HomeMy WebLinkAbout2470 FARADAY AVE | 6200 EL CAMINO REAL; ; 73-1478_MISC; Permit:·:: ;..
BUILDING PERMIT APPLIC.ATION
Permit N;)_'?:..-:11/7 'X'". . City of CARLSBAD, CALIFORNIA 92008 "",, _ ,~-.
Applicant to t'omplete numbered spaces only. Phone 7 29":"l 181 · · ' ..
JOB ADDRESS JL L.
0
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LbT N'O. rm· ,.-I 'fRACT ·~ LEGAL I (OSEE ATTACHED SHEET) r; 1 DESCR,
OWNER MAIL ADDRESS ZIP PHONE
2 --· t' J,.-JL.,.;..._, ·,,;\.,UM\(; -... • '.':i l1v~ .;;:_ ~t.i\•tt '·\ ::-..,'t 1K
~ON TRACTOR MAIL AD'oRESS PHONE LICENSE ."!r://•/ u 3 ,SJ,.\,V;..,.,,,J (,,~ { ~"~t~:t· t ~.l~-~ t.-.. '(.'4¼ '\ ',fi•~,tf?M"I;.,~"-'.,,'-~ f4 ~~1.,t~l .,.., 4-, " fb. -~\i) &-, c~ t,r'* .
ARCHITECT OR DESIGNER ,,, MAIL ADDRESS ' ..,.,,._...,.. ,.,~zr¾,r·-, ~ PHONE LICENSE NO.
4 ~-~ ,.,) J~ ENGINEER MAIL ADDRESS PHONE LICENSE NO.
5 ------. .--. . ~ LENDER MAIL ADDRESS BRANCH
6 \\J;.) 1"'.J e '. l . I•
-USE OF BUILDING -11 •
7 I~\ '4'
~~;~ ·1·..5:~ /~ C. e:: .. ---! -t --l ,-~ 8 Class of work: $(NEW r'D;;;~~~~"':~·:]J ALTERATION 0 REPAIR DM0VE
.,,,,__ .. --,. r"--\,.,...,.,..,
..
9 Describe work: ~~c ~4 ~~ l/','?--. ,: :,,,~½ i-:~~ ~~-4-,:f:'> tlj: r. , ,. ~ --~-.... ;. , i"it I .J\,,..~~l ~
0 REMOVE
.-~· ~
::z
0
.
~
10 Change of use from
Change of use to ..
11 Valuation of work: $ tJ \Q Q-,.;.,:J. ,-,}# PLAN CHECK FEE ,-.. I PERMIT FEE /4,;;. c;l1
,;: .,(
SPECIAL CQNDITIONS: , V " Type of Occupancy
Const. ·ru -!t\J Group ~-Division -"'Jl ~.,.._ .. -Size·or Bldg. _ No. of Max.
(Total) Sq. FtJkuO Stories I 0cc, Load ---... ,&
Fire ? use Fire Sprinklers
APPLICATION ACCEPTEO BY: PLANS CHECKED BY. APPROVED FOR ISSUANCE BY: Zone --Zone Required--DYes Ja~o t."' /..',r r.t-~ / I -,.
l ~y OFFSTREET PARKING SPACES: ,v..,, f+,, f. Jr C: ! /. No. of . . ... /' i~ r ,--;<, ·72 Covered& I Uncovered .._;I,-.,· _.-"'"il ·Dwelling Units C";,: o--"-'. l', './ -':.t , • .,>
' . Special Approvals Required Received Not Required NOTICE
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB-ZONING
ING, HEATING, VENTILATING OR AIR CONDITIONING. HEAL TH DEPT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF FIRE DEPT.
