HomeMy WebLinkAbout2753 JEFFERSON ST; ; 74-1188; PermitPERMIT
City of CARLSBAD,
Applicant to complete numbered spKes only PHOI16 729-1101
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4l,E*AL (TjSEE ATTAC ED SHEE )1 OE3CR V—J
PAW PAR
OWNC* MAIL ADDRESS ZIP ^^ PHOME
CONTRACTOR MAIL ADDRESS PHONE / f LICEHM N« jF»T*TtJ CITY
ARCHITECT OH OCSICNER MAIL ADDRESS PHONE f LICENSE NO JwSfrjgtt f""*
CHCINEER MA L ADDRESS PHO E LICENSE NO
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COMPENSATION INS CARRIER MAIL ADDRESS BRANCH
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1 Cimofwork DNEW D ADDITION D ALTERATION Js^fiEPAIR D MOVE D REMOVE
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11 Valuation of work $ -j ***"^
SPECIAL CONDITIONS
APPLICATICm ACCEPTED *V PLANS CHECKCO BY APPROVED FOR ISSUANCE IV
DATE j , ^ J \ DATE ' * f" ff
NOTICE *
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL PLUMB
INQ HEATING VENTILATING OR AIR CONDITIONING
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC
TION AUTHORIZED IS NOT COMMENCED WITHIN 120DAYS OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM
MENCED
1 HEREBY CERTIFY THAT t HAVE READ AND EXAMINED THISAPPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECTALL. PROVISIONS OF LAWS AND ORDINANCES GOVERNING THISTYPE OF WORK WILL. BE COMPLIED WITH WHETHER SPECIFIEDHEREIN OH NOT. THE GRANTING OF A PERMIT DOES NOTPRESUMat T& OfVc AUTHORITY TO VIOLATE OR CANCEL THEPROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATINGCONSTRUCTION OR TJME PERFORMANCE OF CONSTRUCTION
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-'"SI«N*TURE Of CONTRACTOR OR AUTHORIZED ASE^T jF f (DATE)
MIMATURI or OWNER or OWNER *UII.DIR) (DATE)
PLAN CHECK FEE * "***" ^.WsPERMIT FEE » J?&r
MICJTO FILM FEEType of Occupancy
Const Group
Size of Bid* No of Max
(Total) Sq Ft Stortes Ooe Load
Fire Us* Fir* SprlnkMrs
Zone Zone Required Dvej DNO
OFFSTREETNo of
Dwellin, unttt cSvered
Specul Approvals Raqutrcd
PLANNING DEPT
HEALTH DEPT
FIRE DEPT
SOIL REPORT
OTHER (Specify)
ENGINEERING DEPT
WATER DEPT
PARKING SPACES
Sq. Ft fOp«n
Received NotRstjuirid
r WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
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»LAN CHECK VALIDATION CK MO CASH PERMIT VALIDATION CK CASH
INSPECTOR