HomeMy WebLinkAbout1273 CHINQUAPIN AVE; ; 63-5314; PermitAPPLICATION FOR BliftlING PERMIT
N! 5314
CITY OF CARLSBAD — BUILDING INSPECTION DIVISION
PHONE PArkway 9 1181 - Ext 36
Owner Nam.
(Please Print)
Contractor
To Construct
(Last)
t
(First)(Middle)
Mailing Address
-Mailing Address
Number
To Add D
Type of Const
(Frame Masonry, Etc )
Floor Space of Proposed Construction (sq feet)
Floor Space of Garage (sq feet)
LEGAL DESCRIPTION
rmt) " f ~ Number Street
To Alter D To Repair D To Convert D To Move From
Kind of Foundation. »—*^Hn«- >—•*•* No of Stories
City
/,
City
Phone
Phone
Address
'/«*/
-
To Be Used for ^L-</V*—Cw. ^
(Ons'Family Dwellmq, Store,
Const Valuation
attached A
detached OConst Valuation $
Lot Block
Located at f£7*_
Section
Street, Near
Subdivision
Township Range
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 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
SIGNATURE U>-
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 —
Driveway Permit Required Yes ( ) No (X)
Grading Permit Required Yes ( ) 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 Mam Pipe Line Fee ~~
Water House Service Charge ^^ _ i' &.
Water Meter Charge £ / >\i
Sub Total
Plans Approved by _
Approved by jhr
Date _
Plan Check Fee
Building Permit Fee
Total Charges f*.