HomeMy WebLinkAbout1065 PALM AVE; ; 78-4341; PermitMODEL.: ~•o. _________ _
BUILDING PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA 92008
Applicant to complete numbered spaces only. Phone 729-1181 Permit No. ., •
Joa AOOR [S5 ASSESSOR'S
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PARCEL NUMBER
LOl' NO. I ILK I TRACT 11 BvvK PAGE I PAR,
1 ~~;~~-I~ , 19 3 . tOSEC ATTACHED SHUTI n {. ~
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MAIL AOO,.tSS i,. PHONE
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CONTIIIAClOlll //ok_ -~ MAIL AOORtSS ult~~ .. PHONC. STATE LIC, NO. CITY LIC, NO.
3 ,. I I,,., ... t .,,., I ~ . i'>. ('
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ARCHITECT OR O ESICHCIII MAIL AOOIIICSS PHONE LICtNSt NO.
4
ENGINEE.llt MAIL ADDRESS PHONE LIC[NSC NO.
5
COMPENSATION INS. CARRI ER MAIL AOOJH.55 81U,NCH
6 IL
USE OF IIVILOIN(;
7 I. , ~ NO. B0RMS NO. BATHS
8 Class of work: □NEW 0 ADDITION 0 ALTERATION 0 REPAIR 0 MOVE 0 REMOVE
9 Describe work : ( 11 T ,~r)/ "/; ( q+)
10 Change of use from
Change of use to
11 Valuation of work: $ ~ 1/,/ C, ~ PLAN CHECK FEE$ // _:J PERMIT FEE $ ;bl 1~ -
SPECIAL CONDITIONS: MICRO FILM FEE Type of Occupancy
Const Group
SJZe of Bldg. No. of Ma><
(Total) Sq. Ft Stories 0cc Load
Fore use Fire Sprinklers
APPLJCA TION ACCEPTED BY PLANS CHECKEO BY APPROVED FOR ISSUANCE BY zone Zone Required 0 Yes 0No r 7, 1(.,-., )J No. of OFFSTREET PARKING SPACES
DA.TE(._,/ Dwelling Units No. !No. DA.TE Covered Sq. Ft. Open
NOTICE Special Approvals Required Received Not Required
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB· PLANNING DEPT.
ING, HEATING. VENTILATING OR AIR CONDITIONING. HEALTH DEPT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF FIRE DEPT
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A SOIL REPORT
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM· ~
MENCED. OTHER (Specify)
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS ENGINEERING DEPT APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.
ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS WATER DEPT, TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. ,_ .. --· -----•~, ' ., r I
SIGNATVfU. OP' CONTl'lACTOII Ol'l AUTHOfllltO AGtNT (DATC.l f
5ICNATllN[ 0,-OWN£11 ,,-0WN£11J AUILDEIII) CAT£)
WHEN PROPERLY VALIDATED (IN THIS SPACEI THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M .O. CASH PERMIT VALIDATION CK. M.O CASH
~P'
TOTAL FEES$ ___ / _____ _
INSPECTOR
0
INSPECTION RECORD
DATE REMARKS INSPECTOR
FOUNDATIONS:
SET BACK
TRENCH
REINFORCING
FOUNDATION WALL &
WEATHER PROOFING
CONCRETE SLAB
FRAMING
INT. LATHING OR DRYWALL
EXT. LATHING
MASONRY -
I...__ ...... r I
FINAL ~~~ \"~ "---' ' ~
USE SPACE BELOW FOR NOTES, FOLLOW-UP, ETC.
PLUMBING PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA 92008
Applicant to complete numbered spaces only Phone 729-1181
JOB ADOllt C.$5
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L.OT NO, -I OLK I mCT _/t~t.JVLJ Ii j L(GAL I /9 1 ouc•. _) ' -_. < -,
OWNCft
~.• ,V-I.. /ll{C:..
MAIL AODIJl£55 4Ln, Jh 2
ZIP PHOHC
?c? 7r;
CON TlltA C TOllt -;-) , MAIL A00At55
;f /,~,l'\V 6, 3 ,
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PHONC &. STATE LIC. NO.
2-
A"CHITCCT Oflt OCSIGN[llt MAIL ADO,tE.55
4
CNGINC[llt MAil. AO0AC55
5
COMPENSATION (NS. CARRIER MAIL ADD"ESS
6
US[ o, IUILDING :::>
7 ,., ~
8 Class of work: 0 NEW 0 ADDITION 0 ALTERATION
9 0 escribe work: Ii Jf P __ ;Nr
1-:,.. tc...'
SPECIAL CONDITIONS
"PPLICATION AC(;EPTEO BY PLANS C!-tECKEO BY APPROVED FOR •SSUANCE SY
DATE
NOTICE
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.
I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS APPLICATION ANO KNOW THE SAME TO BE TRUE ANO CORRECT.
ALL PROVISIONS OF LAWS ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE QA CANCEL THE PROVISIONS OF ANY OTHER STATE QA LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
PHONC L ICCNSC t-10.
PHOM£ LICCNSC NO.
ltlU,NCH
0 REPAIR
PERMIT FEES
No. Type of Fixture or Item
WATER CLOSET (TOILET)
BATHTUB
LAVATORY (WASH BASIN)
SHOWE A
KITCHEN SINK & DISP
DISHWASHER
LAUNDRY TRAY
CLOTHES WASHER
1 WATER HEATER
URINAL
DRINKING FOUNTAIN
FLOOR-SINK QA DRAIN
SLOP SINK
I GAS SYSTEMS. NO.OUTLETS
WATER PIPING & TREATING EQUIP.
