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Home My WebLink About2744 CARLSBAD BLVD; # 207; CBR2021-2908; Permit                                                        (Cityof Carlsbad (_ Cicyof Carlsbad Job Address 2744 CARLSBD BLVD #207 RESIDENTIAL BUILDING PERMIT APPLICATION B-1 Plan Check CBR2021-2908 Est. Value PC Deposit Date q/17/21 9/24/21 Unit:, ______ APN: __________ _ CT/Project #: _________________ Lot #: ____ Year Built: ________ _ Fire Sprinklers:O E()No Air Conditioning:Q YES Q NO Electrical Panel Upgrade:QvEs Q No BRIEF DESCRIPTION OF WORK: REPLACE AC 5 TON 0 New SF : _____ Living SF,___,, ___ Deck SF, ____ Patio SF, ____ Garage SF __ _ Is this to create an Accessory Dwelling Unit? Q YQ N New Fireplace? Q vQ N, if yes how many? __ _ D Remodel: SF of affected area -----Is the area a conversion or change of use? O v Q N □ Pool/Spa: ____ SF Additional Gas or Electrical Features? ___________ _ 0 Solar: ___ KW, ___ Modules, Mounted:Ooof~round, Tilt:O vO N, RMA:Qv Q N, Battery:Qv O,J, Panel Upgrade: 0v O.J D Reroof: -----------------------------------□ Plumbing/Mechanical/Electrical 0 Only: Other: PRIMARY APPLICANT Name:IE INC Address:31225 LA BAVA DR. #213 City: WESTLAKE State:_C_A __ .Zip: 91362 Phone:818-735-7878 Email: MITCH@IPERMITCA.COM PROPERTY OWNER Name: PATRICK CONNOLLY Address: 2744 CARLSBAD BLVD #207 City: CARLSBAD Phone: 760-717-7165 State: CA Zip:_9_20_0_8 __ _ Email: __________________ _ DESIGN PROFESSIONAL CONTRACTOR OF RECORD Name: _________________ Business Name: OAK ISLAND HEATING AND AIR Address: Address: 1250 PACIFIC OAKS PL #103 City: _______ State: ___ .Zip: _____ City: VISTA State:_C_A __ Zip: 92081 Phone: Phone: 760-839-8383 Email: _________________ Email: __________________ _ Architect State License: CSLB License#: 74540° Class: -------------- Carlsbad Business License# (Required): _______ _ 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. NAME (PRINT): MITCH BLUMAN SIGN: ~ fJ~ DATE: 9/17/21 ---------- 1635 Faraday Ave Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Email: Building@carlsbadca.gov REV. 07/21 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 REQUIRED PRIOR TO PERMIT ISSUANCE. (OPTION A): LICENSED CONTRACTOR DECLARATION: lherebyaffirmunderpenaltyofperjurythatlamlicensedunderprovisionsofChapter9(commencingwithSection7000)ofDivision3 oftheBusinessandProfessionsCode, andmylicenseisinfullforceandeffect. lalsoaffirmunderpenaltyofperjuryoneofthe following declarations {CHOOSE ONE): Q1 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. PolicyNo. _____________________________________ _ -OR- f.i\1 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. ~Y workers' compensation insurance carrier and policy number are: Insurance Company Name: _s_E_cu_R_ITY_N_A_TI_O_NA_L ______________ _ Policy No. swc1323175 Expiration Date: _1_,1_12_02_2 ____________ _ -OR-O 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'sAddress: ___________________ _ CONTRACTOR CERT/FICA T/ON: 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. NAME (PRINT): ________ SIGNATURE: _________ DATE: _____ _ Note: If the person signing above is an authorized agent for the contractor provide a letter of authorization on contractor letterhead. -OR - (OPTION B): OWNER-BUILDER DECLARATION: I hereby affirm that I am exempt from Contractor's License Law for the following reason: Q 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). -OR-O 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). -OR-O I am exempt under Business and Professions Code Division 3, Chapter 9, Article 3 for this reason: AND, D FORM B-61 "Owner Builder Acknowledgement and Verification Form" is required for any permit issued to a property owner. 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./ 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: I lwww.leginfo.ca.gov/ calaw.html. OWNER CERT/FICA T/ON: 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. NAME (PRINT): MITCH BLUMAN SIGN: ~ fJ~ DATE: 9/17/21 ---------Note: If the person signing above is an authorized agent for the property owner include form B-62 signed by property owner. 1635 Faraday Ave Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Email: Building@carlsbadca.gov 2 REV. 07/21                                      {city of Carlsbad