HomeMy WebLinkAbout264 CARLSBAD VILLAGE DR; ; 62-5201; Permitft]APPLICATION FOR 81111011(8 PERMIT
CITY OF CARLSBAD — BUILDING INSPECTION DIVISION
PHONE PArkway 9-1181 - Ext 36
8! 5201
(Last)
Owner Name
(Please Print)
Contractor
/*To Construct ftO To Add D
First)
Type of Const
(Frame, Masonry, Etc )
Floor Space of Proposed Construction {sq feet]
Floor Space of Garage [sq feet) "~ ~~
LEGAL DESCRIPTION
Lot
Mailing Address
^ Mailing Address
lease Print)
To Alter Q To Repair Q To Convert d
Kind of Foundation s-L-v-fl^V G*-^ No of Sro-ies /
Number
Number
Street
Street
To Move From
To Be Used
City
^City
Address
Phone
Phone
/£ a" y~ Const Valuation $
Adarass
- - £**^&f
(One Family Dwellinq, Store, Etc ]
^T>,
attached EJ
detached QConst Valuation $
Block Subdivision
Township Range
Located at o^t*-^- -<C3>—C^^^T-^ Street, Near
Assigned House Number
LAND AREA / ^ ^~^-^/^OMBER OF EXISTING DWELLINGS ON PROPOSED BUILDING SITE >-2-^-*-*-<^— ^ (INDICATE
SIZE, USE AND LOCATION ON PLOT PLAN) WILL THIS CONSTRUCTION INCLUDE ANY PLUMBING INSTALLATION, ALTERATION, OR
ADDITION?YES NO
! 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
Front Yard Set Back
Side Yard Set Back
Rear Yard Set Back
Distance Between Bldg
Off Street Parking Spa
Sewage Disposal System
Zone - Residential ( )
Zone - Commercial { )
Variance
Eng. Check By
Wi-JtcT"
Driveway Permit Required Yes (}/} No { ) Fee
Grading Permit Required Yes ( ) No [&*} ~~
Sewer Disposal Plant Capital Cont Fee l^ &'$Tr/c
Sewer Pumping Station Capital Cont Fee /)&S) (*
Sewer Main Line Cost X'Z fl/fTf-icf"
Sewer Lateral Connection Charge
Water Stocked Lands Charge
Water Main Pipe Line Fee
Water House Service Charge
"WaferMeter Charge
S~*
&~Sub Total ,X?// ' C-
ff"
Plans ApprovecL-by *" *c.Approved by
Da(e
Plan Check Fee
Building Permit Fee w^ V ""*
Total Charges X--* ^7V