HomeMy WebLinkAbout2820 MADISON ST; ; 62-4160; PermitAPPLICATION FOR BU~DING PERMIT -. _,i
4160
CITY OF CARLSBAD -BUILDING INSPECTION DIVISION
PHONE PArkwoy 9-1181 • Ext. 36
::P~o:isl:::,~~ T:f ::::d:;on ~ .. No. :: S::,~::" ~ T:0 B~o~:e:r:~~lf ~~•~::::::::
(Frome, Masonry, Etc.) !One Fomily Dwelling, Store, Etc.)
Floor Space of Proposed Construction {sq. feet} .. l/ ... '/.K.'..D.... . ......... Const. Veluatlon $ ... Jf--'J--6.6.~---~--~·-·················································
attached D
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1•~·-·leet~i1~1 ::::~e.:.~~t~~~~~.~:;p~.,~~~~f!?::'9~
Lot Block Subdivision
or . . ....... -•.....
Located at ;)/f.,;;J.Q .. ./l'bA-tRt d .~ere,,,,. ..... .
Assigned House Number
·········:::::::::::~~~~:·~: .. :::·. ::~•nge ...................... .
LAND AREA ........................ NUMBER OF EXISTING DWELLINGS ON PROPOSED BUILDING SITE . ..$.N.<...... (INDICATE
SIZE, USE AND LOCATION ON PLOT PLAN). WILL THIS CONSTRUCTION INCLUDE ANY PLUMBING INSTALLATION, ALTERATION, OR
ADDITION? YES ~ NO __ _
I 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 \ ~-A-. ~ • r, n n n
PERMITTEE .. ~.".'.~>l •...... ~
I I
Front Yard Set Back .. /.;i,: ......... /1-?./ .. N.. Driveway Permit Required Yes I No ( ) Foe .'/?:_§ ..
Side Yard Set Back . __ .. b.. ... ~-------&✓-N. .. . Grading Permit Required Yes ( ) No(~ t/._Q~g_
Reor Yord Set Back //) I . _M/.,,y ........... . Sewer Disposal Plant Capital Cont. Fee .............. 1\/'aNC° _______ _
I ,
Distance Between Bldg. ___ /(!__ ... M~_N_ Sewer Pumping Station Capital Cont, Fee .......... /\/ 01\/E .............. .
Off Street Perking Spaces ..... c!!J. .... ;•··
Sewage D;sposal Sy,tem . . ... ~•·4'···
Zone ~ Residential (t~•-n> ...
Sewer Mo;n Une Cost ........... ····#:···········/v._Q..~li#._ ... To··'··v-;s-pj·J:
Sewer Laterol ConnecHon Charge ./Z:.6., .. 50 ......... 2.5...'. . ../-/.Q.R..Z..
Weter Stocked Landi Chergo
:::;::c~ommerc;al ~), . . L 1) ....... .
Eng. Check By0J(#'-... ·
Plons Approved by/'.7,1()~ r~· ..... ~
Approved by -•--········~·d,·~--.......... .
........... Plan Check Fee
__ ...JJ,uilding Permit Fee
Dote ..... ~ -J4-... CJ1--.... ············· ············ Tot.sl Charges