HomeMy WebLinkAbout2399 CIPRIANO LN; ; 62-4175; PermitOwner Name
(Please Print)
Contractor
To Construct
Type of
APPLICATION FOR
CITY OF CARLSBAD â BUILDING INSPECTION DIVISION
PHONE PArkway 9 1181 Ext 36.s,
(Middle)
fc
(Please Print) Number Street
$5 To Add D To Alter D To Repair Q To Convert D To Move From
"9 PConst âĒT/I*A*'+'***A~ Kind of Foundation C-<
N° 4175
Mailing Address
Mailing Address
Phone
Phone
(Frame Masonry Etc )
Floor Space of Proposed Construction (sq feet)
Floor Space of Garage (sq feet) G?"
LEGAL DESCRIPTION /
Lot
or
*5 ^ G*£2 ft'
Located at o£«P / f */
Assigned House Number
No of Stories / To Be Used for
(One Family Dwelling Store Etc )
Const Valuation $ \ «*
attached Cl^ / / ^
detached 0Const Valuation $
Block
Section
Street Near
Subdivision
Township Range
LAND AREA NUMBER OF EXISTING DWELLINGS ON PROPOSED BUILDING SITE £ ^l^ZTT^-*â=â (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 SIGNATURE OF
immediately revoked PERMITTEE
Front Yard Set Back
Side Yard Set Back
Rear Yard Set Back
D tan e Betwe n Bldg
Off Street Parking Spaces
Sewage Disposal System
Zone Residential ( )
Zone Commercial ( )
Variance
Eng Check By
Driveway Permit Required Yes ( V) 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
Fee /
9 A
Plans Approved
Approved by
Date 3 -/ ^
Plan Check Fee
Building Permit Fee
Total Charges
O
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