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Home My WebLink About2413 Jacaranda Ave; ; 75-3122; Permit0 ' BUILDING PERMIT APPLICATION ' City of CARLSBAD, CALIFORNIA 92008 App/icanttocompletenumberedspacesonly. Phone 729-1181 P.erm1I No. JOB ADDA £55 L ASSESSOR"S PARCEL NUMBER B PAGE PAR. PMONt " - LICENSE. NO. ST ATE CITY CONTRACTOR 3 A,-CHITCCT OR 0£51GN£A 4 ( ENGIN£t.111 5 C COMPENSATION INS. CARRI ER 6 USE 0,. I UILOING 7 - 8 Class of work : Q._NEW 0 ADDITION 0 ALTERATION 9 Describe work: 10 Change of use from Change of use to 11 Valuation of work : $ 2/~ Q SPECIAL CONDITIONS: APPLICATION ACCEPTEO BY PLANS CHECKED BY APPR0VEl) FOR ISSUANCE BY DATE 0 REPAIR Type of Const. Size of Bldg. (Total) Sq. Ft. Fire Zone No. of Dwelling Units 0 MOVE 0 REMOVE 00 , i;t 0 PERMIT FEE s MICRO FI\..M FEE N o. of I Max. ~,{' Stories 0cc. Load - use ~ Fore Sprinklers Zone Required OYes O No OFFSTREET PARKING SPACES: No. No. Covered Sq. Ft. Open NOTICE Special Approvals Required Received Not Required SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB· ING, HEATING. VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC· TION AUTHORIZED IS NOT COMMENCED WITHIN120DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM· MENCED I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. la // ./ (DATt) IC.NAT fl[ 0,. OWNER ,,-OWN[" I UILOCIII. OAT£) PLANNING DEPT. HEALTH DEPT. FIRE DEPT. SOIL REPORT OTHER (Specify) ENGINEERING DEPT WATER DEPT. WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. INSPECTOR M.O CASH INSPECTION RECORD 1S-3lc,o- DATE REMARKS INSPECTOR FOUNDATIONS: SET BACK TRENCH REINFORCING FOUNDATION WALL & WEATHER PROOFING CONCRETE SLAB FRAMING INT. LATHING OR DRYWALL EXT. LATHING MASONRY FINAL ~o?o--?t USE SPACE BELOW FOR NOTES, FOLLOW-UP, ETC. 18-75 Fdn. Forms: O.K. B. Nelson ~19-75 Pour: O.K. B. Nelson 1-9-76 Setting_fireplace: O.K. B. Nelson l=J.-9-=--1-0--s.h.ea..th-i.ng · 0 ..IL B. .Ne J SOD -------------------- 2-6-76 Drywall and exterior lath: O.K. B. Nelson 2-4-76 Insulation: O.K. B. Nelson • . (;2 HA~tAL PERMIT APPLICATION -0 ( ~ ' z City of CARLSBAD, CALIFORNIA "' ' , ,..f-o "' C 7tt C ' • to complete numbered spaces only. r ' ' ADO" ESS 2413 Jacaranda Avenue LOT NO, LEGAL I 1 oucR. 21 I 8 LK ITRbncbo Ponderosa tOSEE ATTACHED SHEET) OWN£flt MAIL ADD .. ESS ZIP PHONE 2 Ponderosa Homes, 140 Marine Yfew Avenue, Suite 104, Solana Beach 275-1852 CON TfltACTOllt MAIL ADDRESS PHONE LICENS E NO. 3 Untv. Mech. I Eng. Contr •• 4464 Alvarado tanyon Rd.