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HomeMy WebLinkAbout1052 CHESTNUT AVE; ; 77-374; PermitMODEL NO. BUILDING PERMIT APPLICATION City of CARLSBAD, CALIFORNIA 9200&EB -8-77 Applicant to complete numbered spaces only. PnOn© 729-1181 Permit Nn. JOB ADDS ESS LOT NO. BLK TRACT* 1 DE.5CR. OWNER MAIL ADDRESS CONTRACTOR . " MAIL ADDRESS' f ENGINEER/ / MAIL ADDRESS. 5 COMPENSATION INS. CARRIER . MAIL ADDRESS 6 USE OF BUI LD1 NG ' / 8 Class of work: JZlNEW D ADDITION • D ALTERATION r 9 Describe work: £ ^yj^ -^S^^^X • 10 Change of use from . . Change of use to 11 Valuation of work: $ ^? 7<^!K^ SPECIAL CONDITIONS: . f /I APPLICATION ACCEPTED BY. PLANS CufiCKED BY . APPROVED^Oft I«*UANCE BY DATE ^^^ DATE 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 IS SUSPENDED OR ABANDONED FOR A MENCED. 1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NJDT, TkfE G WANT ING OF A PERMIT DOES NOT PRESUMJLTO /jl VE VVUTHJO'RITY TO VIOLATE OR CANCEL THE PROVISIONS OH ANV/OTHBlR STATE OR LOCAL LAW REGULATING CONiSTRUCTI/QN CXJ4 THli PERFORMANCE OF CONSTRUCTION \^_^rW// "rl£*<rf j2*'<& sA SI CNATyRE^F^fcONTRAC TOR Ofc AUTHORIZED AGENT (DATE) // // SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE) WHEN PROPERLY VALIDATED (IN 1 PLAN CHECK VALIDATION CK. M.O. CASH ASSESSOR'S / - f, x~) xl>0 PARCEL NUMBER ^-"--1 fisf'fs'C' • BOOK PAGE P AR. (1 Istr ATTACHFD SHFFTI ' Z I P /"Vy •- p HJ? N E ^r*jf£-- C»^ • VfcJ'*" X^ '"n^^y PHONE STATE LIC. NO. CITY LIC. NO. PHONE LICENSENO. PHONE LICENSENO. BRANCH NO. BDRMS ___^ NO. BATHS ^ ' D REPAIR nMOVE D REMOVE Z^7x^A^i^ a^/ ^H^L^, ' PLAN CHECK FEE $/$ -^ PERMIT FEE S /£T0 MICRO FILM FEETvoe of *f^ .e Occucancv— • Jf— _ Const. ¥***" ft Group £, ^'Ji rj Size of Bldg. l*f*<) >) *™°- of / Max. _ (Total) Sq. F/ ^ €, C~ Stories f Occ. Load Fire "^ Use/^ '"V'x^ / Fire SC'rinklers Zone ^ . 7nn>s^ f\. 1 Required | |yes DNo . OFFSTREET PARKING SPACES: Dwemng^units f Svered'Z. Sq. Ft^" ^ Open Special Approvals Required Received Not Required PLANNING DEPT. HEALTH DEPT. FIRE DEPT. SOIL REPORT OTHER (Specify) ENGINEERING DEPT. WATER DEPT. "HIS SPACE) THIS IS YOUR PERMIT PERMIT VALIDATION CK. M.O, CASH TOTAL FEES $ ^~