HomeMy WebLinkAbout2635 MADISON ST; ; 76-2623; PermitMODEL NO. __________ _
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BUILDING PERMIT APPLICATION ·o
City of CARLSBAD, CALIFORNIA 92008 ,. // _
Applicanttocompletenumberedspacesonly Phone 729-1181 Permit No
Joe AOOR E~5 ASSESSOR'S
I.Jc 3!:l w·, V J ~r. , ' ,r 11) (.A . PARCEL NUMBER .
L.OT NO, I OLK Ir.ACT BOOK PAGE I PAR,
LEGAL I tOsn •rr•cMro sMur, 1 0£$CA.
OWN(R MAIL AOOA[5S 21 p PMON[
2 l/ ~-} ,( (' f , ,-J Tv1fh~ (11. -
CONTRACTOR MAIL AOOR[S!, PHONE STATE LIC, NO, CITY LIC, NO.
3 ' .J I -,«.,
Aflli(HITCCT OR 0CSIGNCA MAIL AODlltCS'S PHONE LICEN5C NO.
4 ,J~
[NG IN [[ Ft MAIL AOORESS P1-tON [ LICENSE NO.
5
COMPENSATION INS. CARRI ER MAIL AOOACSS IHtANCM
6
U$E or B UILDING
7 ,,, ,,,. {)i} ' I ~ NO. BDRMS NO, BATHS
8 Class of work: □NEW 0 ADD ITION □ALTERATION 0 REPAIR 0 MOVE 0 REMOVE
9 Describe work: l ur , ':) \ ( Q \ 'r • r ~ . ) / ) TH ", t I 1-v, l ( ""Y);)S
I t I ('I -'rld.)',1(i'{I' r I I It {'I N~t fH('. If r,;JI I~ e, P/ /l •-JJ .,/ (.lfi/ ES
10 Change of use from
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1 .J {f\P~,u" , ') IJJ"1~'l,.-->t 0 VA fl t<'11.J,. e
Change of use to I I/ , ,, tJ f) I /h/ If Jl',p
11 Valuatio n of work: $ ~ .J..fJ • (,>0 I V/1/
PLAN CHECK FEE S PERMIT FEE S _,,
SPECIA L CON DITIONS: Type of Occupancy MICRO FILM FEE
Const Group
f,,ze of Bldg. No. of Max.
(Total) Sq. Ft. Stories 0cc. Load
Fire use Fire Sprinklers
APPLICATION ACCEPTED ev PLANS CHECKED BY APPROVED FOR fSSUANCl ev Zone Zone Requ,red OYes □No ,( .. No. of OFFST REET PA RKIN G SPACES: ., fl~½ JNo . / D w elling Units No. DATE DATE Covered Sq. Ft. Open
NOTIC E Special Approvals Required Received N ot Required
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB-PLANNING DEPT.
ING, HEATING, VENTILATING OR A I R CONDITIONING. HEALTH DEPT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF FIRE DEPT.
CONSTRUCTION O R WORK IS SUSPEN DED OR ABANDONED FOR A SOIL REPORT
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-
MENCED. OTH ER (Specif y)
I HEREBY CERTIFY THAT I HAVE READ A N D EXAMINED THIS ENGINEERING DEPT. APPLICATION AND KNOW THE SAME TO BE TRUE A N D CORRECT.
ALL PROVISIONS OF LAWS AND ORDINANCES GOVERN IN G THIS WATER DEPT. TYPE OF WORK WIL L BE COMPLIED WIT H WHETH ER SPECIFIED HEREIN O R NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO V IOLATE OR CANCEL THE
PROVISIONS OF ANY OTH ER STATE OR LOCAL LAW RE GULATING CONSTRUCTION OR TH E PERFORMANCE OF CONSTRUCTIO N.
51GNATURt or CQNTR""CTOl't Ollt AUTHORIZCO AGE.NT (OAT[)
~ 1 JI ,/
51C.NATIIR[ 0,, OWNEfll 1r OWNE" I UILDE"l OAT CJ
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M .O. CA SH
o, TOTAL FEES $ ________ _
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INSPECTOR
INSPECTION RECORD --DATE REMARKS }-INSPECTOR
FOUNDATIONS-: -------------
SET BACK -------'--
TRENCH -
REINFORCING ---FOUNDATION WALL &
WEATHER PROOFING ---
CONCRETE SLAB ---
FRAMING
INT. LATHING OR DRYWALL
EXT. LATHING
MASONRY
FINAL
USE SPACE BELOW FOR NOTES, FOLLOW-UP, ETC.