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MODEL NOT.
BUILDING PERMIT APPLICATION .
City of CARLSBAD, CALIFORNIA 92008** n n **-vx
~" 7 ? J2///^Applicant tn r.amplete numbered spaces only. PhOHG 729-1181 Permit l\|n f ^ ** ' r ****
JOB ADDRESS jr"""1 ,-i JA J it jf if"^ •"•••• •*'*"t ' AJ« / jif > >O f**~ ft J ASSESSOR'S
/f ~7 **? (0 C^/y/^V*/^ 1> C- /' ^ f$ S~ /^^y^T^ *- XT C— ,^ PARCEL NUMBER
LOT NO. »L« TRACT
LEGAL , ~~j> j ^
IDESCR. / / / / <
BOOK PAGE PAR.
'•Vj*^ J*
OWNER . f'i j / / MAIL ADDRESS ZIP ^^ - ^/'j|;afi(^ ^HONE —ii > ^ftW-* ^
CONTRACTOR » ^/ MAIL ADDRESS PHONED 9TJOJT uLia.n*»i CITV LIC. MO.
ARCHITECT OR DESIGNER '* _ , MAIL ADDRESS _ „. , , ^»IONE LICENSE NO.
4 / 'CJ Jl /) A/ £ f s ,{J j /""/"• •* "• j</j' * s^. i~/ t i \ j?t t:~~f **? "?&s
ENGINEER MAIL ADDRESS PHONE LICENSE NO.
5
COMPENSATION INS. CARRIER f jf, MAIL ADDRESS aRANCM
6 €~'\ \, dhsbf' C£ ,j .
USE OF BUILDING f) t^_ f , y
F .' / / £f NO. HnBMfi MO! RATHS
8 Class of work: D NEW ADDITION D ALTERATION D REPAIR D MOVE D REMOVE
9 Describe work: /•,, ;* , y , // ///•^'/^ / !x \' _X /
.10 Change of use from
Change of use to ,.-*-
11 Valuation of work: $ / ' /. _^x V *-*•i ~wi^
SPECIAL CONDITIONS:
V > v
\ "
^
APPLICATION ACCEPTED BV PLANS CHECKED BY APPHOVEJfrOa ISSUANCE BV
DATE tffiT"!!"*'
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 AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-
MENCED.
1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS
APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.
ALL PROVISIONS OP LAWS AND ORDINANCES GOVERNING THIS
TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED
HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOTPRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATINGCONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
SIGNATURE OP CONTRACTOR OR AUTHORIZED ABCNT (DATE)
SIGNATURE OP OWNER IIP OWNER BUILDER) (DATE)
"7 S<? /cT (toPLAN CHECK FEE S / " PERMIT FEE 9 I ^ — — •
MICRO FILM FEE
Type of Occupancy "•
Const. Group
Si« of Bldg. •gijiA.J No- of Max.
(Total) Sq. Ft. J.,f**t ;Stori*s Occ. Load
Fire : Urt Fire Sprinklers
Zone Zone Required QY« DNO
OFFSTREET PARKING SPACES:
Dweilln, Unit. gg^^ Sq. Ft. Open
Special Approvals Required Received Not Required
PLANNING DEPT.
HEALTH DEPT.
FIRE DEPT.
SOIL REPORT
OTHER (Specify)
ENGINEERING DEPT.
WATER DEPT.
. WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH -•" f\
TOTAL FEES S C^V^
INSPECTOR
REQUEST FOR
INSPECTION
Inspector
TIME
jt No. _.Date
Insulation
Dry wall
Fdn. Forms
Steel
Sheathing .
Utn
frame
Final
D
D
Rough
Final -==8
Ready for Inspection - Mon., ^Tues., J Wed., Thurs., Fri.
JftrtQ —^-£
Special Instruction? -- ..
