HomeMy WebLinkAbout2343 KYANITE PL; ; CBR2021-0418; Permit
(Cityof
Carlsbad
(cityof
Carlsbad
RESIDENTIAL
BUILDING PERMIT
APPLICATION
B-1
Plan Check _c_B_R_2_0_2_1_-0_4_1_s __
Est. Value
PC Deposit
Date 2/16/2021
Job Address 2343 Kyanite Pl Suite: APN: 213 280 25 00 ·-----
CT/Project #: __________________ Lot #: ____ Year Built: ________ _
Fire Sprinklers: Q vEsQ NO Air Conditioning:Q YES O NO
BRIEF DESCRIPTION OF WORK:
Electrical Panel Upgrade: Q vEs O NO
New 50a circuit for EV charging
0 Addition/New: _____ Living SF, ____ Deck SF, ____ Patio SF, ____ Garage SF __ _
Is this to create an Accessory Dwelling Unit? O v O N New Fireplace? O v O N, if yes how many? __
D Remodel: SF of affected area -----Is the area a conversion or change of use ? O v O N
□ Pool/Spa: ____ SF Additional Gas or Electrical Features? ___________ _
O Solar:. ___ KW, ___ Modules, Mounted:O Roof O Ground, Tilt: 0 vO N, RMA: O v O N,
Battery:O v O N, Panel Upgrade: O v O N
D Reroof: ------------------------------------~ Plumbing/Mechanical/Electrical
0 Only: Other:
New 50a circuit in msp for new 240v NEMA 1450 outlet to charge EV
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 O PROPERTY OWNERS AUTHORIZED AGENT APPLICANT 0
Name: Sonali Santiago Name: ___________________ _
Address: 2343 Kyanite Pl Address: 2120 Harmony Grove Rd .
City: Carlsbad State:_C_a __ .Zip: 92009 City: Escondido State: CA Zip:_9_20_2_9 __ _
Phone: 7737710682 Phone: 760-546-6043
Email: sonalimaster@hotmail.com Email: smier@bakerhomeenerQV.com
DESIGN PROFESSIONAL APPLICANT O CONTRACTOR OF RECORD APPLICANT 0
Name: ________________ _
Address:. _______________ _
City:. ______ ___,,State: ___ .Zip:. ___ _
Phone: ________________ _
Email: ________________ _
Architect State License: __________ _
Name: Baker Home Energy
Address: 2120 Harmony Grove Rd.
City: Escondido State:_C_A __ Zip: 92029
Phone: 760-546-6043
Email: smier@bakerhomeenergy.com
State License/class: c1 o,c2o,c39, c45 Bus. License: blos1221102
cslb 858088
1635 Faraday Ave Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Email: Building@carlsbadca.gov
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:
DI 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. ______________________________________ _
liJ 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: lnsuranceCompany Name: _0_1d_r....;ep_u_bl_ic_1n_su_ra_n_ce_C_o _____________ _
Policy No. MWC3125520 Expiration Date: _31_1,_21 ___________ _
D 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: ____________________ _
CONTRACTOR PRINT:_S_a_ra_M_ie_r ____ SIGN: (!Sa,,w,, Miet DATE: 2/15/2021
(OPTION B): OWNER-BUILDER DECLARATION:
I hereby affirm that I am exempt from Contractor's License Law for the following reason:
DI, 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).
DI, 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).
DI am exempt under Business and Professions Code Division 3, Chapter 9, Article 3 for this reason:
D"owner Builder acknowledgement and verification form" has been filled out, signed and attached to this application.
D 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
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.
OWNER PRINT: _________ _ SIGN: __________ DATE: ______ _
APPLICANT CERTIFICATION: SIGNATURE REQUIRED AT THE TIME OF SUBMITTAL
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:s_a_r_a_M_i_e_r _____ SIGN:(!Sa,,w,, Miet DATE: 2/15/2021
1635 Faraday Ave Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Email: Building@carlsbadca.gov
2 REV. 08/20
{city of
Carlsbad