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Home My WebLink About2020 CORDOBA PL; ; CBR2022-2650; Permit                                                           (Cityof Carlsbad 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. DocuSign Envelope ID: 2E4482CD-A2B0-4132-B3B2-0ED4EC12B8DA (_ Cicyof Carlsbad RESIDENTIAL BUILDING PERMIT APPLICATION B-1 Plan Check ________ _ Job Address 2020 Cordoba Pl -Carlsbad, CA 92008 CT/Project#: Laguna Riviera Unit #2 -Submap 06165 Est. Va I u e ___,$_1---'6,'---26_0 _____ _ PC Deposit Date Unit: APN: 207-240-31-00 ----- Lot#: 66 Year Built: 1970 ---------- Fire Sprinklers:QvEs@No Air Conditioning:O YES Q No BRIEF DESCRIPTION OF WORK: Roof mounted PY solar -6.48 KW EI e ctr i ca I Panel Upgrade:Q YES0 No 0 New SF : _____ Living SF,___,, ___ Deck SF, ____ Patio SF, ____ Garage SF __ _ Is this to create an Accessory Dwelling Unit? Q vO N New Fireplace? O vQ N, if yes how many? __ _ □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? ____________ _ li]Solar:6.48 KW, 16 Modules, Mounted:{!)oof~round, Tilt:®vO N, RMA:Q v@ N, Battery: O v @N, Panel Upgrade: 0'f ~ D Reroof: ------------------------------------Iii Plumbing/Mechanical/Electrical 0 Only: Other: PRIMARY APPLICANT Name: Thomas Prager PY Solar Electric PROPERTY OWNER Name: Thomas Prager Address: 2020 Cordoba Pl City: Carlsbad State:_C_A __ .Zip: 92008 Address: 2020 Cordoba Pl City: Carlsbad Phone: 760-445-3431 Email: kcprager@gmail.com Phone: 760-445-3431 Email: kcprager@gmail.com DESIGN PROFESSIONAL CONTRACTOR OF RECORD State: CA Zip:._9_2o_o_a __ _ Name: _________________ Business Name: ________________ _ Address: Address: __________________ _ City:. _______ State: ___ Z.ip: _____ City: _______ State: ___ Zip: ______ _ Phone: Phone: __________________ _ Email: Email: ___________________ _ Architect State License: CSLB License #: _______ Class: ______ _ NAME (PRINT): Thomas Prager 1635 Faraday Ave Carlsbad, CA 92008 Carlsbad Business License # (Required): _______ _ 8 "~"'""" ., SIGN: )/4.,_,,l;~ Ph: 760-602-2719 Fax: _8fflg54747L DATE: 7-21-2022 Email: Building@carlsbadca.gov REV. 07/21 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 : CONTRACTOR 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 affirm that I am exempt from Contractor’s License Law for the following reason: 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 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. DocuSign Envelope ID: 2E4482CD-A2B0-4132-B3B2-0ED4EC12B8DA 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: {CHOOSE ONE) Q 1 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. _______________________________________ _ -OR-QI 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: lnsuranceCompany Name: _____________________ _ Policy No. ___________________________ Expiration Date: _______________ _ -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: ____________________ _ 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, 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, liJ 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. DocuSigned by: NAME (PRINT): Thomas Prager SIGN: '/4,_w~ DATE: 7-21-2022 Note: If the person signing above is an authorized agent for the property owner ~t!>:!'~~~;5iigned 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