HomeMy WebLinkAbout2480 JEFFERSON ST; ; CBR2023-5249; PermitBuilding Permit Finaled
Residential Permit
Print Date: 12/11/2023
Job Address: 2480 JEFFERSON ST, CARLSBAD, CA 92008-1487
Permit Type: BLDG-Residential Work Class: P/M/E
Parcel#: 1551600800 Track#:
Valuation: $0.00 Lot#:
Occupancy Group: Project#:
#of Dwelling Units: Plan#:
Bedrooms: Construction Type:
Bathrooms: Orig. Plan Check#:
Occupant Load: Plan Check#:
Code Edition:
Sprinkled:
Project Title:
Description: LANE ; GAS LEAK
FEE
PLUMBING, MECHANICAL & ELECTRICAL PERMITS
Total Fees: $221.00 Total Payments To D_ate: $221.00
NOTICE:
Permit No:
Status:
Applied:
Issued:
(city of
Carlsbad
CBR2023-5249
Closed -Finaled
Finaled Close Out:
12/08/2023
12/11/2023
12/11/2023
Final Inspection: 12/11/2023
INSPECTOR: de Roggenbuke, Dirk
Balance Due:
AMOUNT
$221.00
$0.00
Please take NOTICE that approval of your project includes the "imposition" of fees, dedications, reservations, or other exactions
collectively referred to as "fees." You have 90 days from the date this permit was issued to protest the imposition of these fees. To protest
the imposed fees, you must follow the protest procedures set forth in Government Code Section 66020(a) and file the protest with the City
Manager. Failure to timely follow the required procedures will bar any subsequent legal action to attack, review, set aside, void, or annul
the imposition of these fees.
You are FURTHER NOTIFIED of your right to request an audit to review the fees imposed on your project. To request an audit, follow the
procedures provided in Government Code Section 66023(a). Additionally, you may file a written request for mailed notice for the public
meeting to review the fee account or fund information related to certain fees that are imposed as a result of the approved permit.
You are FURTHER NOTIFIED that your right to protest the specified fees 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 of which you have previously been given a NOTICE similar to this, and the statute of limitation has expired.
Building Division Pagelofl
1635 Faraday Avenue, Carlsbad CA 92008-7314 I 442-339-2719 I 760-602-8560 f I www.carlsbadca.gov
( City of
Carlsbad
RESIDENTIAL
BUILDING PERMIT
APPLICATION
B-1
Plan CheckC.1?'1/D{? -5.) ~q
Est. Value _________ _
PC Deposit
Date i~/QB/23 1 I
/ 1 ,,:> I . -----r t:f:': -> /.
Job Address __ 2-__ 7_,<il_ ' __ _,:;v_ ee,,e:..'.:..r_;_ Tff.fi..;._' ;eJ,::...:;C'_:/V __ Unit: ____ ,APN: _____ -,-__ _
CT/Project #:, ____________ -:r-____ Lot #:. ____ Year Built: ~/"--.&.;'-/J.~~7 ____ _
BRIEF DESCRIPTION OF WORK: ~ Ze:.~
0 New SF: Living SF,, ____ Deck SF,, ___ Patio SF,, ____ Garage SF __ _
ls this to create an Accessory Dwelling Unit? OY o N New Fireplace? O YON, if yes how many? ___ _
D Remodel:, _____ SF of affected area Is the area a conversion or change of use? O YO N
□ Pool/Spa: _____ SF Additional Gas or Electrical Features? ____________ _
□ Solar:. ___ KW, ___ ,Modules, Mounted: ORoof O Ground, Tilt: 0 YON, RMA: 0 YO N,
Battery:CY(l) N, Panel Upgrade: CY CllN Electric Meter number: ____________ _
Other:
APPLICANT Prima Con ct and Res onsible Party) PROPERTY OWNER
Name:_-44~~~:_~~~~=------:-Jame: J'/J.411'&
"-=.a..,..e..,JC....J..,,<c......~!:i....:.L.!....k:.cl-:::;i,;~~+Address.<44::4?¢
_z.~~;i...·City: • I/ State:. ___ .Zip: ____ _
Phone:--,,-..£.~c.oia7 __,.;,......~..--:z....-r-._;.u:.~...,-z~Phone: _____ l_1 _____________ _
Email::,4.:;e.~~~~~'tz.+,/..t.::...,.L£J.~'.:1~,-,:.:'.... 1'
"""' • DESIGN PROFESSIONAL CONTRACTOR OF RECORD
Name: __________________ Business Name: ________________ _
Address: Address:. _________________ _
City:. ________ State:, ___ Zip:._____ City.: _______ State:, ___ Zip:. ______ _
Phone: Phone:. __________________ _
Email: Email: __________________ _
Architect State License: CSLB License #:. _______ Class: ______ _
Carlsbad Business License# {Required):. _______ _
APPLICANT CERTIFICATION: I certify that I have read the application and state that the above information is cor~nd that the information of the plans is accurate. I :::::~:,:&:Z"Z;£~:~ /4. .. " P' -r--2-3
1635 Faraday Ave Carlsbad, CA 92008 / Ph: 442-339-2719 Email: Building@carlsbadca.gov
REV. 04122
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:
I herebyaffirmunderpena/tyofperjurythat I am/icensedunderprovisionsofChapter 9 (commencing with Section 7000)of0ivision 3
of the Business and Professions Code, and my license is in fuU force and effect. I a/soaffirm under penalty of perjury one of the
foUowing declarations (CHOOSE ONE}:
D I 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-
DI 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:-------------------------•
Policy No. ___________________________ Expiration Date: ________________ 1 -OR-
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 ofthe 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 CERTIFICATION: The applicant certifies that all documents and plans clearly and accurately show all existing and proposed buildings, structures, access roads, and
utilities/utility easements. All proposed modifications and/or additions are clearly labeled on the site plan. Any potentially existing detail within these plans inconsistent with the site plan are
not approved for construction and may be required to be altered or removed. The city's approval of the application is based on the premise that the submitted documents and plans show
the correct dimensions of; the property, buildings, structures and their setbacks from property lines and from one another; access roads/easements, and utilities. The existing and proposed
use of each building as stated is true and correct; all easements and other encumbrances to development have been accurately shown and labeled as well as all on-site grading/site preparation.
