The URL can be used to link to this page

Home My WebLink About2252 IVORY PL; ; CBR2023-1223; Permit                                                              (Cityof Carlsbad Plan Check Est. Value PC Deposit Date B-1 Page 1 of 2 Rev. 06/18 RESIDENTIAL BUILDING PERMIT APPLICATION B-1 Job Address __________________________________________Suite: __________ APN: _________________________ CT/Project #:______________________ Lot #:_________ Fire Sprinklers: yes / no Air Conditioning: yes / no BRIEF DESCRIPTION OF WORK: ________________________________________________________________________ __________________________________________________________________________________________________ APPLICANT (PRIMARY CONTACT) PROPERTY OWNER Name: ________________________________________ Name: _____________________________________________ Address: ______________________________________ Address: ____________________________________________ City: _________________ State:______Zip: _________ City: ______________________State:______Zip: ___________ Phone: _______________________________________ Phone: _____________________________________________ Email: ________________________________________ Email: ______________________________________________ DESIGN PROFESSIONAL CONTRACTOR BUSINESS Name: ________________________________________ Name: _____________________________________________ Address: ______________________________________ Address: ___________________________________________ City: _________________ State:______Zip: __________ City: _________________ State:______Zip: _______________ Phone: _______________________________________ Phone: ____________________________________________ Email: ________________________________________ Email: _____________________________________________ Architect State License: __________________________ State License:_____________ Bus. License:_______________ (Sec. 7031.5 Business and Professions Code: Any City or County which requires a permit to construct, alter, improve, demolish or repair any structure, prior to its issuance, also requires the applicant for such permit to file a signed statement that he/she {Chapter 9, commending with Section 7000 of Division 3 of the Business and Professions Code} or that he/she is exempt 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 of 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 Addition/New:____________Living 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? _____ Remodel:__________ SF of affected area Is the area a conversion or change of use ? Yes / No Pool/Spa: __________ SF Additional Gas or Electrical Features? _____________________________ Solar:_______ KW, ______ Modules, Mounted: Roof / Ground , Tilt: Yes / No, RMA: Yes / No, Battery: Yes / No Panel Upgrade: Yes / No Reroof: ____________________________________________________________________________________ Plumbing/Mechanical/Electrical Only: ___________________________________________________________ Other:______________________________________________________________________________________ _______________________________________________________________________________________________ 970 W 190Th St Torrance CA Energy Service Partners ESP Contracting 970 W 190Th St Torrance CA 90502 619149 90502 Jonathan Rosales CarlsbadCA 818-970-5263 jonathan@joinesp.com 818-314-7270 jonathan@joinesp.com B/C10 2252 Ivory Pl, Carlsbad, California 92009 92009 2252 Ivory Pl Robert Makhoul (818) 259-9948 rmmakhoul@gmail.com PV (25) Modules At 440 Watts 11.000 Kw-DC / 10.199 Kw-AC (25)Optimizers Roof Mounted (1) SE7600H Inverter No Panel Upgrade 2132021900 2511.000 □ □ □ [yf □ □ □ ('city of Carlsbad D D D D D is licensed pursuant to the provisions of the Contractor's License Law B-1 Page 2 of 2 Rev. 06/18 ( OPTION A ): WORKERS ATION DECLARATION: I hearby affirm under penalty of perjury one of the following declarations: I have and will maintain a certificate of consent to self- work which this permit is issued. red by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. 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 be come subject to th 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, CONTRACTOR SIGNATURE: _____________________________________________ AGENT DATE: _______________ ( OPTION B ): OWNER-BUILDER DECLARATION: 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. es 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 does not apply to an owner of property who builds or improves thereon, and contracts for such projects with contractor(s) licensed 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 improvement. 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 / p 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 / 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 the performance of the work this permit is issued (Sec. 3097 (i) Civil Code). Name:___________________________________________________ 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 registration form or risk management and prevention program under Sections 25505, 25533 or 25534 of the Presley-Tanner Hazardous Substance Account Act? Yes No Is the applicant or future building occupant required to obtain a permit from the air pollution control district or air quality management district? Yes No Is the facility to be constructed within 1,000 feet of the outer boundary of a school site? Yes 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 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 SAIDCITY IN CONSEQUENCE OF THE GRANTING OF THIS PERMIT.O height. EXPIRATION: Every permit issued by the Building Official under the provisions of this Code shall expire by limitation andbecome 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 after the work is commenced fora period of 180 days (Section 106.4.4 Uniform Building Code). APPLICANT SIGNATURE: __________________________________________________ DATE: ____________________ 1635 Faraday Ave Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Email: Building@carlsbadca.gov BNUWC0156224 Midwest Employers Casualty Co 3/13/23 02/11/24 3/13/23 3/13/23 'COMPENS □ insure for workers' compensation provided by Section 3700 of the Labor Code, for the performance of the Ja: 1 have and will maintain worker's compensation, as requi My workers' compensation insurance carrier and policy number are: □ e workers' compensation Laws of California. interest and attorney's fees. I hereby affirm that I am exempt from Contractor's License Law for the following reason: □ 7044, Business and Professions Code: The Contractor's License Law does not apply to an owner of property who builds or improv □ Contractor's License Law pursuant to the Contractor's License Law). □ □ □ hone/ contractors' license number): contractors' license number): 1tracted (hired) the following persons to p Lender's Lender's □ □ 8 SHA: An OSHA permit is required for excavations over S'O' deep and demolition or construction of structures over 3 stories in ction 106.4.4 Uniform Building Code). c;:~~~                                           {city of Carlsbad