HomeMy WebLinkAbout2371 CIPRIANO LN; ; 62-4178; PermitAPPLICATION FOR Ill f III U PERMIT
CITY OF CARLSBAD — BUILDING INSPECTION DIVISION
PHONE PArkway 9 1181 Ext 36
YS 4178
Owner Name
(Please Print)
Contractor
^tfAA&yP
(L^lt) (/(First) (Middle)
£ //I * cL
(Please Print)
$-To Add D To Alter D
77U^>t«-*— Kind of
Ma.lmg Address
Mailing Address <i>
Type of Const
(Frame Masonry Etc )
To Construct
" / A a **
Foundation
Floor Space of Proposed Construction (sq feet) '
Floor Space of Garage (sq feet)
LEGAL DESCRIPTION
Number Street
To Repair D To Convert D To Move From
Phone
Phona
Add
y
No of Stories / To Be Used for
(One Family Dwelling Store Etc '/ ->
Const Valuation $
s/Cr s/ attached OB""
•7^5 ^ detached DConst_ Vajyation $
/Q5-rf C
Block
Located at c257/
Assigned House Number
Section
Street Near
Subdiv
Township Range
f~6 #£.3 T~
LAND AREA 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 t^ 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
t
If a check is tendered for payment of the above fee and the check is
not honored when presented for payment
immediately revoked
f~
Front Yard Set Back £X 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
your Building Permit will be SIGNATURE OF 1 I ^-^ ff\| * . .. .f\V t^s ,, .
PERMITTEE \l[ D. -~> 0 }~Y^^^^J^^-
sl^i^ Driveway Permit Required Yes (*) No ( ) Fee ' ' ^^ (js'/t*/
Grading Permit Required Yes ( ) No ( \J
Sewer Disposal Plant Capital Cont Fee ^ ^^ '
Sewer Pumping Station Capital Cont Fee /V/ '-' A^ t-i
Sewer Mam Line Cost /\/Q/J(-
) it 1 1
Sewer Lateral Connection Charge ^-" ^ ^ ^ ^ ' '^/ ^- t/'*~*5
Water Stocked Lands Charge
Water Mam Pipe Line Fee
Water House Service Charge
S~\ £* fj
Water Meter Charge *7j? ^7 ®
Sub Total // _
Plans Approved by
Approved by j\ '
Date "SsD ' O? / ~"
-— >.
' " V
Plan Check Fee
Building Permit Fee
Total Charges