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MODEL NO
BUILDING PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA 92008
Applicant to complete numbered spaces only Phone 729-1181
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SPECIAL CONDITIONS *
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APPLICATION ACCEPTED BV PLANS CHECKED BY APPROVED FOHII^sJANCE BY
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' NOTICE / '
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB
ING. HEATING VENTILATING OR AIR CONDITIONING
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS OR IF
CONSTRUCTION OR WORK ISSUSPENDED OR ABANDONED FOR A
MENCED
,1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS
ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS
HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING
5ISNATURE Of OWNEB (IF OWNEO BUILDE") |O*TE)
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PARCEL NUMBER
, . BOOK PAGE PAR '
IIP PHONEi29M 7M-?5*f
PHONE uSJATE LIC NO CITY LIC.NO
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PMONE LICENSE NO /
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OHOhE LICENSE NO ,
BRANCH
^- - NO RDRMS NO BATHS
a REPAIR DMOVE n REMOVE/2 $
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P.LAN CHECK FEE S /jf PERMIT FEE S ^Sjf
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Tyoe of Occupancy
Const Group >
Size ol Bldg No of Max
(Total) Sq Ft Stories Occ Load
Fire Use Fire Sprinklers
Zone Zone Required DYCS DNO
OFFSTREET PARKING SPACESNo of M -Nn No'Dwell. ng Units Covered SQ Ft Open
Special Approvals Required Received Not Required
PLANNING DEPT
HEALTH DEPT
FIRE DEPT f
SOIL REPORT vjr
OTHER (Specify)
ENGINEERING DEPT
WATER DEPT
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WHEN PROPERLY VALIDATED (IN THIS SPACE! THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION CK M O CASH
TOTAL FEES $.
INSPECTOR
INSPECTION RECORD
FOUNDATIONS
SET BACK
TRENCH
REINFORCING
FOUNDATION WALL &
WEATHER PROOFING
CONCRETE SLAB
FRAMING
INT LATHING OR DRYWALL
EXT LATHING
MASONRY
FINAL
DATE
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REMARKS INSPECTOR
USE SPACE BELOW FOR NOTES, FOLLOW-UP, ETC
DEPARTMENT OF PUBLIC HEALTH t
REQUEST FOR NOTICE OF SWIMMING POOL COMPLETION
Of each when 3u<!dmg Permit- /$ issued and fowwded to
10CO CHTTJO,UAPrrT ST.
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CALIF FC-OLS I ^° 1 std
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Owner's Nama
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Owner's AddressPOST OPTICS BOX 74".
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plan Pile No
Health Department , i 3 ^o
No of Pools Approved
Completion Data
/When work is completed and Blectnjz meter )s/reteased, this notice is to be completed and forwarded to the
Health Department
GUNITS ?,sa. 732S-T8W ^ ' COUNTY OF SAN DIEGO
DEPARTMENT OF PUBLtC HEALTH
1600 Pacific Highway
San Diego, CA 921O1 - -
INTERDEPARTMENTAL INFORMATION SHEET
BUILDING DEPARTMENT
BUILDING ADDRESS:
DATE:RECEIVED
MAY 1 71978
TO.OF CARLSBADBuilding Department
PLANNING DEPARTMENT
ZONE LOT SIZE LOT WIDTH
UNITS ALLOWED UNITS PROVIDED
PARKING SPACES REQUIRED
% COVERAGE ALLOWED
BUILDING HEIGHT ALLOWED
FRONT SETBACK:
ALLOWED
PROVIDED
_PROVIDED_
PROVIDED
PROVIDED
SIDE SETBACK:
INTRUSIONS
LANDSCAPE & IRRIGATION PLAN COMMENTS:
REAR SETBACK:
ENVIRONMENTAL PROTECTION REQ
ADDITIONAL COMMENTS:
OK TO ISSUE DATE OK TO FINAL
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us«A ENGINEERING DEPARTMENT™ qH& — __-—— _ — ———~
R.O.W.INDUSTRIAL WASTE
DATE
IMPROVEMENTS
SEWER CONNECTION
GRADING PERMIT
DRIVEWAV LOCATIONS
EASEMENTS
LEGAL DESCRIPTION fa y*. /1T7
DRAINAGE
ADDITIONAL COMMENTS
OK TO ISSUE:DATE/S, —,PWI OK TO FINAL DATE
FIRE DEPARTMENT
SPPIUKLING SYSTEM
FIRE ALARMS
PROTECTION EQUIP.
EXITS
FIRE HYDRANTS LOCATION
ADDITIONAL COMMENTS
OK TO ISSUE:DATE OK TO FINAL DATE
WATER DEPARTMENT
REQUIREMENTS OF APPROPRIATE DISTRICTS MET DATE
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