HomeMy WebLinkAbout2350 CIPRIANO LN; ; 62-4179; PermitAPPLICATION FOR PERMIT
4179
CITY OF CARLSBAD — BUILDING INSPECTION DIVISION
PHONE PArkway 9 1181 Ext 36
(Last)
Owner Name
(Please Print)
Contractor
(Please Print)
To Construct tU-^to Add D To Alter D
(Middb)
Mailing Address
Mailing Address
Type of Const ~f /LA4*^\>*—? Kind of Foundation
(Frame Masonry Etc )
Floor Space of Proposed Construction (sq feet)
Floor Space of Garage (sq feet)
LEGAL DESCRIPTION
Number Street
To Repair Q To Convert D To Move From
No of Stories
Const Valuation
Valuation
City
City
Phone
Phone
Be Used for
(One Family Dwelling Store Etc )
attached
detached
7
Lot Block
or
Located at
LAND AREA
0 ^
Assigned House Number
Section
Street Near
Subdivision
Township Range
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? YES £^"^ NO
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
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 SIGNATURE OF
immediately revoked PERMITTEE
Front Yard Set Back
Side Yard Set Back
Rear Yard Set Back
Distance Between Bldg
Off Street Parking Spaces
Sewage Disposal System
Zone Residential ( ( )
Zone Commercial ( )
Variance
Eng Check By
Driveway Permit Required Yes
Grading Permit Required Yes ( ) No ( /•}
w&o.ooSewer Disposal Plant Capital Cont Fee
Sewer Pumping Station Capital Cont Fee
Sewer Mam Line Cost /VO A/' £Z-
Sewer Lateral Connection Charge
Water Stocked Lands Charge
Water Main Pipe Line Fee
Water House Service Charge
Water Meter Charge
Sub Total
%- t/o *°-f <3/ as~
Plans Approved bjt——«« ^
Approved by /\ *- t^"
Date
Plan Check Fee
Building Permit Fee
Total Charges