HomeMy WebLinkAbout1264 Oak Ave; ; 62-5080; PermitAPPLICATION FOR Bu l fJ DING PERMIT
5080
CITY OF CARLSBAD -BUILDING INSPECTION DIVISION
PHONE PArkway 9-1181 -Ext. 36
fpj;:;e ~~i~;) ..... e..6..1_t:i-L/.Al./U:i;?-}.t.N.. ...... TM1d·f-.! ....... Mailing
Contractor ....... .V..w.. ... A/ .. /:~.ff .,. ....................................................... Mailing
Address ... !i?:.f.5!_ ...... Qq_/.C:. ........ <:(!.!fJ.£.ed
Number Street City Phone
Address .... .:iJ.... A-/\/J ... f::_ ............................................................ .
( Ple11se Print) Number Street City Phone
To Construct ~ To Add D To Alter D To Repair D To Convert D To Move From .......... "7]. ............................................ .
Type of Const. 2~ .. Kind of Foundation ..... ~ .. '. ... No. of Stories .... / ........ To Be Used for -~~ ..
(Frame, Masonry, Etc.) (One Family Dwel · Etc.)
• c::.
$ ........... O ... t, ... D .. 0: ..................... -................................... . I S f P d C t. ( f t) #rJ Cl C V I · Foor pace o ropose onstruc 10n sq. ee ............................................ onst. a u11t1on
Floor Space of Garage {sq. feet) ..................... G..Q .. Q .......... d~:~~:~ ~-Valuation $ ...................... ~ .. f!.,f!..rt!!!? ........ : ................................ .
LEGAL DESCRIPTION ............................................................................................ -...................................................................................................................................... .
Lot Block Subdivision
or ......................................................................................................................... _ ....... Section .................................... Township ............................ Range ........................... .
Located at .. /.~t-si~··l!l?~·#·················································Street, Near ........ d.7.L .. /.."9:N...d.... ................................. -··-·-
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................ NO .... 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 II check is tendered for i:11yment of the above fee 11nd tho check is
not honored when presented for p11yment, your Building Permit will be
immediately revoked.
SIGNATURE OF
PERMIITEE .............................................................................................. ..
Front Yard Set Back ........... .#.~ .. «. ... ~ .................... . Driveway Permit Required Yes { No (~Fee ..................................... .
/
Side Yard Set Back .......... ~ .................................................... . Grading Permit Required Yes ( ) No{~ ................................................... .
~ '
Rear Yard Set Back ......... /0 ............. ~····-Sewer Disposal Plant Capital Cont. Fee ..................................................................... .
r ___.,
Distance Between Bldg ... /0.. ................................................... . Sewer Pumping Station Capital Cont. Fee .................................................................. .
Off Street Parking Spaces ..... ~ Sewer Main Line Cost ..................................................................................................... .
Sewage Disposal System .......... ~ Sewer Lateral Connection Charge ............................................................................... .
Zone • Residential ( / ) ........................................................... . Water Stocked Lands Charge ....................................................................................... .
Zone • Commercial ) ·················································•······•• Water Main Pipe Line Fee ........................................................................................... .
Variance Water House Service Charge ........................................................................................ .
Eng. Check By ............................................................................... . Water Meter Charge ...................................................................................................... .
Sub Total ..................................................................................... .
Plans Appro~~:r.:··?'!:lz.~ .......... Plan Check Fee .................... L).G .................................................................... .
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