HomeMy WebLinkAbout1360 Forest Ave; ; 77-7056; PermitMODEL NO. _________ _
> · BUILDING PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA 92008
Apprcant to complete numbered spaces only Phone 129-1181 Permit No I
JOB AODP £5S ASSESSOR'S
f _ .(,() ,~J;... PARCEL NUMBER
I.OT NO. rLK I TRACT
BOOK PAGE I P AR,
LCCAL I (Qscc ATTACHED SH([TI
1 DtSCA,
OWN(llt MAIL ADDRESS r~ llP PHOt~ E
2 I ,. ,; /\1 n TS u.. b ct.,, C. ._ /.~60
CON TRAC TOR MAIL AOOR(SS PHONE STATE LIC. NO. CITY L IC. NO.
3 ' .. "-ARCHITECT OR O CS1G.N£" MAIL ADDRESS PHONE LICENSE NO,
4
[NGIN CCR MAIL ADDRESS PHONE L ICENSE NO,
5
Co.,..1PENSATION INS, CARRIER ~,_/ MAH. AOOIICSS 8 1'lANCH ) 6 ,, I' ,
-I -' --
U5£ Of' 8UILOINC
7 NO. BDRMS NO. BATHS
8 Class of work: CJ-NEW 0 ADDITION 0 ALTERATION 0 REPAIR 0 MOVE 0 REMOVE
9 Describe work: re: ,e, .•.. £.!tr--. .vcJ l u<; 13 X/6 A J,o Cove,,,.. ,
10 Change of use from
Change of use to
11 Valuation of work: $ t:,.:;;?'/"'2 PLAN CH ECK FEE S
? :, 1 PERMIT FEE S 7~
MICRO FILM FEE
SPECIAL CONDITIONS: Type of Occupancy
Const Group
s ,ze of Bldg No. Of Max.
(Total) Sq. Ft. Stories 0cc Load
F,re use F,re Sprinklers
APPLtCA TION ACCEPTED SJ PLANS CHECKED BY APPROVED F:;lss,ev Zone Zone Requited 0Yes 0No
~I No. Of OFFSTREET PARKING SPACES
Dwelling Units No. 'No. DATE DATE t/ -Covered So. Ft. Open . Special Approvals Required Received Not Required NOTICE
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB PLANNING DEPT.
ING, HEATING, VENTILATING OR AIR CONDITIONING. HEALTH DEPT.
T HIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION A UTHORIZED 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 A T ANY TIME AFTER WORK IS COM·
MENCED. OTHER (Specify)
I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS ENGINEERING DEPT. APPLICATION ANO KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS WATER DEPT.
T YPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED
HEREIN OR NOT, TH E GRANTING OF A PERMIT DOES N OT
PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING
CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
ti
5 1GNATU"f o, G()NT,IACT0" 0" AUTH0flll1t0 AGENT (OAT~)
',.,.[ h A / ( ~I I'-~
S1GNA.Tt1f11E OP' OWN[JII flP' OWIIIEIII IUILDtflJ IOAT £)
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.o. CASH PERMIT VALIDATION CK. M.O. CASH
IJ
TOTAL FEES $ __ /---''£-=-_...., __ ~ __ _
INSPECTOR
INSPECTION RECORD /'} 1 -'O
DATE REMARKS INSPECTOR''
FOUNDATIONS:
SET BACK
TRENCH
REINFORCING
FOUNDATION WALL &
WEATHER PROOFING
CONCRETE SLAB
FRAMING
INT. LATHING OR DRYWALL
EXT. LATHING
MASONRY
FINAL /~-/¥.:1; c:9,/( T.~
I
USE SPACE BELOW FOR NOTES, FOLLOW-UP, ETC.
INTERDEPARTMENTAL INFORMATION SHEET
BUILDING DEPARTMENT
BUILDING ADDRESS:
RECEIVED
DATE : ---AUH-lGf-!-+-1 +..O ·---,9-7--7 -
CITY OF CARLSBAD
Bulrdln2 Department
PLANNING DEPARTMENT
ZONE R-l LOT s I z E ___ 6 ...... 2 ..... Z~D'---__ L OT w ID TH __ 'l4_z/...;._' -----
UNITS ALLOWED UNITS PROVIDED ------+---------l-----------
---~ff--------
% COVERAGE ALLOWED PROVIDED rfll_
PARKING SPACES REQUIRED PROVIDED ~
l BU IL DING HEIGHT AL L_O_W_E_D-------1,,t!L-----p RO VI DE D e;)
i FRONT SETBACK: SIDE SETBACK: REAR SETBACK:
' • I
~LLOWED M:JffD~~\16:~[5
PROVIDED -------
2Dm1-r"
7..P~'~i~
INTRUSIONS
LANDSCAPE & IRRIGATION PLAN COMMENTS:
ENVIRONMENTAL PROTECTION REQ:
ADDITIONAL
OK TO ISSU
ENGINEERING DEPARTMENT
R.O.W. .....___ INDUSTRIAL WASTE ------"'---IMPROVEMEN'l',.S--~ ---------------
SEWER CONNECTION DRIVEWAY LOCATIONS ---
GRADING PERMIT ---EASEMENTSAJ,Ptte ,J.lle3:l.~RAINAGE ____ _
LEGAL DESCRIPTION Eb&,-Co-f: /) Ced(#V i(;I/ Ac:tct /Y1:.0. lr"6 -e>5"Z-l4
ADDITIONAL COMMENTS-1.Jl/cc.=...i04AA..~~~tf:------------------------
OK TO ISSUE: FAJL DATE fl-/0-77 PWI OK TO FINAL DATE ---- --------
FIRE DEPARTMENT
SPRiliKLING SYSTEM FIRE PROTECTION EQUIP. -------------------
FIRE ALARMS EX I TS _______________ _
FIRE HYDRANTS LOCATION _________________ _
ADDITIONAL COMMENTS
OK TO ISSUE: _____ DATE _______ OK TO FINAL ______ DATE __ _
WATER DEPARTMENT
REQUIREMENTS OF APPROPRIATE DISTRICTS MET ________ DATE ________ _