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Home My WebLink About2380 Hosp Way; CARPORTS; 74-827; PermitJ BUILDING PERMIT APPLICATION City of CARLSBAD, CALIFORNIA 92008 Phone 729-1181 Permit N0'7/ Applicant to complete numbered spaces o rily ~ JOB ADDA £SS ASSESSOR 'S ::, ~-r.~,:~~ Cr: .. -· PARCEL NUMBER ....i-:...."'!a~: LOT NO, I OLK I TRACT BOOK PAGE I PAR. L&GAL I <Oscc ATTAC1-1c0 SHCCT) 1 OCSCA. /.r -·-CnUA ~-•-.i r_, L, .. - OWN[A MAIL ADOACSS ZIP PHONE 2 . .~ -, _ _.. \,-_,• E1c ~ •. t!_, ,..,,-...,.!:~ Ctl. i!;-1\'fiM -,' :L, ..•. , , ... ~ -,. I -.; I~ - CONTAACTOA MAIL ADDRESS PHONE LICENSE NO. STATE CITY 3 t1.rn: Co . .-.. :P.O .. -l!i ,,. ., -. ~~ r:tl. v7'"' _-,a,,. 1 :c -" . AACHlTCCT OR DESIGNEA s MAIL ADOAE!iS c PHONE LIC CNS[ NO. 4 __ ...__ _ _.. -~,~ & : _....,.'--•.• ------i,. ~ l,.~\Cj .. -. ~ -~- ENGIN£t:A MAIL. ADDR£5$ PHONE LICEN!E NO, 5 .. •?;, ,.~ .. .=.a;., :f . .-.. C • if.rf'f"....,.,,.~ .. .. .,. .......... .. -- COMPENSATION INS. CARRI ER ' MAIL AOO"tESS .• .~ • cc -BIU,NCH 6 use Of' BUILDING 7 lt.., , .. 0-. 8 Class of work: □NEW h~□0ITI0N 0 ALTERATION 0 REPAIR 0 MOVE 0 REMOVE 9 Describe work: ~ ... t11!'~ \;W!'.~"l.!:. 10 Change of use from Change of use to - 11 Valuation of work: $ /4 .#t:JtJ' v-PLAN CHECK FEE$ l ,._2 ,Gt:'J PERMIT FEE $ • . SPECIAL CONDITIONS: MICRO FILM FEE Type of Occupancy Const. Group Size of Bid,{:,., No. of Max. (Total) Sq. I:., ()(_ Stories 0cc. Load ~ a Ftre Use Fire Sprinklers APPLICATION ACCEPTED av PLANS CHECKED BY l&OFOR ISSUANCE BY Zone Zone Required OYes □No No. of OFFSTREET PARKIN G SPACES: J Dwelling Units No. JNo. CATE CATE: Covered Sq. Ft. Open NOT ICE Special Approvals Required Received Not Required SEPARATE PERMI TS ARE REQUIRED FOR ELECTRICAL, PLUMB· PLANNING DEPT. ING, HEATING, VENTILATING OR AIR CONDITIONING. HEALTH DEPT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- TION AUTHORIZED IS NOT COMMENCED WITHIN 120DAYS, OR IF FIRE DEPT. CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A SOIL REPO~T PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM· .__ MENCED. OTHER (Specify) I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS ENGINEERING DEPT. APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS WATER DEPT. TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO V IOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. .---~~ . ,I t_ .t; Pw .. .StGNATU'I[ 0,-CONTRACTOR Ofll AUTHOflllll.O AGCNT IOATCl I,.,, SI GNATVfltt 0,-OWN[R I,, OWN[,. BUILDER IOAT[) WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH INSPECTOR 0 C BUILDING PERMIT APPLICATION City of CARLSBAD CALIFORNIA 92008 ' ...,r,;... Applicant to complete numbered spaces only. Phone 7 29-1181 Permit No. ~-JOB ADOA C:SS ASSESSOR'S ... Lb..? Bey.; f'.r.,,.1-r-' :a •.. PARCEL NUMBER --"' l . LOT NO, I 8LK I f,::.~-~-T~ L, (OS£C. ATTACHE.C SHC:CT) BOOK PAGE I PAR, LECAL I 1 DC.SCA, _, 1'.t.i.. ffi~-t fi. .. OWN[A MAIL ADOR ESS ZIP PMON[ 2 ·• ,, -~"l -·•.ff 7 vac··· ·,_,. ~-r. C::. • t ... -Ell& ~.,i, c~ . ., . ,. • ~a .. li.F.11'. JO; ~NU --CONTRACTOR MAIL AOORE.SS PHONE LICENSE NO. STATE CITY 3 . -_ • .,....., Cel.. 0Piili~-L ;,. -. ~ -... C ~"1Cll JL• CA-•, •l ... •i ....