HomeMy WebLinkAbout1110 CHINQUAPIN AVE; ; 62-5104; PermitAPPLICATION FOR BIlftDING PERMIT
5104
Owner Name
(Please Print)
Contractor
CITY OF CARLSBAD — BUILDING INSPECTION DIVISION
PHONE PArkway 9 1181 Ext 36
• Mailma Address /C/
(Last)(First)(Middle)
(Please Print)
To Construct |£r To Add D To Alter Q To Repair LI
Mailing Addr
Mailing Address
To Convert [
Number
Number
7/xStreef
Sk.
Street
City
City
Phone
Phone
To Move From
Type of Const
(Frame Masonry Etc ,
of Foundat.on No of Stories f To Be Used for
(One Family Dwellmq Store Etc )
Const Valuation $Floor Space of Proposed Construction (sq feet) /^rf Cx
/•/«;—*/N attached
Floor Space of Garage (sq feet) f^ ^ detached QConst Valuation $
LEGAL DESCRIPTION
Lot Block
Located at ) / J &
Assigned House Number
Section
Street Near
Subdivision
Township Range
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
^Z
COMPLYI HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AG
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 tz:
Front Yard Set Back
Side Yard Set Back /
Rear Yard Set Back / O
Distance Between Bldg / ^
Off Street Parking Spaces '
Sewage Disposal System L^ L*4
Zone Residential ( / )
Zone Commercial ( )
Variance
Eng Check By a
r
Iveway^Eefmit Required Yes ( **J No ( ) Fee /
Grading Permit Required Yes (i/J No (
$^Sewer Disposal Plant Capital Cont Fee '^ '
Sewer Pumping Station Capital Cont Fee
Sewer Mam Line Cost /*-///
Sewer Lateral Connection Charge
Water Stocked Lands Charge
Water Main Pipe Line Fee
Water House Service Charge
Water Meter Charge
Sub Total
/ V/
7%
t. /
Plans Approved by
Approved by
Date
Plan Check Fee
Building Permit Fee
Total Charges
O o