HomeMy WebLinkAbout1280 BUENA VISTA WAY; ; 61-4022; Permit.......... II_-_ ... ~- .. --..- ... .I
CITY OF CARLSBAD - BUILDING INSPECTION DIVISION
PHONE PArkway 9-1181 - Ext. 36 n Y
(Please Print) [Last) (First) (Middle] Number Street
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Owner Name ...... h6.U.N .............. A! ................. I .... 1. .................... Mailing Address ..............................................................
......... .. ................... ........................................................................................................ Number Street City Phone
To Construct e3/ To Add 0 To Alter D To Repair 0 To Convert 0 To Move From ..............................................................
Type of Cons+.% .... Kind of Foundation no. of Stories ..... J! ....... To Be Used for ...3&.d,h&..G ....................
Contractor ??A !.. .! Wkd .......................................................... Mailing Address (Please Print)
Address,
(One Family Dwelling, Store, Etc.) [Frame, Masonry, Etc.)
Floor Space of Proposed Construction (sq. feet) ....... /ad!./! ................. Const. Valuation $ ...............................................................................................
Floor Space of Garage (sq. feet) ........ fbJ70 &E2 aluation $ ....................................................................................................
...d+y--4.b.&. ,..~.M?!.HL?p.L2/.7 LEGAL DESCRIPTION ................... q.
ot Subdivision
or .................................................................................................................................. Section .................................... Township ............................ Range ...........................
Located at ../,~..~ d .......& .e.y........u.L..........................Street, Near ..................................................... ...................................... Assigned House Number
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 ................ ,
I HEREBY ACKNOWLEDGE THAT 1 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.
tf 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. SIGNATURE OF PERMITTEE ...............................................................................................
Front Yard Set Back ......................................................................
Side Yard Set Back ........................................................................
Rear Yard Set Back .......................................................................
Dislance Between Bldg. ................................................................
Off Street Parking Spaces ................ ............................................
Sewage Disposal System ................................................................
Zone - Residential ( ) ............................................................
Zone - Commercial ( ) ......................................
Driveway Permit Required Yes o() No ( ) Fee %,25 .................................... ..
Grading Permi) Required Yes ( ) No ( ) ........................................................
Sewer Disposal Plant Capikl Cont. Fee ............................
Sewer Pumping Station Capital Cont. Fee ............. F\l..o.!.?-!.!k __.________._.____._______._I
Sewer Main Line Cost pa.... 8123~6.0 .......... et................ 3+3
Sewer Lateral Conniction Charge ' 7#5'REPTL/ .Za.!...!h%~...!?P.& ..................................... d/Zc.So
Water Stocked Lands Charge .......................................................................................
Water Main Pipe Line Fee ........................................................................................... I
Water House Service Charge /v/chn ............... , q. s8& ............................................................
............................ /&$!..&a ..................................... Water Meter Charge
Sub Total ..................
............ Plan Check Fee .......................................................... / ..........................................