HomeMy WebLinkAbout2410 Jacaranda Ave; ; 82-182; Permit"' z 0 " .. .. :'i u .. 0
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O 1 hereby affirm that I am licensed under
provisions of Chapter 9 (commencing with
Section 7000) of Division 3 of the Business
and Professions Code, and my license is in
full force and effect.
l•C No _ Closs
I hereby atf1rm that I am exempt from the Con-
~!o;·~~~~i;;: ~;' ~t~~.~~l~~r~~,(~r
county wh,ch requires a pem11t to construc1 ,11Uer. ,mprol'I!, demolish, or repair any structure,
prior to 11s issuance also requires the applicant for
such perm,1 to tile a s,gned statement that he ,s
licensed pursuant to 1he prov1smns of the Con
tractor's License law (Chapter 9 commencing with
5eclloo 7'CO) of Dw,s,on 3 ol the Business and Pro-
fessions Code) or that ,s exempt therefrom and the
bas•~ for the alleged e~emptmn Any vmla!1on of
Section 7031 5 by an applicant tor a permit sub1ec1s me apphcant 10 a c1v1I penalty o! not more 1han !Ive
hundred dollar., (S,500)
□ 1, as owner of the property, or my employees
,.,th wages as their sole compensat,on, w111 do the worlt. and the structure Is not intended or offered tor
sale (Sec 7()4.(, Business and Pro!ess,olls Code
The Contrac!or's License Law does not apply to an owner o! property who builds or improves thereon
and who does such work himself or through his own employees. provided that such 1mproveme,1ts ate
n.ol 1ntende1 or ottered !or sale If. however. the
bu1ldmg or ,mprovement ,s sold within one year of
completion, the owner-builder will have 1he burden
of provmg thal he d,d not build or ,mprove for the
purpose of sale)
D I, as owner of the property. am exclus1~ely
con1ractmg w,th hcensed contractors to construct
the proiect (Sec 7CMA. Business and Protess1ons
Code: The Contractor's License Law does not apply
to an owner of property who builds or improves
thereon, and who contracts Im each proiects w1tri a
contractor(s) hcens.e pursuant to !he Contractor's
License Law)
0 lamexemptunderSec
for this reason
. B & PC
D I hereby afllrm that t ha•e a cert1f1cate o! consent
to sell-insure, or a cert1f1cate of Workers
Compensation Insurance. or a cert,f1ed copy thereof
;Sec 3800. Labor Code)
POLICY NO
COMPANY
O Copy ,s hied with the c,ty
□ Cert1t,ed copy ,s hereby furmshed
CERTIFICATl OF EXEMPT!ON FROM
WORKERS' COMPENSATION INSURANCE
(This section need not be completed ,f the permit
,s !or one hundred dolia~ 1$100) or less)
0 I cer11fy that m the performance of the won< !or which this perm,t 1s issued. I shall not employ any
person m any manner so as to become sub1ect to
the Worl<ers· Compensation Laws o! C.iilfom1a
NOTICE TO APPLICANT 11, after m.ikIn-;i this Cert,
t,cate"ot Exemption. you should become sub1ec1 10
the Wor1<.ers· Compensation prov1s1ons ol !he Labor
Code. you must forthwith comply with such
p,ov,s1ons or lh1s perm,t shall be deemed revoked
0 I hereby a!t,rm 1hat there ,s a conslrucl10"
:ending agency tor tt,e pertorrnance of the worl< to,
,..h,ch 1hrs perm,! ,s ,ssued (Sec 3097 C>vil Code1
Lenders Name ___________ _
Lender's Address __________ _
USE BALL POINT PEN ONLY & PRESS HARD APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS
CARLSBAD BUILDING DEPARTMENT APPLICATION & PERMIT
1200 Elm, Carlsbad, California 92008 (714) 438-5525
JOB AOORESS
:J!flD
•.. . . \. . Jr. Ta:c:..o..:fu \l.\t'.X:& .
BUSINESS UCENSE # VALUATION PERMIT NUMBER AV. ST_.IOATE OF APPLICATION
RO. 1 Vii\.~ y '{'a'!
PRIME CONTRACTOR, J CONTRACTORS PHONEtt-ZONE ~)--/ g./
.... """"
!!:.NE.R"S NAME ;' • , . .'. -. -, .--• · • :. :. • / ,_. ~ OWNER'S f'HONE
~l."l.t"'I ~\-(.:6.:. :'t;':$...'1\Mll?:~~-:'·~ 9'1.~-94"1 ... ~
OWNER'S Mt•.t..lNG ADOR'ess. ~r:~· . . · •. II . ••_· ·;". . .. . LICENSE NO. n•N 1.0. • BLDG use coo,
1l.tt 10 :r-a,~r-g,"I.IU.":~:-~,-,b ,i~ ..
