HomeMy WebLinkAbout2828 CARLSBAD BLVD; ; 71-374; PermitBUILDING PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA
Applicant to complete'numbered spaces only.
JOB ADDH ESS
ATTACHED SHEET)
WAIL ADDRESS
CONTRACTOR WAIL ADDRESS LICENSE NO.
ARCHITECT OR DESIGNER MAIL ADDRESS
ENGINEER MA]L ADDRESS LICENSE NO.
MAIL ADDRESS
USE OF BUtLDl NG
8 Classofwork: D NEW nADDITION DALTERATION D REPAIR D MOVE D REMOVE
9 Describe work:
10 Change of use from
Change of use to
3>w UJ
11 Valuation of work:PLAN CHECK FEE PERMIT FEE
SPECIAL CONDITIONS:Type of
Const.
Occupancy
Group Division
Size of Bldg-
(Total) Sq. Ft.
No. of
Stories
Max.
Occ. Load
PLANS CHECKED BY
Fire
Zone
Use
Zone
Fire Sprinklers
Required Qv
No. of
Dwelling Units
OFFSTREET PARKING SPACES:
Covered Uncovered
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 THISAPPLICATION 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 SPECIFIEDHEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT
PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISJONS OF ANY OTHER STATE OR LOCAL LAW REGULATING
CONSTRUCTION OR ,THE PERFORMANCE OF CONSTRUCTION.
Special Approvals
ZONING
HEALTH DEPT.
FIRE DEPT.
SOIL REPORT
OTHER (Specify)
Required Received Not Required
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT
SIGNATURE OF OWNER UF OWNER BUILDER}
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK.M.O.CASH PERMIT VALIDATION CK.M.O.CASH
Form 100.1 9-69
INSPECTOR
REORDER FROM: INTERNATIONAL CONFERENCE OF BUILDING OFFICIALS • 50 »NIA 91101