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A SOIL REPORT
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-
MENCED. OTHER (Specify)
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 VIOLA'TE OR CANCEL THE PROVISIONS OF ANYiOTl'iEiR ST~E OR LOCAL LAW REGULATING
co/s::rRUCTION Pit' THEi' PER; RMANCE OF CON,TRhTION. · 1 t t1 • : -Lt I •. t• t: ., '·' ;,,; fi : ' i A, -~ . .,,,.At .:..~ u~-""'-..._. t,, 1J 1 :s-
SIGN-A•'l'URE OF CONTRAC·TOFf OR AUTHORIZED AGENT f(D/\'F£)
----
SIGNATURE OF OWN£R (IF OWNER BUILDER) !DATE)
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
INSPECTOR
FOUNDATIONS:
SET BA.C.l<
TRENCH .
R_EINFOR(;ING
.FOUNDATION· WALL &,
WEATHER PROOFING
. -CON.GRETE SLA~.
FRAMING
-f~T. -LATH IN~ ORDRYWA_Ll
ext.. L.AT:H iNG.
'. 'MASQNRY
-Fl~AL. ,
DATE.
U$E SPACE BELOW FOR NOT~S; FOLL(JW-UP, ETC.
REMARKS INSPECTOR.
. .J
• J
,.
BECKMAN@
2470 FARADAY AVE
ORIGINALLY ADDRESSED
AS 6200 EL CAMINO REAL
r--;
,·
--,-:---------
BUILDING. PERMIT APPLICATION
Permit No. -7J-.i<l7'f City of CARLSBAD, CALIFORNIA 92008 ·:·'-~"'
Applicant to complete numbered spaces only. f?.hone 7 29-1181
JOB ADDRESS
ARCHITECT OR DESIGNER
4
ENGINEER
MAIL ADDRESS PH.ONE f LICENSE NO.
~
MAIL ADDRESS PHONE LICENSE NO.
1,
t i~
_---. ----· -. 'l . ·,\.\ -1--L_E_N_O-ER _________________ M_A_l_L_A_D_DR_E_S_S ______ ~-------------B-R-A-NC-H--------l'l ~
5
6 \t_, ~,J \~ 'l -~~~ 1
7
1uJSSlEE10»,;-B;;;u.i'i1i:iLDOIINNGG C-.::;~;;,i;;;;,_..;_.,,.,.-...,..""""""'"""'"""'....., __ ~:~" "!'1-~~.;;;j;i~~=s_;;;;;;;;:;;;;;:;;;;;::::----:: .. ~--:----:-:-. --------------j ') 1t
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8 Class of work:
9 Describe work:
t ... ~. l\.\
-~·\ -·~: 10 Change of use from
0 ' 1--C_h_an_g_e_of_u_s_e_to ____ --.---------------1..------------.,....------------·--1:i ~
'1/,r;.oo-e,vv PLAN cHEcK FEE /\ I PERMIT FEE 4.')f ,_;.-t:,,; · r-,.,.,.() 11 Valuation of work: $
SPECIAL CONDITIONS: Type of • 1 Occupancy J/:
Const. 'Tr)' ~ 1j\J ~r.oup f"'" Division ·:,_
~""" $_ 1-------------------------------i Size of Bldg. i:J} No. of
(Total) Sq. F~/'f! Stories ,I
Max.
0cc. Load --1---------..-----------,.----------1 Fire Use Fire Sprinklers
APP,~ATION ACCEPTED BY. PLANS CHECKED BY APPROVED FOR ISSUANCE BY· Zone
~½1 t~ C'/fl &h1h1 .
NOTICE
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB-
ING, HEATING, VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-
MENCED.
No. Of
Dwelling Units ,.: ·.,
Special Approvals
ZONING
HEALTH DEPT.
FIRE DEPT.
SOIL REPORT
OTHER (Specify)
Zone Required Dves i;;:}No
OFFSTREET PARKING SPACES:
Covered ,'. J I Uncovered ,
Required Received Not Required
hrptf t~.r10CJ~.:~iYKJ~~TT~EHt:JE i;.'bA~E~iit~~~ 1iI~~ Ri~~~ 1, _______ --1-------+--------+--------l
ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS
TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED
HEREIN OR NOT, THE GRANTING OF A PERMIT .DOES NOT--
PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE 1-------~--t-------t---~------1-------1 PROVISIONS OF ANY OTHISR STATE OR LOCAL LAW REGULATING
SlGNA-:n.JRE Of" CONTRACTOR OR' AUTHORIZED AGENT ;i,. (OA:.-rE) ;e
CO~TRUCTION ~'R_;;r!"f,E 'PERFOij'MANCE OF coi::4sTRUCTION.