' ~TATE LICEN~E # STANDARD PLAN# BUILDING SO. FOOT AGE
LO.T BLOCK §UBD1Vl$oN • . •· .i ASS~ l'AJl(la NO.
lh ,:.;. I..;. ~I'll t,,,,Jt;,; ' \ ;.J"5$ 0 ;() '-/ ~00 DESIGNER
,,,.,,.
DESIGNER'S ADDRESS OESJGNER'S PHONE
.~f--. F/P FLA ELEV. NO OCC GP EDU
A. /· I ...,_ -,.,. STORIES re;... t, r ltl'U YO NO ---
RES UNITS GRADING PERMIT ISSUED REDEVELOPMENT . AREA
v □NO YON □
TYPE
CONST
ace LOAD I FIRE SPA
YO NO
i.~ l:~i ;-:: r .
l..;-i 1,;;_.<~ = //
Nor Valid Unkss fbchine Certified
QTY. PLUMBING PERMIT -ISSUE QTY. MECHANICAL PERMIT -ISSUE SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP
EACH BUILDING SEWER >---+--. ---·--
EACH WATER HEATER ANO/OR VENT --··----------
r-~·fH GAS SYSTEM_2 !0 4 OUTLETS
~ACH GAS SYSTEM 5 OR MORE
.._ _ _,__EA_C_H_INSTA~ .. ALTER, REPAIR WATER PIPE
~--EACH VACUUM BREAKER
L__~R SOFTNER -==-ti E-~CH R~~~ ~R~-IN (INSIDE~-
TOT AL PLUMBING l
QTY. ELECTRICAL PERMIT· ISSUE
NEW CONST EA AMP/SWT:·BKR
---+--
--+---
·--+--
--t--·
INSTALL FURN DUCTS iJP TO 100,000 BTU
OVER 100,000 BTU I----· -
BOILER/COMPRESSOR UP TO 3 HP
I I BUILDING_P~!!M!L_
SIGN PERMIT +------+--
-~----''---I-PLAN CHECK
I 801LER/COMPRESSOR:C15HP. I I TOTAL PLUMBING
METAL FIREPLACE ____ ELECTRICAL
. .. ---. ---· --
VENT FAN SINGLE DUCT ____ _j ____ :__-,1---'MECHANICAL
--------+----~-MOBILEHOME
t--
MECH EXHAUST -HOUU-'UUC IS
RELOCATION OF EA FURNACE/HEATER -1 ~iEH0MEPARK INSP
SOLAR
t--
. ·---.,._ __ TQT,4,L MECHANICAL STRONG MOTION
+ r= I ~FIRE SPRINKLERS
OTY. SOLAR -ISSUE I .PuBuc FACILITIES FEE
----"'-.. -----------+-------l·-BRIDGE FEE =----scHOOlFEE-~-□IS-TRiCT
----II-COLL EC I UK::i
----·
01-000-4220 i
01-000-422~'-~-+---
~I --_____,
_01-000-4806
01-000~~ -------1
01-000-4223
01-000-42~~ --
01-000-4225--+--
01-000-4226 f----
65-640-0519
-------,
--01-000-4~
-· 25-000-49~_ ---
--·-
1 PH 3 PH ----+-·--jj---1-?0RA~~TANKS ----------+-~~!1.s~ad
ROCK STORAGE • D Enc1mtas
-t--
65-6_?_~-05~9-----!--
65-624-0519 EXIST BLDG EA AMP/SWT/BKR
1 PH 3 PH
-+-.. PUMP
PLAN CHECK FEE
·---
---------+-----'----11. San Dieguito 65-625-0519 ~
r San Marcos 65-626-~ REMOOEL.1ALTER -+---PER CIRCUIT . -·1----------+-+-. --------
I-TEMPPOLE 200AMPS
f---+-□c_VccEc_R_200 AMPS
TEMP OCCUPANCY 130 DAYS)
·---·--ff---+--
·-. ----+.-----· . -+---+ ---
------ir--.. +-----
-----
--
--··+---··--
·-··---+---
J__ _____ _ -i -------!I----j
TOTAL SOLAR TOTAL ELECTRICAL TOTAL FEES PAYABLE T v-.r ---
<, _,··· --~··,· ,·"' ,,,
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I HAVE CAREFULLY EXAMfNED ~~C),,~iND PERMIT'' AND DO HEREBY E•piration. ~~~bytheBuiktingOfficialunderthePf~~ionsof'thil '!/t" MfQlillHlt., Pbllllf-◄-a¼:Ja,l~--0¥£1':"
CERTIFY UNDEfl PENAL TY OF""~URY THAT ;\LL t~ON HEREON INCLUDING THE Code ~all exJ)lre by liffl!~Ol'I and become n~ll ~nd void. If the bi.nldmg or work ·~· Cr"' ,ANO. f\Jl~ OF DECLARATIONS ARE TRUE AND coi:mr::-t":T AND I r.ff>fl.tetGERtlFY AND AGREE IF A PERMIT IS aultlc~nzed ~y such ~rmit IS not commenced w1th1n 180 days fr~ the date of such , · , O¥Efi <lif --~~UT , .
