HomeMy WebLinkAbout1250 CHINQUAPIN AVE; ; 63-5248; PermitAPPLICATION FOR PERMIT
~N! " 5248
CITY OF CARLSBAD — BUILDING INSPECTION DIVISION
PHONE PArkway 9 1181 Ext 36
Owner Name
(Please Print)
Contractor
To Construct P To Add
(Last)(Middle)
..Mailing Address
Number Stre
-Mailing Address
Type of Const
(Frame Masonry Etc)
Floor Space of Proposed Construction (sq feet)
Floor Space of Garage (sq feet)
LEGAL DESCRIPTION
Lot
or
Located
iase Print) Number Street
To Alter Q To Repair Q To Convert D To Move From
Kind of Foundation R^iG^L^. <*_-" No of Stones / To Be Used for
City
City
Phone
Phone
Address
CAA«-*V_
(One Family Dwellmq, Store, Etc )
//' fr^p- Conrt Va|uatlon $ Jf
attached D
— detached DConst Valuation $
Block
Section
Street Near
Subdivision
Township Range
Assigned House Numyer /
LAND AREA NUMBER OF EXISTING DWELLINGS ON PROPOSED BUILDING SITE (INDICATE
SIZE USE AND LOCATION ON PLOT PLAN) WILL THIS CONSTRUCTION INCLUDE ANY PLUMBING INSTALLATION. ALTERATION, OR
ADDITION?YES NCv><L
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
immediately revoked
Front Yard Sat Back
^^**
Side Yard Set Back C
Rear Yard Set Back \
Distance Between Bldg J
Off Street Parking Spaces (
Sewage Disposal System I
Zone Residential ( ) \
Zone - Commercial ( ) \
Variance
Eng Check By
Plans Approved by .
Approved by ^»/ "^^.-.^-^^C^
Date //y/JF"xL..^Lff
your Building Permit will be SIGNATURE OF
PERMITTEE
Driveway Permit Required Yes ( ) No ( ) Fee•" /
Grading Permit Required Yes ( ) No ( ) I
Sewer Disposal Plant Capital Cont Fee 7
Sewer Pumping Station Capital Cont Fee — /
Sewer Mam Line Cost 1
Sewer Lateral Connection Charge 1 .....
Water Stocked Lands Charge \ .. ..
Water Mam Pipe Line Fee J
Water House Service Charge
Water Meter Charge
Sub Total
Plan Check Fee
S /•* &-&
l^^xC——. _ Building Permit Fee ^f "~~
-» 0*&
Total Charges / _ _ [