HomeMy WebLinkAbout1003 DAISY AVE; ; 79-4293; PermitMODEL NO
Applicant to complete numbered spaces only
BUILDING PERMIT APPLIC
City of CARLSBAD, CALIFORNIA 92008
Phone 729-1181
9/Q5/79S5D6"SI/D5/79
n.
Permit No
JOB ADDRESS ^^
LOT NO BLK TRACT -. •,
!DES"R /%% 71-?>Cl($PU
OWNER MA!L ADDRESS
CONTRACTOR MAIL ADDRESS
3
4
ENGINEER MAIL ADDRESS
5
COMPENSATION INS CARRIER MAIL ADDRESS
£
USE OF BUILDING f *
7
8 Class of work D NEW D ADDITION D ALTERATION
9 Describe work ^
^. •>
10 Change of use from
Change of use to
11 Valuation of work $ ^ 2^§?O t 0 O
SPECIAL CONDITIONS
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J
*\ /
APPLICATION ACCEPTED BV PLANS CHECKED BY APPRSrvE Uf f ȴ4iukli| B*f />XVPr PMM
NOTICE ^
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL PLUMB
ING HEATING VENTILATING OR Al R CONDITIONING £
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM
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
SICNAJjJRE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
'T'r&rTMfoA/ * ^-"T^J?^}/ flsf Jf-Za -~7^Sf *<f rr/££A9^ ,^r ^ ^&fi£^s£&&^^e ^ ^ f f
SIGNATURE OF Q^XER (IF O WJ^fiMBU 1 L D E R ) (DATE)
^ .A ASSESSOR S
/3/yz^ C- r? / £. tfOQ P^/C^L— N^2^-* //
BOOK | PAGE PAR
^/flkdA MILL) #45-3
ZIP PHONE ^^^~ -^^
PHONE STATE LIC NO PTl li |J_, fJ" f—
PHONE LICENSING
PHONE LICENSENO
BRANCH
NO BDRMS NO BATHS
D REPAIR DMOVE D REMOVE
r7o c, ,^c- ^ r/o Co i/c&} I
i^1
PLAN CHECK FEE $ / r~ ^ PERMIT FEE $ ff\ f ^^^
M! CRO FILM FEEType of Occupancy
Const Group
Size of Bldg No of Max
(Total) Sq Ft Stones Occ Load
Ftre Use Fire Sprinklers
Zone Zone Required LJYes CDNo
OFFSTREET PARKING SPACESNo of
Dwelling Units Covered i,Sq Ft dSen
Special Approj/jjjs, {S^~ RequijajfJ^^ Received Not Required
FIRE DEPT
SOIL REPORT
OTHER (Specify)
ENGINEERING DEPT
WATER DEPT
7
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK CASH PERMIT VALIDATION CK M O CASH
TOTAL FEES $
4M3 INSPECTION RECORD
FOUNDATIONS
SET BACK
TRENCH
REINFORCING
FOUNDATION WALL &
WEATHER PROOFING
CONCRETE SLAB
FRAMING
INT LATHING OR DRYWALL
EXT LATHING
MASONRY
\
FINAL
DATE
!*$1
REMARKS INSPECTOR
USE SPACE BELOW FOR NOTES, FOLLOW UP ETC
BUflLDING DEPARTMENT
INTERDEPARTMENTAL INFORMATION SHEET
BUILDING ADDRESS
DATE
PLANNING DEPARTMENT
70NE
CITY OF CARLSBAD
Building Department
LOT SIZE LOT WIDTH
UNITS ALLOWED UNITS/'PROVIDED
PARKING SPACES REQUIRED
% COVERAGE ALLOWED
BUILDING HEIGHT ALLOWED
FRONT SETBACK.
ALLOWED
PROVIDED
INTRUSIONS
LANDSCAPE & IRRIGATION PLAN COM
PROVIDED_
PROVIDED
PROVIDED
REAR SETBACK
ENVIRONMENTAL PROTECTION REQ
. .SCHOOL FEES;AMOUNT:
ADDITIONAL COMMENTS
OK TO ISSUE DATE 'OK TO FINAL DATE
ENGINEERING DEPARTMENT
ROW INDUSTRIAL WAC.TE IMPROVEMENTS
SEWER CONNECTION
GRADING PERMIT
_ DRIVEWAY LOCATIONS
EASEMENTS/^>£DRAINAGE
LEGAL DESCRIPTION
ADDITIONAL COMMENTS
OK TO ISSUE jO^^ DATE 1?/j/ /) °l PWI OK TO FINAL_DATE
FIRE DEPARTMENT
SPRINKLING SYSTEM
FIRE ALARMS
FIRE HYDRANTS
ADDITIONAL COMMENTS
FIRE PROTECTION EQJIP
EXITS
LOCATION
OK TO ISSUE DATE OK TO FINAL DATE
WATER DEPARTMENT
REQUIREMENTS OF APPROPRIATE DISTRICTS MET_DATE
- Wi,
CITY OF CARLSBAD
BUILDING DEPARTMENT
(714) 729 1181
CERTIFICATION
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
If, after making this certificate 1 become subject to the workers' compensation pro
visions of the California Labor Code, I will forthwith comply with Section 3700 of the
Labor Code
I understand that if I fail to comply with the workers' compensation laws, this permit
shall be deemed revoked
I further certify that if I should contract or subcontract with any person, including any
firm or company, to do all or part of the work for which this permit is issued, I shall assure
compliance by that contractor or subcontractor with Section 3800 of the California Labor
Code
SIGNED
PRINT NAME AND TITLE
JOB ADDRESS
DATED F'3/~ 7?