspection Incomplete
COMMENTS PassedChecklist Item
BLDG-Building Deficiency March 25, 2022: (Not ready)-final gas pipe
Air pressure leak test for new upgraded
gas meter.
1. Existing gas pipe, under air pressure
leak test, upgrading gas meter, to
accommodate new pool and gas barbecue,
scope of work-approved.
No
BLDG-Plumbing Final March 25, 2022: (Not ready)-final gas pipe
Air pressure leak test for new upgraded
gas meter.
1. Existing gas pipe, under air pressure
leak test, upgrading gas meter, to
accommodate new pool and gas barbecue,
scope of work-approved.
No
04/29/2022 BLDG-23
Gas/Test/Repairs
181762-2022 Scheduled Tony Alvarado Incomplete
COMMENTS PassedChecklist Item
BLDG-Building Deficiency No
BLDG-Final Inspection 181763-2022 Passed Tony Alvarado Complete
Friday, April 29, 2022 Page 1 of 2
{cityof
Carlsbad
PERMIT INSPECTION HISTORY for (CBR2022-0959)
BLDG-Residential 03/23/2022Application Date:Permit Type:Owner:
P/M/E 03/23/2022Work Class:Issue Date:Subdivision:CARLSBAD TCT#74-04
09/21/2022Expiration Date:Status:
IVR Number: 39494
Closed - Finaled 2694 MEDFORD CT
CARLSBAD, CA 92010-2177
Address:
Scheduled
Date
Inspection Type Inspection No.Inspection
Status
Primary Inspector Reinspection InspectionActual
Start Date
COMMENTS PassedChecklist Item
BLDG-Building Deficiency March 25, 2022: (Not ready)-final gas pipe
Air pressure leak test for new upgraded
gas meter.
1. Existing gas pipe, under air pressure
leak test, upgrading gas meter, to
accommodate new pool and gas barbecue,
scope of work-approved.
No
BLDG-Plumbing Final March 25, 2022: (Not ready)-final gas pipe
Air pressure leak test for new upgraded
gas meter.
1. Existing gas pipe, under air pressure
leak test, upgrading gas meter, to
accommodate new pool and gas barbecue,
scope of work-approved.
No
Friday, April 29, 2022 Page 2 of 2