HomeMy WebLinkAbout2551 STATE ST; ; 71-295; Permit0 L
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~P;~o 1175**'
z -'[; _,., City of CARLSBAD, CALIFORNIA APft 28-11 ~., 3~ ioOO
App/4n-;;0~1/?ete numbered spaces only. "' ..
!tr .. JOBADO Rii5"""o/ )~Q (J ~ ;('-~ ~~J?~ 0 ~, LO~O. ,~; S~ -~ ,cJP ~ .,,k /4?/~A7:.:;;_ 5H:rl -~ 1 ~~;~~-r,r:-.J l . J74 f'q µ;/ of I
OWNER ., -
57i7J Lnak?1C/ M{J;.JJ, r1at1:la2
ZIP ,/ PHONl -......:..
2f A-fi<!O ~-:2..3S? '!1~-~ ~ /~CY
CONTIIIIACTOA I/ MAIL ADDRESS PHONE LICENS\: NO,}
-~ 3 /"lJu, ""'trcY-
ARCHITECT OA DESIGNER MAIL ADDRESS PHONE LICENSE. NO, ~ 4
----
UIGINEER MAIL ADDRESS PHONE LICENSE NO,
5 ~
BUILDING PERMIT APPLICATION 1
L l NO[R MAIL ADOflESS BflANCH
6 /IJo,yu
use 0,. BUILDING . ih l cf c, 7 {').f:l.C I ~ t6"
8 Class of work: ~ __,
~DITION 0 ALTERATION 0 REPAIR □MOVE ~MOVE
9 Describe work: £ I ~.J._;'lA a b /Jq <:.. +/1 ),,.> J/"-,;,,,,"t/('rl iv rlp_,,~d ·hft ,,
J ✓ /
10 Change of use from 'I • ;-
Change of use to
11 Valuation of work: $ <;?-z:;:11 /, // ~ .-I PERMIT FEE ~ /, lll!l.. PLAN CHECK""
SPECIAL CONDITIONS: ,
Type of ·£, Occupancy 2.... Const. ~ -/ r -Group .;z Division
Size of Bld~~k 80 No. of ,,2 Max.
(Total) Sq. F. Stories 0 cc. Load
-
Fire 2 use e,-M Fire Sprinklers ~ i--
APPLICATION ACCEPTED BY. PLANS CHECKED BY APPAOV=-'.:_ ~y Zone z one Required □Yes
~/fy-1 o. of OFFSTREET PARKING SPACES:
/ ":;/\I Dwelling Units ~ Covered 6 I Uncovered 17
NOTICE Special Approvals Required Received Not Required
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB-ZONING
ING, HEATING, VENTILATING OR AIR CONDITIONING. HEAL T H DEPT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC·
TION AUTHORIZED IS NOT COMMENCED W ITHIN 60 DAYS, OR IF FIRE DEPT.
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A SOIL REPORT
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM·
MENCED. OTHER (Specify)
I HEREBY CERTIFY THAT I HAV E READ AND EXAMINED THIS
APPLICAT ION AND KNOW THE SAME T O BE TRUE AND CORRECT.
ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WO RK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE O R CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
~1-1 ?PlaY
s1r.NyuRE or CONTRACTOilll OR AUTHOftlZED AGE.NT (DATE)
S IC.NAT RE 0,. OWNER 1, OWNER BUILDER) DATE)
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
INSPECTOR
Form 100.1 9-69 R £0"10ER ,-IIIOM : IN T ERNAT ION A L CON FER E NCE OF B UILDIN G OFFICIA LS e t50 50. LOS ROBLES e PASADENA, CALl,.ORNIA Q110 1
INTERDEPARTMENTAL INFORMATION SHEET /' _ / _,,, /
DATE :--r:::;::,,'--r:y~ -:2tp-++-~1I-·
" =B,.;;;U-=I::.;;;Lc-D....;I=N;.;..G;:;__.;:;;.D-'-E.;;;.P.;;..A;.:_R.;.::T::.;;;M.;;.;;E:c:.;:NT;.;.=.. ~ -.
Ownc.'s Nat-4-~---L-~-----Permit No.
