HomeMy WebLinkAbout2370 CIPRIANO LN; ; 62-4181; PermitAPPLICATION FOR
CITY OF CARLSBAD — BUILDING INSPECTION DIVISION
PHONE PArlcway 9 1181 Ext 36
"N5 4181
Owner Name
(Please Print)
Contractor
First)
(Please Print)
To Construct &^ To Add Q To Alter D
Type of Const /f/fr$SlfUSl^ Kind of Foundation
(Frame Masonry Etc)
Floor Space of Proposed Construction (sq feet)
Floor Space of Garage {sq feet)
LEGAL DESCRIPTION /Lot
Located at
LAND AREA
(Middle)
To Repair O
Mailing Address
Mailing Address
To Convert |
Number Street
Phone
Phone
To Move From
.ddres
No of Stories / To Be Used for r***t*l+4S~~{ e
(One Family Dwelling Store Etc )i
Const Valuation $
attached
detached QConst Valuation $
Block
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
immediately revoked
*** j>
Front Yard Set Back <X § /^Vt_
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
Plans Approved by -,
is* C /D /
Approved by A - V * ^^ r~ <-»?
Date ~*5 &£- / ~~~ G ^ — """
Building Permit will be SIGNATURE OF ] V\ ^<. „ (N . , AU^rt i^
PERMITTEE j FL« °> ° W>^V^P/OX^H
i-***" Driveway Permit Required Yes ( **) No ( ) Fee A<--'-2 ^jS/*
Grading Permit Required Yes ( ) No ( i\l
Sewer Disposal Plant Capital Cont Fee cJ ^-* ' *•'
Sewer Pumping Station Capital Cont Fee / Y OA/&
Sewer Main Line Cost f \r Of^* C-
/ /' ' '
Sewer Lateral Connection Charge ^""" ' ^^ rs^j
Water Stocked Lands Charge
Water Main Pipe Line Fee
Water House Service Charge -,'
•J»yX-- LL A /xa?
Water Meter Charge /**$
Sub Total // — ^=^
Plan Check Fee
^^^- -~^__ Building Permit Fee cP ^r ~~~~ ^
**
%
J
Total Charges / / —~=!*1°1***^