HomeMy WebLinkAbout1165 CHINQUAPIN AVE; ; 62-5152; PermitAPPLICATION FOR BllDING PERMIT
"N? 5152
CITY OF CARLSBAD — BUILDING INSPECTION DIVISION
PHONE PArkway 9 1181 Ext 36
Owner Name
(Please Print)(Lost)First)
Contractor
(Please
To Construct £f To Add D To Alter D
id \MMiddle) (]
) \J
(Middle)
^t^L
ailing Address
..Mailing Address
Numbe
Type of Const '"JJ/J^UvvA,. Kind of Foundation
(Frame Masonry Etc )
To Repair D To Convert d
No of Stories /
Nurrtfer
To Move From
Street / / City
Street City
Addtess
Phone
Phone
To Be Used for
(One Family Dwellmq Store Etc )
Floor Space of Proposed Construction (sq feet) <fC?J f Const Valuation
attached D
detached QConst Valujdio. ^
Akikn. '6^-
Floor Space of Garage (sq feet)
LEGAL DESCRIPTION
Lot Block
Located at
Section
Street Near
Subdivision
Township Range
Assigned House timber /
LAND AREA NUMBER OF EXISTING DWELLINGS ON PROPOSED BUILDING SITE ^>l-O-*-»— *— ^. (INDICATE
SIZE USE AND LOCATION ON PLOT PLAN) WILL THIS CONSTRUCTION INCLUDE ANY PLUMBING INSTALLATION, ALTERATION OR
ADDITION?
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 SIGNATURE OF
immediately revoked PERMITTEE
Front Yard Set Back
/OSide Yard Set Back U'
Rear Yard Set Back / /
Distance Between Bldg / "
Off Street Parking Spaces '
Sewage Disposal System
Zone - Residential ( / )
Zone - Commercial ( )
Variance
Eng Check By
Driveway Permit Required Yes ( )
Grading Permit Required Yes ( ) No
Sewer Disposal Plant Capital Cent Fee
Sewer Pumping Station Capital Cent Fee
Sewer Mam Line Cost
Sewer Lateral Connection Charge
Water Stocked Lands Charge
Water Mam Pipe Line Fee
Water House Service Charge
Water Meter Charge
Sub Total
No (
( )
Fee
.— o O
Plan Check Fee
« *~- -"O o T
Building Permit Fee T» /
Total Charges /-*.