HomeMy WebLinkAbout2801 ROOSEVELT ST; ; 61-4105; PermitAPPLICATION FOR B~DING PERMIT 4105
CITY OF CARLSBAD -BUILDING INSPECTION DIVISION
PHONE PArkwoy 9-1181 • Ext. 36
Owner Nome J!.e./!.J,/.R!J/. .. ... t ~k.. . ........... Moiling Address . ~ t), i3o X. 3 9/. ~£, /4.Jl
( Pleose Print) (last) (1-irst) (Middle} Number Street City Phone
...... __ ------Mailing Address ............... ~
(Please Print) Number Street City Phone
(0ove From 67.J~,.f Z.M ;;;,, ....
Contractor
To Construct 0 To Add 0 To Alter 0 To Repair D To Convert D
Typo of Con•tF~Kind of Foundation .... l.:.~., ...... No. of Stories .... ./ .... To Be Used 110;~!~~iii~9 ..... 51~~;,
Floor Spece of Proposed Construction (sq. feet) ................................ ,Const, Valuation $ ..... ~.8-1/~-Etc.)
attached D
Floor Space of Garage ( sq, feet) ............. detached □Const. Valuatlon $ .. .................... _____ _
LEGAL DESCRIPTION
Lot ------···-··········· Block Subdivision
or ... t2.:tJ:SJ........ r'7') Section ......... Township ........................... Rang• ......................... .
Localed al ...... .5J...8'0j ...... /C'~.~ ................... Stroet, Near
Assigned House Number
LAND AREA .......... NUMBER OF EXISTING DWELLINGS ON PROPOSED BUILDING SITE . .... .. (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 p-oyment of the above fee and the check is
not honored when presented for payment, your Building Permit will be
immediately revoked.
Front Yard Set Back .
Side Yard Set Back ..
Rear Yard Set Back .
Driveway Permit Required Yes (
Grading Permit Required Yes { J
No (,,(Foo
No,-< .....
Distance Between Bldg ..
Off Street Parking Spaces .
Sewage Disposal System ..... .
Zone w Residential (
Zone w Commercial
Variance
Eng. Check By .
Sewer Disposal Plant Capital Cont. FH .
Sewer Pumping Station Capital Cont, Fee
Sewer Main Line Cost .
Sewer Lateral Connection Charge .
Weter Stocked Lands Charge .
Water Main Pipe Line Fee .
Water House Service Charge .
Weter Meter Charge .
Sub Total .
Plans Appro~··············•····•·············/·--·························································''an Check Fee
Approved by ..... t;;_ .. S. .. ~ ... ~•····· .. ····Buildi'ng Permit Fee ~~<,
.. ..S~.o Total Charge5 ······································----