HomeMy WebLinkAbout2380 CIPRIANO LN; ; 63-5369; PermitAPPLICATION FOR PERMIT
5369
CITY OF CARLSBAD — BUILDING INSPECTION DIVISION
PHONE PArltway 9 1181 Ext 36
Owner Name
(Please Print)
Contractor
To Construe
(Please Prm
To Add D To Alter
(Middle)
To Repair
Type of Const
(Frame Masonry Etc
of Foundation
Mailing Address
Mailing Address
To Convert Q
No of Srories
. -s ^ *-*• j
Number Street
<^^. ^£~*&—^*~~'<'
Number Street
To Move From
^t
To Be Used for ^^
w^
City
a
City
, Address
^-e-^ <l
Phone
Phone
-«~_
(One Family Dwellmq Store Etc )
Floor Space of Proposed
Floor Space of Garage (sq feet)
LEGAL DESCRIPTION
Lot
Const Valuation $
attached D
detached QConst Valuation $
Block
or
Located at
LAND AREA
Subdivision
TownshipSection
Street Near
Assigned Hous"e Number
NUMBER OF EXISTING DWELLINGS ON PROPOSED BUILDING SITE
Range
(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 Building Permit will be SIGNATURE OF
immediately revoked PERMITTEE
Front Yard Set Back
Side Yard Set Back
Rear Yard Set Back
D st nee 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
Wafer Stocked Lands Charge
Water Main Pipe Line Fee
Water House Service Charge
Water Meter Charge
Sub Total
f/
Plans ApprovecJJoy "^
Approved by
Date
Plan Check Fee
Building Permit Fee
Total Charges 3 -