HomeMy WebLinkAbout2538 LA GRAN VIA; ; 76-5772; PermitMOOEL ~O. _________ _ ~-.
BUILDING PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA 92008
Applicantto complete numbered spaces only Phone 729-1181 Permit N, 7 b -5 771-
JOB AODR C! ~ ASSESSOR'S ,.
·,~ l-FI ~✓~AN "t//r9 PARCEL NUMBER ""~· LOl NO I I L• I '"?T BvvK PAGE I PAR.
LCOAL I 49-S (nSCC ATTACH[O 5H(lTI 1 OBC~.
OWN[llt MAIL. ADORCSS 9.,700% PMONC
2 t.:...., Jd y p r#£,~ z.. ?'.5~ J -, / -"-
CON TIU,C TO"II MAIL AOORC.55 PMON C STATE LIC, NO, CITY LIC, NO.
3 __ illbP-
AIIICMIT[CT 0,. OCSIGNC1' MA L AOORCSS PHON [ LICCN SC NO.
4
lNCIN[[III MAIL AOO't[~S PHOM[ L1CLN5C NO.
5
COMPENSATION INS. CARRI ER MAIL AOOIH 55 fUU,NCM
6
uac 0,. •t..ilLOING
7 NO. BDRMS NO. BATHS
8 Class of work: □NEW ~OOITION 0 ALTER ATION 0 REPAIR 0 MOVE 0 REMOVE
9 Describe work: /!.£.. 'r'A ✓A,.// A/Cr ,A/AL-C-, ~1 X a_;,
10 Change of use from
Change of use to
11 Valuation of work: $ 7 otfJ. 00 PLAN CHECK FEE S I PERMIT FEE s r
SPECI A L CONDITI ONS· MICRO FILM FEE Type of Occupancy
Const Group
Sile of Bldg N o. Of Max
(T otal) SQ. Ft Stories 0cc L oad
Fire use Fire Sprinklers
APP LI CATION ACCEPTE O 8 Y PLANS CHECKED BY APPROVE O F OA ISSUANCE BY Zone Zone Reau,red 0 Yes 0 N o
N o. of OFFSTREET PARKING SPACES
Dwelling Units No. !No. DATE DATE Covered SQ. Ft. Op.,n
NOTICE Special Approvals Requ ired Received Not Required
SEPARATE PERMITS ARE REQUI RED FOR ELECTRICAL, PLUMB PLANNING DEPT.
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 120 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 (Spec ify)
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINEO THIS ENGINEERING DEPT APPLICATION A N O KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND OROINANCES GOVERNING THIS WATER DEPT. TYPE OF WORK WILL BE COMPLIEO WITH WHETHER SPECIFIED
HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO G IVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF A N Y OTHER STATE OR LOCAL LAW REGULATING CON STRUCTION O R THE PERFORMANCE OF CONSTRUCTION.
S GHATU"[ or CONTlltACTOllt 0 111 AU THOIII IZ.CO .\GCNT IOATC)
SIGNA,TU .. C o, OWNEllt ,,-OWNl:llt I UILOEA) DA.TC)
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VA LIDATION CK . M.O. CASH
TOTAL FEES$ __ /_..) ____ _
INSPECTOR
MODEL Np. _________ _ ... ,,, BUILDING PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA 92008 --i /
Applicanttocompletenumberedspaces only Phone 729-1181 Permit No
JOl!I AOOR £55
,' l I+
L [ GAL I 1 otsc•. ITR4CT 10sr£. ATTACHED 5HCETI
OWNER MAIL AOOR[SS
2 -, . <. y p ,II:&..,:. < ..
ASSESSOR'S
PARCEL NUMBER
BvvK PAGE I
. ~ .,.
PAR.
CON TRA.C TOlll Pv1AIL ADDRESS PHON £ STATE LIC. NO. CITY LIC. NO. 3
Allt(HITtCT OR Dl.51GNCA MAIL ADOR(SS PHONE LICENSE NO,
4
[NGINECR MAIL A 0Dltt5S LICENSE NO.
5
COMPENSATION INS. CARRIER MA1L AODl!:CSS 811lANCH
6
use or 8.JILOING
7 NO. BDRMS NO. BATHS
8 Class of work : □NEW 0 ADDITION 0 ALTERATION 0 REPA IR 0 MOVE 0 REMOVE
9 Describe work:
10 Change of use from
Change of use to
11 Valuation of work: $ PLAN CH ECK FEE s
1-S_P_E_C_I_A_L_C..:.O_N_D_I_T_I_O_N_S_: __________________ --1 Type o t
Const
1-------------------------------~ Size o f Bldg.
(Total) Sq. Ft.
1-=---~==---r------------,----------~ Fire APPLICATION ACCEPTED BY PLANS CHEC~EO BY APPAOVE.O FOR ISSUANCE BY Z one
DATE
.,,
DATE / > I I
No. of
Dw elling Units
Occupancy
Group
N o. o f
Stories
Use
Zone
., 20
I PERMIT FEE s
MICRO FILM FEE
Max.
0cc. Load
Fire Sprinklers
Required OYes
OFFSTREET PARKING SPACES:
No. Covered Sq. Ft. INo. Open
ONo
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 WITHIN 120 DAYS.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 H EREIN OR NOT. THE GRANTING OF A PERMIT DOES NOT
PRESUME TO G IVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIO NS OF ANY OTHER S"TATE OR LOCAL LAW REGULATING
CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
5tCNATUR[ or CONTNACTO .. ON AUTHOIIIIZtO AC.ENT ID• TC)
51C.NA T11111£ o, O~NUt IIF OWN[N IUILOCA) (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. M.O. CASH
TOTAL FEES $ ___ ,,.j ____ _
INSPECTOR