HomeMy WebLinkAbout2711 VIA JUANITA; ; 78-4151; PermitG PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA 92008
Applicant to complete numbered spac;s only Phone 729-1181 Permit No
JOB ADDA [5S ,4 ASSESSOR'S
;;. 7ll v,~. At PARCEL NUMBER
LOT NO.
I BL< I TRACT
BvvK PAGE I PAR,
L [GAL I (Q scc. ATT,1,CHE.O SHEtTI 1 OEOC~.
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fl q.. FR 11 -/.')... (I(,) fx( '}--) r-.s l)
CON TIIAC TOA MAIL, ADDRESS PHONE STATE L IC. NO. CITY LIC. NO.
3 t.t ' l-1 ;I ,
A "ICHI TE.CT OR DESIGNCA MAIL AOOAESS PHONE l!CCNSE. NO,
4
El<,IGINECR MAIL AOOACSS PHONE LICENSE NO,
5
COMPENSATION INS, CARRIER MA.IL ADOll[SS 8 ,IIANCH
6
use or BUILDIN G
!-I £, ""'
7 NO. BDRMS NO. BATHS
8 Class of work : 0 NEW 0 ADDITION ~TERATION 0 REPAIR 0 MOVE 0 REMOVE
9 Describe work: I , s 1-~ )/ tJ-..I 1 ~ tf v,1I
10 Change of use from
Change of use to
11 Val uation of work :$ ~ ..svt:1£ .,. ~ PERMIT FEE $
-I'
PLAN CH ECK FEE $ -
SPECIAL CONDITIONS: MICRO FILM FEE Type of Occupancy
Const. Group
Size or Bldg. No . or Ma><.
(Total) Sq. Ft. Stories 0cc. Load
' Fire use Fire Sprinklers
APPLICATIOf;,ACCrP EDBY ~LA:S,q-t~KEO BY APPROVED FOR ISSUANCE BV Zone Zone Required 0Yes □No l,J
I _,} • 1 -.) \ ), J OFFSTREET PARKING SPACES:
' OAT J 1 ~ ,7 No. of I No. Dwelling Units No. OATE Covered Sq, Ft, Open
NOTICE Special Approvals Required Received Not Required
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB-PLANNING DEPT.
ING, HEATING, VENTILATING OR Al R CONDITIONING.
THIS PERMIT BECOMES N U LL AND VOID IF WORK OR CONSTRUC-HEAL TH DEPT.
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS,OR IF FIRE DEPT.
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A SOIL REPORT
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-
MENCED. OTHER (Specify)
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS ENGINEERING DEPT. APPLICATION ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS WATER DEPT, TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIEO HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION .
.
SIGNATUAijONTJ'A~ AUTH0~4 GENT (DATE)
'I~;) ,..J'_ ~~;.w ./.,..,.,,,.-7 \2:,,1J1,,, l--'J l
SIGNA'T"T'fw.r o..-OWNMII H,f",-""-E" IIVILtiE·-..) I lt'lt.Jlo'Tt .,
WHE,i]ij(OPERI.¥ VA&/iDATED (IN THIS SPACE) THIS IS VOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
TOTAL FEES $ ----,,,""/ __ ,..,__..,,,=---
INSPECTOR1
INSPECTION RECORD
DATE REMARKS INSPECTOR
FOUNDATIONS: -.
SET BACK
TRENCH
REINFORCING
FOUNDATION WALL &
WEATHER PROOFING
CONCRETE SLAB
FRAMING
INT. LATHING OR DRYWALL
EXT. LATHING
MASONRY
I -
FINAL 7i7h2 7/he-,,
/' /'
USE SPACE BELOW FOR NOTES, FOLLOW-VI, ETC.
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