HomeMy WebLinkAbout1237 BELLEFLOWER RD; ; CBR2024-0017; PermitBuilding Permit Finaled
Residential Permit
Print Date: 02/09/2024
Job Address:
Permit Type:
Parcel#:
Valuation:
Occupancy Group:
#of Dwelling Units:
Bedrooms:
Bathrooms:
Occupant Load:
Code Edition:
Sprinkled:
Project Title:
1237 BELLEFLOWER RD, CARLSBAD, CA 92011-2501
BLDG-Residential Work Class:
2145420400 Track#:
$0.00 lot#:
Project#:
Plan#:
Construction Type:
Orig. Plan Check#:
Plan Check#:
Description: BEMIS : REPLACE GAS METER
FEE
PLUMBING, MECHANICAL & ELECTRICAL PERMITS
P/M/E
Total Fees: $221.00 Total Payments To Date: $221.00
(cityof
Carlsbad
Permit No: CBR2024-0017
Status: Closed -Finaled
Applied: 01/03/2024
Issued: 01/03/2024
Finaled Close Out: 02/09/2024
Final Inspection: 01/04/2024
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 hereafter
collectively referred to as "fees/exaction." You have 90 days from the date this permit was issued to protest imposition of these
fees/exactions. If you protest them, you must follow the protest procedures set forth in Government Code Section 66020(a), and file the
protest and any other required information with the City Manager for processing in accordance with Carlsbad Municipal Code Section
3.32.030. Failure to timely follow that procedure will bar any subsequent legal action to attack, review, set aside, void, or annul their
imposition.
You are hereby FURTHER NOTIFIED that your right to protest the specified fees/exactions 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/exactions of which you have previously been given a NOTICE similar to this, or as to which the
statute of limitation has previously otherwise expired.
Building Division Page 1 of 1
1635 Faraday Avenue, Carlsbad CA 92008-7314 I 442-339-2719 I 760-602-8560 f I www.carlsbadca.gov
(Cityof
Carlsbad
RESIDENTIAL
BUILDING PERMIT
APPLICATION
B-1
Plan Check Cf;pU)?'t-0017
Est. Value
PC Deposit
Date
Job Address._1 _2._3_1....,....B ..... e __ l ...... /_e_[..&.)/o~w .... .e.-"-'-y ____ /<._<.:! __ J __ unit: ___ APN: _______ _
CT/Project#: _________________ Lot #: ____ Vear Built: ________ _
BRIEF DEscR1Pr10N oF woRK: R-e f 1 ().. c e G--A s--fl,1.e,A..e,y
0 New SF: Living SF, ____ Deck SF, ___ Patio SF , ____ Garage SF __ _
Is this to create an Accessory Dwelling Unit? O Y O N New Fireplace? O YO N, if yes how many? ___ _
D Remodel: _____ SF of affected area Is the area a conversion or change of use? C) YON
□ Pool/Spa: ____ SF Additional Gas or Electrical Features? ___________ _
□ Solar:. ___ KW, ___ Modules, Mounted:ORoof O Ground, Tilt: 0 YON, RMA: 0 YO N,
Battery:OYO N, Panel Upgrade:OYON Electric Meter number: ------------0th er:
APPLICANT (PRIMARY CONTACT)
Name: "Q ~-e eh 73-e J,,1,1 ,·1
Address: f Z..3c B< 1/.t. +'lo L-.i-l.V l<-d
City: (Ayfrhc.c. A State: CA: Zip:C/U> I I
Phone: ~ &-1 le Ii, Y q~y-
Email: .J be..wi I S' 00 7 MJ£1, L , C...{) ~
PROPERTY OWNER
Name: SA.t,A(
Address: _________________ _
City: ________ ,_State: ___ Zip: ____ _
Phone: __________________ _
Email: __________________ _
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 r have read the application and state that the above information is correct and that the information of the plans is accurate. I
agree to comply with all City ordinances and State laws relating to building construction.
NAME (PRINT): ~ o r..e,p h {3-eMPh·.
44
i s2_339_21s191G•(l@lt ~ oA n, t/ 3 / 2 '/
1635 Faraday Ave Carlsbad, CA 92008 •u 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 herebyaffirm under penalty of perjury that I am licensed underprovisionsof Chapter 9 ( commencing with Section 7000) of Division 3
of the Business and Professions Code, and my license is inf u/1 force and effect. I also affirm under penalty of perjury one of the
following declarations (CHOOSE ONE):
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 .. _________________________________________ _
-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: Insurance Company 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 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 CERTIFICATION: The applicant certifies that all do.cuments and plans clearly and accurately show alt e•isting and proposed buildings, structures, access roads, and
utilities/utility easements. AU proposed modifications and/or additions are clearly labeled on the site plan. Any potentially e~isting 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 construction, unless otherwise noted.
