HomeMy WebLinkAbout2195 BASSWOOD AVE; ; 62-5211; Permit. APPLICATION FOR B u I D I1y C PERMIT
CITY OF CARLSBAD - BUILDING INSPECTION DIVISION
PHONE PArkway 9-1181 - Ext. 36
..... ......... dz- .riaai..M.iling Address Number Street City (Please Print (Last)
Contractor -Mailing Address ..................................................................... ........................ .-. -
lease Print) Number Street City Phone
To Construct To Add 6 To Alter 0 To Repair 0 To Convert To Move From ..............................................................
Type of Const. 3- of Foundation .......... &&tu. of Stories../ .......... To Be Used for .... p< ......................
Address
[Frame, Masonry, Etc. (One Family Dwelling, ore Etc.)
Floor Space of Proposed Construction (sq. feet) ......./../@...................b nsi. Valuation $ .................................................... Y@ - ............................................. 4
attachrd 0 - Floor Space of Sarage (sq. feet) ................................................. detachrd OConst. Valuation $ ........................................ .............................................................
LEGAL DESCRIPTION ../&..+ ...... b..-2.52 ......... -MX&&..: ............................ ...._.. Lot Block Su ivision
or .................................................................................................................................. Se~ion .................................... Township ............................ Range ..................... ".-.*
..Street, Near ....................................... ....................-...................................._... -.--
LAND AREA ...................................... NUMBER OF EXISTING DWELLINGS ON PROPOSED BUILDING SITE .................................................... (INDICATE
SIZE, USE AND LOCATION ON PLOT PLAN). WILL THIS CONSTRUCTION INCLUDE ANY PLUMBING INSTALLATION, ALTERATION, OR
ADDITION?
I HEREBY ACKNOWL
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.
Located at $k.
YES ........... NO ................. P 6E THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
PERMITTEE SIGNATURE OF
Variance
Eng. Check By ................................................................................
Driveway Permit Required Yes ( ) No
Grading Permit Required Yes ( ) No (
Sewer Disposal Plant Capital Cont. Fee ..........
Sewer Pumping Station Capital Cont. Fer ........
Sewer Main Line Cost ............................................
Sewer Lateral Connection Charge ................... -.
Water Stocked Lands Charge ..............................
Water Main Pipe Line Fee ..................................
Water House Service Charge ..............................
Water Meter Charge ................................................................... " ...............................
Sub Total ......................................................................................
.......................... ............................................................. Plan Check Fee ~
........ Building Permit Fee ............................................................................................. k-
(sd -,:( Approved by
.............................. .... ....... ...................... ........ Total Charger 6 - ......................................
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Plans Approved by .............................................................................................. k' I'
I
-,:( Approved by ......
Date ........ /.y/.y/ t$ ___.._ i/, .. ..........._...... -. .............................. Total Charger L -
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