HomeMy WebLinkAbout2381 CIPRIANO LN; ; 63-5276; PermitAPPLICATION FOR IDftlHG PERMIT
5276
CITY OF CARLSBAD — BUILDING INSPECTION DIVISION
PHONE PArlcway 9 1181 Ext 36
(Last)(Ewfl)
Owner Name
(Please Print)
Contractor
To Construct
Type of Const Kind of Foundation
(Frame Masonry Etc )
Tease Print)
To Add D To Alter
(Middle)
To Repair
Mailing Address
Mailing Address _
Number
To Convert O To Move From
No of Stories
Sfrset
_— --
Street
i
City
City
Address
Phone
Phone
To Be Used for ^^~ " " — -— ,
(One Family Dwellinq Store Etc )
Floor Space of Proposed Construction
Floor Space of Garage {sq feet)
LEGAL DESCRIPTION
Lot
or
Located at ••<
LAND AREA
feet)«=** Const Valuation $
attached D
detached QConst Valuation $
Block
Section
Street Near
Subdivision
Township Range
Assigned Horfse Number
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 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
immediately revoked
SIGNATURE OF
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 ( )
Zone Commercial ( )
Variance
Eng Check By
Driveway Permit Required Yes ( ) No (
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
Water Stocked Lands Charge
Water Main Pipe Line Fee
Water House Service Charge
Water Meter Charge
Sub Total
Plan Check Fee
Building Permit Fee «^X
Total Charges