t\. -[,;,;·· 1 I t I ~ J f :.J · f· .IL · t .... ,,,,.., ? , , • , -", .. ,,,..fr ,_, . .._. ,,..._if .. ......._ -it~tf. · 1 ~
SIGNATURE Of' OWNER !If' OWNER BUILDER) (DATE)
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
INSPECTOR
-.J
. ,..: ...
. -:F.oUNDA'TIONS:
'•.'' '·,.·
SET BACK
)RENCH
FO.(JNOAtlON WALL &·
-WEATHER PRQOFING
:'. F;~AMING .
, .
. iNt. ~ATHING OR DRYWALL .
. ~.~er. LATHING ·
MASONRY
: ''.FINA~
DATE
U$E SPACE SELOWfOR NOTES;FOLLOW-t/P, .E.TC.
l0NSPECTION RECORD ·
... (:IEMARKS .. . ,INSPEC:TOFi
••• • BU.ILDING PERMIT APPLICATION
= . City _of CARLSBAD,. CALIFORNIA 92008 . . ::;,jJ .· .. ~ .
App/icanttocompletenumberedspacesonly Phone 729-1181 Permit N~-./7lr"7
JOB ADOR ESS
I LOT NO;
1 LEGAL .
DES CR.
CONTRACTOR
3 5~!,Jt_ t,)
ARCHITECT OR DESIGNER
4
5
COMPENSATION INS. CARRIER
6 V C'.:' .. t\ .r,;,.~i 1. .• »-1..8
"USE OF BUILDING'
7
.. I BLK I TRACT
~AIL ADDRESS PHONE
MAIL ADDA ESS PHONE
MAIL ADDRESS
-'i;,,.,~t;
<Osi::E ATTACHED SHEET)
PHONE
ASSE'SSOR'S Ji PARCE!-NUMBER
BOOK t PAGE I ·PAR •
·-:..,,,,... t-1 Lk t ; . ,._
L.ICENSE NO.
LICENSE NO.
8 Class of work: DNEW li{AOOITION D ALTERATION D REPAIR D MOVE D REMOVE
9 Describe work:
10 Change of use from
Change of use to
11 Valuation of work: $ PLAN CHECK FEE$ ~. I ~ ~ .J2..!,:• PERMIT FEE $ / J'
SPECIAL CONDITIONS: 1--------------------,-----------f Type of "tr"· ,, J
Constl ·" l{ ,,,,,.;. N.
1-------------------------------1 Size of Bldg.
(Total) Sq. Ft.
~~~~~~=~~-,--~~~~·~·~----r~-"!l""A-+---~..£_,-:--1 Fire
MI C R 0
0
.!i-)i-),.'!l F E E Occupancy·&: t:,l'"V -. ..-. .tr'. ~ Group · -2 '"',;;.·
No. of
Storh,s
Max.
0cc. Load
Use Fire Sprinklers
Zone Required DYes DNo
OFFSTREET PARKING SPACES:
APPLICATION ACCEPTED BY. PLANS CHECKED BY 2f JebJone
No. of
DATE ·"'·" Dwelling Units ~~vered Sq. Ft. l~ge,n
NOT I C·E ~ l" Special AJ)provals Required Received Not Required
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUdB-1--PL..cA_N_N_I_N_G'-D'-. E_P_T_. -,--ll-----'----+--------1----'----i
ING, HEATING, VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-HEALTH·OEPT.
