HomeMy WebLinkAbout2754 JEFFERSON ST; ; 75-1269; PermitG PERMIT APPLIC TION
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City of CARLSBAD, CALIFORNIA 92008Pe _
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Phone 729-1181 /D -spaces on y. ' rm, 0. ,J
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BOOK PAGE I PAR.
LEGAL I Q sEC ATTACHED SHEET) 1 OtSCR.
OWN[,t MAIL •ODfllES5 ZIP PHONE
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CONT,tACTOfll MAIL ADDRESS PHONE LICENSE NO. STATE CITY
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AIIICHIT[CT OR OESIGNEfll MAIL ADDRESS PHONE LICENSE NO.
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ENGINEER MAIL ADDA [SS PHONE LICENSE. NO.
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COMPENSATION INS. CARRI ER MAIL AODlltES5 8111:ANCH
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USE OF' BUILDING
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8 Class of work: DNEW [] ADDITION 0 ALTERATION 0 REPAIR 0 MOVE 0 REMOVE
9 Describe work: ?A T;,i / c;,,. ~ )t' .;;~ ,
10 Change of use from
Change of use to
11 Valuation of work : $ /7 40 V ;.,/ / I ,.-;--' ...-PLAN CHECK FEES PERMIT FEE S
SPECIAL CONDITIONS: Type of Occupancy MICRO FILM FEE
Const. Group
s,ze of Bldg. No. of Max.
(Total) Sq. Ft. Stories 0cc. Load
Fire Use Fire Sprinklers
APPLICATION ACCEPTED BY PLANS CHECKED BY APPROVED FOR ISSUANCE BY Zone zone Required 0Yes 0No
No. of OFFSTREET PARKING SPACES:
Dwelling Units No, 'No. DATE 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 120DAYS, 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 AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS WATER DEPT. TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED 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.
SI GNATURE o, CONTPIIACTOR Ollt .A.UTHOJIIIZED AGENT (DATE)
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SIGNATURE OF OWNER (IF OWNEl'I 9UfLOtR) IOATE)
WHEN PROPERLY VALIDATED (IN THIS SPACEI THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
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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.
9-)9-75 Very good Eraroing, sheathing all OK footings very :well done l' Ma
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. BUILDING PERMIT APPLICAT101'l
Permit No. 71-(II _: City of CARLSBAD, CALIFORNIA 92008
Applicant to complete numbered spaces only. Phone 7 29-1181 ..
JOB ADOR ESS .,. , ,( / ) . .• . I TR .. CT -
LEGAL I 1 DESC R,
<DSEE ATTACHED SHEET)
MAIL ADDRESS .x "
OWNER ZIP
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PHONE
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. MAJL ADDRESS CONTRACTOR / PHONE ., ~-LICENSE NO.
ARCHITECT OR DESIGNER MAIL ADDRESS PHONE LICENSE NO.
4
ENGINEER MAIL ADDRESS PHONE. LICENSE NO.
5 .... ,,,..,,.,,_.,,,,
LEN DER MAIL ADDRESS BRANCH
6 ..
USE OF BUILDING ' 7
~
8 Class of work: DNEW 0 ADDITION 0 ALTERATION 0 REPAIR 0 MOVE 0 REMOVE
9 Describe work:
-~ ---
10 Chfhge of use from
Change of use to
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ll
',:
'
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11 Valuation of work: $ PLAN CHECK FEE -/ I ,-PERMIT FEE !J C;9.
~S_P_E_C_I_A_L_C_O_N_D_I_T_IO_N_S_: ____ /'---------------------1Typeof
• Cond.
>-----------------------------... Size of Bldg. (Total) Sq. Ft.
Occupancy
Group
No. of
Stories
Division
Max.
0cc. Load
use Fire Sprinklers
"' (""'\ , ... :;.
L.
0
(IJ
)>
0 0
ll
fTl
(/1
(/1
....
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---------..... ----------...----------1 Fire APPLICATION ACCEPTED BY. PLANS CHECKED BY APPROVED FOR ISSUANCE BY Zone Zone Required DYes DNo
No. of
Dwelling Units
OFFSTREET PARKING SPACES:
,I' -r Jr'
NOTICE
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 60 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 AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED
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.
SIGNATURE OF' CONTRACTOR OR AUTHORIZ.E.D AC£NT (D .. TE)
Covered I Uncovered
Special Approvals Required Received Not Required
ZONING
HEALTH DEPT.
FIRE DEPT.
SOIL REPORT
OTHER (Specify)
~~~--~~----~~~~~~~~~~-,...,,.,..,..;.._,1.:_-1tf_,5 1--~~~~-----,~~~~-----,r-~~~~1--~~~---1
SIGNATURE OF OWNER (IF OWNER !SUILOE.R) (DATE)
WHEN PROPERLY VALIDATED (ii\ THIS SPACEI THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH "\ERMIT VALIDATION CK.
'/ fu 1...>
M.O. CASH
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.