HomeMy WebLinkAbout2398 CIPRIANO LN; ; 62-4194; PermitAPPLICATION FOR PERMIT
Owner Name
(Please Print)
Contractor
To Construct
CITY OF CARLSBAD — BUILDING INSPECTION DIVISION
PHONE PArkway 9 1181 Ext 36
/>2? C/ /ft ' O (
irst) (Middle)
N° 4194
(Las
(Please Print)
'To Add D To Alter D
of Foundation
Mailing Address
Mailing Address
Number
To Repair Q To Convert D To Move From
C<3>-V\— No Of Stories /
City
City
.ddress/
Phone
Phone
Type of Const
(Frame Masonry Etc
Floor Space of Proposed Construction (sq feet) / ^~7 / Const Valuation $
/ I ^ - I attached H^^^
Floor Space of Garage (sq feet) t *> T" detached OConstValuation $
LEGAL DESCRIPTION
or
Located at
LAND AREA
To Be Used for
(One Family Dwelling Store Etc '
Lot Block
Assigned House Number
Section
Street Near
Subdivision
Township Range
NUMBER OF EXISTING DWELLINGS ON PROPOSED BUILDING SITE [INDICATE
SIZE USE AND LOCATION ON^RL-OT 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 ba SIGNATURE OF
immediately revoked PERMITTEE fll.^.
Qj
Front Yard Set Back
Side Yard Set Back
Rear Yard Set Back
Distance Between Bldg
Off Street Parking Spaces
Sewage Disposal System
Zone Residential ( j]
Zone Commercial ( )
Variance
Eng Check By
Driveway Permit Required Yes (Y\ 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
I**
V /
Plans Approved
Approved by
Date
Plan Check Fee
Building Permit Fee
Total Charges