HomeMy WebLinkAbout2381 CIPRIANO LN; ; 62-4176; PermitAPPLICATION FOR i!iltni\ti PERMIT
CITY OF CARLSBAD — BUILDING INSPECTION DIVISION
PHONE PArkway 9 1181 Ext 36
N° 4176
(
Owner Name
(Please Print)
Contractor
(Please Print)
To Construct 0^ To Add D To Alter D
-&
(Middle)
Mailmg Address
Mailing Address
Type of Const -3$/l^l-'i-vt^c——Kind of Foundation
(Frame Masonry Etc )
Floor Space of Proposed Construction (sq feet)
Floor Space of Garage (sq feet)
LEGAL DESCRIPTION
Lot
or
Located at
LAND AREA
Number
To Repair D To Convert D To Move From
i
No of Stories
Const Valuation $
To Be Used for
(One Family Dwelling Store Etc )
GO
//G>-cS attached
"TQO detached FJConst Valuation $
Block
Assigned rlouse Number
Section
Street Near
Subdivision
Township Range
ADDITION?YES
NUMBER OF EXISTING DWELLINGS ON PROPOSED BUILDING SITE
LOT F
NO
(INDICATE
SIZE USE AND LOCATION/ON PLOT PLAN) WILL THIS CONSTRUCTION INCLUDE ANY PLUMBING INSTALLATION ALTERATION OR
r
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 01
Front Yard Set Back ~^- 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
A"?/A'Driveway Permit Required Yes \V} No ( ) Fee
Grading Permit Required Yes ( ) No ( )
Sewer Disposal Plant Capital Cont Fee
Sewer Pumping Station Capital Cont Fee
Sewer Mam Line Cost
Sewer Lateral Connection Charge
Water Stocked Lands Charge
Water Mam Pipe Line Fee
Water House Service Charge
Water Meter Charge
Sub Total
4.
/A/
yo £9-
Plans Approved b^
Approved by
Date
HAA/v—
Plan Check Fee
Building Permit Fee
Total Charges