HomeMy WebLinkAbout2713 LUCIERNAGA ST; ; 78-216; PermitMODEL ~•-----------
BUILDING PERMIT APPLIC TION -C g••-c. •
City of CARLSBAD, CALIFORNIA 92008
Applicant to complete numbered spaces only Phone 7 29-1181 Perm I l No ;o•:;,1a ASSESSOR'S
/-(.,I r ~ i 4J 1 PARCEL NUMBER •
L0~,70 I I LK 411 TOACT {e4/4 /f/l..L~ i□sJt 'uT11,~to SHEET)
BvvK PAGE I PAR,
L[CAL I 1 ocsco. ..)
OWN[lt le (_ ((, MAIL A00fll'C55 A t!P r" "":Jr' ,,,,.. ~~-, 2 G: (. <,. C"f .J :JS') -1-1 C l ,_ -J(.L.-~ -,, .
CONlftACTOR M,.tL •DOfltCSS PHONE STATE LIC. NO. CITY LIC. NO.
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AJIICHITECT OR DtSIGNClll MAIL ADDRESS 1 PHON C LICENSE NO 7't ✓f:. 4 ; L I \ .I ..Ii:~ ..._ C I l • 1~
l1 -I
[NGINCtlt ( M"IL AOORt$S PHONE tCNSt NO,
5 l 0 ~\ (., ' . ~ " COMPENSA!ION INS, CARRIER MAIL AOOltESS BIIIANCH
6 ..
USE OF BUILDING
-" _/_ ( l (.~ Al I..,. ) · 11'-f!
1 1 P/4 ..,, / NO. BDRMS ~--NO. BATHS '/ i ('
8 Class of work: I ~EW 0 ADDITION 0 ALTERATION 0 REPAIR 0 MOVE 0 REMOVE \..
9 Describe work: tv/ ,~,, ( / __ / (', b_,;._ ,t "'f,___..t \. ,~' \. ,,~ CJ -,J '\. t _./ / G ~ ~v.,~
10 Change of use from \" \I'\."
Change of use to --~~-I PERMIT FEE $ 11 Valuation of work: $ ~,...,. ----I 11 e :; ,e;, ~=,.,;?(), ~ :2 '~ PLAN CHECK FEES
SPECIAL CONDITIONS, MICRO FILM FEE Type of N Occupancy~ /11 ' -Const Group ft,.,_
Size of Bldg. C(p/ No, of ;>.. Max -(Total) Sq, Fi. Slorles 0cc Load
j Fire ..s Use .---} ...., Fire Sprinklers -APPLICATION ACCEPTED BY PLANS CHECKED BY APPROVED ~OR 1$SUANCE BY Zone Zone I -Required 0 Yes 0No ~7 No, of I OFFSTREET PARKING SPACES:
OATE~j Dwelling Units No. I No. DATE Covered Sq. Ft. Open
NOTICE Special Approvals Required Received Not Required
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB-PLANNING DEPT.
ING, HEATING, VENTILATING OR AIR CONDITIONING, HEALTH DEPT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF FIRE DEPT
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A SOIL REPORT
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM
MENCED OTHER (Specify)
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS ENGINEERING DEPT. APPLICATION ANO KNOW THE SAME TO BE TRUE ANO CORRECT.
ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS
TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED WATER DEPT.
HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
51CHIATU,-l o, CONT"AC TOJl Oflt AUTH0,.11l0 AGtNT (DATE)
"IGNATUIII[ o, OWNtlfll ,,. OWNttlll aulLDE.1111 OATll
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. CASH __..D
~ ... 1y )
TOTAL FEES$ __ / ___ _, ___ _
M,Q,
INSPECTOR
SEE
2711 LUCIERNAGA
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INFO
{78-215)