HomeMy WebLinkAbout1040 BUENA PL; ; 63-5298; PermitAPPLICATION FOR B u 1 L D I N 6 PERMIT
CITY OF CARLSBAD - BUILDING INSPECTION DIVISION
PHONE PArkway 9-1181 - Ex+. 36
Owner Name ..M.K..&..&..d6-- (Please Print) (Last)
Contractor ease Print) Mailing Address .~..~~..~~...~~.-...~
Mailing Address ................................................................................................. ......- Number Street City Phone
............................... Number Street City Phone
To Construct$ To Add 0 To Alter IJ To Repair 0 To Convert 0 To Move From ..............................................................
Type of Const.2d..-ind of Foundation ...*...I .... No. of Stories ....... [ ...... To Be Used for . __.___ ...........
(Frame, Masonry, Etc.) (One Family Dwelling, Store, Etc.] r-n fi
Floor Space of Proposed Construction (sq. feet) .... /sg..# ......... Const, Valuation $ .... J.4 ... o...&.@...: .... I...] ..... [,z..G-w4
bd attached detached&Const. Valuation $ ....... z+.J.y+ ....... rd ............................... ..-.: ..... Floor Space of Garage (sq. feet) ............
........................................................................................................... Section .. ................................. Township Range ............................ ............................
>. . ..!h ................................................................... .- ....... Located at .c. a ...e.................................................! D
ADDITION? %
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
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 payment of the above fee and the check is
not honored when presented for payment, your Building Permit will be PERMITTEE immediately revoked. ................... .... ................. SIGNATURE OF
f Front Yard Set Back .....................
Side Yard Set Back ..................... Q ..............................................
Rear Yard Set Back .................................................................... s
Distance Between Bldg. ......./r...................................................... D
...................
I
I
/
z Off Street Parking Spaces ............................................................
Sewage Disposal System ..............................................................
Zone - Residential ( ] __ .....................................................
Zone - Commercial ( ) ..........................................................
q-
Driveway Permit Required Yes ( L) No ( ) Fee &25 .......... : ...........................
Grading Permit Required Ye5 (
Sewer Disposal Plant Capital Cont. Fee
) No [ -r': ....................................................
N 4, Sewer Pumping Station Capital Cont. Fee ....................................................................
Sewer Main Line Cost ........................................................................................................ 8, 4
Sewer Lateral Connection Charge .................................................................................. %2G*SO - /z!-/ak
Water Stocked Lands Charge ..........................................................................................
Water Main Pipe Line Fee ..............................................................................................
Water House Service Charge ..........................................................................................
/JDsG4/4 c.= 5/y1ffFTF43* 4 Water Meter Charge ............................................... /h? ............................................ E?' - tu S-J-,
........................................................................................................ Plan Check Fee /- 7 Approved by .............................. Building Permit Fee ..&$ ..............................................................................
Date Total Charges ....-
It4 11
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