HomeMy WebLinkAbout2201 CAMINO VIDA ROBLE; ; 77-679; PermitMODEL NO.
BUILDING PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA 92008
Applicant to complete numbered spaces only. PnOflG 729-1 lOl Permit No.
JOB A DDR ESS S^t *- » j^~\ V) /7
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ASSESSOR'SPARCEL NUMBER
BOOK PAGE PAR.
2°""W-K>. <s,IU-K20= ^/23l' YAlZEDbU PJSIV& 4ti'nEC-,^ajSefi05«ur- 438-^552
CONTRACTOR
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ENGINEER
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COMPENSATION INS. CARRIER
6
USE OF BUI LDING
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MAIL ADDRESS PHONE STATE LIC. NO. CITY LIC. NO.
MAI L ADDRESS JL
MAIL ADDRESS PHONE L
ICEN5E HO.
1 C EN SE NO.
MAIL ADDRESS BRANCH
NO. BDRMS Nfl. PATHS
D ALTERATION D REPAIR D MOVE O REMOVE
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11 Valuation of work: $
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY
DAT E
PLANS CHECKED BY
NOTICE
SEPARATE PERMITS ARE REQUIRED FOR E
ING. HEATING, VENTILATING OR AIR CONDI
THIS PERMIT BECOMES NULL AND VOID IF V
TION AUTHORIZED IS NOT COMMENCED Wl
CONSTRUCTION OR WORK IS SUSPENDED OR
PERIOD OF 120 DAYS AT ANY TIME AF
MENCED-
1 HEREBY CERTIFY THAT 1 HAVE READ AAPPLICATION AND KNOW THE SAME TO BE 1ALL PROVISIONS OF LAWS AND ORDINANCTYPE OF WORK WILL BE COMPLIED WITH VHEREIN OR NOT, THE GRANTING OF APRESUME TO GIVE AUTHORITY TO VIOLAPROVISIONS OF ANY OTHER STATE OR LOCACONSTRUCTION OR THE PERFORMANCE
SIGNATURE Of CONTRACTO
SIGNATURE OF OWNER (IF
fc'OH AUTHORIZE DfSG E N 1i
3WNER BU ILDe")
APPROVED FOR ISSUAMCE BY
DATE
LECTRICAL, PLUMB-
riONlNG.
VORK OR CONSTRUC-
FHIN 120 DAYS, OR IF
ABANDONED FOR A
TER WORK IS COM-
ND EXAMINED THIS
"RUE AND CORRECT,
ES GOVERNING THIS
VHETHER SPECIFIED
PERMIT DOES NOT
TE OR CANCEL THE
L LAW REGULATING
OF CONSTRUCTION,
/ [DA/E)
(DATE)
PLAN CHECK FEE S &<9&? PEH
Type of Occupancy
Const. Group
Size ol Bldg. No. of
(Total) Sq. Ft. Stories
Fire Use
Zone Zone
No. of OFFSTREETPA
Dwelling Units ^^ ^
Special Approvals Required
PLANNING DEPT.
HEALTH DEPT.
FIRE DEP1.
SOIL REPORT
OTHER (Specify)
ENGINEERING DEPT.
WATER DEPT.
'"jfflm&JDtA***
MIT FEE S
MICRO FILM FEE
Max.
Occ. Load
Fire Sprinklers
Required Qves DNO
RKING SPACES;
No.Ft. Open
Received Not Required
r<<
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 $
1200 ELM AVENUE
CARLSBAD, CALIFORNIA 92008
Citp of Cartebab
January llth, 1978
TELEPHONE:
(714} 729-1181
SUBJECT:
PROJECT:
LOCATION^
II
CORRECTIONS ON STRUCTURAL DESIGN
EATON LEONARD CORPORATION BUILDIN<^P£
PALOMAR AIRPORT BUSINESS PARK
YARROW DRIVE, CARLSBAD, CALIFORNIA
CALCULATIONS.
1. Recheck roof beams along grid lines B and E for
additional load from 4* wide strip of roof at
side where adjacent purlin runs parallel.
2. Submit design calcs for roof beams along grid
lines C and D.
3. Show calcs for required area of slab to resist
sliding or shear parallel to walls.
DETAILS
1. Indicate load bearing partition stud spacing
per calcs requirements. (See page 14 of calcs
2" x 4" @ 12".)
