HomeMy WebLinkAbout2160 JANIS WAY; ; 76-4643; PermitMODEL NO. _________ _
BUILDING PERMIT APPLICATION
~ -. ~J£O~if?n
Perm it No Applicant to complete numbered spaces only
City of CARLSBAD, CALIFORNIA 92008
Phone 729-1181
Joe ADOR ESS
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LOT NO, I TRACT
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2 -· R MAIL A0DRE55
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(QSEC ATTACt:4£0 SHEET)
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ASSESSOR"S
PARCEL NUMBER
eovr. PAGE I
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PAR.
CONTAACTO,_ -~MAIL AOOAtSS I 6' P,-4'ON E j STATE LIC. ~O. CITY LIC. NO.
3
ARCHITECT OR Ot.SIGNEII MAIL ADDRESS LICENSE NO.
4
ENGINC[R ~AIL AOORC.55 PHONE. LICENSE NO.
5
COMPENSATION INS. CARRIER MAIL AOOPl£.S5
6
USE Of" BUILDING -7 e NO. BDRMS NO. BATHS
8 Class of work: 0 NEW 0 ADDITION 0 ALTERATION 0 REPAIR □MOVE 0 REMOVE
9 Describe work:
• 10 Change of use from \ '
Change of use to I \ •'
11 Valuation of wori(: $ PLAN CHECK FEES PERMIT FEE S
1-SP_E_C_IA_L_C_O_N_D_I_T_I_O_N_S_: __________ -· __ ._ ---------1 Type o.( MICRO FILM FEE
Const. ;,-I\' Occupancy
Group
1-------------------------------i Sile of Bldg. (Total) Sq. Ft
N o. of
.Stories I '
M11x~
0cc Load
._----------,,-----------...-----,--------1 Fire Use Fire SpnnKlers APPLICATION ACCEPTED BY PLANS CHECKED BY APPROVECJ,.FOR ,s~UANCE av z one Zone Required OYes DNo
DATE DA,;r--{_
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.
I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS APPLICATION AND KNOW THI!: SAME TO BET-AUE ANO CORRECT, ALL PROVISIONS OF LAWS ANO ORDINANCES GOVERNING THIS
TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT
PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL T HE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING
CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
SIGNATUAC o, CONTfllACTOfllt Ollll AVTHOflltlZED AGENT (OATt)
51GNATU IU: 0,-OWNEflt u,-OWNtllll 8 UILOtfllt) OAT£)
1--------'-·---+-0-F_F_S_T_R,-E.,..E=-T_P_A_R_K_I N-G-S':-P::-Ac-:-c-=E--=s-, -------1
No.of I D I U It No. No. wel Ing n s Covered Sq. Ft. Open
Special Approvals Required Received Not Required
PLANNING DEPT.
HEALTH DEPT.
FIRE DEPT.
SOIL REPORT
OTHER (Specify)
ENGINEERING DEPT/. !;..J -.
WATER DEPT. -7"
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M .O. CASH PERMIT VALIDATION CK. M.O. CASH
TOTAL FEES $ ----=-5_<._f' ___ _
--uo
INSPECTOR
DATE
FOUNDATIONS:
SET BACK
TRENCH
REINFORCING
FOUNDATION.WALL &
WEATHER PROOFING
CONCRETE SLAB
FRAMING
INT. LATHING OR DRYWALL
EXT. LATHING
MASONRY
FINAL
USE SPACE BELOW FOR NOTES, FOLLOW-UP, ETC.
r
,.•11'
INSPECTION RECORD ,
REMARKS INSPECTOR
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