HomeMy WebLinkAbout2787 STATE ST; ; 76-2746; PermitBUILDING PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA 92008
Applicant to complete numbered spaces only Phone 729-1181 Perm it No
JOB ADDA ESS ...,
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LEGAL I 1 ocsc•.
LOT NO, l'"'CT t0 SEC A TTACHED SHEET )
OWN[R ZIP
2
ASSESSOR'S
PARCEL NUMBER
BvvK PAGE I PAR,
CON Tl'lAC TOR ~NC STATE LIC, NO. CITY LIC. NO.
3
AIIICHITCCT OR OCSIGNCR MAIL ADOAC.SS Pt10NE LICtNS£ NO.
4
CNGINCCR MAIL ADDRESS PHONE LICENSE NO.
5
COMPENSATION I NS. CARRIER
6
USE OF BUILDINC.
7 NO. BORMS NO. BATHS
8 Class of work: □NEW 0 ADDITION 0 ALTERATION 0 REPAIR 0 MOVE i;,clEMOVE
9 Describe work:
··"' I '--10 Change of use from /
Change of use to
11 Valuation of work: $ PLAN CH ECK FEE S
~S:...P....:E_C_I_A....:L:......:.C..:.O_N_D_I_T_I O_N_S_: __________________ --1 Type of
Const.
1-------------------------------~ Size of Bldg.
(Total) SQ. Ft.
1-----------..----------.----------..1 Fire APPLICATION ACCEPTED BY PLANS CHECKED BY APPROVED FOR ISSUANCE BY Zone
~'7 .... >No. of
~&-te. ~-/ -:::,_" (1wellfng Units DATE CATE
Ii NOTICE
SEPARATE P~MITS 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 120 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 THIS APPLICATION 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 SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT
PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY..-0,THER STATE OR LOCAL LAW REGULATING CONSTRUCTION Off THE PERFORMANCE OF CONSTRUCTION.
~.. .,.#f.v_( ,A..Aff/ ( ,,
SIGNATUAC OY CONT7TOO 00 AUTHO .. IZ<O AGENT IDATEI
SIGHATUll':t 01" OWNU• ,,-OWN£" BUILDEIII) DATE)
Special Approvals
PLANNING DEPT.
HEALTH DEPT.
Fl RE DEPT.
SOIL REPORT
OTHER (Specify)
ENGINEERING DEPT.
WATER DEPT.
Occupancy
Group
No. of
Stories
Use
Zone
I PERMIT FEE $
MICRO Fl[M FEE
Max.
0cc. Load
Fire Sprinklers
ReQulred DYes 0 No
OFFSTREET PARKING SPACES,
No. INo. Covered SQ. Ft. Open
Required Received Not Required
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATIONA /~CK. -M .O.
irr ~.,e -=~:::-:--OTAL FEES $1,..:..::...==:!:..._-----
CASH
INSPECTOR