NAME (PRINT): _________ SIGNATURE: __________ DATE: ______ _
Note: If the person signing above is an authorized agent for the contract ' "d I tter 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:
D 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-
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).
-OR-
DI 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. I understand that a copy of the applicable law, Section 7044 of the Business and Professions Code, is available upon request when this app/ ication is
submitted or at the following Web site: http:Ilwww./eginfo.ca.gov/ ca/aw.html.
OWNER CERTIFICATION: The applicant certifies that all documents and plans clearly and accurately show all e,isting 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; ,ccess 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
i::::n;;:;:~; ~h~ 7;;;;;plet7&;c;; all r~ul:i;: in :•istence atue of their construc~ion, unless o::~~ :ote;; 3 I 2-tf:
Note:lfthe ersonsl nln aboveisanauthori~eda entforthe ro eformB-62si nedb owner. I '
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 .ca rls bad ca .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
property located at: (\ / a2
Site Address a2-37 &-/ let foC,,J-ev !<d CC\:v-l ~h , C-A 92-01 I
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
permit activities.
I. __ I 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 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
the limits of my insurance coverage for injuries to workers on my property.
II. __ I understand building permits are not required to be signed by property owners unless they are responsible
for the 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
or her name instead of my own.
IV. __ I understand contractors are required by law to be licensed and bonded in California and to list their license
numbers on permits and contracts.
V. __ I 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. __ I understand if I am considered 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 compensation for each "employee." I also understand my failure to abide by these
laws may subject me to serious financial risk.
VII. __ 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 the number of structures does not exceed four within any calendar year, or all of
the work is performed under contract with a licensed general building contractor.
VIII. __ 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.
IX. __ I understand I may obtain more information regarding my obligations as an "employer" from the Internal
Revenue Service, the United States Small Business Administration, the California Department of Benefit
Payments, and the California Division of Industrial Accidents. I also understand I may contact the California
Contractors' State License Board {CSLB) at 1-800-321-CSLB (2752) or www.cslb.ca.gov for more information
about licensed contractors.
X. __ I am aware of and consent to an Owner-Builder building permit applied for in my name, and understand
that I am the party legally and financially responsible for proposed construction activity at the following address:
XL __ I agree that, as the party legally and financially responsible for this proposed construction activity, I wil I a bide
by all applicable laws and requirements that govern Owner-Builders as well as employers.
XII. __ 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 this form.
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 property, 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 o/ Carlsbad Building Division.
I declare under penalty of perjury thClt I hClve read and understand all Clf the infClrmation provided on this form and that my responses, including my
authority to sign this form, Is true and correct. I am aware that I have the option to consult with legCll counsel prior to signing this form, and I have
either (1) consulted with legal counsel prior to signing this form or (2) hove waived this right in signing this form without the advice of legal counsel.
Property Owner Name (PRINT)
ili}ztf
Date
2 REV.08/20
Building Permit Inspection History Finaled
{City of
Carlsbad
PERMIT INSPECTION HISTORY for (CBR2024-0017)
Application Date: 01/03/2024 Owner: JOSEPH BEMIS Permit Type: BLDG-Residential
Work Class: P/M/E Issue Date: 01/03/2024 Subdivision: CARLSBAD TCT#92-02 UNIT#01
Status: Closed -Finaled Expiration Date: 07/02/2024
IVR Number: 54099
Scheduled Actual Inspection Type Inspection No. Inspection
Date Start Date Status
01/04/2024 01/04/2024 BLDG-23 235596-2024 Passed
GaslTesURepairs
Checklist Item COMMENTS
BLDG-Building Deficiency
BLDG-Final Inspection 235752-2024 Passed
Checklist Item COMMENTS
BLDG-Building Deficiency
BLDG-Plumbing Final
BLDG-Structural Final
Friday, February 9, 2024
Address: 1237 BELLEFLOWER RD
CARLSBAD, CA 92011-2501
Primary Inspector Reinspection
Dirk de Roggenbuke
Passed
Yes
Dirk de Roggenbuke
Passed
Yes
Yes
Yes
Inspection
Complete
Complete
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