• San Diego 283-3181 88552 ARCHITECT OA DESIGNER MAIL ADDRESS PHONE L ICENSE NO, 4 ENGINEEflt MAIL AODRES.S PHONE LICENS E NO, 5 LENDER MAIL A00fllE$S BfltANCH 6 USE 01" BUILDING 7 8 Class of work: CJ.NEW 0 ADDITION 0 ALTERATION 0 REPAIR 9 Describe work: Install forced a1r heatfng and afr cond1t1on1ng Type of Fuel: Oil D Nat. Gas ltl LPG. D PERMIT FEES SPECIAL CONDITIONS: No. Type of Equipment Fee 1 Air Cond. Units-H.P. Ea. 2lt ton s4 00 Refrigeration Units-H .P. Ea. Boilers-H.P. Ea. Gas Fired A .C. Units-Tonnage Ea. l Forced Air Systems-B.T.U. 80 M Ea. 4 00 APPLICATION ACCEPTED BY: PLANS CHECKED BY APPROVED FOR ISSUANCE BY Gravity Systems-B.T.U. M Ea. -'~ Floor Furnaces-B.T.U. M .,, Wall Heaters-B.T.U. M NOTICE Unit Heaters-B.T.U. M THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC· Evaporative Coolers TION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF Clothes Dryers CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-Ventilation Fan MENCED. Range Hood I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ANO KNOW THE SAME TO BE TRUE ANO CORRECT. Air Handling Unit-C.F.M. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED Incinerator HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. I ;; I ~ I / ~ I L. ) l SIGNATU,.£ or CONTRACTOR OR AUTHORIZED AGENT (DATE) PERMIT $ ~ uu "-IGNAT Rt or OWNEIII Ir OWNER I UILDtlt DATE) TOTAL FEE $ " uu WHEN PROPERLY VALIDATED (IN THIS SPACEI THIS IS YOUR PERMIT PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH AUDIT s:'ru'fT'I 1 nn 4 a.,;a IIICOIIID Ill F°IIIOtr..t: INT~RNATIONA CON FERENC OF BlllLnlNC OFFICIALS !iO ~O. LO~ •oALF'~ P A e. n F'N& r.e.1 1trnANI Q1 1n 1 i1 ••... 4 ' PLUMBING PERMIT APPLICATION Permit No. __ _ City of CARLSBAD, CALIFORNIA A 1· I b d pp ,cant to comp ete num ere s space on y. ; c-/ JOB A.DOR [SS ., -0 '- :I: 0 z (II •. ! 1 ~ .J~r ----'-•-m )> LOT NO, BLK I TII .. CT :0 0 L[G .. L I \OSEE .. TT .. tHED SHUT) 0 1 0£Stll, :0 1' m MAIL A0Dft£5S ZIP PHONE "' OWN£" . "' 2 ~~"' -,An•-~ . "··"• ,...... .. ... .,._,....._ ••ftA . ",,,. -~ .... ~-, ----,,.,, -, . 1 ' . CONT,-ACTO" MAIL ADDRESS .. --. PHONE . LICENSE NO, -- 3 •<1v,,i:t:on -~l!ll n-ttwTn. Tn~-'/ -, 7 l ;,,ft___,, 1 'J'.'ill • •C!nn 1'1-i--,..I'\ c:--•• "1 i., l AIIICHIT£CT OA 0£$ICNUI ,_ MAIL AOO,t£SS -· PHONE LICtNS[ NO. 4 '~~"1 Rnild.f..m i:;,._.,, 'f-n ENGIN££111 MAIL A0D9'£S5 PHONE LICENS[ NO. -5 .. / Lit.HOER MAIL ADDRESS 9,-ANCH 6 US£ o, BUILDING 7 't,e"1 i lµt1 t-t'A 1 ~ 8 Class of work: »JNEW 0 AD DITION □ALTERATIO N □ REPAI R 9 Describe work: J: tall ].t'lr\'h4~ PERMIT FEES No. Type of Fixture or Item Fee SPECIAL CONDITIONS: WATER CLOSET (TOILET) $ ,I 1r,J ' BATHTUB I t-ll _) LAVATORY (WASH BASIN) ~ 1, ) ,· SHOWER I ,":h I KITCHEN SINK & DISP. -, ~ f) J DISHWASHER ,,.