All improvements existing on the property were completed in accordance with all regulations in existence at the ti their con~, unless otherwise noted.
NAME {PRINT): ~y/t, SIGNATURE: 1~~ /~_,, DATE: / .:1 'f'· ~ !J
thorized agent for the contractor provide a atio/o~~r letterhead.
(OPTION B): OWNER-BUILDER DECLARATION:
I hereby affirm that I am exempt from Contractor's License Law for the following reason:
0 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-
(2] I, as owner of the property, am exclusively contracting with licensed contractors to construct the project (Sec. 7044, Business and Professions Code: The
/~ontractor'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-D I am exempt under Business and Professions Code Division 3, Chapter 9, Article 3 for this reason:
AND,
0 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./ understandthat a copy oftheapplicablelaw, Section 7044 of the Busfnessand Professions Code, is availab/euponrequestwhen this applicatfonis
submitted or at the following Web site: http:l lwww.leginfo.ca.gov/calaw.html.
OWNER CERTIFICATION: The applicant certifies that all documents and plans clearly and accurately show all existing and proposed buildings, structures, access roads, and utilities/utility
easements. All proposed modifications and/or additions are clearly labeled on the site plan. Any potentially existing detail within these plans inconsistent with the site plan are not approved
for construction and may be required to be altered or removed. The city's approval of the application is based on the premise that the submitted documents and plans show the correct
dimensions of; the property, buildings, structures and their setbacks from property lines and from one another; access roads/easements, and utilities. The existing and proposed use of each
building as stated is true and correct; all easements and other encumbrances to development have been accurately shown and labeled as well as all on-site grading/site preparation. All
improvements existing on the property were completed in accordance with all regulations in existence at the time of their ion, unless otherwise noted.
DATE~~ • ,j? 2b
erty owner.
1635 Faraday Ave Carlsbad, CA 92008 Ph: 442-339-2719 Email: Building@carlsbadca.gov
2
REV. 04/22
( City of
Carlsbad
OWNER-BUILDER
ACKNOWLEDGEMENT
FORM
B-61
Development Services
Building Division
1635 Faraday Avenue
442-339-2719
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
C-4/~/,j',,./4.,d property located at:
Site Address 2, ,Y g-(}
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 initialed your understanding of each
provision 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
pfit activities.
I. __ I understand a frequent practice of unlicensed contractors is to have the property owner obtain an "Owner-
uilder" building permit that erroneously implies 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
~,!!.mits of my insurance coverage for injuries to workers on my property.
JI. ~l understand building permits are not required to be signed by property owners unless they are responsible
e construction and are not hiring a licensed contractor to assume this responsibility.
Ill I understand as an "Owner-Builder" I am the responsible party of record on the permit. I understand that I
may protect myself from potential financial risk by hiring a licensed contractor and having the permit filed in his
,b h/' name instead of my own.
IV~'. urderstand contractors are required by law to be licensed and bonded in California and to list their license
• f')umbf!Js on permits and contracts.
V./{~I understand if I employ or otherwise engage any persons, other than California licensed contractors, and
\!,/total value of my construction is at least five hundred dollars ($500), including labor and materials, I may be
considered an "employer" under state and federal law.
REV. 08/20
Building Permit Inspection History Finaled
( City of
Carlsbad
PERMIT INSPECTION HISTORY for (CBR2023-5249)
Permit Type: BLDG-Residential
Work Class: P/M/E
Status: Closed -Finaled
Application Date:
Issue Date:
Expiration Date:
IVR Number:
Scheduled Actual Inspection Type Inspection No.
Dale Start Dale
12/11/2023 12/11/2023 BLDG-23 233217-2023
Monday, December 11, 2023
Gas/Test!Repairs
Checklist Item COMMENTS
BLOG-Building Deficiency
BLDG-Final Inspection 233218-2023
Checklist Item
BLDG-Building Deficiency
BLDG-Plumbing Fina/
BLDG-Structural Final
COMMENTS
12/08/2023
12/1112023
06/10/2024
53698
Inspection
Status
Passed
Passed
Owner: RANDY LANE
Subdivision: SUNNY SLOPE TRACT
Address: 2480 JEFFERSON ST
CARLSBAD, CA 92008-1487
Primary Inspector Reinspection Inspection
Dirk de Roggenbuke
Dirk de Roggenbuke
Passed
Yes
Passed
Yes
Yes
Yes
Complete
Complete
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