2. Indicate detail for wall to slab dowels per
calcs requirements. (See page 24 to 29 of calcs.)
3. Show detail for required tilt-up panel hold down
reinforcements for walls w-29, 30 and 31. (See
page 24 of calcs.)
CAME
LDING INSPECTOR
BY:/
Jurisdiction of
Owner .
Job Address
GENERAL PLAN CORRECTION LIST
Based on 1976 Edition of the Uniform Building Code i r~jgy
^./A/aluatiPlan Check
Use
aluation
State
Total Allowable Floor Area Sq. Ft.
Basis for Increase
Type rff " _^. . jfc Occupancy
Constructior^r~u../:.7......Classification ./:•:.
Fire Zone No. ../.•s*&-..; ^Stories ...,._* .*..
Floor Area:
5>*-7 ptf?Floor •** -**^*-r°s
Floor (Total)
Occupant Load
*")
COMMENTS OR ASSUMPTIONS:
....>.. ................. Sq.
t^^
Corrections checked below are to be made on plans before permit is issued.
The approval of plans and specifications does not permit the violation of any section of the Building Code, or other City Ordinance or
State Law.
GENERAL
i.
2.
3.
4.
5.
Show job address on plans.
Give name of person responsible for plans.
Submit fully dimensioned plot plan.
Give all dimensions on plot plan.
AREA LIMITATIONS AND GENERAL
OCCUPANCY REQUIREMENTS
k
6.
7.
9.
Ground elevations should be shown at corners
of the building and at changes in ground siope.
The ground elevations should be taken at tne
lowest point between the exterior wall and a
point 5 feet out or at the property line, if
closer. Where the exterior wall is parallel to and
within 5 feet of a public sidewalk, alley, or
other public way, the ground elevations should
be the elevation of the public way. The number
of stories in this building cannot be determined
until this data is furnished.
The total floor area is limited to
square feet. Sections 505 and 506.
Unobstructed yards of feet should
be maintained on sides
of the building for area purposes. Section 506.
Provide details to show that
-hour area separation walls should comply with
Section 505 (c).
(a) Extend vertically from the foundation to a
point 30 inches above the roof.
(b) Total width of all openinRS limited to 25 per-
cent of the wall length in the story under
consideration.
10.
11.
12.
13.
(c) All openings protected with fire assemblies
having a fire-resistive rating ot one-and-one-
half (three) hours.
(d) Ducts through area separation wails should
be avoided. If allowed, fire dampers on eacii
side of the wall are required.
A fire-resistive occupancy separation in conforrn-
ance with Table No. 5-B and Section 503 is
required between the
( 'hours)
\ ( -hours)
Horizontal occupancy separations should be sup-
ported with a structural system having equiva-
lent fire-resistive protection. Section 503 (b).
structure. Section 507 and Table No. 5-D.
A room in which a water closet is located should
be separated from food preparation or storage
rooms by a tight-fitting door. Section 510.
TYPE OF CONSTRUCTION
-
14.
15.
Type V (II-N) (III-N) buildings are not permitted
in Fire Zone No. 1. Section 1602 (a).
Roof coverings should be lire retnrdant. Section
.1603 (a) or 1704. Details or specifications
complying with Section 32Q3 (e) are required.
form 200.3
Sheet No. 1 of 6 Sheets
82.
83.
84.
85.
86.
87.
88.
89^
90.
91.
92.
93.
94.
95.
96.
97.
98.
99.
100.
101.
102.
A ftoor or landing not more than 1 inch below
the threshold is required on each side of an
exit door. Section 3303 (h).
Doors should not project more than 7 inches in-
to the required corridor width when fully
opened or more than one-half into the requiredcorridor width when in any position. Section
3304 (d) . . ...•
Revolving (sliding) (overhead) doors are not per-mitted as exit doors. Section 3303 (f).
Exit doors should provide immediate access to anapproved means of egress. Section 3303 (g).
Exiting through another room does not com-
ply, except as provided for in Section 3302 (e).
'Corridors should have a minimum width of 44
inches. Section 3304 (b).
Corridors serving nonambulatory persons should
have an 8-foot minimum width. Section 3318
(c).
Dead end of corridors and exit balconies arelimited to 20 feet. Section 3304 (e).
Walls and ceilings of corridors should be of one-
hour fire- resistive construction. Section 3304
(g)-»An architectural section through the corri-dor fs riecessafy'Td "determine how this isaccomplished.
