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Home My WebLink About2641 REGENT RD; ; CBR2024-2200; Permit                                                             (Cityof Carlsbad RESIDENTIAL BUILDING PERMIT APPLICATION B-1 ,~ ,_,k -------- JobAddress_2._-_0_Y_'_l __ R._e___B_-e_1l __ '\,_~_ .... \<.&f _____ , __ Unit: ___ APN: _______ _ CT/Project#: _________________ Lot #: ____ Year Built: ________ _ G ~ s v-e._p e__; r- fY\-ettr Ls _l o c k-e c( b, s o G ~ (.._ 0 New SF: Living SF, ____ Deck SF, ___ Patio SF, ____ Garage SF __ _ Is this to create an Accessory Dwelling Unit? QY ON New Fireplace? O YON, if yes how many? ___ _ D Remodel: _____ SF of affected area Is the area a conversion or change of use? 4Q) Y Ql N □ Pool/Spa: ____ SF Additional Gas or Electrical Features? ___________ _ 0Solar: ___ KW,. ___ Modules, Mounted:QRoofQGround, Tilt: 0Y0N, R.MA:()Y ON, Battery:OYO> N, Panel Upgrade: Ov ON Electric Meter number: ------------ Other: Name:, _______________ Business Name: C 04-f k . ( p (!Jl-tv\ 6 :\5 'IrLc Address: Address: P.O~ Ben( __ /7 rz City: _______ State: ___ Zip:____ City: (0iidsbct<f State: CA-Zio: q,z_.,o I K Phone: Phone: "7 h O /--J ·2, 0 --'2..)} 9 } Email: Email: 1<birylw~c0s JJ5 ( r 1.uWJb11 ~ inc ( CoW) Architect State License: CSLB License#: 7 Sb I S--1 Class: CJ lo --"------ Carlsbad Business License# (Required): .BLO SDO 7.S-laV ·-OJ -2-U 2 (J APPLICANT CERT/RCAT/ON: I certify that I have read the application and stat1' that the above information is correct and that the informatlpn af the plans Is accurate_ I "::::::):fy~tf '&~;'.'.'.''";-ooan::,'.fip £NK DATE: g b ~ /uf 1635 Faraday Ave Carlsbad, CA 92008 Ph: 442-339-2719 Email: REV 04/22 THIS PAGE REQUIRED AT PERMIT ISSUANCE l herebyaf firm under penalty of perjury that I am licensed under provisions of 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 :o/lowing declarations {CHOOSE ONE): 0 1 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-ii have and will maintain worker's compensation, as required by Section 3700 of the Labor Code, for the pe ormance of the J?Grlnit,is issued. My workers' compensation insurance c.rrier and policy number are: lnsuranceCompany Name: __ }~\'\-'-''-"'~~-· Q;~:ir~.-a-.-,_..__.,__,__~----l~-f~JM.>~~~• _G;,_·~w,.,~,--~-t\1/ Polley No. :EA G. 5::: 3 l) U / Explratl n Da / -OR- LJ 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. 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 dearly and accurately show all existing and proposed buildings, structures, access roads, and ~tl!ities/utWty easements. All proposed modmcations and/or additio11s are clearly labeled on the site plan. Any potentially exisling 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 premrse that the submitted documents 3nd plans show the correct dimensions of; the property, buildincs~ structures and their setbacks from prop~rty tines and from one another; access roads/easements, ilnd utilities. The existing 1:md proposed use of each buildinR as stated is true and correct; air easements and other encumbrances to development have be-en accurately shown and labeled as welj as aU on-site gradi g/site p paration. All improvements existing on the property were comp!eted in accordance with all regulations in existence at the time of their construction nless other\vise noted. NAME (PRINT): ls:~{) B:e,inde,,r' SIGNATURE:_-r-"'-'ff~---.;.J ~4-.J.,,6::JLlo...,,,- Note; If the person signing abovrsan authorized agent for the contractor provide a letter of uthorization on contractor I hereby affirm that I am exempt from Contractor's License Law for the following reason: n 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-. 0 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-0 1 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. ~, my signature below I acknowledge that, except for my person.JI residence in which I must have resided for at least one year prior to completion of the imorovements 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 :omractors./ understand that a copy of the applicable law, 5ection 7044 of the Business and Professions Code, is available upon request when this application is submitted orat the following Website; http:l lwww.leginfo.ca.gov/calaw.html. OWNER CERTTFICAT/ON: The al)plicant certifies that all documents and plans clearly and accurately show aH 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 corr~ct dimensions of; the property; buildings, structures and their setbacks from property lines and from one another; access roads/ea5ements, 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 an the property were completed in accordance with all regulations in eKistence at the time of their construction~ unless otherwise noted. NAME (PRINT): SIGN: ___________ DATE: ______ _ 163S Far-adav Ave Carlsbad, CA 92008 Ph: 442-339-2719 Email: REV. 04/22                                     {city of Carlsbad