HomeMy WebLinkAbout163 ACACIA AVE; ; 63-5268; PermitAPPLICATION FOR B u , D IN 0 PERMIT _" N? 5268 ..
CITY OF CARLSBAD - BUILDING INSPECTION DIVISION
PHONE PArhvay 9-1181 - M. 36
Owner Name ..... &..%?&= ............................. ODq f , Address .&.x .... k .... - ......... &&k~..~.~--&~6
(Please Print) (Last) (First) (Middle) Number Street Cltv Phons
Contractol ....... ............................................................. Mailing Address ...... \ ..
c
3
(Pleare Print) Number Street City Phone
TO Construct 0 To AddN To Alter 0 To Repair 0 To Convert To Movo From .. -.
ryp. of con*. .&AX$& .... Kind of Foundatio&&.h.z. of Stories ............. To Be Used for .............. : .... ..e ......................... (Frame. Masonry. Etc.1 / m "u
b
(One Family Dwelling, Store. Etc.)
Floor Space of Propored Construction (54. feet) .... /g ......................... Const. Valuation 5 0
attoehod 0 FI~,,, sPaE. of Garage (rq. feet) . .............? .......................... ..detoch.d OConst. Valuation $ ............................................ .-
......._. ................................................................................................................................ - "_
Subdivision
or / Section Township ............................ Ronga ..
Losat.d at /43&&&.&.:.& ................................................. st r..t . _, -N.or
Assigned Home Number
LAND AREA ...................................... NUMBER OF EXISTING DWELLIN~~~N PROPOSED BUILDING SITE ............... b ............. ...
SIZE, USE AND LOCATION ON PLOT PLAN). WILL THIS COMRUCTION INCLUDE ANY PLUMBING INSTALLATION, ALTERATION, OR
(INDICATE
ADDITION? YES / NO ,,.' ................ .................
I HEREBY ACKNOWLEDGE THAT I HAVE READ TH 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 is not honored when presented for payment, your Building Permit will be SIGNATURE OF immediately revoked. PERMITTEE
Front Yard Sei Back Driveway Pormit Required Yes ( 1 No ( I ha
Side Yard S.t Bock Grading Permit Required Yes ( ) No ( I
Rear Yard Set Bask Sower Disposal Plant Capitol Cont. he
Distance Between Bldg. Sewer Pumping Station Capital Cont. he
Off Stne+ parking Spaces Sewer Main Line Cod
sewage Dispos.1 Syrtem Sewer Loterol Connestion Chargo ,.....
.....................................
Water Stoskod lands Chorgo
zone . commarsial ( ) Water Main Pip0 Lino For
Varianca Water Hour. Senis. Charge
Water Meter Charge
Sub Toto1
Plans ApproF2 a~ ............ ~ Plan Check Fee 00
Qlt' Approved by ... L ..... ..m. ...... - ...... Building Permit he.+. ...... 9 ...............
Total Charger L ........... .............. ............. .......