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HomeMy WebLinkAbout2425 LA COSTA AVE; B; CBR2024-2061; Permit                                                         (Cityof Carlsbad 'r (_ Cifyof Carlsbad Job Address 2425 LA COSTA AVENUE #B RESIDENTIAL BUILDING PERMIT APPLICATION B-1 Plan Check Est. Value PC Deposit Date Unit: APN: 216.240.55.19 ------- CT/Project#: __________________ Lot #: ____ Year Built: _________ _ BRIEF DESCRIPTION OF WORK: REPLACE 50 GAL WATER HEATER 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 ofuse? O YON □ Pool/Spa: _____ .SF Additional Gas or Electrical Features? ____________ _ 0Solar: ___ KW, ___ Modules, Mounted:QRoofQGround, Tilt:OYON, RMA:OYO N, Battery:OYO> N, Panel Upgrade: Ov ON Other: PRIMARY APPLICANT Name: DEBORAH EDMISTON Address: 9895 OLSON DRIVE #B PROPERTY OWNER Name: SAL CARUSO Address: 2425 LA COSTA AVENUE #B City: SAN DIEGO State:_C_A __ Zip: 92121 City: CARLSBAD State: CA Zip:_9_20_0_9 __ _ Phone: 858-518-2393 Email:DEDMISTON@ARS.COM Phone: 760.815.9871 Email: SPCARUSO@COX.NET DESIGN PROFESSIONAL CONTRACTOR OF RECORD Name: Business Name:ARS/RESCUE ROOTER ------------------Address: Address: 9895 OLSON DRIVE #B City: ________ State: ___ Zip:_____ City: SAN DIEGO State: CA Zip:_9_21_2_1 ____ _ Phone: Phone: 858-518-2393 Email: Email: DEDMISTON@ARS.COM Architect State License: ___________ _ CSLB License#: 765155 Class: C-36 --------------- Carlsbad Business License# (Required): BLOS1 030700 APPLICANT CERT/FICA TION: I certify that I hove read the application and state that the above information Is correct and that the information of the plons is accurate. I ogree to comply with all City ordinances and State lows relotlng to bu//dlng constructior1. NAME (PRINT): DEBORAH EDMISTON SIGN: DEBORAH EDMISTON DATE: 08/02/2024 163S Faraday Ave Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 Email: Bulldlng@carlsbadca.gov REV. 10/21 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: lherebyaffirmunderpenaltyofperjurythatlamlicensedunderprovisionsofChapter9(commencingwithSection7000)ofDivision3 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{CHOOSE ONE): D1 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- 1:!)1 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: _L_IB_E_R_T_Y_M_U_TU_A_L ___________________ 1 Policy No. 7631508631023 Expiration Date: _1_0_11_,2_0_24 _______________ 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 CERT/FICA TION: The applicant certifies that all documents and plans dearly 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 detall 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): DEBORAH EDMISTON SIGNATURE: DEBORAH EDMISTON DATE: 8/2/2024 Note: If the person signing above Is an authorized agent for the contract er of authorization on contractor letterhead . . -OR -. (OPTION B): OWNER-BUILDER DECLARATION: I hereby affirm that I am exempt f rom 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 lo 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 theapplicablelaw, Section 70440/ the Business and Professions Code, is available upon request when this application is submitted ar at the following Web site:http://www.leginfo.co.govl 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 h°'e 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): Note: If the rson si nin above Is an authorized a 1635 Faraday Ave Carlsbad, CA 92008 Ph: 760-602-2719 Fax: 760-602-8558 2 owner. Email: BµildlnR@carlsbadca.gov REV.10/2                                    {city of Carlsbad