__: ~uu;..l:....~ "-·~•Y11' --·--..... ' AACH1T[CT OR OCSIGNCA MAIL ADOA[SS PHONE LICENSE NO. 4 ,.,...,./i"3r,ot'l'\'J1.n"""1', ,-. Ir~ .. = !H"' . ·-n,,_ .. ,.._ ~ ...... -_ i''.'tMf ENGINEER .. .• ""-.r-MAIL ADDRESS ---~ PHONE -~ LICE."'15£ ,-iQ. ,. 5 -·' ~,. Inc. l Ave.,.~~-· , .............. ~ . .. . . ----·-· I _ _,..._L ~ COMPENSATION INS, CARRIER MAIL A0D11t£SS BAANCH 6 US£ o,-BUILDING 7 -,. / .. : -. .. 8 Class of work: □NEW rf'A□0ITI0N 0 ALTERATION 0 REPAIR 0 MOVE 0 REMOVE 1c·· 9 Describe work : -~~ -,, .... ':'I.• -.,. ... - 10 Change of use from Change of use to 11 Valuation of work: $ :3~0o~ I A.I"? PLAN CH ECK FEE $ PERMIT FEE $ .,. ✓•·• -- SPECIAL CONDITIONS: MICRO"'FILM FEE Type of Occupancy Const. Group Size of Bld g.~ No. of Max (Total) Sq. F n) Stories 0cc. Load ,- Fire Use Fire Sprinklers APPUCA fl0N ACCEPTEO BY PLANS CHECKED BY APPROVEO FOR ISSUANCE ev I zone zone Required OYes □No ~ No. of OFFSTREET PARKING SPACES: I DATE Dwelling Units No. 'No. DATE Covered Sq. Ft. Open NOTICE Special Approvals Required Received Not Required SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB-PLANNING DEPT. ING. HEATING, VENTILATING OR AIR CONDITIONING. HEALTH DEPT. 1 THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC· 11 TION AUTHORIZED IS NOT COMMENCED WITHIN 120DAYS, OR IF FIRE DEPT. CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A SOIL REPOtH PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-OTHER (Specify) MENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS ENGINEERING DEPT. APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS WATER DEPT. TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR THE GRANTING OF A DOES NOT NOT, PERMIT PRESUME TO GIVE AUTHORITY TO VlOL:ATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMAN.v CONSTRUCTION. r ~ .. --!· / ·-· ) .. fr ... 51GNATURE o, CONTAACtOJIII 0,. AUTHORIZED AGE.NT (DATE) ~-· ••I VNATu Rt OJP OWNCflt 1, OWN[III 8UILOEft) DATE) WHEN PROPERLY VALIDATED IIN THIS SPACE) THIS IS YOUR PERMIT . PLAN CHECK VALIDATION CK . M.O. CASH PERMIT VALIDATION CK. M.O. CASH ' ,-~-·· INSPECTOR 0 BUILDING PERMIT APPLICATIOh-1 l City of CARLSBAD, CALIFORNIA 92008 Applicanttocompletenumberedspacesonly. Phone 729-1181 Permit No. JOB AOOR CSS ASSESSOR'S -:::;".':l ~ c...v. cm-'l~~ ea. ~-.. •,: PARCEL NUMBER LOT NO, I OLK ITAACT BOOK PAGE I PAR, LEGAL I Qsct ATTACMEO 5MECT) 1 DC$CA, ., -. _,_ nntt E,, , __ •_;.;,:-,,, J ,:..:..;-<A ,, OWNE.R MAIL ADORES! --ZIP PMONt -- 2 .A.· >, ~a:_J .. -...... -. C~"I __ . :ta,·~~-~ --~ .. CD. . -~-?: ~.LC-n •a:~ II. ,E.;;:i""_r, ,.n I ,rJ •il_--.. ------~ CON TRAC TOR MAIL ADDRESS PHON C LICC.N5E NO. STATE CITY 3 -~ -~ -~ c~ .. P.O. -:: -.IL en. ,._'JQU 11::"L C.l ~ ... --_,., . -· I....----AftCHITECT 0111 0C51GNER MAIL >-DOAE:55 PHONE LICENSE NO, 4 ~fr.l~l....-..'.'1 F\ 1.t:":'t-~~ .,.'" t.7'-11:f' r -L"t,,; .. ~ " . c':: :::-'..:'. CNGIN£.ER-,----. _. MAIL ACOR £S5 -PHO NC LICENSC NO, 5 ~~ i r·t !'t•ri-·5 Y~ .