HomeMy WebLinkAbout1060 CHESTNUT AVE; ; 63-5396; PermitAPPLICATION FOR PERMIT
5396
CITY OF CARLSBAD — BUILDING INSPECTION DIVISION
PHONE PArkway 9-1181.-Ext. 36
Owner Name ..CX£AI.L*<<$M&!b&
(Please Print) ^/v(Last) .'(First)
Contractor (ij^^r^2fdj^d^^ Mailing Address :'..
..'•-. ' (Please Print) ' ; ;• .....'
To Construct D To Add Q To Alter D To Repair D To Convert Q
Number Street
To Move From
Type of Const'. r$4&sM*&-, . Kind of Foundation.../^je ./2...S.. ...... No. of Stories ..... /.....! To Be ' Used for
(Frame, Masonry, Etc.
Floor Space of Proposed Construction (sq. -feet) ......... /...&~..Q. ....... . ........... Const. Valuation $
Floor Space of Garage (sq. feet)
LEGAL DESCRIPTION ..................
(One FamilgTDwelling, Store, Etc.)
attached D . , ' ' :
. detached QConst. Valuation $..
Lot Block
Located at
..Section .
:.Street, Near.
Subdivision
,...:... Township... Range..
Assigned House Number'
LAND AREA .'....: NUMBER OF EXISTING DWELLINGS ON PROPOSED BUILDING SITE 1. (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 payment of the above fee and the check is
not honored when presented for payment, your Building Permit will be SIGNATURE OF
immediately revoked. ' . PERMITTEE
Front Yard Set Back
Side Yard Set Back
Rear Yard Set Back
Distance Between Bldg.
Off Street Parking Spaces
Sewage Disposal System
Zone - Residential ( )
Zone - Commercial ( )
Variance
Eng. Check By ..; :
Driveway Permit Required Yes ( ) No (^7 Fee
Grading Permit Required Yes ( ) No ('
Sewer Disposal Plant Capital Cont. Fee
Sewer Pumping Station Capital Cont. Fee ...
Sewer Main Line Cost
Sewer Lateral Connection Charge
Water Stocked.'Lands Charge
Water, Main Pipe Line Fee
Water House Service Charge
Water Meter Charge
Sub Total
Plans Approved-"by"rrrrs», ^....-...*0£3 ,/£..-........., :... ..'.Plan • Check Fee
Approved by £\«: jQ).l...L}:^^.£*!&{#3*^^ Permit Fee
Date £5.:..^....Z-63-^Z-Jfc>v.....^ :..,...: .:....... Total Charges