HomeMy WebLinkAbout2360 CIPRIANO LN; ; 62-4180; PermitAPPLICATION FOR PERMIT
CITY OF CARLSBAD — BUILDING INSPECTION DIVISION
PHONE PArlcway 9 1181 Ext 36
"N! 4180
Owner Name
(Please Print)
Contractor
To Construct
(Please Print)
Add n To Alter D To Repairn>
Kind of FoundationType of Const
(Frame Masonry Etc )
Floor Space of Proposed Construction (sq feet) /(p *f/
Floor Space of Garage (sq feet)
LEGAL DESCRIPTION
Lot
Located at
Mailing Address
Mailing Address
To Convert D
No of Stories /
Const Valuation $
attached B—•"
ched QQqnstoValuation $
Number
-£
Number
Street
Sfreat
City f Phone
City Phone
Addrea
To Move From
To Be Used for
(One Family Dwelling Store Etc \
Block Subdivision
Section
Street Near
LAND AREA
SIZE USE /
ADDITION?
Assigned House Number
NUMBER OF EXISTING DWELLINGS ON PROPOSED BUILDING SITE
riON ON-
YES IS"^ NO
Township
rf
Range
^INDICATESIZE USE AND LOCATION CJN-PLOT PLAN) WILL THIS CONSTRUCTION INCLUDE ANY PLUMBING INSTALLATION ALTERATION OR
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
SIGNATURE OF
PERMITTEE
Front Yard Set Back C
Side yard Set Back
Rear Yard Set Back
Distance Between Bldg
Off Street Parking Spaces
Sewage Disposal System
Zone Residential ( I )
Zone Commercial ( )
Variance
Eng Check By
Driveway Permit Required Yes (V) No
Grading Permit Required Yes ( ) No ( )
Sewer Disposal Plant Capital Cont Fee
Sewer Pumping Station Capital Cont Fee
Sewer Mam Line Cost A/ O,^^—
/—
Sewer Lateral Connection Charge
Water Stocked Lands Charge
Water Main Pipe Line Fee
Water House Service Charge
Water Meter Charge
Sub Total
' OO
/A/
Plans Approved by
Approved by
Date
Plan Check Fee
Building Permit Fee
Total Charges