HomeMy WebLinkAbout1277 FOREST AVE; ; 62-5130; PermitAPPLICATION FOB B Eft Dim G -jj-, gjg,,
CITY OF CARLSBAD — BUILDING INSPECTION DIVISION
PHONE PArkway 9-1 181 - Ext. 36
Owner Name Mailing Addrou
(Please Print) (Last) f (first) (Middle) Wumber SireeT ' City Phono
Contractor A/ ^ Mailing Addrosso2Z)j(3<S._.^^^^^i^AdZ!i^^j<<iC.-—^!3Sj6^^LZZ^^
(Please Print) Number n Street / City Phone
To Construct D To Add To Alter Q To Repair D To Convert □ To Move From
Type of Const. of Foundation —No. of Slories...^. To Be Used for(Frame, Masonry, Etc.) (One Family Dwelling, Store, Etc.)^ j ^ G'0>
Floor Space of Proposed Construction (sq. feet) Const. Valuation $
attached □Floor Space of Garage (sq. feet) detached QConst. Valuation $ , ,
LEGAL DESCRIPTION Lot Block Subdivision
Located at Street, NearAssignecr House Number r
LAND AREA NUMBER OF EXISTING DV/ELLINGS ON PROPOSED BUILDING SITE (INDICATE
SIZE, USE AND LOCATION ON PLOT PLAN). WILL THIS CONSTRUCTION INCLUDE ANY PLUMBING INSTALLATION, ALTERATION, OR
ADDITION? 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 Isnot honored when presented for payment, your Building Permit wi II be SIGNATURE OF Vimmediately revoked. PERMITTEE 4
Front Yard Set Back
Side Yard Set Back
Rear Yard Set Back
Distance Between BIdg.
Off Street Parking Spaces
Sewage Disposal System
Zone - Residential ( j )
Zone - Commercial ( ) —
Variance
Eng. Check By
Driveway Permit Required Yes ( ) No F«e
Grading Permit Required Yet ( ) No
Sewer Disposal Plant Capital Cont. Foe
Sewer Pumping Station Capital Cont, Fee
Sewer Main Line Cost
Sewer Lateral Connection Charge
Water Stocked Lands Charge
Water Main Pipe Line Foe
Water House Service Charge
Water Meter Charge
Sub Total
Plans Approve
Approved by
Date
Plan Check Foe
Building Permit Fee .
Total Charges