1
...... "'-¥• ru9..-1 permit, or 1f the building or woril authotiZed by such permit ta auspended or ---~' , --~•
ISSUED. TO COMPLY WITH ALL C TY, COUN-TY ANJ) STATE t.AWS GOVEFINING BUILDING CON· t~•~ba!!!!ndo~Md!!!!1•~•!•~•(.!!lim!!!!•1afte,!!!,~tt>!!!!•~W0!2!!1k!J!i>~c~om'!!!!m~•~•~c!ed!..!!fo~•~•~~ri~od!!,SU1~!!1>~•~-____ ..,..,,,~~,.,.,..----------~~~f'-----.ii
STRUCTION, WHETHER $PEC!Afl)fll:REIN OR NOT. JAL.SO AGREE TO SAVE INDEMNIFY AND c , ""'l'IIE,.::;___ PP~V n KEEP HARMLESS THE CITY OF C,VlLS~O .!iGAfN$. T"AU..UABIUTIE&. JUDGMENTS, COSTS AND ~I A~S SI~:-1f. CONTRACTOR O A ED BY
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAJ0 ciJY IN CONSEQUENCE OF THE BY PH 0 GRANTING OF THIS PERMIT., .~ . " ' , " , • ~ ........_ Q.__ ONE lo/7/r~~
} ..... ,
INSPECTION TYPE DATE INSPECTOR
BUILDING ----FOUNDATION
REINFORCED STEEL
MASONRY
GUNITE·OR GROUT
FLOOR & CEILING SUB FRAME
SHEATHING
FRAME
EXTERIOR LATH lNSULATION
INTERIOR LATH & DRYWALL
PLUMBING
-
SEWER AND BL/CO
PLUMBING UNDERGROUND
PLUMBING TOP OUT
TUB AND $HOWER PAN
GAS TEST '
ELECTRICAL
TEMPORARY POWER
ELECTRIC UNDERGROUND
ROUGH ELECTRIC •
ELECTRIC SERVICE •
BONDING '1
G. F. I. -SMOKE DETECTOR
MECHANICAL
DUCT & PLEM., REF. PIPING
HEAT -AIR COND. -SOLAR SYSTEMS
VENTILATING SYSTEMS
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HAVE BEEN APPROVED.
JOB SITE FINAL ,,{./
PLUMBING . ) ",V .,r /
ELECTRICAL 8,1"" "i,r;-
MECHANICAL n,,,.w, / " ,V ' ,.
GAS (/ I / V /
BUILDING ,,,
SPECIAL CONDITIONS
CERT OF OCCUPANCY ISSUED
--. -
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR"S NOTES --
INSPECTION REQ IF INSPECTORS DATE CHECKED APPROVAL
SOILS COMPLIANCE
PRIOR TO -
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRESTRESSED
CONCRETE -POST TENSIONED
CONCRETE --
FIELD WELDING
---------------HIGH STRENGTH
SOL TS ~----· ---------I SPECIAL MASONRY
I
-~
i PILES CAISSONS
----~-
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-
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-----
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-----·---
------
-----
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O I hereby affirm that I am licensed under
provisions of Chapter 9 (commencing with
Section 7000) of Dlvlslon 3 of the Business
and Professions Code, and my license is in
full force and effect.