Exterior exit balconies cannot project into an
area where protected openings are required
due to location on property. Section 3304 (i).
Interior openings into corridors should be pro-
tected as specified in Section 3304 (h).
and handrails should not project more than
3l/2 inches into the required width. Section3305 (b).
Risers on stairways should not exceed 7'/2inches and runs should not be less than 10inches. Section 3305 (c).
Landings on stairways should have a dimension
in the direction of travel equal to the width of
the stairway but need not exceed 4 feet. Sec-tion 3305 (g).
Landings should not be reduced in width more
than 3y2 inches by a door when fully open.
Section 3305 (g).
Basement portion of stairways should have an
approved barrier where continuous to upperfloors in an exit enclosure. Section 3305 (h).
Vertical distances between stairway landings are
limited to 12 feet. Section 3305 (i).
Handrails should be placed not less than 30
inches nor more than 34 inches above the
tread. Section 3305 (j). Two handrails are re-
quired where stairways exceed 44 inches inwidth.
Guardrails for stairs, balconies, and landingsshould conform with Section 1716. Note that
maximum clearance between intermediate railsis 9 inches.
Openings in exterior walls within 10 feet ofexterior stairways should be protected with
self-closing three-fourths-hour fire-resistive as-semblies. Section 3305 (1).
Enclosed usable space under interior stairways
should be protected on the enclosed side as
required for one-hour fire -resistive construc-tion. Section 3305 (m).
Noncombustible exterior stairs are required.Section 3305 (n).A j .
<
103.
104.
105.
106.
107.
108.
109.
110.
111.
112?,
113.
114.
115.
116.
117.
118.
119.
Exterior stairs should not project into an area
(yards or courts) where wait openings must be
protected. Section 3305 (n).
One stairway should extend to the roof. Section
3305 (o). It must be in a smokeproof enclosure
in buildings over 75 feet in height. Section3309 (b).
Six-foot 6-inch' minimum headroom clearancefor stairways should be indicated on plans.
Section 3305 (p). Note that this is from a
plane tangent to the stairway tread nosings.
Ramp slopes should not exceed one foot in
feet. Section 3306 (c) (d).
Surface of ramps should be roughened or of anonslip material. Section 3306 (f).
Stairways should be enclosed as specified inSection 3308.(a) One (two)-hour fire-resistive walls are re-
quired.
(b) Only exit doors are allowed to open into exit
enclosures.
(c) Doors should be labeled one (one-and-one-
half)-hour fire assemblies,
(d) Exit enclosures should include a corridor on
the ground floor extending to the exterior.Fire-resistive construction should be as re-quired for the exit enclosure, including pro-
tected openings. Only exit doors are per-
mitted to open into the corridor.
(e) An approved barrier is required at theground floor to prevent people from acci-dentally continuing to the lower level.
(f) Usable space is not allowed under the
stairs.
One exit from the building should be a smoke-proof enclosure complying with Section 3309.
Openings into exit courts less than 10 feet wide
should be protected with labeled 45-minute fire
assemblies. Section 3310 (d). Also see "exit
court" definition in Section 3301 (c). Openingsmore than 10 feet above the court floor areexempt.
No openings other than required exits are per-
mitted in exit passageways. The passageways
should be of -hour fire-resistive
construction. Section 3311 (a).
'Exit illumination and signs should be provided in
conformance with Section 3312^^, .^-Wt^^^ST^
Aisle (cross aisie) in auditorium should have a
3313 (b). Section 3313 (e).
Panic hardware is required on exit doors serving
Group A Occupancies having an occupant toad
of more than 100. Section 3316 (a). In lieu
of this, doors shall have no locks or latches.
Main. and side exits in conformance with Sec-
tion 3315 are required for B-2 (1) Occupancies.
Section 3316 (a).
Corridors of Group E Occupancies should have a
width required by Section 3302 plus 2 feet, but
not less than 6 feet. Section 3317 (e).
Each floor above or below the ground floor level
of Group E Occupancies should have no less
than two exit stairs. Section 3317 (g).
Exit stairs serving an occupant load of more
than 100 in a Group E Occupancy should havea minimum clear width of 5 feet. Section 3317
(g).
Every room with an occupant load exceeding300 should have one of its exits into a separate
exit system. Section 3317 (b).
120.
