HomeMy WebLinkAbout1065 PALM AVE; ; 61-4014; Permit--~
APPLICATION FOR B • L DING PERMIT 4014
CITY OF CARLSBAD -BUILDING INSPECTION DIVISION
PHONE PArkwa'Q.81 • Ext. 36
fe;';::. ~;,~;, Lt,. T~;;j ~;, ~~ .... m., ....... ,({};~-~c;;; Ph;;;
Contractor ........................ ~•~·······································Mailing Address ........ 9"z'c/~ <¼'~ ............................. .
To Co"''"" 0 To Add ✓ P~:•~lt" 0 To Ropol, O To Coo,ori □ N,;0
6
:0,. F~m~ ~ity Phoo:
Type of Cons(hf!.~t~-_,Kind of Foundation .................................... No. of Stories ... :-::-::=: .. To Be Used f(b~~t;:;;ii:j~:9 ..... St;·;~,···Et~·.f·--
Floor Space of Proposed Construction (sq. feet) ~ ... cl~O ........ Const. Valuation $ ............. /.4.? .. q···~···························································
attached 0
Floor Space of Garage (sq. feet) ................................................. detached OConst. Valuation $ ....................................................................•................................•
LEGAL DESCRIPTION ···············································································•·••·······•-···•······································································································•···························· Lot Block Subdivision
or .................................................................................................................................. Section .................................... Township ............................ Range .......................... .
Located at ...... /4>.b.....S.: ................................................................................ Street, Near .... /J...d...,4_.Y.._...s._ ........ ~ .. ~ .. : ......................................... .
Assigned House Number
LAND AREA ...................................... NUMBER OF EX STING DWELLINGS ON PROPOSED BUILDING SITE .................. /.. ........................... (INDICATE
SIZE, USE AND LOCATION ON PLOT PLAN) ILL 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 II check is tendered for i::·oyment of the above fee ond the check is
not honored when presented for poyment, your Building Permit will be
immediately revoked.
SIGNATURE OF
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 I ................... ·····················•···············
Variance
Eng. Chock By ............................................................................. .
Driveway Permit Required Yes (
Grading Permit Required Yes ( )
No ( ) Fee
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 ..................................................................................... .
:::
5
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Date ........... 7: ..... i!:-.G.. .. := .. ~................................................................. Total Charges ....... e?: ... °...':.. ..................................................................... ..
APPLICATION FOR B DING PERMIT ~ 4005
CITY OF CARLSBAD -BU ILDING INSPECTION DIVISION
PHONE PArkway 9-1181 • Ext. 36
Address ........ //).~::=: ..... %~ ................................. .
Number Street City Phone
Contractor ............. LJuc.ArJ-""LA~.,,._ ... "" ....... -... -... -........................................................ Mailing Address ....................................................................................................... .
( Please Print) Number Street City Phone
To Construct ~o Add O To Alter O To Repair O To Convert O To Move From ............................................................. .
,,,-Z Address
Type of Const.B./J>.C...k ............... Kind of Foundation ..... ~ .... No. of Stories ................ To Be lJffd . .hr .. ±.~ ~ ............ .
(Frame, Masonry, Etc.) -------(bne F~·;.;;iiv-o::~~·:··s~.)
Floor Space of Proposed Construction (sq. feet) ............................................ Const. Valuation $ ............ /;I.£)()_ ... ~~································································
attached 0
Floor Space of Garage (sq. feet) ................................................. detached OConst. Valuation $ ..................................................................................................... .
LEGAL DESCRIPTION Lot ··· ···· Block Subdivision
:~c·~·~~~···~·~··:::::::1.d.:;:£::p~::::::::::::::::::::::::::::::::::::::::::::::::::::::::::~·~~~~··::::::::~.·.·.:·.~·.· ... ~.~.~.~8-::::::::::::::::::::::::.:::
Assigned House Number
LAND AREA .;..;;,..£:, .. o .. c ......... NUMBER OF EXISTING DWELLINGS ON PROPOSED BUILDING SITE ······················•·/.•····•··············· (INDICATE
SIZE, USE AND LOCATION ON PLOT PL~L 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
immediately revoked.
I
SIGNATURE OF 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 ~ J ........................................................... .
Zone • Commercial --· ) ·················································••···•·•·
Variance
Eng. Check By ............................................................................... .
Driveway Permit Required Yes (
Grading Permit Required Yes { )
) No(~ee ..................................... .
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 .................................................................................................... Plan Check Fee ....................................................................................................... .
~OCP Approved by .............................................................................................................. Building Permit Fee ............... . .............................................................................. . --,~
Total Charges ............ a. ............................................................................ . Date .................. /-~····C.~~ ..... ~./ ............................................ .