HomeMy WebLinkAbout1141 CARLSBAD VILLAGE DR; ; 63-5388; PermitAPPLICATION FOR UlfflliU PERMIT
"N! " 5388
CITY OF CARLSBAD — BUILDING INSPECTION DIVISION
PHONE PArUay 9-1181 - Ext 36
[Last](First)
Owner
(Pleaso Prmt[
Contractor j£2s£'***—~ t
(Pleaso Print)
To Construct D To Add D To Alter
(Middle)
To Repair
Mailing Address/
~?
Mailing Address
To Convert I
Type of Const
(Frame, Masonry, Etc
of Foundation No of Stones
J
To Move From '
r-——Address
To Be Used for A —•*"-
(Ono Family Dwellmq, Store, Etc )
Floor Space of Proposed Construction (sq feet)
Floor Space of Garage (sq^feet)
LEGAL DESCRIPTION/A^
Lot
Const Valuation $
attached Q
detached dConst Valuation $
Block Subdivision
Townshi
t
Range
Located at
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
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 chock is tendered for payment of the above fee and the check is
not honored when presented for payment, your Building Permit will be SIGNATURE OF
immediately revoked PERMITTEE
Front Yard Set Back
Side Yard Set Back
Rear Yard Sot Back
Distance Between Bldg
Off Street Parking Spaces
Sewage Disposal System
Zone - Residential [ }
Zone - Commercial { )
Variance
Eng Check By
Driveway Permit Required Yes ( ) No (
Grading Permit Required Yes ( J No ( )
Sewor 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 Motor Charge
Sub Total
Fee
Plans Approved by
Approved by
Date
Plan Check Feeww$Building Permit Fee
Total Charges ^
IK*