121.
122.
123.
124.
125.
126.
When three or more exits are required, no more
than two required exits should exit into the
same exit system. Section 3317 (b).
No point in a room in a building should be more
than 75 feet to an exit corridor, enclosed stair-
way or exterior of the building. Section 3317
(c).
Exiting through adjoining rooms should comply
with Section 3317 (d).
Panic hardware is required on exit doors serving
rooms containing more than 100 occupants
and in corridors of Group E Occupancies. Sec-
tion 3317 (j).
All required exterior exit doors in a Group 1 Oc-
cupancy shall open in direction of exit travel.
Section 3318 (a).
Doors from bedrooms and wards of Group 1
Occupancies and all exit openings where non-
ambulatory patients are housed should have a
minimum clear width of 44 inches. No pro-
jections in this width are allowed. Section
3318 (b).
Panic hardware is required on exit doors serving
more than 50 occupants in Group 1 Occupan-
cies unless there is no latch or lock. Section
3318 (f).
FIREPLACES AND CHIMNEYS
FLOOR, ROOF CONSTRUCTION, COVERING,
SKYLIGHTS, ROOF STRUCTURES
127.
128.
129.
130.
131.
The space between wood floor construction and
a suspended ceiling below should be divided
into areas not exceeding 1000 square feet.
Section 2517 (f).
Attics of combustible material should be divided
into areas not exceeding 3000 (9000) square
feet. Section 3205 (b).
Roof drainage should be conducted under the
public sidewalk. Section 3207 (e).
Overflow drains having the same size as roof
drains and on independent drain lines are re-
quired. In lieu of this, overflow scuppers three
times the size of roof drains should be installed
in parapet walls. Overflow system should have
inlets located 2 inches above the low points
of the roof. Section 3207 (c).
The aggregate area of penthouses and other roof
structures cannot exceed 33y3 percent of the
supporting roof area. Section 3601 (b).
FIRE-EXTINGUISHING SYSTEM
132.
133.
134.
135.
136.
137.
An approved automatic fire-extinguishing system
Section 3802 (b). This includes blind spaces
enclosed wholly or partly by combustible con-
struction.
Dry standpipes are required in buildings four or
more stories in height. Section 3803.
Wet standpipes are required as specified in Sec-
tion 3804.
Combination standpipes are required in build-
ings exeeding 150 feet in height. Section 3805
(b).
Buildings six stories or more in height should be
provided with not less than one standpipe dur-
ing construction. Section 3806 (b).
Fire-extinguishing system plans should be sub-
mitted to you to determine compliance with
applicable building, plumbing, and fire codes.
138.
139.
Chimneys should comply with Sections 3703
and 3704.
Fireplaces and barbecues should comply with
Section^ 3^707. -7— •* * /_
?&£&*>*-><*-&*
FINISH WORK
140.
141.
142.
143.
144.
The interior wall and ceiling finishes should be
specified and comply with Table No. 42-B and
Section 4203.
Gypsum wall board (interior lath and plaster)
cannot be installed on weather-exposed sur-
faces. Sections 4705, 1711. See Section 424
for definition of weather exposed surface.
Skylights should comply with Chapter 34. Plastic
skylights are allowed only under the conditions
specified in Section 5205.
Glass and glazing should comply with Chapter
54. Type and thickness of glass should be
specified.
Glass and glazing subject to human impact
should comply with Section 5406.
STRUCTURAL
145.
146.
147.
148.
149.
150.
151.
152.
153.
154.
155.
156.
Special inspection in conformance with Section
305 is required.
Soil classification in conformance with Table No.
29-B and pounds per square
foot soil bearing value used in design should
be specified on plans. Section 2905 (a).
The foundation investigation report mentioned in
plans was not included in data forwarded to us.
It should be submitted for review.
All masonry or concrete elements resisting seis-
mic forces should qualify as reinforced ele-
ments. Section 2312 (j) 2B.
Precast concrete wall panels are limited to an
h/t ratio of 36 (25). Section 2616 (c).
Wood members may support toads from ma-
sonry or concrete only under the conditions
specified in Section 2516 (a).
Structural calculations should be submitted to
justify the adequacy of the structural system
in resisting seismic and wind loads, and sup-
porting dead and live loads. This includes
foundations.
Justifying calculations and details should be pro-
Roofs shall be designed for snow loads of
pounds per square foot. Section
2305 (d).
