HomeMy WebLinkAbout2351 CIPRIANO LN; ; 62-4177; PermitAPPLICATION FOR PERMIT
4177
CITY OF CARLSBAD — BUILDING INSPECTION DIVISION
PHONE PArkway 9 1181 Ext 36
(Last)
(Please Print)
Add D To Alter D
(Middle)
To Repair
Owner Name
(Please Print)
Contractor
To Construct
Type of Const ^^-^^*^L Kind of Foundation
(Frame Masonry Etc )
Floor Space of Proposed Construction {sq feet) / /Of?'*&
Floor Space of Garage (sq feet) i^ <-> T^
e>
Mailing Address <^O^=5
Mailing Address
To Convert O
Number Street City /
<=^#--T--t^-J^___
Number Street City
To Move From
Phone
Phone
No of Stories / To Be Used for
(One Family Dwelling Store Etc 's~ •»
Const Valuation $
LEGAL DESCRIPTION
Located at
LAND AREA
detached QConst Valuation $
Lot Block
Assigned Horfse 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 IS 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
immediately revoked
)Front Yard Set Back O^ 0
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 ( ^] No ( ) Fee / *-
Grading Permit Required Yes ( ) No
Sewer Disposal Plant Capital Cont Fee
Sewer Pumping Station Capital Cont Fee
Sewer Main Line Cost
Sewer Lateral Connection Charge
Water Stocked Lands Charge
Water Mam Pipe Line Fee
Water House Service Charge
Water Meter Charge
Sub Total
/A/
Plans Approved by
Approved by
Date
Plan Check Fee
Building Permit Fee
Total Charges