HomeMy WebLinkAbout250 CHINQUAPIN AVE; ; 62-5076; PermitAPPLICATION FOR BUftDIM PERMIT
N? 5076
CITY OF CARLSBAD — BUILDING INSPECTION DIVISION
PHONE PArkway 9 1181 Erf 36
Owner Name
(Please Print)
Contractor
/ (First)(Middle)
To Construct
Type of Const
/tSt-^t~ ~r*
•Bonn Spnffl)..of
(Please Print)
To Add D To Alter D
'C'C Kind of Foundation
ram* Masonry Etc )
Mailing Address
Mailing Address
Proposed Construction (sq feet)
Floor Space of Garage (sq feet)
LEGAL DESCRIPTION
To Repair Q To Convert d
No of Sto les
Const Valuation $
attached D
detached QConst Valuation $
Number
c5^
Number
To Move From
Straff / City Phone
Street City Phone
Address
To Be Used for
(One Family Dwellmq Store Etc )
Lot Block Subdivision
Located at _ _ , ^ft*s~ctfe^—..
Assigned House Nuntber V
Section
Street Near
/J Township^Ls/^a^Range
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
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 OF, .
PERMITTEE X
Front Yard Set Back
Side Yard Set Back
Rear Yard Set Back
Distance 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 Mam Pipe Line Fee
Water House Service Charge
Water Meter Charge
Sub Total /
Fee
Plan Approved
Approved by
Plan Check Fee
Building Permit Fee
Total Charges