-o APPLICATION ACCEPTED BV PLANS CHECKEO BV APPROVED FOR lSSU .. NCE ev LAUNDRY TRAY ' ' CLOTHES WASHER I co . WATER HEATER "/ "i 0 ' NOTICE I• --URINAL THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC· DRINKING FOUNTAIN -TION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF " FLOOR ·SINK OR DRAIN CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM· SLOP SINK , MENCED f GASSYSTEMS:NO.OUTLETS ,._, J <'fl I HEREBY CERTIFY THAT J HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. WATER PIPING & TREATING EQUIP.' , ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED WASTE INTERCEPTOR HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE VACUUM BREAKERS PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. LAWN SPRINKLER SYSTEM SEWER r i' CESSPOOL - lr-J/ SEPTIC TANK & PIT -I .SrCiNATURE OF CON TRAC TO" Oft AUTHORIZED AGENT (DATE) PERMIT $ SICNAT Air OP' OWNER 1,-OWNE.lt IUILDE.111 OAT£) TOT4L FEE $ WHEN PROPERLY VALIDATED UN THIS SPACE) THIS IS YOUR PERMIT PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH INSPEC TOR INSPECTION REPORTS DATE ITEM REMARKS USE SPACE BELOW FOR NOTES, FOLLOW-UP, ETC. 12-17-75 Underground: O.K. B. Nelson 12-18-75 Underground water: O.K. B. Nelson 1-27-76 Top out and Copper: O.K. B. Ne lson 1-28-76 Rough: O.K. B. tJelson -'~ INSPECTOR , ' ·i,' O•'·· . '•... ·o··· -.. t, -•· .·. . . !, .. J •• ~ •• i·· ........ 1, -.. ~:.: :-~r;"".t':frlittt • .. 1:,~ ELECTRICAL PERMIT APPLICATION -. -~• . .; City of CARLSB.AD, CALIFORNIA 92008 -,/ J C)c-- Appticanttocomptetenumberedspacesonty Phone 729-1181 Permit No /fr.;, /"-.} JOI AOOJIII C59 LCGAL I 1 o£SCN. OWNUI 2- Per Attoehod _c; LOT NO. 1 ■LK 191/11 d ..::/_~, .' COHTNACT01'. 3 AIICHIT[CT Oft'D[SIC.Ntll 4 l.NGINCEII 5 I T~AC T MAIL A DDIICSS MAIL ADOftCSS MAIL AOOR[SS , ,/ / ZIP PHON[ PHON C ~HON[ ... ~ r--•.,_,... > ~SCt ATTACHCD SH[tTI PMOHt LICCNSt NO, S_TATE CITY LICCNSt NO, LICCNSC NO. 6 COMPENSAT~ON INS. CARRIER • MAIL AO01'E55 fUU,NCH . "?ir~rin *e ··rund-~t' Offic~-ffo;r f97f"S:ii'taJ"/maCnll!01T.ia927'J2~"4'.~1""...-•'• J•~ .. ----;~ I ·' -~·••r·' ,. ·-:-· uat or IUILOINC'. 7 ??ew P.csident.13.l -., 8 Class of w'ork: llNEW 0 ADDITION 0 ALTERATION O REPAIR ~ 9 Describe work: FJ.octrienl wirlnr? ot neu h0I!leS PERMIT FEES SPECIAL CONDITIONS: ISSUANCE OF EACH PERMI,: MPllCATION ACCEPTEO BY; PLANS CHECKEO BV; .0// NEW CONSTRUCTION . FOR EACH AMPERES OF MAIN SERVICE, SWITCH , APPROVEO FOR ISSUANCE ev. FUSE OR BREAKER f ' ' DATE ,, NOTICE THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC· TION AUTHORIZED IS NOT COMMENCED WITHIN 60 OAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAY~ AT ANY TIME AFTER WORK IS car-..: MENCED. \ · · · •.. •• . ,,. . ·, .. , ,. I HEREBY CERTIFY THAT· I HAVE READ AND EXAMl~ED THIS. APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCE~ GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPEC IFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. / f -<1· / ' ~ / / ' 'VI I / ,.. I ,(. ,'.L SIGHATUltE OP' COHTflACTOII Ofll AI./THOflllll9•AGt.NT .,· •IGl•P·9 ""-1' o, OWNt." IP' OWNCfll IUll.DC") IOATCI 1-...