• , t t.-rn,-.. 1 .. '.#1,,. ~~ . ..... , --·•-.il; COMPl!'NSATION INS, CARRIER MAIL AODRESS 9ll'IANCH 6 use 0" BUILDING 7 ,~·p,~ b / -- 8 Class of work: . □NEW ~ ADDITION 0 ALTERATION 0 REPAIR □MOVE 0 REM OVE 9 Describe work : •1..-'H ,,,._ -tD .,. L.-111' ~c 10 Change of use from Change of use to 11 Valuation of work: $ :f::;/,1r1 or, PLAN CHECK FEES ii . I PERMIT FEE $ --~/~ SPECIA L CONDITIONS: ·c MICRO Fll.M FEE Type of Occupancy Const. Group Size of Bld g. , ';Jy'ji No. of Ma><, (Total) Sq. Fj, Stories 0cc. Load #I Fire use Fire Sprinklers APPLICATION ACCEPTED BY PLANS CHE CKE OBY APPll()V[O FOR ISSUANCE BY Zone Zone Required O ves □No N o. of OFFSTREET PARKING SPACES: A Dwelling Units No, !No. DATE DATE Covered Sq, Ft. Open NOTICE Special Approvals Required Received Not Required SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB-PLANNING DEPT. ING, HEATING, VENTILATING OR AIR CONDITIONING. HEAL TH DEPT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- TION AUTHORIZED IS NOT COMMENCED WITHIN 120DAYS, OR IF FIRE DEPT. CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A SOIL REPOtH PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM- MENCED. OTHER (Specify) I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS ENGINEERING DEPT. APPLICATION AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS WATER DEPT. TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE= OF CONSTRUCTION. _,. _,,,,.,-I, • . : ~v . ' 51C.NAIU91tt o, CONTJIACTOtll OJI AUTMO,.IZ.lO ACE.NT IDATC) ~ '"',,..✓ '5IGNATU,t[ 01" OWNI' .. II" OWNUI IUILOl:JI DAT£) WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH INSPECTOR 0 ~ BUILDING PERMIT APPLICATION City of CARLSBAD, CALIFORNIA 92008 • Applicant to complete numbered spaces only. Phone 729-1181 JOe AOOR tSS ASSESSOR'S _..:~ CT .. ,. r?Hii1 dh .ho PARCEL NUMBER • / LOT NO, I ac, I TRACT BOOK PAGE: I PAR, LEGAL I QsEE ATTACHED SHEET) 1 OCSCR, t ·, -A; .!l..o.l."Lb.L l~!'.l ... , C:-5. I-Ii OWN[A MAIL A00A£55 21. PHONE 2 .. -' ~-• le' .tw.,, C~lr ~ ·~..J19a . .. · ""' . " .. ,, ', I :le, ., ... CON TA ACTOR M A IL AODRESS PHONE LICENSE NO. ST AT e: CITY 3 .. :1'.~.na C:t.H P •. ( . '• -.~ .. l!mlo'T~. C. -~79]1 . IJ,.1t8'i'l {._ . .. . . ARCMtT(CT Oii. DESIGNER MAIL AOOR£SS PHONE LICENSE NO. 4 ,. ~ A !:t'HWII--~ ii ~ •,t V1:ct .. '1~0-C ., ·' i.! ,_,. ~· t --ENGINEER MAIL ADDRESS PHONt. LICf.NSE NO. 5 ; ~-., lne.,. 3 l7c •. ,-:;--~-.:l., 745-~ . -· . ~ ,. COMPENSATION INS. CARRI ER . MAIL ADDRESS BIIIANCH . 6 USE OF" BUILDING 7 h , 8 Class of work: □NEW 0 ADDITION 0 ALTERATION 0 REPAIR 0 MOVE 0 REM OVE 9 Describe work: :h'llf'.~ ~ll.l.C ...... :,, ·- 10 Change of use from Change of use to -- 11 Valuation of work: $ ~ ~C),r) ob I ?