HomeMy WebLinkAbout2330 Hosp Way; ; 74-820; Permit0
BUILDING PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA 92008 ~
Applicant to complete numbered spaces only. Phone 7 29-1181 Permi t No.~~ .fr..
JOI AOOR ES.,
LC GAL J OBCO, I
LOT ~0.
OWNtR
2
CON TfU,CTOR
3
4
ENGINttR
5
COMPENSATION INS. CARRIER
6
U$E 0,. 8\JILOING
7
8 Class of work: 0 NEW
9 Describe work:
10 Change of use from
Change of use to
11 Valuation of work: $
l A1'C T
MAIL Aoo.-css
MAIL AOOfttSS
MA L AOOllllSS
I
VAOOITION 0 ALTERATION
ASSESSOR'S
PARCEL NUMBER
Bvv" ,LJscc ATTACM[O 5H(£TJ PAGE I
?IP PHOtlC ,' J,,
LICENSt NO. STATE
PH0"4C LICtNSC NO,
~jl .,~1.5
LICt,-.al. NO,
BIU,NC--t
0 REPAIR 0 MOVE □ REMOVE
'
PLAN CHECK FEE$ I PERMIT FEE$ /,:2._~
PAR.
CITY
1-S_P_E_C_I_A_L_C_O_N_D_I_T_I O_N_S_. ---------"-'-------------1 Type of
Const.
MICRO FILM FEE Occupancy
Group
Max t------------------------------1 Size of Bldg (Total) Sq. Ft
No of
Stories 0cc. Load
1-----------.-------------·=--------I Fire U se Fore Sprinklers APPLICATION ACCEPTED BY PLANS CHECKED BY !"••,~FOR ISSUA E av zone Zone Required 0Yes r?< No. of OFFSTREET PARKING SPACES
OATE DATE Dwelling Units ~g~ered Sq Ft ,~gen t---..;;. ______________________ .... .;;.;.;..;..;;;... _______ ~-~-_______ ....,...., __ '9-_. __ . ___________ """'
NOTICE Sp~c1al Approvals Required Received
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 120DAYS, 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 AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.
ALL PROVISIONS OF LAWS AND 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 THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING
CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION,
,< .. /2 t_ r' ~/~, /,£/
9IGNAf'4URC: o, CONTRACTOR OR AUTHOIIIIZ£0 AG(NT (DATE,
!ll i;NATUJllt o, OWNfR (IP' OWN[III 9UILO[fl) OAT[)
PLANNING DEPT,
HEALTH DEPT.
FIRE DEPT.
SOIL REPO~T
OTHER (Specify)
ENGINEERING DEPT.
WATER DEPT.
______________ W_H_E_N_P_R_Oc...P_E_R_.cc,L_Y_V_A_.cc,L_I D_A_Tc...E_Dc... (IN THIS SPACE) TH IS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK.
INSPECTOR
M.O.
Not Required
CASH
' BUILDING PERMIT APPLICATION
Applicant to complete numbered spaces only. Phone 729-1181
JOI!! ADDA tSI
I LOT ,o,
L~GAL 1 Ot5C~.
OWNCR
2
CON TRAC TOfll
3
AfllCHITtCT O" 0£.SICN[flt
4
-.....
.
i_ -• '
~A L AODIIICSS
MAIL AOOACSS
tNGINE[ft MAIL AOOIH,$5
5
COMPENSATION INS. CARRI ER MAIL AOOIU .SS
6
usr. Of' BUILDING
7 -· 'Til
PHON[
PHON(
0sec ATTACH[D SH[[T)
ASSESSORS
PARCEL NUMBER
BOvl'\ PAGE I
LICtNS.t NO. ST ATE
LIC(NS£ NO.
PAR,
CITY
8 Class of work: 0 NEW Ji ADDITION 0 ALTERATION 0 REPAIR 0 MOVE 0 REMOVE
9 Describe work:
10 Change of use from
Change of use to
(f 11 Valuation of work: $ l/!Jl'Jf) PLAN CHECK FEES 1-r I PERMIT FEE s ~ O
,_S_P_E_C_I_A_L_C_O_N_D_I_T_I O_N_S_: ____ -__ , _____________ Type of
Const
1-------------------------------t Sile of Bldg. (Total) Sq. Ft
~~~~~.,,.,.,,,.,,...,.,.~--,..-----~--------,----------I Fire APPLICATION ACCEPTED BY PLANS CHECKED ev APPROVED FOR ISSUANCE av zone
CATE O~TE~:r
NOTICE
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB
ING, HEATING, VENTILATING OR AIR CONDITIONING.
No of
Dwelling Units
SpP.cial Approvals
PLANNING DEPT.
Occupancy
Group
N o. of
Stories
MICRO FILM FEE
Ma><
0cc. Load
Use Fire Sprinklers
Zone Required 0Yes ONo
OFFSTREET PARKING SPACES
No.
Covered
Required
Sq. Ft.
Received
INo. Open
Not Required
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC
TION AUTHORIZED IS NOT COMMENCED WITHIN 120DAYS. OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM,
MENCED
HEALTH DEPT. -------+--------+---------ti-------~ FIRE DEPT ---~---+-------+--------+--------
I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS APPLICATION ANO KNOW THE SAME TO BE TRUE 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 THE. PROVISIONS OF ANY OTHER S1ATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. ~-✓ ,,/ /4 _/,,..,{ l'' ; .J.:
(DA Tl)
~IC.NATU"C OP' OWN[" t,. OWHCIII IUILOEA) OATt)
SOIL REPO~T
OTHER (Specify)
ENGINEERING DEPT
WATER DE.PT.
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT -----'----------------PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
INSPECTOR