HomeMy WebLinkAbout1075 PALM AVE; ; 62-5065; PermitAPPLICATION FOR Bu . DING PERMIT
CITY OF CARLSBAD -BUILDING INSPECTION DIVISION
PHONE PArkway 9•1181 • Ext. 36
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Contractor -~~ ... .A/.~ ..................... Mailing Address .. ~•·················································· ( Please Print) Number Street City Phone
To Construct ~To Add D To Alter D To Repair D To Convert D To Move From ............................................................. .
Type of Cons+.1.~ind of Foundation ...... ~~J. ..• No. of Stories ...... / ..... To Be Used for ....... ~ ....................... .
( Frame, Masonry, Etc.) (One Family Dwelling, Store, Etc.)
Floor Space of Proposed Construction (sq. feet) ........ ~~==·············Const. Valuation $ ........ ~ ................. TD··~·············································
Floor Space of Garage (sq. feet) ................... ~Q ............ d::~~:~ a;:st. Valuation $ ..... (:_ .... <~<: ..................................................................... .
LEGAL DESCRIPTION .~.e,i ....... f...~ .. .i.. ... /. .. '7. .............................. B...l/~.5 ......... /l.J!.. .. !fP. .. f ... -!.!:..i.9 .......... .£2. .. c.: .. R. .. IJ:.5..
Lot Block Subdivision
:~c·~~:~ .. ·~·~··::;;:7.;.::::::::::::::t.1.£:z;:::::::::::::::::::::::::::::::::::::::::::::::::::::~·::~~··:::·.:::::::1.9.::;.?;;~'.;.;_·.·.·;.::·.:·.·.·.·.·.:·.::: .. ~.~.~.~~::::::::::::::::::::::::::::
Assigned House Number
LAND AREA ...................................... NUMBER OF EXISTING DWELLINGS ON PROPOSED BUILDING SITE ....... N..f) .. ~ .. e.. .......... (INDICATE
SIZE, USE AND LOCAT✓ 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.
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
immediately revoked.
SIGNATURE OF
PERMITTEE ............ .
I I
Front Yard Set Back ...... o.? .. O. ......... ~ .......... . Driveway Permit Required No ( ) Fee . ./.~ .. ?.§. ............. ..
ol ...,..-
Side Yard Set Back ........ 0 .......................................................... ..
Rear Yard Set Back ...... J.b. .. :. ...................... ~ ................ -
Grading Permit Required Yes ( ) No ( <.. .......... ~~S. ...................... .
Sewer Disposal Plant Capital Cont. Fee ..... f....9...Q.-:: ... 9...Q ........................ .
1 '--Distance Between Bldg .... /.l>. ............. ~ ..................................... .
Off Street Parking Spaces ....... / ... ;·~·~··············."··· .. ·············
Sewage Disposal System .......... &;·7·· .. ········ ..................... .
Zeno • Residential ( / ) ........................................................... .
Sewer Pumping Station Capital Cont. Fee ..... N..Q.&C.. ................................... .
Sewer Main Lino Cost ...... CA.-F.!l.. .... ~~!.:.0.!7'!..'::!.. ..... B...(D. .... .
Sewer Lateral Connection Charge .4../?...Q.!. ... ~Q ....................................... .
Water Stocked Lands Charge ......................................................................................... .
Zone • Commercial ) ......................................................... .
Variance
Eng. Check By .............................................................................. ..
Water Main Pipe Line Fee ............................................................................................. . i I
Water House Service Charge ··r·······~···f'!.~ ..................... .
Water Meter Charge ............ ~~········· .. ····-'--./..l./).~ ....................... .
# t9.:: 87 .z£ Sub Total ............................................. : .................................... .
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PIPanpsroAvepdprobvyeco/.2 ..... b ........ ~::s.;:::o~:::~::::::::::::::::::::::::~~l:i:gheck Fee ·····················;=·b···o································································
Permit Fee ......... 3.. . .... :-:=:: ........................... ,,_ ........................... ..
Date ................ 2.=/·?,f._·=·G ... ~............................................................ Total Charges .......... ~ ........... ~ ... ;;? .. ii? ..... ~:: ................................. _
APPLICATION FOR BU111DING PERMIT 5255
CITY OF CARLSBAD -BUILDING INSPECTION DIVISION
PHONE PArkway 9-1181 -Ext. 36
Ownor Name~£.~.C~4:!.:r.~ .... ~ ........ Mailing
(Please Print) (Last) (First) (Middle)
Contractor ............... ~,f ;t,:t\"""···~················································Mailing
To Construct Ol To Add O To Alter O To Repair O To Convert O To Move From ............................................................. . T '-Address
Type of Const ...... ~/!.~.~ Kind of Foundation ........ ~ .. ~=No. of Stories ... /~ ........ To Be Used for ~~ ....•................
(Frame, Masonry, Etc.) (Ona Family o;.;-6H1n~i:·~. Etc.) fib .
Floor Space of Proposed Construction (sq. feet) ............... t. ..... f.:= ............ Const. Valuation $ ...... /4.<?...¥:····'. ................................................................ .
attached 0
Floor Space of Garago (sq. feet) ................................................. detached OConst. Valuation $ ................................ :,,,. ................................................................. .
LEGAL DESCRIPTION ...........................................................................................•.......................................................................................................................................
Lot Block Subdivision
::,,t,d ,t /~i~~~~~:= :~:::::~::: :'•:"M~ : ::· ••=• : ~~
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 .. f ·····•
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 p·aymont of tho above fee and tho check is
not honored when presented for payment, your Building Permit will be
immediately revoked.
SIGNATURE OF
PERMITTEE ·······················································································-····
Front Yard Set Back ................................................................... .
Side Yard Set Back ..................................................................... .
Rear Yard Set Back ....................... ··············································-
Distance Between Bldg .............................................................. .
Off Street Parking Spaces ......................................................... .
Sewage Disposal System ............................................................. .
Zone -Residential (
Zone -Commercial
Variance
) ·················· ....................................... .
) .............. ·······················•·•·•··············
Eng. Chock By .............................................................................. .
Driveway Permit Required Yes (
Grading Permit Required Yes ( )
No ( ) Fee ................................... .
No ( l .................................................... .
Sower Disposal Plant Capital Cont. Fee ................................................................... .
Sewer Pumping Station Capital Cont. Fee ................................................................. .
Sewer Main Line Cost ..................................................................................................... .
Sewer Lateral Connection Charge ..................................... ··································-·······
Water Stocked Lands Charge ....................................................................................... .
Water Main Pipe Line Fee ........................................................................................... .
Water House Service Charge ....................................... . ............................................... .
Water Meter Charge ..................................................................................................... .
Sub Total .................................................................................... .
Plans Approved by ........................................... 7 .................................................. Plan Check Fee .......................... ~/. ................................................................ .
Approved by ·····#:·:~L't..:-~.eL.£ , .............. Building Permit Foe .$ ......... ~ ................................................................ .
Dot, ······--Y-.,2.Y-.t,__:3.. .......................................... Tot,I Cho,go, & ..... ~ ............................................. .