TION AUTHORIZED IS NOT COMMENCED WITHIN 120DAYS, OR IF ._·_F_IR_E_D_E_P_T_. ---+--------,1--------+--------1
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A SOIL REPORT
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-·1--------+-------+-------+--------1
MENCED.. -.·O_T_H_E_R_(S_p_e_c_lf""'':f._) --t--------1~------t----------1
I HEREBY ,CERTIFY THAT I HAVE READ ANO EXAMINED THIS APPLICATION AND KNOW THE SAME TO BE TRUE ANO 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 GI-VE AUTHORITY TO VIOLATE OR CANCEL THE
~~~~}S~SN18~(~J 0
{~tRP~1t,it~~~g~A5°FL~9.tJf-?~~t-1i~~
l s, , t,.f ,1, l , 7.i~f)I 'rt A , k,.,.,,,.--~·--: ~ . i' /"/,· .i ..;_ . 1'!!! "J l~
SIGNATURE OF OWNER (IF OWNER BUILDER) (DATE.)
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
, '
f ~-
: ·FOl;JNOATIONS:.
SETB,ACK
TRENCH
REINFQR_ClNG.
FOUNDATION WA'LL &
WEATl'iER, P.ROQFINQ.
~ _.,. . .
CONCRETE SI-AB
INT. LATHING OR-DRYWALL
EXT .. LATHIN~
MASONRY
·FINAL
i-· ~• · INS.PECTION, RECORD~·
DATE. R.EMARKS·
:•. ' '
USE SPA(;E BELOW FOR NOT~S, FOLLOWUP, ETC.
INSPECTOB,
· · · .·· · iii·-·· ;-·---· ,~ ·· · -··· · i' ;:~Iii:~-=: ;7:~1·;ii~;,;:.~f ~
BUILDlf!JG PERMIT APPttC~TION -~;;
..
-City of CARLSBAD, CALIFORNIA 92008 '7r/_ . . -. . '
ApplicanttocomP,letenumberedspacesonly Phone 729-1181 Permit No o/ .. l':!:-7 o
JOB ADOR ESS
'fTV"' ~~
~-4..
LEGAL l DESCR. I
LOT NO.
OWNER ... 2 i~ C ,_ h,. i ""i ,~ ,.J
ARCHITECT OR DESIGNER
4
ENGINEER
5 ...... ,.-...
CO~NSATION INS. CARRIER . l"t
6 · ~----. ~--;<,, ,A . ~ """"7'.~, ,·. 'VV,~~
usE OF eu1Lo1~fG
Change of use to
MAIL ADDRESS
.... ,J
MAIL ADDRESS
ZIP
PKONE
PHONE
<OSEE ATTACHED SHEET)
PHONE
ASSESSOR'S.
PARCE!-NUMBER
BOOK I PAGE I
L.-ICENSE NO.
LICENSE NO.
-, . --0 REPAIR O MOVE D REMOVE
PAR.
11 Valuation of work: $ PLAN CH ECf< FEE $ I PERMIT FEE$ ~
1-S~.P_E_C_I_A_L_C_O_N_D_I_T_IO_N_S.~: ------------------~ Type of
Const.
1---------------------------------f Size of Bldg,
(Total) Sq. Ft.
1----------.---------.....,.---,;-;a.,./,,.:;'l __ ___,,..,1:..-_-, Fire
APPR,OV,~-~-O•FOR IS ANC~E BY Zone APPLICATION ACCEPTED BY. PLANS CHECKED BY "J.&:/'. · . ·"f 4 No. of
~-" ,I' DATE ~·DATE Dwelling Units
NOTICE "' f Special Approvals
SEPARATE PERMITS ARE REQUIRED FOR E,LECTRICAL, PLUMB-
ING, HEATING, VENTILATING OR AI.R 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 ALJ;fHOJ3ITY TO VIOLATE OR CANCEL THE PRQV+SIONS OF Al'!b ~~E'R !>TATE OB LOCAL LAW;REGULATING crs t~UCTIONf; Off )'/le: 1;',-E:RFJ~Rr:1.'ANCE OF CO,NSJlfRUaCTION.
l ff !1 J"' t /" ;Ii "C ,-:, ~-'
\_ ~ -·~-}-,., ;~ w,!?",,,-~ t;_'l '-I
SIGN'A<T\'fRE OF CONTRACTOR OR AC\,,THORIZED AGENT I' (IJATE)
SIGNATURE OF OWNER (IF OWNER BUILDER} (DATE)
PLANNING DEPT.
