HomeMy WebLinkAbout2380 CIPRIANO LN; ; 62-4195; PermitAPPLICATION FOR
CITY OF CARLSBAD — BUILDING INSPECTION DIVISION
PHONE PArkway 9 1181 Ext 36
N° 4195
Owner Name
(Please Print)(Last)
Contractor
To Construct
rst)(Middle)
Type of Const
(Frame Masonry Etc )
(Please Print)
Add D To Alter Q To Repair D
of Foundation
Floor Space of Proposed Construction (sq feet)
Floor Space of Garage (sq feet)
LEGAL DESCRIPTION
Mailing Address
Mailing Address
To Convert [
Number Street'
Number Street
To Move From
City
City
Phone
Phone
Add re.
No of Stones / To Be Used for
(One Family Dwelling Store Etc )r >
Const Valuation $
detached dConstluation $
Lot Block
Located at
LAND AREA
<2 , 0 A /
Assigned House Number
Section
Street Near /# /?
Subdivision
Township Range
NUMBER OF EXISTING DWELLINGS ON PROPOSED BUILDING SITE (INDICATE
SIZE USE AND LOCATION ON^BLOT 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
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 ( I )
Zone Commercial ( )
Variance
Eng Check By
> i)
Driveway Permit Required Yes ( ) No ( ) Fee
Grading Permit Required Yes ( ) No ( .)
Sewer Disposal Plant Capital Cont Fee x-PCx
Sewer Pumping Station Capital Cont Fee /S/O/Vv£.
Sewer Mam Line Cost
Sewer Lateral Connection Charge
Water Stocked Lands Charge
Water Main Pipe Line Fee
Water House Service Charge
Water Meter Charge
Sub Total
Plan Check Fee
Building Permit Fee
Total Charges