HomeMy WebLinkAbout1210 PINE AVE; ; 76-102; PermitG PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA 92008
Applicanttocompletenumbered spacesonly. Phone 729-1181 Permit No./~
J O& ADDA £SS ASSESSOR'S
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LOT NO, -I OLK
I T"ACT BOOK PAGE I PAR,
LEGAL I (!
tOstc ATTACHCD 5HCtT) 1 D£5C ... <) ~. ,, t
OWN[llt MAIL ADDRESS ZIP PHON(
2 "
L_ ... -'l"1', l-~, ~ ~'\'} 76L I
CONTRACTOR --•. MAIL ADDRESS it..."' PHONE LICf.N5£ NO, STATE CITY
3 -i.\< A44,.;~ .. M~ ,. \~ / .. (, , C\f t 'l'-11, Oa:lo _,___ ' ,:
ARCH ITECT OR DESIGNER -MAIL ADDRESS
4 l.~ ~";>f.l PHON t l.lC tN5E NO.
[NGIN[[R MAIL AOORtSS PHONE LICENSE NO,
5
COMPENSATION INS, CARRIER MAIL ADDRESS BRANCH
6 u.l --~. -
USE 01' 8UILOING \) 7 4 .~. ...
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8 Class of work: 0.NEW 0 ADDITION 0 ALTERATION 0 REPAIR 0 MOVE 0 REMOVE
9 Describe work: S u ~!t'.> f 4~ .,-I ;,:-:
., Se 1) •,
'"' t ~,
.:(' ~I ,c ,;
...,J
I u 5/5
10 Change of use from
Change of use to
11 Valuation of work : $ I~ (, 0 ()C) !~ ~(:) 1 "" 0 PLAN CHECK FEE S ... PERMIT FEE s, ,
SPECIAL CONDITIONS: MICRO FILM FEE
Type of Occupancy
Const. Group
Size of Bldg'!'"" ,r Je;--No. ot Max.
(Total) Sq. Ft,., Stories 0cc. Load
-Fire use Fire Sprinklers
APPLICATION ACCEPTED BY PLANS CHECKED SY APPROVE(a) FOR ISSUANCE BY Zone Zone Required 0Yes DNo
~eff;./ ,--~7-7~ N o. of OFFSTREET PARKING SPACES•
ft ~.t'? -D~ Dwelling Units No. JNo. DATE Covered Sq. Ft. Open
NOTICE Special Approvals Required Received Not Required
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB· PLANNING DEPT.
ING, HEATING, VENTILATING OR AIR CONDITIONING. HEALTH DEPT. THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC·
TION AUTHORIZED IS NOT COMMENCED WITHIN 120DAYS, OR IF FIRE DEPT.
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A SOIL REPORT
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-
MENCED. OTHER (Specify)
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS ENGINEERING DEPT. APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.
ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS WATER DEPT.
TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED
HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT
PRESUME TO GIVE AUTHORITY TO VIOLATE DR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING
CONSTRUCTION QR THE PERFORMANCE OF CONSTRUCTION.
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51GNATu,u: 0,. CONTftACTO" Ofl' .&.UTHO .. IZ.tD AGENT (DA.Tl.)
51GNATU!lt£ orr OWNC" 1rr OWN[ft IUILDI.Jlt) -IOATt) --I~
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION . $..c~ -r: // ----M.O. CASH
INSPECTOR
INSPECTION RECORD
DATE REMARKS INSPECTOR
FOUNDATIONS: .
SET BACK I•
" TRENCH '
REINFORCING
FOUNDATION WALL &
WEATHER PROOFING
CONCRETE SLAB
FRAMING
INT. LATHING OR DRYWALL
EXT. LATHING
MASONRY
FINAL
USE SPACE BELOW FOR NOTES, FOLLOW-UP, ETC.