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HomeMy WebLinkAbout1769 YOURELL AVE; ; 62-4212; PermitAPPLICATION FOR BL I IJ DING PERMIT 4212 CITY OF CARLSBAD -BUILDING INSPECTION DIVISION PHONE PArkway 9-1181 • Ext. 36 f;,:::, ~:t;;?g~i~~Mid~<M,m,, Contractor ................. ~•··················································Mailing ( Please Print) Number Street City Phone Address .............. ~ ....................................... . Number Street City Phone To Construct ~ Add O To Alter D To Repair D To Convert O To Move From ............................................................. . Type of Const. 7~ Kind of Foundation ... ~l'. ...•..• No. of Storie: ....... / ..... To Bo Used for ....... ~ ......................... . (Frame, Masonry, Etc.) (One Family Dwelling, Store, Etc.) Floor Space of Proposed Construction (sq. feet) ....•.. ./. .• Y.../..fJ:.. ............. Const, Valuation $ ............ £·····························~···································· Floor Spaco of Garage (sq. feet) .......................... 3/.'~.Z ..... dae~=~~=~ ~ Valuation $ ....... .C. ... ~~ .. ~:.~ ................................................. . LEGAL DESCRIPTION ............... ~•····························································-···························~···~·····~~ ................................................ . Lot Block Subdivision or .................................................................................................................................. Section .................................... Township ........................... , Range .......................... . l oootod ot ••••••• J1;,~i~;;-[Jl~···························""''• Noo, .~~························································· LAND AREA ...................................... NUMBER OF EXISTING DWELLINGS ON PROPOSED BUILDING SITE .. ~ ......... (INDICATE SIZE, USE AND LOCATION ON PLOT PLAN). WILL THIS CONSTRUCTION INCLUDE ANY PLUMBING INSTALLATION, ALTERATION, OR ~ ADDITION? YES................ NO ................ . I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION. If a check is tendered for s:,aymenl of the above fee and the check is not honored when presented for payment, your Building Permit will be immediately revoked. SIGNATURE OF PERMITTEE ............................................................................................... . I I' Front Yard Set Back ........ B... .. O. ........... ~ /' ~ / --Side Yard Set Back ........... ...r'1 .. ~ ................................................... . Is' L--Rear Yard Set Back ....................................................................... . Distance Between Bldg. /.4 .... ~ ................ ~ .................. . Off Street Parking Spaces •••••• /.. •• c;:..··:····································· Sewage Disposal System •········~·7···········•·······•················· Zone • Residential ( / ) ........................................................... . Zone . Commercial ) ·················•········································ Variance Eng. Check By ............................................................................... . Driveway Permit Required Yes ( Grading Permit Required Yes ( ) No ( ,f' Fee ..................................... . No 1X ····································· ... · .............. . Sewer Disposal Plant Capital Cont. Fee .......... :~~QL~.'?::~ ............................... . Sewer Pumping Station Capital Cont. Fee ....... /t?. .. /)_.f. ... '!..~ ................................. . Sewer Main Line Cost ....................................................................................................... . Sewer Lateral Connection Charge ................................................................................. . Water Stocked Lands Charge ......................................................................................... . Waler Main Pipe Line Fee ....................... , ................................................................... . Water House Service Charge ·····;;··~··t1-.lJ~¥~·;:. ... ;,.;;._··········· .. ·· Water Meter Charge ........... , ............. ~ ................................................. . Sub Total ................. .#.!~.~·•·······7...~~ ..