Lie No Cla,s
I hereby att,rm that I am exempt from the Con
~,'0;·a~~~i;:: ~; ~~1~1:s,1i~1~~e'8t~~~.\~ir
counly which requires a permit 10 construc1
alter. improve, demolish. or repair any structure pnor to ,ts ,ssuance also requires !he applocant for
such permit to hie a s,gned stalement that he ,s
l,cen58d pursuant to the prov,s,ons of the Con
tractor's License Law (Chapter 9 commencing wrth
Sect,on 70ClO o! O,v,s1on 3 of the Business and Pro tess1ons Code) o, !hat ,s exempt !here!rom arid the
bas•S !or the alleged exemption Any v,olat,on of
s«t1on 7031 5 by an appl,can1 to, a perm11 sub1ects tne applicant to a c1v11 penalty of not more 1han 1,ve
hundred dollar.; (S500)
O I, as owner ot the property, or my employees
11,nth wages as their sole compensa1•on, w,11 do the wort<, and the structure 1s not ,ntended or offered to,
sale (Sec 7044, Business and Protess1ohs Code
The Contractors L•cense Law does no1 apply to an owner ot property who builds o, improves !hereon
and who does such won< h1mse1! or triroug~ h,s own
employees, provided tha1 such 1mproveme;its are
not m1ende'.l or oflered for sale II. however. the
building or improvement ,s sold w,th1n one year ol
complet,on. the owner-builder w111 have the burden
of prov,ng that he did not build or ,mprove for the
purpose of sale)
D I. as owner 01 1he property. am exclus,vely
contract1nc;1 wrth licensed contractors to cons1ruct
~r~:;~~ac;~-l~cu:~~=s~!nJ:;~t~f!~p~!
to an owner o! property who builds or ,mproves !hereon. and who con1racts tor each proiects w,th a
contractorls) hcense pursuant to the Con1f1octo,·s
License Law)
0 I am exempt under sec
tor 1h•s reason
. B & PC
D I hereby a!lorm that I have a cert1!,cate of consent
10 self.insure. or a cert1!1cate of Workers
Compensation Insurance. or a cen1!1ed copy thereof
(Sec JBOO. Labor Codel
POLICY NO
COMPANY
0 Copy ,s filed w,th the city
0 Cert11,ed copy ,s hereby !urn,shed
CERTIFICATE:. OF EXEMPTION FROM
WORKERS' COMPENSATION INSURANCE (Th,s sect<On need no! tie completed ,! the perm,1
15 101 one hundred dollars iSHX)) or less)
D I cen1ty that ,n 1he per1ormance o! the wort< for
wh,ch this perm,t 1s issued. I shall no1 employ any
person many manner so as to t.iecome sub1ect to
the Won<ers Compensation Laws ol Cal1!om1a
NOTICE TO APPLICANT If. after maktn~ lh1s Cert,
hcate o! Exemp11on, you should become sub1ec1 l'J the Wort<ers· Compensation prov1s,ons ot the Labor
Code. you must !or1hw,th comply w,th such
prov1s1ons or 1h,s perm,! shall be deemed revoked
D I hereby aH1rm that the,e ,s a constrJct,o~
1end1ng agency !or the per1ormaw,e of 'he wofl< lo, wh,ch tn,s D£!rm,! ,s ,ssued 15ec 3037 C,v,: Code1
Ler,der s Na...-,e ___________ _
Ll'nder s Address __________ _
USE BALL POINT PEN ONLY & PRESS HARO APPLICANT TO FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS
CARLSBAD BUILDING DEPARTMENT
~200 Elm, Carlsbad, California 92008 (7~4) 438-5525 APPLICATION & PERMIT
J08 ADDRESS
1..~Q -\A.('_A~\t":A
OWNER'S NAME
~ \~\.)\,.At:=:
OWNER'S MAILING ADDRESS
.c:=._Aa. }~
,~ ~~7Z-~iDIVISIQN
DESCRIPTION-bf WORK
l OWN£ R'S PHONE
I )f;.'?f~::.cr52zo -A-z--~
AV.J_T I Dq: 1~8P,.CATION
PRIME CONTRACTOR
CONTRACTOR'S ADDRESS
DESIGNER
1----------------------------------------l! DESIGNER'S ADDRESS
BUSINESS LICENSE #
CONTRACTORS PHONE #
LICENSE NO.
STATE LICENSE#
DESIGNER'S PHONE
~w'-~_\__Q__(:O~ --------I F/P FLA ELEV j [ NO I ace GP \ EDU f
crnsus rnAo I ce CANO USE I eARK,NG S>ACE I ReS uN,;s I GRADING f:ERMIT ISSUED
y □ N 0
YO NO
I REDEVELOPMENT
AREA
vQ NO
STORIES
TYPE
CONST \I -1\.
