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Home My WebLink About2519 UNICORNIO ST; ; CBR2023-2937; Permit                                                       (Cityof Carlsbad ( City of Carlsbad RESIDENTIAL BUILD ING PERMIT APPLICATION 8-1 ' , ~l_ Plan Check C8t 2o2..3 -2q 31 Est. Value PC Deposit _'1.;_C>_%~'---- Date '4 \:::,\2,023 Job Address 2,S \ 9 \.AQ\('<c,ro l O ;n:, Unit: _____ APN: __________ _ CT/Project #: _________________ Lot #: ____ Year Built: _________ _ BRIEF DESCRIPTION oF woRK: Shower ceMode.\ ~ SA:J11. □ New SF : Living SF, ____ Deck SF, ___ Patio SF, ____ Garage SF __ _ Is this to create an Accessory Dwelling Unit? O Y O N New Fireplace? Q YO N, if yes how many? ___ _ cf-Remodel: '2-L\:< SF of affected area Is the area a conversion or change of use? ~Y O N D Pool/Spa: _____ SF Additional Gas or Electrical Features? ____________ _ □ Solar: ___ KW, ___ Modules, Mounted:0 Roof O Ground, Tilt: 0 YO N, RMA: Q) Y O N, Battery:Q YC N, Panel Upgrade: Q y O N Electric Meter number: ------------ 0th er: PROPERTY OWNER .....a.~~~~t-i,,,,,__t,-t,,---'-'1-"""+~-::+-d:-1-t-'~-Name: ___________________ _ ,__.~.,.._..._-,E,ll..ll.J..:...1...-i::::.+-.L.L~;.......,.a,,,i:..+.J.-...--Address: __________________ _ -4-_11.,1,L....__City: __________ State: ___ Zip: ____ _ ,.....,;s..a....a.......:r:::..-.--.,,........1&,,1.....:.-=--------Phone: __________________ _ ,....:,,.-..aL,Z,...111..,;;;.,..a..z..a.....1....1....~~..-~l,Z..l~-=:..;;_.1.-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 CERT/FICA TION: I certify that I 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 o/1 City ordinances and State Jaws relating to building construction. NAME (PRINT):9'Mb\to Co r1:t-'ti, s1GN: 1635 Faraday Ave Carlsbad, CA 92008 Ph: 442-339-2719 REV. 04/22 TH IS PAGE REQUIRED AT PERM IT ISSUANCE PLAN CHECK NUMBER: CS~ °2(!)Z3 .. 2$1 '} 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 underpenaltyof perjury that I am licensed underprovisionsof Chapter 9 ( commencing with Section 7000) of Division] of the Business and Professions Code, and my licen~e is in full 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: ________________ _ -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 sha ll 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 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 construction, unless otherwise noted. NAME {PRINT): __________ SIGNATURE: __________ DATE: ______ _ Note: If the person signing above is an authorized agent for the contractor rovide a letter of authorization on contractor letterhead. (OPTION B): OWNER-BUILDER DECLARATION: I hereby affirm that I am exempt from Contractor's License Law for the following reason: 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. 44, 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). ~~:~wner of the property, am exclusively contracting with licensed contractors to construct the project {Sec. 7044, Business and Professions Code: The ~~ractor'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./ 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 I www.leginfo.ca.gov I ca/aw. html. OWNER CERT/FICA T/ON: 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 t of their construction, unless otherwise noted. ~'~~~h!p!!:~~!'~,~-,f:!~~t ( r rn }!~::i,dode 1o,m a ., si , ,rt ,w,,~ATE: L, \1 \r,i.'.? 1635 Faraday Ave Carlsbad, CA 92008 Ph: 442-339-2719 Email: Building@carlsbadca.gov 2 REV. 04/22 OWNER-BUILDER ACKNOWLEDGEMENT FORM B-61 Development Services Building Division 1635 Faraday Avenue 442-339-2719 www.carlsbadca.gov ow R-BU LDER ACKNO EDG E T 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: • Site Address 'Z CS ( 'f lA \1 ( '" t'V\\ 0 s-+, CA rt"°,,J / 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 ~ity 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. _&_1 understand a frequent practice of unlicensed contractors is to have the p.roperty 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 se'rious 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. 11. ~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. 111. ~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. .Jtt._1 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. 05/22 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. k I understand under California Contractors' State Lice nse Law, an Owner•-Builder who builds single·-family res idential 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 se ll the property for which t his permit is issued, I may be held liable for any financial or personal injuries susta ined by any subseq uent 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. _&_1 am aware of and consent to an Owner-Builder building permit applied for in my name, ar,id understand that I am the party legally and financially responsible for proposed construction activity at the following address: XI. ~ I agree that, as the party legally and financially responsible forth is proposed construction ~ctivity, I will abide 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. Ucensed 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 of Carlsbad Building Division. I declare under penalty of perjury that I hove read and understand all of the information provided on this form and that my responses, including my authority to sign this form, is true and correct. I om aware that I have the option to consult with legal counsel prior to signing this form, and I hove 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. 3 REV. 05/22                                                                                                                                                                                        {city of Carlsbad                                              (Cityof Carlsbad ( City of Carlsbad PLAN CHECK REVISION OR DEFERRED SUB MITTAL APP LI CATION 8-15 Development Services Building Division 1635 Faraday Avenue 442-339-2719 www.carlsbadca.gov (by City Staffj CONTACT INFORMATION: J Name ;;'.Mlo\fm Go r-1-'..e-1-fTt;;one 1 loD•Lf1'2; %~1 Fax ~ #(<. Address '2}5 ll1 ~n, Coen {O '.fA:: Citytavv\:'2 ,~u Zip 6l1ttCfo/ Email Address GOO ¥--P~ \1 ~qq@ ~ vA.\orJ , [';o\1\1 Original plans prepared by an architect or engineer, revisions must be signed & stamped by that person. 1 . Elements revised: [S'.l~lans D Calculations D Soils D Energy D Other 2. 3. Describe revisions in detail tJ{ 4. Does this revision, in any way, alter the exterior of the project? Oves □No 5. Does this revision add ANY new floor area/s)? Oves -~o 6. Does this revision affect any fire related issues? Oves ·~o 7. Is this a full set re Oves £S'Signature Date /Z ,o 1635 Faraday Avenue, Carlsbad, CA 92008 Ph: 7 60-602-2719 E__· 7 -602-8558 Email: building@carlsbadca.gov www.carlsbadca.go ~7