HomeMy WebLinkAbout2398 CIPRIANO LN; ; 63-5265; PermitAPPLICATION FOR AlLDIM PERMIT
5265
CITY OF CARLSBAD — BUILDING INSPECTION DIVISION
J»HO>4E PArkway 9 1181 Ext 36
£fOwner Name / /
(Please Print)
Contractor
To Construct ftf To Add D
V«
(Last) V (First)(Middle)
(Ple/se Print)
To Alter Q
md of Foundation
Mailing Address
' Cj--"t <"Number
Type of Const
(Frame Masonry Etc
Tloor Space of Proposed Construction (sq feet)
Floor Space of Garage (sq feet)
LEGAL DESCRIPTION
Lot
or i
Located <
To Repair D To Convert
^—**—*U-^~N« of Stories '
Number
To Move From
City
City
Phone
Phone
Address
To Be Used for
(One Family Dwellinq Store Etc )
0 Const Valuation $
attached Q
detached DConst Valuation $
Block
Section
Street Near
Subdivision
Township Range
Assigned House Number
LAND AREA 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 OFf ^
PERMITTEE V^\ 1 -
Front Yard Set Back
Side Yard Set Back
Rear Yard Set Back
Di tance 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 Mam Line Cost
Sewer Lateral Connection Charge
Water Stocked Lands Charge
Water Main Pipe Line Fee
Water House Service Charge
Water Meter Charge
Sub Total
Plans Approved by Plan Check Fee
Building Permit Fee
Total Charges
.,