HEALTH DEPT.
FIRE DEPT.
SOIL REPORT
OTHER (Specify)
: ENGINEERING DEPT.
WATER DEPT.
Occupancy
Group
No. of
Stories
Use
Zone
MICRO FILM FEE
Max.
0cc. Load
Fire Sprinklers
Required DYes DNo
OFFSTREET PARKING SPACES:
No. Covered
Required
Sq. Ft.
Received
'
No. Open
Not Required
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN···cHl;CK VALIDATION CK. M.o. CASH PERMIT VALIDATION CK. M.0, CASH
INSPECTOR ...... ,: ..
-~
'','Ii
.' . ,,
'• .. ~
: :.~
. 'FOUNDATIONS:
_SET BACK
f ,., 1
TRENCH .
--~-
. -R!;INFORCINO
FOUNbitnQN WALL &
W!=ATHER PRQOF!NO
CO~CRETE SLAl;I
FRAMING
INT .. LATHING OR DRYWAl,.L
EXT. LATHING
MA$ONRY
.. FINAL
•·· -..,'
{!SE SPACE BELOWFOH NOTES, FOLLOW0UP, ETC.
<' '.,. ~,. -.., ~-,·-•,,
IN.SPEC1:-_ION RECORD
REMA,RKS .
"
MODEL NO._\, ------,--B~u,l.DtG ,. -· ~ ::--' ':" --\ 'f_:'f',' .·-. -./ • <, ;
PERMIT ~PPuC'!~10N
City of. CARLSBAD, CALIFORNIA 92008 .,~ ~,~ -
Applicant to complete numbered spaces only Phone 7 29'-1181 Permit No
~! '· '~ ·'f,j~~ /--« ~~ "' ".
77-9~~~
...
JOB AOOR ESS ASSESSOR'S t..-~ ./ t" (. f[ i ~_ .... i,h 1/J i::.t -r.::. i. .. PARCEL NUMBER
LOT NO, I BLK I TRACT BOOK I PAGE I PAR.
LEGAL I (0SEE ATTACHED SHEET) 1 OESCR.
OW.N~ER MAIL ADDRESS ZIP PHONE
2 \,<-... ,. . ~ ' /' ! \' ,_ ~ j(' J. : ·i ,._ f 1 ! i _:, (. _:~t t'ft•i:l·.,··D ~e{--I -\.-\°ll ~<: ( ~ l f ' /t ,,;;-4 ~~ ,, ,,.. ~ ,~" I
CONTRACTOR MAIL ADDRESS PHONE STATE LIC, NO, CITY LIC, NO,.-
3 -~rv· '.: .. ,: F 1-. t,._ r: ,.;.:., ,:r ,,1 t ·-:-·: < t L i,. t ;,.~ ,-1-,·,
,, } •' 1"· •.-· ;-{ l . , l • J. •• Cf ' ·1 ,.,. f ." ) !"'}: (t,"!' ~~ : f, .~. l -4 -!-!
ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO.
4 J, ' ~ T. : ' ,< r,~-.. L t_ , . ! ' + "f'( · ~-If •:.'.'\_ .... ..\ ' f ,:: .... \::_~ . ;
ENGJfEER ' .. , .•. £ . t
MAIL ADDRESS PHONE LICENSE NO,
5 .L ,_, i-.L .\ // ( L .• <,:_i:i" "'1; .... , ,..,t''r,u,;f•'{, t_ ::• , .. ~ n ~~· ~ t p, -1
COJ,'1°PJ;:NSATION INS. CARRIER MAIL ADDRESS f'~. I'' ,_ /1, /r;:-; BRANCH ,14 , ' 6 f \ } ' .l,. t • .. .. t L '\,.t, 1· I . ;, ' .. 'I;)'·' ~ t ' \ ". f / ~ ·/ H # ~· ,•! ... l, ! :£ .:,,, ; ,· ~ /., . -_, i ,. .,..,, ..,.-.•.-, ~ • 1~
...__..,.,,-I
/
USE OF BUILDINt ; ~' ' 7 \ ' 'i...-. r ~ < , '-"' -· -\ .~, '-·, -NO. BDRMS NO. BATHS
·s Class of work: 0:NEW ['m(e,oolTION 0 ALTERATION 0 REPAIR 0 MOVE 0 REMOVE ....