WASTE INTERCEPTOR
VACUUM BREAKERS
LAWN SPRINKLER SYSTEM
SEWER NUMBER CLEANOUTS
CITY LIC. NO.
Fee
$
i l / ( J I CESSPOOL X \. .-. () -) )
7
r F--'----+--sEPT_1c TA_NK _• P1T ___ ----+----+----1 _,_..:>,I-Ii "I ROOF DRAINS
si,NATURE or CONTRACTOR Ollt AUTH011111ED AGCMT IDATtl f
ISSUANCE FEE -c $
SIGNATUllt[ 0,-OWH[N ,,-0WMtllt BUILDER DATE.) TOTAL FEES $
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M .O. CASH PERMIT VALIDATION CK. M .O. CASH
INSPECTOR
ELECTRIE:AL PERMIT APPLICATION
c·t f CARLSBAD CALIFORNIA 92008 I y 0 ' ;lffe ~J../JY. Applicant to complete numbered spaces only. Phone 729-1181 Permit No.
JOB ADDRESS
ALFI'> .,
LOT NO. I HK. I TRJl,CT /1a <OsEE ATTACHED SHEET) LEGAL I 1CJI ~ .#1'.lix-' 1 DESCR, :
OWNER MAIL ADDRESS,'?__ J'hi,, ZIP PHONE
2 ~ ~(", iY L ,'\.r,;;c;;. I ,l n-> -:, 7<7
CONTRACTOR J /l,,;_< MAIL ADDRESS
n)1<,t"'1 r A.I
PHONE -STATE LIC. NO. C ITV LIC, NO.
3
,-s "'
( ... -
ARCHITECT OR DESIGNER / MAIL ADDRESS PHONE LICENSE NO. ,
4
ENGINEER MAIL ADDRESS PHONE LICENSE NO.
5
COMPENSATION INS CARRIER MAIL ADDRESS BRANCH
6 'J
··-USE Of BUILDING :"") 7 -
8 Class of work: □NEW 0 ADDITION 0 ALTERATION 0 REPAIR
9 Describe work: fl h<e I I l, N' ,,,, r /-c..,.,:.'
t'✓r I ?, .... L
PERMIT FEES
No. Each Fee
SPECIAL CONDITIONS: SWIMMING POOL WIRING,
NO INCREASE IN SERVICE
I ( 1 :i,.. ~---
NEW CONSTRUCTION, FOR EACH
Al'l'LICATION ACCE,TED BY PLANS CHECKED BY APPROVED FOR ISSUANCE av AMPERES OF MAIN SERVICE, SWITCH,
FUSE OR BREAKER
{--', J ,, o' 'I NEW SERVICE ON EXISTING BLDG. DATE
NOTICE FOR EA. AMPERE OF INCREASE
IN MAIN SERVICE, SWITCH, FUSE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-OR BREAKER
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 REMODEL, ALTERATION, NO CHANGE
IIIIENCED. IN SERVICE, FOR EA. AMPERE OF
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS INCREASE
APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCE~ GOVERNING THIS
TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED
HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT TEMP. SERVICE UP TO AND INCLUD· PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING ING 200 AMP.
CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
' ( 1,,)7(; TEMP. SERVICE OVER 200 AMP. \ . ~\) i I PER 100
SIGNATURE Of CONTRACTOR OR AUTHORIZED AGENT (DATE) f r d ISSUANCE FEE
TOTAL FEES -/ .,,.
SIGNATURE of' OWNER rr OWNER BUILDER DATE! -WHEN PROPERLY VALIOATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK, M.O. CASH
INSPECTOR
I,.
INTERDEP~~FORMATION SHEET RECEIVED
BUILDING DEPARTMENT
-BUILDING ADDRESS:
DATE:
/4!4£ ~L ~ _J_U_L-20-1-97_8_
CITY OF CARLSBAD
Building Department
PLANNING DEPARTMENT
ZONE __ e_~/ ______ LOT SIZE _________ LOT WIDTH _________ _
f NITS ALLOWED ____________ UNITS PROVIDED ____________ _
PARKING SPACES REQUIRED PROVIDED ------------
% COVERAGE ALLOWED PROVIDED
BUILDING HEIGHT ALLOWED PROVIDED -----------
FRONT SETBACK: SIDE SETBACK: REAR SETBACK:
ALLOWED -------
PROVIDED ______ _
INTRUSIONS
LANDSCAPE & IRRIGATION PLAN COMMENTS:
ENVIRONMENTAL PROTECTION REQ:
ADDITIONAL COMMENTS:
OK TO ISSUE: ________ DATE ____ _
ENGINEERING DEPARTMENT
R.O.W. ______ INDUSTRIAL WAS TE _______ IMPROVEMENTS _______ _
SEWER CONNECTION ________ DRIVEWAY LOCATIONS ____________ _
GRADING PERMIT _______ EASEMENTS~~ DRAINAGE ____ _
LEGAL DE s CRI p TI ON~efi:=' ::..i....L/!.LJ..:!..i..!....1./-7_&/4==,6::__;:_~~---"====--~~=-===--------.. ~??Ly~~:2=0.c->-....£.Z ____ _
ADDITIONAL COMMENTS ____________________________ _
PWI ____ OK TO FINAL ~/;? DATE ___ _
FIRE DEPARTMENT
\
SP RINKLING SYSTEM FIRE PROTECTION EQUIP.
FIRE ALA RMS _______________ EXITS ________________ _
FIRE HYDRANTS LOCATION __________________ _
ADDITIONAL COMMENTS
OK TO ISSUE: _____ DATE _______ OK TO FINAL ______ DATE ___ _
WATER DEPARTMENT
REQUIREMENTS OF APPROPRIATE DISTRICTS MET ________ DATE ________ _