HomeMy WebLinkAbout2775 ROOSEVELT ST; ; 63-5300; PermitAPPLICATION FOR B LDING PERMIT 5300
CITY OF CARLSBAD -BUILDING INSPECTION DIVISION
PHONE PArkway 9-1181 -Ext. 36
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Owner Name .. 11 .. -1-.. ~.k .. €..&..j······/2...£ .. r.J. .............................. Mailing
(Please Print) (Last) (First) (Middle)
Contractor .C~ .. ~ ............................ Mailing
{ Please Print)
Address ~~~:f~s~itf .' ~
Address J.~ .. t!. ... d...7 .. k~-:: .. .$'..'h-!.'Y.,.M ~
Number Street City Phone
::,.C..:t:::,~~i,dT:f ::::,:,.,c::•: No. :: ,::,:::•~-,:• ,:•~:,:•:;Q~'.~~;w.
Floor Space of Proposod Construction (sq. foot) . ./, .... 1...ff..t ................. Const. Valuation $ ..... /.$. . ., ... 1....t ... J2. ... 2.. .............................................. .
attached D
Floor Space of Garage (sq. fe et) ................................................. detached □Const. Valuat_ion $ ..................................................................................................... .
LEGAL DESCRIPTION ./.?.4./4./. ....... -;t!!~~O ......... ~.A_,~ ............................................. .
Lot Block Subdivision
:~.~:~:~ti,~~::: ·: :~:::::~:::: T::··hl: :· •. ,,. :::=:
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.
l;,._/J -~ ~" PBr
lf a check is tendered for p·ayment of the above fee and the check is ~ ~ ...____t:'.? i°" • ~ 7""'--
in~~;di~~:i; ,::~ke:,resented for payment, your Building Permit will be SIG~~~~~fTE~~·······a.····~~.
Front Yard Set Back ..................................................................... . Driveway Permit Required Yes (X J No ( ) Fee ...... ~L .• 4-'..5.:' .... ./..:::
Side Yard Set Back ................ &. ... :. ............................................. . Grading Permit Required Yes ( ) No ()<) ....................................................... .
Rear Yard Set Back ........... /L...~········································-Sewer Disposal Plant Capital Cont. Fee ..................................................................... .
Distance Between Bldg. ff.lLE/. .. C,,,..l:f.:/.;=" D ....... . Sewer Pumping Station Capital Cont. Fee ................................................................... .
Off Street Parking Spaces ............... 2. ....................................... .
Sewage Disposal System ················~························
Zone -Residential ( p ) ........ R:.-:..2--::-:. .......................... ..
Sewer Main Line Cost .............. .l!r...t.J:e.:.f.e. ...... !.~~.!..t!!.t. ....... &..UJ. .. t ............... .
Sewer Lateral Connection Charge ...... :?..f!::~ ...... 0.!.! .. ~ .. 'o(.f ....................................... ..
Water Stocked Lands Charge ......................................................................................... .
Zone -Commercial ( Water Main Pipe Line Fee ............................................................................................. .
Variance
E,g. Choo, By ·········~······················································
Water House Service Charge ......................................................................................... .
,=1!r 't~~; t!~e!;~."!..5 ................ $.'/ ....... ~ .................... ~ ... ~.::.~~
Jlf 'ejt!.!I. r; I,, !:," ~ .,,2 S-
Sub Total ......................... : ........................................................... .
Plans Approved by ···························································-·······································Plan Check Fee ....................................................................................................... .
App,md by ....... ):./.:.~ ..................... B•ildi,g Po,mit F,o .... -4.t'J., .... ~ ................................................ /.-,/. ..
Date ........... 4',¥~......................................................................... Total Charges ......... //.. ..... 2.,2.~ .......................................... _