12=--3
OCC LOAD
""-i 0
Fl RE SPA
YO Nii
,:g41
ZONE
PERMIT NUMBER
Bl-310
PLAN 1.0. # BLDG USE CODE
fA-110 c~
STANDARD PLAN# BUILDING SO. F90TAGE
~r/{
Not Valid Unless Machine Certified
QTY. PLUMBING PERMIT -ISSUE 7.50 QTY. MECHANICAL PERMIT -ISSUE 3.00 SUMMARY/ACCOUNT NUMBER
EACH FIXTURE TRAP
EACH BUILDING SEWER
EACH WATER HEATER ANO,-QR VENT ---+------------
EACH GAS SYSTEM 1 TO 4 OUTLETS
BUILDING PERMIT -□~BTU ~---~-4~~ -INSTALLF_URN DUCTSiJPTOlD, --1 SIGNPERMIT_. _ -l ___ -_-----_ --+--__ ----f-~ -0 VER 1 OO .DOD BTU -f------rPLAN CHECK ~ ~ ft±fil -_ _ --------j
--TOTAL PLUMBING ----
-----\--f-_ -t+ -_-_ -_ -_ -_ -~--' -_ -_ -_ Tl_MEELECTRICAL
--+-=--""' ~l~---;,\:-\1-~--•--~-/i-_._ MEGHAN!:_----~-==t -------=
---1 --
-------
t----
BOILER/COMPRESSOR UP TO 3 HP
---+ ~~-
EACH GAS SYSTEM 5 OR MO RE
EACH INST Al ALTER, REPAIR WATER PIPE
----------
EACH VACUUM BREAKER f---+----· -----
WATER SOFTNER
---+--+-----------
~T-CH ROOF _DR=l~~D~~--
TOT AL PlllMBING _L -----~ ~~~~-r--lr;:;;;; = = ----~-~~= PUBLIC FACILITIES FEE
QTY. ELECTRICAL PERMIT -ISSUE ------
BRIDGE FEE 2.00 QTY.
-------+---
NEW CONST EA AMP.'SWT BKR
I PH 3 PH
EXIST BLDG EA AMPiSWT/BKR
I PH 3 PH
REMOOEL'ALTER PER CIRCUIT f---+---------
TEMP POLE ZOO AMPS f-----
1---+-0VER 200 AMPS
TEMP OCCUPANCY {30 DAYSI +-
1--_J_
SCHOOL FEE -DISTRICT -T-t----t---1'------
Carlsbad
Enc1nitas --
San D1egu1to --+-----------
PLAN San Marcos
--
-+---
V
--------#-----
----· ---
----j------
-+---
t--------
-~
f----------
f-------
--
TOTAL ELECTRICAL 1
I
-t---
1
TOTAL FEES PAYABLE I i.+, 00
I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT" AND DO HEREBY Expiration. Every permrtissuedbythe&ilding Offic1alundertheprovisionsofthis
CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMAT\ON HEREON INCLUDING THE Code shall expire by Um.it~ilon ~d become n~II ~nd void. If the building or work
DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER GERTI FY AND AGREE tF A PERMIT IS aulh~nzed by such permit Is not commenced within 180 days from the date of such
* AN OSHA PERMIT IS REOUtREO ~ EXCAVATIONS OVER
5' O" DEEP AND DEMOLITION OR CONSTRUCTION OF
STRUCTURES OVl:A 3 STOAJES IN HEIGHT ISSUED· TO COMPLY WITH All CITY COUNTY ANO STATE LAWS GOVERNING BUILDING CON ~rm::o or tf the buil<1ing or work sulhonzed by such permit is suspended_ o,
STRucT10N, WHETH.,EA SPECIFIED HEREIN OR NOT. 1 ALSO AGREE TO SAVE INDEMNIFY AND <-,'c::"'::';::"":°"":'':-'••c•uUomo•c•""""'"-'"'!!!•awe0e'>'-"'''-"cosmme°"'"""~c••e•.!10S'C''-'~"•°""-'0e1-11•80"-'!!l'L--c--f"~~..,..,,-,,---------------------I
KEEP HARMLESS THt CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS, COSTS AND APPLICANT'S SIGNATURE Jf. OWNER O CONTRACTOR O A~PR VED BY ~ DATE
EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE q q_f:,_ GRANTING OF THIS PERMIT. BY PHONE □ ~ ". I --v ,
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INSPECTION TYPE DATE INSPECTOR
BUILDING
FOUNDATION
REINFORCED STEEL
MASONRY
GUNITE OR GROUT
FLOOR & CEILING SUB FRAME
SHEATHING
FRAME
EXTERIOR LATH lNSULATION
INTERIOR LATH & DRYWALL
PLUMBING
SEWER AND BL/CO
PLUMBING UNDERGROUND
PLUMBING TOP OUT
TUB AND SHOWER PAN
GAS TEST
ELECTRICAL
TEMPORARY POWER
ELECTRIC UNDERGROUND
ROUGH ELECTRIC
ELECTRIC SERVICE
BONDING i
G. F. I. -SMOKE DETECTOR
MECHANICAL
DUCT & PLEM., REF. PIPING
HEAT -AIR COND. -SOLAR SYSTEMS
VENTILATING SYSTEMS
CALL FOR FINAL INSPECTION WHEN ALL APPROPRIATE
ITEMS ABOVE HA VE BEEN APPROVED.
