HomeMy WebLinkAbout1650 CHESTNUT AVE; ; 62-5075; PermitAPPLICATION FOR PERMIT
N° 5075
CITY OF CARLSBAD — BUILDING INSPECTION DIVISION
PHONE PArkway 9-1181 - Ext. 36
Owner Name .-../--
(Please Print)(Las (First)(Middle)
..Mailing Address >
Contractor O?^>T*^^ Mailing Address
(Please Print)
To Construct D To Add D
Type of Const. ,
(Frame, Masonry, Etc.)
Number Street
To Alter n To Repair D To Convert n To Move From
of Foundation....(2^*^€^..'. No. of Stories / To Be Used
Addresi
r^bd,
(One Family Dwelling, Store, Etc.)
Floor Space of Proposed Construction (sq. feet) -Const. Valuation $
attached Q f / "/
Floor Space of Garage (sq. feet) detached QConst. Valuation $..
LEGAL DESCRIPTION
Lot Block Subdivision
.Section .^ Township.
.Street, Near
LAND AREA^r:EXISTING DWELLINGS ON PROPOSED BUILDING SITE" .................................................... (INDICATE
SIZE, USE AND LOCATION ON PLOT PLAN). WILL THIS CONSTRUCTION INCLUDE ANY PLUMBING INSTALLATION. ALTERATION, OR
ADDITION? YES.....fe^l. NO .................
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION 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
immediately revoked.
SIGNATURE OF
PERMITTEE
Front Yard Set Back
Side Yard Set Back ..
Rear Yard Set Back .
Driveway Permit Required Yes ( P^J No ( ) Fee
Grading Permit Required Yes ( ) No (
Sewer Disposal Plant Capital Cont. Fee
Distance Between Bldg ...... /..Q. ................................................. Sewer Pumping Station Capital Cont. Fee
Off Street Parking Spaces
Sewage Disposal System
4Sewer Main Line Cost ....... T.>
Sewer Lateral Connection Charge
Zone - Residential ( / ) Water Stocked Lands Charge
Zone - Commercial ( ) Water Main Pipe Line Fee
Z lf
t~"
Sub Total ...
Eng. Check By
Plans Approvedby.
Approved by ...l\±...^-.£^-~l^&^..^..::~. Building Permit Fee .,
Date c£_™...£2..- S?.~~^r^ Total Charges '
O &