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8-6-1 DESIGNER'S ADDRESSI STATE LICENSE NO. ]0027 05/13 0101 02BldPmt 111.,Hot Valid Unless Machine CertifiedIDESCRIPToz
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^^ m^^^S ^CARLSBAD BUILDING DEPARTM2075 Las Palmas Dr., Carlsbad, CA 92009-4859 (619fJSiiei APPLICATION & PEFH
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:ILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS.White — Inspector Green — (1) Finance Yellow — Assessor Pink — Applicant Gold — Temporary File
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DEVELOPMENT PROCESSING SERVICES DIVISION
2075 LAS PALMAS DRIVE
CARLSBAD, CA 92009-4859
438"1 1 61
MISCELLANEOUS FEE RECEIPT
Applicant Please Print And Fill In Shaded Area Only
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AnnpFQQ / / , *7 J / /^ iMuuneso /(^p ^2 I \.Jt\£ f^^LfT
ASSESSOR'S ^-^._ „ /
PARCEL NO. £<9S- /30-2*/
OWNER <J \J>DY /^^/L£.y
OWNER'S
MAILING --
ADDRESS ^^AMC.
CITY C*«C<>BA* ZIP 320O& TEL V3V- 5*6'/6*
CONTRACTOR *^2, ^ /°
CONTRACTOR'S
MAILING OLef/S-f\ ^^>
ADDRESS o>JjOO \K.O l>t'C7lO/«J A/t
CITY ^^ ZIP ^Z/Z/ TEL. 2^)1 -&&Z1
STATE BUSINESS
LICENSE NO. 'JZ.S'SSVZ. LICENSE NO.
SUBDIVISION LnT(-Q)
LEGAL DESCRIPTION //}/$[ O°^^%
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DESCRIPTION OF WORK
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CONTACT PERSON c J^J^ &6lJL.AfZr
ADDRESS O35 1 ^EAlTBfJ <!OT
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PLAN ID NO.
0002 05/05 0101 OSMisc. 52.35
VALIDATION AREA
FRTMATFD VAI IIATIOM ^ / ^0
PI AN nHFCiK FFF 001-810-00-00-8821 50L '
IF THE APPLICANT TAKES NO ACTION
WITHIN 180 DAYS, PLAN CHECK FEES
WILL BE FORFEITED.
•
CHECK IF SUBMITTED:
£] 2 ENERGY CALCS
i— i 2 1987 ENERGY CALCS
L- ' FOR NON RESIDENTIAL. BLDGS
£] 2 STRUCTURAL CALCS
D 2 SOILS REPORTS
i
Q 2 SELF ADDRESSED ENVELOPES
J
DATE GIVEN/ nATF
SENT TO APPLICANT
LA COSTA LETTER
SCHOOL FEE FORM i
P & E CORRECTIONS LIST j
CERTIFICATE OF OCCUPANCY j
___AE»?ICANTXSIGNATURE DATE
White - File Yellow - Applicant Pink - Finance Gold - Assessor
PLAN CHECK NO.Q_2l>^/' ADDRESS DATE
PLANNING
ZONE:
SCHOOL DISTRICT:
SETBACKS: FRONT
TYPE OF PROJECT AND USE:
~~P* / j>'' ^'
SAN DIEGUITO ENCINITAS /CARLSBAD
SIDE REAR
SAN MARCOS
DISCRETIONARY ACTIONS:
REDEVELOPMENT PERMIT REQUIRED:_
LANDSCAPE PLAN COMMENTS:
ENVIRONMENTAL REQUIRED:
COASTAL PERMIT REQUIRED: YE
ADDITIONAL COMMENTS:
NO
OK TO ISSUE:DATE:
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ENGINEERING
LEGAL REQUIREMENTS
LEGAL DESCRIPTION VERIFIED?
EASEMENTS: xO // .
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EDU'S: / /
APN CHECKED?
/-"" RIGHT-OF-WAY:
DRAINAGE:
^_^
IMPROVEMENTS:
FIELD CHECK DATE & INITIALS:
PERMITS REQUIRED
GRADING: /-> ' ^
DRIVEWAY:
'/y
.
GRADING COMPLETION CERTIFIED:
INDUSTRIAL WASTE:
FEES REQUIRED
PARK-IN-LIEU QUADRANT:
P.F.F.:
UNIT:
FACILITIES MGMT. FEE:
SEWER FEE (CONNECTION):
TRAFFIC IMPACT FEE PER UNIT:
TOTAL FEE:_
TOTAL FEE:
BRIDGE & THOROUGHFARE FEE:
SEWER LATERAL:
c ADDITIONAL COMMENTS:
Q OK TO ISSUE:_
DPD2:DPD6:10/24/86
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