The roof should be designed for uplift wind pres-
sures with due consideration for lateral support
of compression flanges of flexural members.
Floor load should consider a 20 pound per
square foot partition load. Section 2304 (d).
Marquees should be designed for a 60-pound per
Square foot live load. Table No. 23-A.
Sheet No. 5 of 6 Sheets
157.
158.
159.
160.
161.
162.
163.
164.
165.
166.
Garages for the storage of private pleasure cars
should be designed for a minimum 2000-pound
wheel load. Section 2304 (c).
Live load reductions should comply with Sec-
tion 2306.
Glued-Iaminated lumber should be fabricated inaccordance with Section 2511 (f).
Allowable stress in glued-laminated members
over 12 inches in depth should consider adepth reduction factor. Section 2511 (d) 6.
Bolted connections exposed to the weather are
limited to 75 percent of the allowable load
under protected conditions. Where always wet,
the allowable load shall be 67 percent of theallowable load under protected conditions.U.B.C. Standard No. 25-17.
Anchorage of concrete and masonry walls shouldcomply with Section 2310.
Plywood grades should conform with Table No.
25-B.
Justification is required that sufficient slope or
camber is available to assure adequate roof
drainage after long time deflections. In lieu of
this, roofs must be designed for possible pond-ing of water. Section 2305 (f).
Details on stressing method and hardware along
with justifying data are required on prestressed
concrete work. This data should be submittedand approved prior to ordering of material.Note that all tendons should comply with Sec-
tion 4303 (c) 3, for fire-resistive purposes.
Welding data or details for steel decking used as
a diaphragm should be provided. Information
should comply with a specific ICBO researchrecommendation or test data submitted incompliance with Section 106.
Additional Corrections:
167.
168.
169.
170.
171.
172.
173.
174.
175.
Details should be provided on roof (floor) dia-
phragm connections that indicate how the
shears are transferred to vertical shear-resist-
ing elements. Connections should be justified
with structural calculations for compliance with
allowable values.
Nailing for gypsum board (lath, sheathing board)
used structurally on shear walls should be
specified to comply with Table No. 47-1.
Shear walls utilizing gypsum board (lath, sheath-
ing board) cannot be used to resist loads im-
posed by masonry or concrete walls. Footnote
1, Table No. 47-1.
Railings should be designed to withstand a 20
(50) pound per foot horizontal force. TableNo. 23-B.
Ceiling framing should be designed for total load
of not less than 10 (20) pounds per squarefoot. Table No. 23-B.
Interior partitions should be justified structurally
for strength and deflection criteria specified in
Section 2312 (b).
should comply
with a specific ICBO research recommendation
or justifying test data should be submitted in
compliance with Section 106.
Plans should indicate that foundations extend
below the frost line.
Provide complete specification in conformance
with the design for
These sheets are a part of the plans and shall remain attached thereto. Corrections as above indicated will be complied with.
Rechecked and Approved (Sign Here)
Date
(Signature of Owner or Applicant)
Sheet No. 6 of 6 Sheets
1200 ELM AVENUE
CARLSBAD, CALIFORNIA 92008
Citp of Cartebafc
COMMERCIAL VALUATION CHART
BUILDING PERMIT FEE . . |_
PLAN CHECK FEE (fc5% of building permit fee). . . . $_
MICRO FILM FEE .....$
TOTAL FEES $
TELEPHONE:
(714)729-1181
USE OF BUILDING
BUILDING AREA QOyO&O 4
(Less Office Area)
OFFICE AREA
SPRINKLER SYSTEMS
AIR CONDITIONING
PILE FOUNDATION -
PAVING
TOTAL
" x*) r^-JT" Y'&, p^l • A
X
X
X
X
X
$
$
$1
$2
$
$
4s c
£>&£
icC
.10/
.25/
.25/
* i (j C? t
/ CQ
sq.
sg.
m
sq.
&
"*>
C
ft.
ft.
ft.
= $-
= $
= $
A
= $
— $ ^ ^ "^^T" ~"
$ ^-T<» ooau/
*NOTE; EACH BUILDING
REQUIRES A
SEPARATE
PERMIT.