" I i 9 Describe work: ;~ ~ '\ ~ +, ·" l; ' t' ',• ' ~ ! i .,; aL, 1 ,i,: i:~ 1· • i,..' . \-< •. ~\Ut'~~f'"·A , ... \ .\ ·• 'I,• l ' ~ \ . ~ -' * ~-. ' 'I ·,' : I , ,' t
l <, ., , \:,:
~
10 Change of use from -~4': ...
Change of use to
Valuation of work: $ -e~~:.: "J q..-·, -... ,,, Ii" l'J I PERMIT FEE $
7..,,... ,:;; 11 !~.,..., ...... ~
·-;l.~?,f'\ ,_ .-r· .fl , i PLAN CH ECK FEE $ t/' .,..
{';"
SPECIAL CONDITIONS: MICRO FILM FEE Type of">~""-Occupancy~ ;e,:;;,
Const. .,,,.~ ~ ?./ Group J-, ?,,..._ ~ ... -'
Size of Bldg. t No. of 1 Max.
(Total) Sq. Ft, )i~l.c-Stories 0cc. Load
' _.,, Fire {'.:-; Use Fire Sprinklers
APPLICATION Ao/EPTED BY PLANS CHECKED BY _,"?'... '$"'"''" -;1'.one ,::5' Zone /t.t'\ Required DYes Gl-~o ~ I. ,.. r
i_ a No. of D OFFSTREET PARKING SPACES:
DAT,..-,/ ' DAT, , J. .. Dwelling Units · No I No. · co;,ered Sq. Ft. Open
NOTICE Special Approvals Required Received Not Required
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB-PLANNING DEPT. /\
ING, HEATING, VENTILATING OR AIR CONDITIONING. HEALTH DEPT. I THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC· C J TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS,OR IF FIRE DEPT.
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A SOIL REPORT I, fD{ PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM->JV I MENCED. OTHER (Specify)
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS ENGINEERING DEPT. I .'1 ( 1' APPLICATION ANO KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS WATER DEPT. I ';fl l I ~, ( /
TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED r I I ~ )( t ) HEREIN OR NO:r, Tlo;!E G_RANTING OF A PERMIT DOES NOT PRESUME ,:_'<Q GIX/¥, AlTHORITY TO VIOLATE OR CANCEL THE ~. I/ , I -PROVISIONS'OF AJY Oi HER STATE OR LOCAL LAW REGULATING 4 -/I,/ CONSTRUCTlfN R THE PERFORMANCE. OF CONSTRUC1.0N. / ) V )( 1../ r' . \~\ I. ,_ ~-. \....,__). ., I ?t/i ,_,.,_p.,;~...,J 5 I(;,.·~ 71 I I /<./ } I .,/It _)
SIGNATURE O_,F' CO~RAC~OR OR AUTHORIZED AGENT (DATE) \...Y -I/. V 7'I . / / ,, ...
,.,,/ ..,,/ ·"" 7 ' <._,/
SIGNATURE OF OWNER IIF OWNER BUILDER} (DATE)
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
;-...:-~t~f
TOTAL FEES$___,./~ .. _t::~f.,-f ____ _
INSPECTOR
"--.,. '
-,\.'
_INSPECTION RECORD
DATE REMARKS INSPEC!TOR_
FdlJNDATIONS:
SET BACK -.
TR.ENCH -
:REINFORCING
FOUNDATION WALL &
'WEATHER P-RQOFIJ\JG '
CONCRETE SLAB
--
FRAMING ,.
INT; _LATH.ING OR DRYWALL -
EXT~ LATH ING . . .
MASONRY -
--·
FINAL ,. -·
USE SPACE BELOW FOR NOTES( FOLLOW-UP, ETC.