AddressJ5S/ ~~ ----------------
Lot No. ------------------
ntractor -----------------Legal Description ------------
Approval to I ssu e Permit ---------Ce rtificate of Occupa ncy --------
PLANNING DEPARTMENT
P a.r k i n_<J Spaces Provided ,17 Required / I/-
setbacks ~ Zone ~
Remarks:_o o o-e__
Date 7 \ Date ~ Z.0 -3 ~ '/
Approval to I ssue Permit Approval for Occupancy ~ <
ENGINEERING DEPARTMENT
/:::).,, / /}_ ··-~ / Right of w ay_....,t, .... '-ft'~-v_s-r_~c:;;_a_-___ !7?,.......,.-L:>...,,?o~-f.-h_.n..._ .... aSd. ........ _ Ind ustrial Waste ).//7. -,.cec=---=---,ir-"2-.a--'--,o--p--9-,-_-
Sewer Connection -<"'3~"1r. h <> o / r r., .1 ;; 1// 1,1 -,
Wa t er Connection ffe ~if&>/.et&;;J
Drain age '7>~,4-,;v rtJ S' 77Urcr 7?I ,eq ,LJ,,bf/b.J tJ
Improve ments ___ ~ey~"'""""i -x~v~·N......,., ______ _
Driveway Locations_~'lfi----~!-'~.-t .......... ,-~_n-\~_,5~~--
Easements /lf .4 --------------------\ <,.7~'
Remarks : _ _:-~e...-~~~~@~M~O,.,~P~~~ffe,32::<=~~~~•='5~,~►-~'Z'a~JZ~7~h"J~.;LLA~~:4,,~~~sc~:6~2r:=~L2~..v.;~U~~.=/4a~z~€~-:2A-i::::.T~=-----
~5 /()(24,o., 5::z:: 4 A-c::--K )t:J / /4,,(' ftff,4;J-_s;:.#tzz: t..J1;:;G"",,_;,N ?
Date ___ ~7j.__,.J~~/._·"--'-7/ ___
7
..,,_1 Date 8 -/4-0-7 I
Approval for Occupancy __ ~ _ _;..,,;. _____ _
FIRE DEPARTMENT
.2-2A ~,,u? elln,._,,-, /,.o;-JJv
,_re Protection Equi pment Pll~, lv~n:-12. .i9.S S-'F'ire Alarm ----------------
Exits -------------------Permit Required -------------
Spe cial Haza rds --------------Fire Hyd r ant ---------------
Date ~ -/'3 -7 / Date ---------------------------------------
Approva l to Iss u e Permit .A-½J~c~ Approva l for Occupa ncy ________ _
CITY OF CARUBAD
BUILDING DEPARTMENT
FOR APPLICANT TO FILL IN
LEGAL
DESCRIPTION LOT NO.
BLOCK TRACT
USE OF
BUILDINGS
CONTRACTOR
ADDRESS
CITY TEL. NO.
CONTRACTOR'S STATE
LICENSE NO.
C ARLSBAD BUSINESS
LICENSE NO.
NO. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO PUBLIC SEWER 0 $3.00
SEPTIC TANK, SEEPAGE PIT OR
PITS 0 $15.00
OVERl'LOW SEEPAGE PIT, DRAINl'IELD EXTN.,
CESSPOOL. DRYWELL, MANHOLE • S!l.00
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM 0 $1.150
CONNECT ADDITIONAL BLDG. OR
WORK TO HOUSE SEWER O $1.!IO
ALTER, REPAIR OR ABANDON HOUSE SEWER OR DISPOSAL SYSTEM O $2.00
• •
OWNER'S I PERMIT s 2
AUTHORIZATION TOTAL P'IEE
00
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN CONTRACTOR TO CONNECT THE ABOVE DESCRIBED BUILD-
ING TO THE PUBLIC SEWER,
SIGNED THIS -----DAY OF ----------OWNER OR
OWNER'S AGENT-----------------
ADDRESS
I HEREBY ACKNOWLEDGE THAT I HAVE RE.AD THIS
APPL ICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY W ITH ALL C ITY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED
A ND/OR LICENSED AS REQUIRED BY THE CITY OF CARL&.
BAD AND STATE OF CALI FORNIA OR THAT I AM THE LEGAL
OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROP.
ERTY.
SIGNATURE
OF PERMITTEE -----------------
SEWER
PERMIT • APPLICATION
BUILDING
ADDRESS
NEAREST
CROSS ST.
OWNER
MAIL
ADDRESS
CITY
Lateral Charge
30' H., 10' V.
Add. Horiz.
Add. Vert.
TEL. NO.
CONNECTION DATA
Computation
@ 4" = ___ 6"
@ 4" = ___ 6" ----
@ 4" = ___ 6" ----
Total Construction Cost
10% Service Charge
Toto( Lateral Chorge ____ _
Lot. No.: Logged in Plot:
LINE COST DATA
A. D. & Assmt. No. _________ ....;____;___;.:..;.__ __ _
LINE COST: ________________ _
C. C. @ __ / dwelling -~-------'-----
P. S. @ __ / dwelling ---------____ _
OTHER __________________ _
TOTAL
Grand Toto(, Loteral, etc.
FOR SEWER LOCATION
~-----------------1~
St.
ENGINEERING SEWER DEPT.
NORTH
Signed ________ _ Signed ________ _
This i1 e Sewer Permit When Properly Filled Out, Signed end Validated
l11ued By ---------·----------
PERMIT VALIDATION