HomeMy WebLinkAbout204 SEA BREEZE DR; ; 69-M12; Permit) STATE OF CALIFORNIA co. ____ 10 No _____ _
Dep. ,ent of Housing and Community Development SHL 0
EPL 0
MP 0
Division of Building and Housing Standards
APPLICATION FOR PERMIT TO CONSTRUCT
BUILDING-PLUMBING-ELECTRICAL ~I?'}_ I~ Acc/S n
TO BE COMPLETED BY APPLICANT
(COMPLETE IN TRIPLICATE-PLEASE PRINT)
'---''------'---'--L--"---''-'--"'-'--"'-=-------State lie. No . .e:::i'--'-<=L-.L.L.'?"_C=-G=..,/'----11
Address,'-'....,.C.L.--..:....--"~----"-~'"-'--'----J'---..---"--'--.,._'---'-'-''--_;::::...i..._-0.=_C ___ -jl
Workmen's Comp. Certificate Verified•-------------------------ii
Approved=----------~~~~~~~----------------11 Project Owner/Operator
(Required for accessory structure, mobilehome park)
MOBILEHOME PARK
Lots: lndep. __ Dep--Acc. Structure _____________________ 11
BUILDING
Accessory Building: Type, __________________________ -11
PLUMBING
Fixtures/Sewer lnlets ___________ ,Fire Hydrant~--------------il
Main sewer ___________ ,Prlvate Sewage Disposal, ___________ ----!
Water Heaters, _______ Gas Outlets, _______ Gas Regs ________ --,,
Water Pipin ________ ~lt/Rep _________ Sprlnkler ________ -11
Backllow Preventers, ___________ Other _______________ -11
ELECTRICAL
Outlets, _________ Flxtures, _________ Motors (HP1----------ll
Generators (KVA), ____________ Merc Lamps _____________ -11
Ranges/Heaters, _______ Signs _______ ,Fire Alarm Syste .. ~--------<,
MH Lots, ______ .servlce: 200 AMP or less ______ Over 200 AMP _______ --11
Over 600 v ______ Other ______________________ -;1
I hereby acknowledge that the information I have provided is correct and agree that all construc-
tion shall be in accordance with applicable provisions of the health and safety code and related
rules and regulations of the State of California, and on behalf of the owner, I herewith consent to
all necessary inspections incident to the issuance of this permit.
Datl'fdJ-f-t. 7
Plan Check Fee due with application-Not Refundable.
Distribution: Orig. to Area Office, 1 DR, 1 Applicant
HCO FORM !>OIA (REV. S-'58)
DIVISION USE ONLY
Prior I ocal Approval:
Fire Department Jl1=C 1 69 5PUO lctl******lJ.OO
Health Depa~ment -• 7 /-CC J -Planning Comm _____________ _
Other ________________ _
BUILDING Fee
Type __ Gr __ Val.
Type __ Gr __ Val.
BUILDING PERMIT FEE . . . . . . . . . . __
PLUMBING
No. Item Fee --
--Fix/Inlets
--Hydrants
--Main Sewer
--Pvt. Disp, Sys.
--Water Heaters
--Gas Outlets
--Gas Regs
--Water Piping .
--Alt/Rep.
--Sprinkler
--Backflow Prev.
--
PLUMBING PERMIT FEE . . . . . . . . . . __
ELECTRICAL
No. Item
--Outlets .
--Fixtures
--Motors (HP)
--Generators (KVA)
--Mere Lamps
--Ranges/Heaters
--Signs
--Fire Alarm
--MH Lot Equip,
--Service (AMP)
--
ELECTRICAL PERMIT FEES
ISSUANCE FEES
Total Permit Fee .
Plan Check fee
Total Fee
Fee
~OSP
DATE __________ _
CUSTOMER NAME ~ ~~
CUSTOMER ADORES ~ SLd: ~
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SPACE NUMBER h ·
CITY c:ti,_ 1.s 4 d_. CA 1/-r 7 ,
ENFORCEMENT AGE NCY __________ _
DEPARTMENT OF BUILDING AND SAFETY
MOBILE HOME
P/L
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STREET LOT NO.
SOLAMAR MO~'-tE ESTATES
6!:'500 i'iik:,llway 161
NAME OF PARK Ca.rlsbadl Calif. 92008
PARK MANAGER'S AUTHORIZATION TO INSTALL -------,--+:-~.......,f---::---,,...r---'-..a...a.-----r--
PARK MGR"S SIGNAT URE J g -~wt
NOTE:
PARK BUILT PRIOR TO 10-16~5 Yes_No_