~6 OAT( NEW SERVICE ON EXISTING BLOG. FOR EA. AMPERE OF INr.REASE IN MAIN SERVICE, SWITCH, FUSE OR BREAKER REMODEL. ALTERATION, NO CHANGE ,IN .SERVICE.. FOR . EA, ,AMPERE OF "INCREASE · --• .. ' .. •· . -. TEMP. SERVICE UP TO AND INC LUO· ING 200 AMP. TEMP. SERVICE OVER 200 AMP. PER 100 PERMIT FEE WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT PLAN. CHECK VALIDATION CK. M.O. CASH PERMli VALIDATION CK. INSPECTOR No. Each Fee I >S.00 121: 00 .· ~. ..• .,, ~ :,. M.O. CASH PLUMBING PERMIT APPLICATION st--653* ** ~ 1 l. City of CARLSBAD, CALIFORNIA Appl ·c t t 1 an o c mp e e num 0 I t bered spaces only Pe ·1 N rm1 0. ~ JOB ACOR E5S ,Z~/...:1 .J,, / ~ >, ,/0 /,ICI.JNl LOT NO. I ILK I TU,CT LEGAL I ~/ ~L _,,efN 1 DE5C~. 2 / k,;,,. ('"//t OWN[" MAIL ADDRESS ZIP PHONE 2 I~ 1;1,t.,J < .<t: ~/✓ //.,4,1,11; l'/t ,, ~,,. ,,,,.J,,,,,;., BL· /I;// -t(,,, /)~ -1, _, ,h/,,1,, -;,,,,,, ///d,A/ #,oc;, 1// CON TIit.AC TO" MAIL AOOlll:ESS PHONE LICENSt. NO. STATE CITY 3 Lil• U.I': ,<, (,,,. ..,r,rvrT/t:,,.J ('o. .Pt, /3,x .511 .-¥1,. /It~,-, <!J t,,, ( {/ /I/Yr Al'tCHITECT O A: OE.SIGNER MAIL AODlltCSS PHONE LICCN5£ NO. 4 ENGINEEA MAIL ADDRESS PHONE LICENSE NO, 5 COMPENSATION (NS, CARRIER MAIL AOD .. ESS 8 .. ANCH 6 ,r A USE OF BUILDING !1 7 /~ :_/,µ,:,,, 71.,,.:/4-Ii 8 Class of work: BNEW 0 ADDITION □ALTERATION 0 REPAIR 71/ ,1)~ q Describe work: L/uv.v .;fµ/~h,.J/. t c.K $-/.s/',c .n) I i -. PERMIT FEES No. Type of Fixture or Item Fee SPECIAL CONDITIONS: WATER CLOSET (TOILET) $ BATHTUB LAVATORY (WASH BASIN) SHOWER KITCHEN SINK & DISP. DISHWASHER ,_PPLIC .. TION ACCEPTEO BY PLANS CHECKED BY APPROVED FOR ISSUANCE BY LAUNDRY TRAY CLOTHES WASHER OATE WATER HEATER NOTICE URINAL THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-DRINKING FOUNTAIN TION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF FLOOR·-SINK OR DRAIN CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-SLOP SINK MENCED. GAS SYSTEMS, NO.OUTLETS I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APP.LICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. WATER PIPING & TREATING EQUIP. ALL PROVISIONS OF LAWS ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED WASTE INTERCEPTOR HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE I VACUUM BREAKERS ., I I PROVISIONS OF ANY OTHER STATE OA LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. I LAWN SPRINKLER SYSTEM SEWER CESSPOOL L / SEPTIC TANK & PIT A ,,,,,,,4,,, //; /? ROOF DRAINS /ATUR[. o, 06NTRACTO,-OR AUTHO~IIED AGtNT (DATE) PERMIT $ -? " ~ .51GNATl•Rt 0,-0 WN["7tP" OWNEJII BUILO[,t) OAT[} TOTAL FEE $1.f, WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH INSPECTOR THid IS TO CERTIFY THAT INSULA'l ON HAS BEEN INSTALLED IN CONFORMANCE WITH THE CURREJl'1' ENERGY REGULATIONS, CALIFORNIA ADMINISTRATIVE CODE, TITLE 25, STATE OF CALIFORNIA, Ill THE BUILDING LOCATED AT: ::>411 Jacaranda Street EXTERIOR WALLS Manufacturer0.0€.AI.S"/C •ll..N 1u4-: > CEILINGS Rancho Del Ponderosa Tract Thickness/Type. __ £,.