HomeMy WebLinkAbout1605 CHESTNUT AVE; ; 78-5778; PermitMODEL NO.
BUILDING PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA 92008
Applicant to complete numbered spaces only. PnOHG 729-I1O1 Permit No..
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JOB ADDRESS ASSESSOR'S
PARCEL NUMBER
LEGAL
| DESCR.
{Q3SEE ATTACHED SHEET)
MAIL ADDRESS
CONTRACTOR MAIL ADDRESS STATE LIC..NO.CITY LIC. NO.
LICENSE NO.
ENGINEER MAIL ADDRESS LICENSE NO.
COMPENSATION INS. CARRIER**'MAIL ADDRESS
USE OF B U
NO. BDRMS NO. RATHS
8 Class of work: D NEW ADDITION D ALTERATION D REPAIR D MOVE D REMOVE
9 Describe work:
10 Change of use from
Change of use to
11 Valuation of work: $PLAN CHECK FEE $PERMIT FEE
SPECIAL CONDITIONS:
Const
Occupancy
Group
Ml'CRO FILM FEE
Size of Bldg.
(Total) Sq. Ft.
No. of
Stories
/
'
Max.
Occ. Load
APPLICATION ACCEPTED BY PLANS CHECKED BY
Fire
Zone
Use
Zone
Fire Sprinklers
Required DYes UNO
OFFSTREET PARKING SPACES:
welhng Units"Open
NOTICE
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB-
ING, HEATING, VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS,OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-
MENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS
APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.
ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS
TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED
HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT
PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING
CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
Special Approvals
PLANNING DEPT.
HEALTH DEPT.
FIRE DEPT.
SOIL REPORT
OTHER (Specify)
ENGINEERING DEPT.
WATER DEPT.
Required Received Not Required
OF OWNER (IF OWNER BUILDER)
PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK.M.O. CASH PERMIT VALIDATION CK. ,/*-£'
TOTAL FEES $.
CASH ,.;
INSPECTOR
IWSPECT8OW RECORD
FOUNDATIONS:
SET BACK
TRENCH
REINFORCING
FOUNDATION WALL &
WEATHER PROOFING
CONCRETE SLAB
FRAMING
INT. LATHING OR DRYWALL
EXT. LATHING
MASONRY
FINAL
DATE
#&
REMARKS INSPECTOR
-
J^5^=I__T—T~T
USE SPACE BELOW FOR NOTES, FOLLOW-UP, ETC,
CITY OF CARLSBAD
BUILDING DEPARTMENT
(714) 729-1181
CERTIFICATION
I certify that in the performance of the work for which this permit is issued I shall not
employ any person in any manner so as to become subject to the workers' compensation
laws of California.
If, after making this certificate, I become subject to the workers' compensation pro-
visions of the California Labor Code, I will forthwith comply with Section 3700 of the
Labor Code.
I understand that if I fail to comply with the workers' compensation laws, this permit
shall be deemed revoked.
I further certify that if I should contract or subcontract with any person, including any
firm or company, to do all or part of the work for which this permit is issued, I shall assure
compliance by that contractor or subcontractor with Section 3800 of the California Labor
Code.
SIGNED:
PRINT NAME AND TITLE:
JOB ADDRESS:
DATED:
INTERDEPARTMENTAL INFORMATION SHEET
BUILDING DEPARTMENT
f BUILDING ADDRESS:
RECEIVED
DATE:
MOV 7 1978
CITY OF CARLSBAD
Building Department
PLANNING DEPARTMENT
ZONE &L LOT SIZE LOT WIDTH
UNITS ALLOWED UNITS PROVIDED (
' PARKING SPACES REQUIRED
% COVERAGE ALLOWED
BUILDING HEIGHT ALLOWED
FRONT SETBACK:
ALLOWED
PROVIDED
PROVIDED
_PROVIDED
PROVIDED
SIDE SETBACK:REAR SETBACK:
INTRUSIONS
LANDSCAPE &'IRRIGATION PLAN COMMENTS:
ENVIRONMENTAL PROTECTION REQ:
ADDITIONAL COMMENTS:A CC-£SS~& Jt^f ~$Lb6- . ^ /°
OK TO ISSUE:.UfoS^Vtf^Lll / 7 /J OK TO FINAL DATE
- ENGINEERING DEPARTMENT
R.O.W.INDUSTRIAL WASTE IMPROVEMENTS
SEWER CONNECTION..
GRADING PE&HIT
DRIVEWAY LOCATIONS
EASEMENTS
LEGAL DESCRIPTION ^/^ 30^-3^0 ~ 0- _ Y^/{,#/
DRAINAGE
/^y
ADDITIONAL COMMENTS
OK TO ISSUE DATE //PWI OK TO FINAL DATE
FIRE DEPARTMENT
SPRINKLING SYSTEM
FIRE ALARMS
FIRE HYDRANTS
ADDITIONAL COMMENTS
_FIRE PROTECTION EQUIP.
EXITS
LOCATION
OK TO ISSUE:DATE OK TO FINAL DATE
WATER DEPARTMENT
REQUIREMENTS OF APPROPRIATE DISTRICTS MET DATE