Requested by _
Phone number , Person Taking Report:
REQUEST FOR
INSPECTION
Inspector *€/_ ^ Permit
Owner 1^&£
TIME
Date
Insulation Q
Drywall Q
Fdn. Forms *GQ
Steel Q
Sheathing Q
Uth n
frame Q
Final Q
Gas
Water Heater Q
Sewer Q
Undergrnd. Plbg, Q
Undergrnd. Water
Rough
Final
•a•a•a
Pool Bonding.... Q
Temp Pole Q
a
Underground Q
Ceit Heat Q
Rough D
Final I. n
Plenum & Ducts....... n
Porch n
Patio Q
Driveway ,.„ Q
Sign n
Wall G
Fence
Grading
Ready for Inspection - Mon., jfuesj) Wed.,
Special Instructions —
Requested by
Phone number _„. Person Taking Report:
REQUEST F^R-HSSPECTION
INSPECTOR Jss€^*t^ ^ PERMIT NO.
OWNER
ADDRESS
n
a
a
a
a
FOUNDS
REINFORCING STEEL
MASONRY
GROUT - GUN1TE
FLOOR AND CEILING FRAME
SHEATHING
FRAME
EXTERIOR LATH
INSULATION
,INTERK3R LATH OR DRYWALL
FINAL
C] TEMPORARY SERVICE
Q ELECTRIC UNDERGROUND
C] ROUGH ELECTRIC
Q POOL BONDING
C3 ELECTRIC SERVICE
a CEILING HEAT
Q Q.F.I.
Q SMOKE DETECTOR
CD FINAL
PLUMBING
Cj UNDERGROUND PLUMBING
Q UNDERGROUND WATER
D ROUGH PLUMBING
Cl TOP OUT PLUMBING
O SEWER AND PL/CO
CD TUB OR SHOWER PAN
CD GAS TEST
D WATER HEATER
C3 FINAL
READY FOR INSPECTION: D MONDAY
DA.M.
0 P.M.
SPECIAL INSTRUCTIONS.
MISCELLANEOUS
a PLENUM AND DUCTS
O COMBUSTION AIR
Cl PATIO
a SIGN
C3 GRADING
a DRIVEWAY
C3 CONDITIONED AIR SYSTEMS
a REFER PIPING
a FINAL
UESDAY D WEDNESDAY D THURSDAY D FRIDAY
REQUESTED BY..PHONE NO.
PERSON TAKING REPORT
INSPECTION RECORD
DATE REMARKS INSPECTOR
FOUNDATIONS:
SET BACK
TRENCH
REINFORCING
FOUNDATION WALL &
WEATHER PROOFING
CONCRETE SLAB
FRAMING
INT. LATHING OR DRYWALL
EXT. LATHING
MASONRY
f/S£ S/»X»C£ BE LOW FOR NOTES, FOLLOW-UP, ETC.
INTERDEPARTMENTAL INFORMATION SHEET
BUILDING DEPARTMENT
BUILDING ADDRESS:
DATE:
J*7Ay/ IO (0
RECEIVED
MAR 2
OF CARLSBADBuilding Department
PLANNING DEPARTMENT
ZONE LOT SIZE LOT WIDTH
UNITS ALLOWED
PARKING SPACES REQUIRED
% COVERAGE ALLOWED
BUILDING HEIGHT ALLOWED
FRONT SETBACK:
ALLOWED
PROVIDED
/J/V
INTRUSIONS
UNITS PROVIDED
0^-
(Jf\
PROVIDED,
PROVIDED
PROVIDED
SIDE SETBACK:
LANDSCAPE & IRRIGATION PLAN COMMENTS:
REAR SETBACK
ENVIRONMENTAL PROTECTION REQ:
ADDITIONAL COMMENTS:
OK TO ISSUE:DATE OK TO FINAL
ENGINEERING DEPARTMENT <JTa —» ^
^ 7 / -2-
DATE
R.O.W.INDUSTRIAL WASTE IMPROVEMENTS
SEWER CONNECTION
GRADING PERMIT
DRIVEWAY LOCATIONS
EASEMENTS /L/6 &.DRAINAGE
LEGAL DESCRIPTION
ADDITIONAL COMMENTS
OK TO ISSUE:DATE PWI OK TO FINAL DATE
FIRE DEPARTMENT
SPRINKLING SYSTEM
FIRE ALARMS
FIRE HYDRANTS
ADDITIONAL COMMENTS
FIRE PROTECTION EQUIP
EXITS
LOCATION
OK TO ISSUE:DATE OK TO FINAL DATE
WATER DEPARTMENT
REQUIREMENTS OF APPROPRIATE DISTRICTS MET DATE
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