(c) Expiration of Plan Check. Applications for which no permit is
issued within 180 days following the date of application shall expire by
limitation and plans submitted for checking may thereafter be returned to
(he applicant or destroyed by the Building Official. The Building Official
may extend the time for action by the applicant for a period not exceeding
180 days upon written request by the applicant showing that circumstances
beyond the control of the applicant have prevented action from being
taken. In order to renew action on an application after expiration, the ap-
plicant shall resubmit plans and pay a new plan-check fee.
(d) Reinspection Fee. The fee for each reinspection shall beSlO.OO.
TABLE N0.3-A—BUILDING PERMIT FEES
TOTAL VALUATION FEE
$1.00 to $500.00
$501.00 to $2,000.00
$2,001.00 to $25,000.00
$25,001.00 to $50,000.00
$5.00$5.00 for the first $500.00 plus $1.00
for each additional $100.00 or frac-
tion thereof, to and including $2,000.
$20.00 for the first $2,000.00 plus
$4.00 for each additional $1,000.00
or fraction thereof, to and including
$25,000.00
$112.00 for the first $25,000.00 plus$3.00 for each additional $1,000.00
or fraction thereof, to and including$50,000.00
$50,001.00 to $100,000.00 $187.00 for the first $50,000.00 plus$2.00 for each additional $1,000.00
or fraction thereoF, to and including
$100,000.00
$100,001.00 to $500,000.00 $287.00 for the first $100,000.00 plus$1.50 for each additional $1,000.00
or fraction thereof, to and including
$500,000.00
$887.00 for the first $500.000.00 plus
$1.00 for each additional $1,000.00
or fraction thereoF
$500,001.00 and up
<?<r
000
00
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PHOENIX, ARIZONA 85012
3820 NORTH THIRD STREET
TITLE:JOB NO.X1S17
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TITLE:JOB NO.X1S77
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Application for Grading Permit
CITY OF CARLSBAD
PUBLIC WORKS & BUILDING DEPARTMENT
1200 Elm Avenue
729-1)81
PERMIT NO.^
(letter code + number)
L=lot
S=subdivision
C=City contract
1
FOR APPLICANT WF1LL IN
Site Address
Tte,\\/s-
Surety Bond Bond No.
LegaI Descriptioncri prion «
U-t-rc. PAB? QUIT *1
Map No.Surety Company
Subdivision Name Surety Address
Owner Phone Date Filed Rec'd by
Owner's Address Cast), deposit Rec!d by Date f iIed
The following documents are required and shal
become a part of the grading permit when they
are approved.
7*Grading plans Specifications
i I report Vicinity map
lans by Civil Engineer R.C.E.
Phone
Soil Enaiaeer
-A&dB^StL
R.C.E,Phone
Sradina Contractor Phone
— • -^—^. ' •_Drainage structures >CRetaining walls
Other_X_Compaction report
!\ddress Check if supervised
grading
SPECIAL CONDITIONS WHICH ARE MADE
A PART OF THIS PERMIT
'arty responsible for overall supervision
1. Authorized hours of operation: 7:00 AM to
roposed Ajse .of grade site 5:00 PM, Monday-Friday.
2. Haul routes are to be approved by City
dumber of cubic yards1
Cut Fill Import Waste
44 aoo tesst>
Total
Engineer.
5. Adequate provisions shall be made for
erosion and siltation control.
4. All slopes shall be planted per direction
of Parks & Recreation Director.
416Q&
Compacted fills (yes or no)//*:£. "D*^- *ff»*0 ^/3/77
I Jf/l f\hf 1£>A AS" .•?." " ' t-"jTji / 'W" *~"
'roposed Schedule of
Operations (dates)
.Start Finish ^ /A A^C//^-/A ,'7 y?
I hereby acknowledge that I have read the applica-
tion and state that the information I have providec
is correct and agree to comply with all City
ordinances and State laws regulating excavating anc
grading, and the provisions and conditions of any
permit issued pursuant to this application.
INSPECTION DATE INSPECTOR'S
SIGNATURE
Ground preparation
Rough grading
Signature of Permittee
Compaction report rec'd.
Owner or authorized agent L .
Planting & drainage
g Final certification rec'd
Grading permit fee $Work completed
Permit Validation
by
Surety bond released
Date
Permit Expiration Date //- /8
A<
THIS FORM WHEN PROPERLY VALIDATED BY SIGNATURE IS A PERMIT TO DO THE WORK DESCRIBED
THIS PERMIT IS VALID FOR A SIX (6) MONTH PERIOD