HomeMy WebLinkAbout1255 CYNTHIA LN; ; 63-5332; PermitAPPLICATION FOR BUtDlSG PERMIT
"N? 5332
Owner Name
(Please Print)
Contractor
CITY OF CARLSBAD — BUILDING INSPECTION DIVISION
PHONE PArkway 9-1181 - Ext 36
n t
S^S^s ^jtf^^a^y f >j^,_ ^Mailing Address
-Mailing Address
Type of Const ^J^f^t ^jft*«2._Kind of Foundati
(Frame, Masonry, Etc)
(Please Print) Number Street
To Construct D To Add $\ To Alter D ^ To Repair^ D To Convert D To Move From
-^No of Stories
Floor Space of Proposed Construction (sq feet) / f S
Floor Space of Garage (sq feet)
LEGAL DESCRIPTION
City
/ To Bo Used for
(One Family Dwellinq, Store, Etc )
Const Valuation $
attached D
detached DConst Valuation $
Lot Block
. Section
Street, Near
Subdivision
Township Range
Assigned House Wrimber
LAND AREA NUMBER OF EXISTING DV/ELLINGS ON PROPOSED BUILDING SITE (INDICATE
SIZE, USE AND LOCATION ON PLOT PLAN) WILL THIS CONSTRUCTION INCLUDE ANY PLUMBING INSTALLATION. ALTERATION. OR
ADDITION?YES NO L
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE I
WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION
If a check is tendered for payment of the above feo and tho check is
not honored when presented for payment, your Building Permit will bo SIGNATURE OF
immediately revoked PERMITTEE
RRECT AND AGREE TO COMPLY
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 Check By
7
Driveway Permit Required Yes ( ) No ( ) Fee
Grading Permit Required Yes ( ) No ( )
Sewer Disposal Plant Capital Cont Fee
Sewer Pumping Station Capital Cont Fee
Sewer Main Line Cost
Sewer Lateral Connection Charge
Water Stocked Lands Charge
Water Mam Pipe Line Fee
Water House Service Charge
Water Meter Charge
Sub Total
Plans Approved by
\/ Approved by
^rV/
Date £> / / '
Plan Check Fee
Building Permit Fee f ^
Total Charges / ^