JOB SITE FINAL
PLUMBING
ELECTRICAL
MECHANICAL
GAS
BUILDING
SPECIAL CONDITIONS
CERT OF OCCUPANCY ISSUED
I
-...... , ... -
FIELD INSPECTION RECORD
REQUIRED SPECIAL INSPECTIONS INSPECTOR'S NOTES
INSPECTION AEQ IF INSPECTORS DATE CHECKED APPROVAL
SOILS COMPLIANCE
PRIOR TO
FOUNDATION INSP
STRUCTURAL CONCRETE
OVER 2000 PSI
PRES TRESSED
CONCRETE -~
POST TENSIONED
CONCRETE
FIELD WELDING
HIGH STRENGTH
BOLTS ~------------
SPECIAL MASONRY
--
PILES CAISSONS
-~
-
,
------
-
•
INTERDEPARTMENTAL INFORMATION SHEET
BUILDING DEPARTMENT ..
BUILDING ADDRESS: d).'f/o Oa-~a<
PLANNING DEPARTMENT
DATEi!ECEIVED
SEP O 11981
CITY OF CARLSBAD
BulldlRS gepaftment
ZONE __ [2__-_,..__ _____ LOT SIZE _________ LOT WIDTH ________ _
UNITS ALLOWED ___________ UNITS PROVIDED ____________ _
PARKING SPACES REQUIRED eL PROVIDED ____ /"J_-11L~-----
% COVERAGE ALLOWED -----"_t::::::_ _______ PROVIDED __ __:V=-~t::::. _____ _
BUILDING HEIGHT ALLOWED PROVIDED
FRONT SETBACK:
# A!,LOWED
PROVJDED __ ~oc.+1v..,.c;,/ __ _
INTRUSIONS i
SIDE SETBACK: REAR SETBACK:
LANDSCAPE & IRRIGATION PLAN COMMENTS: -N"-11-!A:------------------
ENVIRONMENTAL PROTECTION REQ: ~0~'t.~€~t'.vtL..:..>~e-)..,_ ____________ _
ADDITIONAL COMMENTS: ~fVL.:..tlL"''-----------------------
OK, To IssuE~DATE 'lj1:/s1 OK TO FINAL _______ DATE. ____ _
ENGINEERING DEPARTMENT
R.O.W. ______ INDUST WASTE _______ IMPROVEMENTS _______ _
SEWER CONNECTION ________ DRIVEWAY LOCATIONS ___________ _
GRADING PERMIT EASEMENTS. _________ DRAINAGE ____ _
LEGAL DESCRIPTION ii:z-/~ C..T' 7:3 ~ /
ADDITIONAL COMMENTS ____________________________ _
OK TO ISSUE:illUO✓ DATE ~ ~2. ~I PWI ____ OK TO FINAL ____ DATE ___ _
FIRE DEPARTMENT
SPRINKLING SYSTEM ___________ FIRE PROTECTION EQUIP. _______ _
FIRE ALARMS EXITS. _______________ _
FIRE HYDRANTS LOCATION. _________________ _
ADDITIONAL COMMENTS ____________________________ _
t
OK _J;O ISSUE: _____ DATE _______ OK TO FINAL ______ DATE ___ ~~
WATER DEPARTMENT tJ
REQUIREMENTS OF APPROPRIATE DISTRICTS MET ________ DATE ________ _