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Home My WebLink About2507 NAVARRA DR; # 201; CBR2022-0987; Permit                                                             (Cityof Carlsbad Cifyof Carlsbad Job Address2507 Navarra Dr. RESIDENTIAL BUILDING PERMIT APPLICATION B-1 Plan Check _______ _ Est. Value PC Deposit Date Unit:201 APN: ---------------- CT /Project #: __________________ Lot #:___,~ __ Year Built: ________ _ Fire Sprinklers:OE~NO Air Conditioning:0YESQNO Electrical Panel Upgrade@YESQNO BRIEF DESCRIPTION OF WORK:Adding washer/dryer & A/C. Need to upgrade electrical panel to accomodate. 0 New SF : _____ Living SF,__, ___ Deck SF, ____ Patio SF, ____ Garage SF __ _ Is this to create an Accessory Dwelling Unit? QvQN New Fireplace? ovoN I if yes how many? -- 0 Remodel: _____ SF of affected area Is the area a conversion or change of use?QvON 0 Pool/Spa: ____ .SF Additional Gas or Electrical Features? ___________ _ O solar: ___ KW,. ___ Modules, MountedOootO;round, TiltO vO N, RMA:QvQN, Battery: CJ( CN, Panel Upgrade: Qv CtJ D Re roof: __________________________________ _ [ii Plumbing/Mechanical/Electrical 0 Only: Other: PRIMARY APPLI< ANT Name:Chris & Mary Nelson Address:4502 N. Royal View Dr. Adding washer/dryer & A/C. Need to upgrade electrical panel to accomodate. PROPERTY OWNER Name:Chris & Mary Nelson Address:2507 Navarra Dr., #201 City: Phoenix State:_AZ. __ .Zip: 85018 City: Carlsbad State: CA Zip:_9_20_0_9 __ _ Phone: 602-522-1988 Phone: 602-522-1988 Email: mary@mmiconstruct.com Email: mary@mmiconstruct.com DESIGN PROFES~IONAL 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 Buslnes se # (Required): _______ _ APPLICANT CERTIFICATION: I certify that I have read the applicatio v information iscorrec t and that the information on the plans is accurate. I agree to comply with all City la s relating to building construction. /_ . NAME (PRINT) -;...._~~.....a...~~--=a~ SIGN:----l.~J..lll....--........,.;"--c-vb....::::;_ ATE: 2 --z_~ 22_ 1635 Faraday Ave Carl1bad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Email: BuJldlos@carlsbadca.gov t_ 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: I herebyaf firm under penal tyof perjury that I am licensed under provisions of Chapter 9 ( commencing with Section 7000) of Division 3 of the Business and Professions Code, and ,PY license is in full force and effect. I also affirm under penalty of perjury one of the following declarations (CHOOSE ONE): Q1 have and will maintain a certificate of consent to ,elf-Insure for workers' compensation provided by Section 3700 of the Labor Code, for the performance of the work which this permit Is Issued, Polley No •• _-------------------------------------- -OR- f'l1 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. '11y workers' compensation insurance carrier and polloy 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 Callforrila. 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 ag ncy for the performance of the work this permit Is issued (Sec. 3097 (i) Civil Code). Lender's Name:. ____________ ._ _______ Lender's Address: ___________________ _ 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. /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 ag~nt 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: @ 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 tiave 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: A D, liJ FORM 8-61 "Owner Builder Acknowledgement and Verification Form• ls 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 low, Section 7044 of the Business and Prof esslons Code, is available upon request when this application Is subml tted or at the following Web sl te: http: I I www. /eginfo. ca. gov I ca/aw. html. OWNER CERTIFICATION: I certify that I have read the applicationanqst te that the a, ove i formation is correct and that the information on the plans is accurate. I agree to comply with all Cit 1 ·nonces and S t laws relating to bui /ding construction. 1 NAME (PRINT): ~,\s Ne\soC) s1GN: ~~F,-1--.......4-.i.:...:....~~.,.......,.ATE: 2 -23-22- Note: If the person signing above Is an authorized agent for the property owner incl 1635 Faraday Ave Carlsbad, CA 92008 Ph: 760-602·2719 Fax: 760-602-8558 Email: Bulldlng@carlsbadca.gov 2 REV. 07/21 I. II. Ill. IV. V. ( City of Carlsbad I OW,.jER-BUILDER ACKNOWLEDGEMENT FORM B-61 Development Services Building Division 1635 Faraday Avenue 760-602-2719 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 t he property located at: Site Address 2507 Navarra Dr., #201, Carlsbad, CA, 92009 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 constr ction 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 el'ecute 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 a1d 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 permit activities. cl, understand a frequent practice