HomeMy WebLinkAbout167 Hemlock Ave; ; 77-10633; Permit.. MODEL NO. _________ _ tt fill• t ..
BUILD NG PERMIT APPLIC TION
City of CARLSBAD, CALIFORNIA 92008
App/1canttocompletenumberedspaceson/y Phone 729-1181 Permit No
J
0/b07 .. /leAtJ.oc,,f<_ AJ~ ASSESSOR'S
• rl'f( .. /)1'1~ PARCEL NUMBER
\.OT NO I 8LK I TOACT "vv" PAGE I PAR.
LCGAL I tOS[[ ATTACHED SH[lTI 1 OtsCA,
MAIL AOOJIC.SS OWN[II V )1-qJ" 7 PHONE
2 l u W C 2 /'I;(' .Z.#t; ,. ,u/ /'71./'c.) Crl ,'<J~ ✓ 7$7-.Jc.>7
CON TIIIAC TOIi MAIL AO011£S5 PHON[ STATE LIC, NO. CITY LIC, NO.
3
AJlltCHI TCCT OJI OlSIGNCJII MAI\. .AOOll[SS PHON[ LIC [NS(. NO.
4
CNGINECfll MAIL AOOIIIC.SS PMON[ LICC.NSE NO.
5
COMPENSATION INS, CARRIER MAIL AOD,.tSS 811ANCH
6
USl Of' liJILOING
7 NO. BORMS ~ NO. BATHS I
8 Class of work: •NEW 0 ADDITION 0 ALTERATION 0 REPAIR 0 MOVE 0 REMOVE
9 Describe work: C Hf<. I I ,, C T., ~
i,,./11,, '"''
c/141tJ,"' 1/o✓St' ?L vC.. , ; ,w S I✓.!" ;/4 ~::., ~ .
'71 T, ..1 Ac)( Co11, n If/ I IC 1-:-
10 Change of use from -
Change of use to
11 Valuation of work. $ PLAN CHECK FEES (J I PERMIT FEE $ ✓-"'("
..) --
SPECIAL CONDITIONS Type of Occupancy MICRO FILM FEE
Const Group
s,ze of Bldg No. Of Max
(Total! SQ Ft Stories 0cc Load -
I' JI Fire Use Fire Sprinklers
AP~LICATION ACCEPTED ev PLANS CHECKED BY APPRD~'!ltJANC[SY Zone Zone ReQuired 0Yes 0No
N o. of OFFSTREET PARKING SPACES.
Dwelling Units No. I No. OATE CATE Covered SQ. Ft. Open
NOTICE Sp,.cial Approvals Required Received Not Required
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB· PLANNING DEPT.
ING. HEATING, VENTILATING OR AIR CONDITIONING HEALTH DEPT THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUC·
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF FIRE DE.PT.
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A SOIL REPORT PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM
MENCED. OTHER (Specify)
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS ENGINEERING DEPT. APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS WATER DEPT. TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR THE GRANTING OF A PERMIT DOES NOT NOT, PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER S'TATE OR LOCAL LAW REGULATING .
CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
SIGNATUIIU. o, CONTIIIAC:TO .. Ollt AUTHOlltlltD AC.[NT IDATl) '
!IICHAT fl_F' 0 1" OWN[" 11" OWNClll au IL DC ft IDATtJ
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O CASH
./C-, ~ )-TOTAL FEES $ ___ :-L_ ______ _
INSPECTOR
INSPECTION RECORD
l>ATE REMARKS INSPEC~OR
FOUNDATIONS:
SET BACK
TRENCH
REINFORCING
FOUNDATION WALL &
WEATHER PROOFING
CONCRETE SLAB
FRAMING
INT. LATHING OR DRYWALL
EXT. LATHING
MASONRY
~ /J
FINAL-u~~ 14-27-~ 'p1 Ii -
USE SPACE 8. LOW FOR NOTES, FOLLOW-UP, ETC.
1 "' .. ~ ~ 720* ~ • l
ELECTRICAL PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA 92008
Applicant to complete numbered spaces only Phone 7 29-1181 Perm it No
JOB ADDRESS ,JI/ /(,. -, ·. c-:n"" LO i
LOT NO, I BLK, I TRACT (OSEE ATTACHED SHEET) LEGAL I 1 DESCR.
OWNER ~we. MAIL ADDRESS ( '!:r'J»ff-) ZIP /' PHONE 8'Y7l/ 2 .. ., Zr ~A \( <i2UO .... .._~
CONTRACTOR
l Le /'I 71-" /<: MAIL ADDRESS PHONE STATE LIC, NO. CITY LIC. NO,
3 -,;11¥ ,t;;J(J # /6~•· I'S )
ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO.
4
ENGINEER MAIL ADDRESS PHONE LICENSE NO.
5
COMPENSATION INS CARR1ER MAIL ADDRESS BRANCH
6 -Lr:: r•
1
USE or BUILDING 'II 'i>
(: c; I vl:J ' ,J{._
' 8 Class of work: •NEW 0 ADDITION 0 ALTERATION ~ REPAIR
~
9 Describe work: f<L,,:, {d? (' I yo-~ve-... to ~/4~ f~9,/.' 13-l\..(l, ti. IA l~
.Jl,ll'.MU-; ,-;. ,4,•.rCt al,. 1,-,r_a_ ((j /'-r.f l~ I.} 'JI< _AC/4 ~ db""" ·p?
PERMIT FEES
No. Each Fee
SPECIAL CONDITIONS: SWIMMING POOL WIRING,
NO INCREASE IN SERVICE
NEW CONSTRUCTION, FOR EACH
Al'f'LICATION ACCEPTED IIV PLANS CHECKED IIV APPROVED FOR ISSUANCE av AMPERES OF MAIN SERVICE, SWITCH,
1Jv·
FUSE OR BREAKER
DATE NEW SERVICE ON EXISTING BLDG.
NOTICE FOR EA. AMPERE OF INCREASE
IN MAIN SERVICE, SWITCH, FUSE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-OR BREAKER
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS,OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A REMODEL, ALTERATION, NO CHANGE PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM -vi MENCED. IN SERVICE, FOR EA. AMPERE OF 5 I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS INCREASE ,,.
APPLICATION ANO KNOW THE SAME TO BE TRUE ANO CORRECT. -
ALL PROVISIONS OF LAWS AND ORDINANCE!> GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT TEMP. SERVICE UP TO AND INCLUD-PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING ING 200 AMP. CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
ri,✓-.L-1~ TEMP. SERVICE OVER 200 AMP.
1-111-7 ¥ PER 100
SIGNATURE or CONTRACTOR OR AUTHORIZED AGENT (DATE) . ,, ,~
ISSUANCE FEE ("Y ~ .
TOTAL FEES ~/ ~": ~1r.NATUR n,-EA I• OWNER 8 I DER DA£
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK, M.O. CASH PERMIT VALIDATION CK. M.O. CASH
INSPECTOR
' IN~PECTION REPORTS
DATE ITEM REMARKS INSPECTOR
USE SPACE BELOW FOR NOTES, FOLLOW-UP, ETC.