HomeMy WebLinkAbout165 CHESTNUT AVE; ; 71-896; Permitt •
BUILDING PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA
1
Applicant to complete numbered spaces only.OCT 21-71 /STRIPS**' *•* M
JOB ADDR ESS
LEGAL
[DESCR.
ATTACHED SHEET)
MAt L ADDRESS
J\CONTRACTOR MAIL ADDRESS LICENSE NO:
ARCHITECT OR DESIGNER MAI L ADDRESS LICENSE NO.
MAIL ADDRESS LICENSE NO.
fi'
MAIL ADDRESS
USE OF BUILDIN G
8 Classofwork: . D NEW '^ADDITION DALTERATION D REPAIR D MOVE D REMOVE
9 Describe work:'
f/
10 Change of use from
Change of use to u
11 Valuation of work: $PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:Type of
Const.
Occupancy
Group Division
Size of Bldg.
(Total) Sq. Ft.
No. of
Stories
Max.
Occ. Load
APPLICATION ACCEPTED BY:PLANS CHECKED BY:APPROVED FOR ISSUANCE BY
Fire
Zone
Use
Zone
Fire Sprinklers
Required Qves DNO
No. of
Dwelling Units
OFFSTREET PARKING SPACES:
Covered Uncovered
/ .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 AUTHORIZEDJS NOT COMMENCED WITHIN .60 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 THISAPPLICATION 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 SPECIFIEDHEREIN 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
ZONING
HEALTH DEPT.
FIRE DEPT.
SOIL REPORT
OTHER (Specify)
Required Received Not Required
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
BCAN CHECK VALIDATION CK.M.O.CASH PERMIT VALIDATION CK.M.O.CASH
Form 100.1 9-69
INSPECTOR
REORDER FROM: INTERNATIONAL CONFERENCE OF BUILDING OFFICIALS • 50 SO.