of unlicensed contractors is to have the property owner obtain an "Owner• Builder" 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 contr~ctor and his or her employees while working on my property. My homeowners insurance may not provide coverage for those injuries. I am willfully acting as an Owner-Builder and am aware of the limits of my insurance coverafe for injuries to workers on my property. hl1 understand building permits are not required to be signed by property owners unless they are responsible :or \he construction and are not hiring a licensed contractor to assume this responsibility. ~I urderstand as an "Owner-Builder" I dm the responsible party of record on the permit. I understand that I may prot, •ct myself from potential financial risk by hiring a licensed contractor and having the permit flied in his or her na•ne instead of my own. l!L, understand contractors are required by law to be licensed and bonded In California and to list their license ~Jffifers on permits and contracts. ,C.!11 understand if I employ or otherwise engage any persons, other than California licensed contractors, and the 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. 1 REV. 08/20 Owner-Builder Acknowledgement Continued VI. VII. VIII. IX. X. ~ N understand if I am consi ered an "employer" under state and federal law, I must register with the state and federal government, withhold payroll taxes, provide workers' compensation disability insurance, and contribute to unemployment cop,pensation for each "employee." I also understand my failure to abide by these laws may subject me to serious financial risk. ~I understand under California Contractors' State License Law, an Owner-Builder who builds single-family residential structures cannot legally build them with the intent to offer them for sale, unless all work is performed by licensed subcontractors and t~e number of structures does not exceed four within any calendar year, or all of t6 work is performed under contract with a licensed general building contractor. ~ I understand as an Owner-Builder if I sell the property for which this permit is issued, I may be held liable for any financial or personal injuries sustained by any subsequent owner(s) which result from any latent construction defects in the workmanship or materials. hl understand I may obtain more information regarding my obligations as an "employer" from the Internal Revenue Service, the United ltates Small Business Administration, the California Department of Benefit Payments, and the California D vision of Industrial Accidents. I also understand I may contact the California Contractors' State License Boar (CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.gov for more information ~b~uf licensed contractors. ~ am aware of and conse nt to an Owner-Builder building permit applied for in my name, and understand that I am the party legally and financially responsi ble for proposed construction activity at the following address: XI. CJ I agree that, as the party legally and financially responsible for this proposed construction activity, I will abide by ap applicable laws and requirements that govern Owner-Builders as well as employers. (l~_I agree to notify the issuer of this form immediately of any additions, deletions, or changes to any of the information I have provided on t~is form. XII. Licensed contractors are regulated by laws designed to protect the public. If you contract with someone who does not have a license, the Contractor's State License Board may be unable to assist you with any financial loss you may sustain as a result of a complaint. Your only remedy against unlicensed Contractors may be in civil court. It is also important for you to understand that if an unlicensed Contractor or employee of that individual or firm is Injured while working on your broperty, you may be held liable for damages. If you obtain a permit as Owner- Builder and wish to hire contractors, you will be responsible for verifying whether or not those contractors are properly licensed and the status of their workers' compensation coverage. Before a building permit can be issued, this form must be completed, signed by the property owner and returned to the City of Carlsbad Building D/vision. I declare under penalty af perjury that I have read and understand all af the information pra ided on this farm and that my responses, including my authority to sign this form, Is true and corr1ct. I om owore that I have the option to consult h leg counsel prior to signing this form, and I hove either (1) consulted with legal counsel prior to signing this form or (2) have w lved this right In nln this form without the advice of legal counsel. 22- 2 REV.08/20                                                                            {city of Carlsbad                                                    