~'7 PLAN CHECK FEE$ PERMIT FEE $ ,-✓ -- SPECIAL CONDITIONS: . MICRO FILM FEE Type of Occupancy Const. Group Size of Bldg. /~ No. of Max. (Total) Sq, F~. Stories 0cc. Load -Fire Use Fire Sprinklers APPLICATION ACCEPTEO BY PLANS CHECKED BY APPROVED FOR ISSUANCE BY Zone Zone Required O Yes □No 1_.; No. of OFFSTREET PARKING SPACES: p Dwelling Units No. JNo. CATE: 0Al'E I Covered Sq, Ft. Open NOTICE Special A pprovals Required Received Not Required SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB-PLANNING DEPT. ING, HEAT ING, VENTILATING OR AIR CONDITIONING. HEAL TH DEPT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- TION AUTHORIZED IS NOT COMMENCED WITHIN 120DAYS, OR IF FIRE DEPT. CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A SOIL REPOtH PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM MENCED. OTHER (Specify) I HEREBY CERTIFY THAT I HAVE READ ANO EXAMINED THIS ENGINEERING DEPT. APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT, ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED WATER DEPT. HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. ~" -~-· ~ w .,-I , // 5I GNATURt o,-CONTAACTOfl OR AUTHOfltlZ.lD AGENT (OAT£} ,'=- 9IGNATUIII[ o, OWN[fl (If' OWN[llt BUILOl:R) {DATC) WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH INSPECTOR 0 C BUILDING PERMll APPLICATION City of CARLSBAD, CALIFORNIA 92008 -,y ff 3V Applicant to complete numbered spaces only. Phone 7 29-1181 Perm 11 No. - Joe AOOA tSS ASSESSOR'S ·~ nos~ ·c:s.7i ear1c __ ~ PARCEL NUMBER . _'-Ji LOT "'10, I OLK l T"ACT BOOK PAGE I PAR, ewe I A~. -· ~. Unit, & Qsct ATTACMED SHEETI l OCSCR. . OWNER MAIL AOOR E.55 ll P PM ONE 2 . • ,r". -• • 1C: :-::-,:.-f.ltrn~+ CCl"l.r__ -• 'f'l_,j'\f'.">)Lj, ,, _ "' .: •. tr.:n1: _; -, C. ~~-. _ . .,. :ll'J: :...6~ .( .. _ •"'!:-"•· ._ •• CONTJtACTOR M A lL AOOA £SS PHONE LIC£N5[ NO. STATE CITY 3 . ·tnn ca._, p,. c . 5 •. , r-n,-."l t.': ..... ~~-C _..11~w-. ~'1911 'll.;~ 1."!., 'I f 1 All'ICHITtCT OR 0£51<.NtA MAIL AODRtSS l>HONt LICE.NS[ NO, 4 r:.c:w ... ~Im, .-; .... -.. .. & ~.... ---.,, n.d'.: ~:!,; ~ ~--~ ENG INC.CA MAIL A00RtSS PHONC LICl.NSt NO. 5 "F-"4 ... --, .,...;--..... ., (I.,..-.~~ ' -, ""' - fffc_,(>_~ ~ . - COMPENSATION INS, CARRIER .. ... --MAIL AOOllllSS ... ·--.....• -,. ,,._ P' BRANCH 6 USE o, BtJIL.OING 7 ~-~. ::!' (1 ,·.n· 8 Class of work: □NEW EJ ADDITION 0 ALTERATION 0 REPAIR 0 MOVE 0 REMOVE 9 Describe work: ~ --~ . '\ow·~1:,~ lO Change of use from Change of use to 11 Valuation of work: $ ~ '1-t1tJ ct 0 /') I Q,J ,,,,...., PLAN CHECK FEES . PERMIT FEE $ 1 • I • -SPECIAL COND ITIO NS: Type of Occupancy MICRO FILM FEE Const. Group , No. of Size of Bldg. t:;-;~ Max (Total) Sq. Ft .,, J Stories 0cc. Load ~ Fire use Fire Sprinklers APPLICATION ACCEPTED BY PLANS CHECKED BY APPROVED ~OR ISSUANCE BY Zone Zone Required OYes □No D~-No. of OFFSTREET PARKING SPACES: Dwelling Units No. JNo. DA.TE Covered SQ. Ft. Open NOT ICE Special Approvals Required Received Not Required SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB-PLANNING DEPT. ING, HEATING, VENTILATING OR A IR CONDITIONING. HEALTH DEPT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC· TION AUTHORIZED IS NOT COMMENCED WITHIN 120DAYS. OR IF FIRE DEPT. CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A SOIL REPORT PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM- MENCED. OTHER (Specify) I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS ENGINEERING DEPT. APPLICATION AND KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS WATER DEPT. TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER 51 ATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. =" .,-,:, ... .,.,, SIGNA,.URt o, CON TRAC TO,-OR AUTHOIIIZlD AGCNT (DA Tl I .d I, .... ·< SICt-i!ATURC OF OWNCA (IF OWN£JII 9UILCt,t) (DAT£) WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH INSPECTOR .,. 0 () BUILDING PERMIT APPLICATION City of CARLSBAD, CALIFORNIA 92008 Applicant to complete numbered spaces only. Phone 7 29-1181 Perrn,t No. JOB ACOR £$5 ASSESSOR'S ,_.-,._ 2~-tt\v--em.,: • en .. -PARCEL NUMBER ..: 11..vJl U'lM LOT NO, I OCK I rAACT BOOK PAGE I PAR. cmc I 'f~ ~~·· ",_r,~ <Ostc ATTACHrD sMCl!."TI 1 DC5CA, OWNER MAIL Aoo,u:ss ?IP PMONE 2 1 ., ' . ' .]ft £ro.: .. r,,.,...__.,' , . ca,.. -____ ?Q)l; -. :'\, ;_' .. ;11 • ~ . .... ' y~ CON TRAC TOR MAIL AOORESS PHCNC. LICENSE NO. STATE CITY 3 -. . ~ .. l.l'\:'1 Co·;,." P ... O .. · . ..-Ctt'ffl.~. Cf' • 92Q-"Nll ~i:,~a CA. G ..).-.... ~ .... -• C -· ARCHITECT OR Ol.SICN~R MAIL AOOAESS PHONE LIC£NS£ NO. 4 ~,b,tr;L~m-n a:. !.:=:., ,~..:-+(_"';.._ .J~..;, trit"~c 9~ ..... '1 ,----. ,. tNGINEtA MAIL AOOR£5S PHONE LICE.NS[ NO. 5 Cttt -' ~:, Jar. s ~ l .. ire:. •. ,-~ --.. •m ea., v1,a::;...~ . -w COMPENSATION INS CARRIER MAIL .-.ooR£5S SPlANCH 6 USE OF BUILDING 7 -· ~-~ s - 8 Class of work: □NEW 0 ADDITION 0 ALTERATION 0 REPAIR 0 MOVE 0 REMOVE 9 Describe work: -fll'OL~~l<.UC~ 10 Change of use from Change of use to 11 Valuation of work:$ ~400"6 l"J l V 0 PLAN CHECK FEE$ ... PERMIT FEE $ -SPECIAL CONDITIONS: MICRO FILM FEE Type of Occupancy Const. Group Size of Bldg / ,o No. of Max. (Total) Sq. 'f1 ~, Stories 0cc. Load Fire use Fire Sprinklers APPLICATION ACCEPTED BY PLANS CHECKED BY I APPRQV~lf FOR ISSUANCE BV Zone . Zone Required OYes □No ,b No. of OFFSTREET PARKING SPACES: Dwellln11 Units No. !No. OATE Covered Sq, Ft. Open NOTICE SpP.cial Approvals Required Received Not Required SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB• PLANNING DEPT. ING, HEATING, VENTILATING OR AIR CONDITIONING. HEALTH DEPT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC- TION AUTHORIZED IS NOT COMMENCED WITHIN 120DAYS, OR IF FIRE DEPT. CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A SOIL REPOHT PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM- MENCED. OTHER (Specify) I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS ENGINEERING DEPT. APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS ANO ORDINANCES GOVERNING THIS WATER DEPT. TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. ~.,. ..-,:Jr_~ t {.!<-~11? ,,f_ ~-''Jr' _... ,,- 1 :!;5ri:.1,u,T.£Jfit 0,. CONTRACTOIII: Oft AUTHORIZ.[0 AGl:NT IDATI:) i~ :-"' SIGNATUJll:t: o, OWN[R ,,. OWNtft IUILDCN lDAT[I WHEN PROPERLY VALIDATED UN THIS SPACE) THIS IS YOUR PERMIT PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH INSPECTOR