__.k""-------R Value. __ /_/ __ _ Batta: Manufacturery';11,wJ-k11;.u 1116'C..~ Thickness __ _.G..c-.-t=-----:R Value / '? Blown: Manuf'acturer ________ ..;:;;Thickne$B _____ --=No. Bags ___ W"tl. /'Baf!r. __ _ Sq. Ft. Covered R Value ·---- FLOORS Manuf'acturer _______ ----'Thickness/Type _________ R Value _____ _ GENERAL CONTRACTOR ________________ ___,;LICENSE NUMBER ________ _ BY ___________ TITLE. __________ ___,;DATE. ____________ _ INS~r ~~'l'OR S,vring Vallev Insul. Contrs . LICENSE NUMBER. ___ ;;>_0_,.,_0_3_? ____ _ BI h L Af417_•~=------__,;TITLE . ........_~ · ;Jp~-------------....;;DATE ,z... -"(-7, ' ' \,._/ BUILDING PERMIT APPLICATION City of CARLSBAD, CALIFORNIA 92008 Applicanttocompletenumberedspacesonly. Phone 729-1181 Permit No. JOl!i AOOA C$S LEGAL I 1 0£SCR. OWNtR 2 LOT NO. CON TftAC TO" 3 ,UIICHITECT Oft DESIGNER 4 ENGIN[[tlt 5 COMPENSATION INS. CARRIER 6 US£ OF' BUIL DING 7 -, MAIL AOOlltCSS M ... IL AOOlll:ESS MAIL ADDRESS MAIL AOOACSS J,,,AAIL Aoo•uss ZIP PMON E '/ PHONE PHONE Q.scE ATTAC.HED SM(t.TI P .. ONC ASSESSOR'S PARCEL NUMBER BOOK PAGE I LIC.CNSt NO. ST ATE PAR, CITY ,, .. 't'i,. LICENSE NO. LICCNSC NO. BAAN CH 8 Class of work : 0 NEW GrADOITION 0 ALTERATION 0 REPAIR 0 MOVE 0 REMOVE 9 Describe work: 10 Change of use from Change of use to 11 Valuation of work: $ PLAN CHECK FEE$ 1-S_P_E_C_I_A.:..:L::...._C..;.O_N_D_I_T_l..;.O_N_S_: ___________________ Type o f Const. 1-------------------------------4 Size of Bldg. (Total) Sq. Ft. 1------------------------....::/;;....!... ___ ..... Fire z one PLANS CHECKED BY APPROVED FOR ISSUANCE av APPLICATION ACCEPTED BY L b~4 .. •) ' OATE NOTICE SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB· ING, HEATING, VENTILATING OR AIR CONDITIONING. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC· TION AUTHORIZED IS NOT COMMENCED WITHIN120DAYS, OR IF CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM· MENCED. I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PE:=tFORMANCE OF CONSTRUCTION. c/. __ // ,,_4cs "" SUliNAfUll'I o, CONTAACTOIII Oflt AllTH01'1Zl:D AGIE:NT / / (DATE) !ilGNATu,ic 0,. OWNER 1,. OWNCIII BUILDE") OAT() No. o f Owelllng Units Special Approvals PLANNING DEPT. HEAL TH DEPT. Fi RE DEPT SOIL REPORT OTHER (Specify) ENGINEERING DEPT. WATER DEPT. Occupancy Group No. of Stories use Zone I PERMIT FEE $ 9 MICRO FILM FEE Max. 0cc. Load Fire Sprinklers Required OYes O No OFFSTREET PARKING SPACES: No. Covered Required Sq. Ft. Received INo . Open Not Required WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH 7 - IN SPECTOR