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HomeMy WebLinkAbout1280 BUENA VISTA WAY; ; 61-4022; Permit.......... II_-_ ... ~- .. --..- ... .I CITY OF CARLSBAD - BUILDING INSPECTION DIVISION PHONE PArkway 9-1181 - Ext. 36 n Y (Please Print) [Last) (First) (Middle] Number Street I Owner Name ...... h6.U.N .............. A! ................. I .... 1. .................... Mailing Address .............................................................. ......... .. ................... ........................................................................................................ Number Street City Phone To Construct e3/ To Add 0 To Alter D To Repair 0 To Convert 0 To Move From .............................................................. Type of Cons+.% .... Kind of Foundation no. of Stories ..... J! ....... To Be Used for ...3&.d,h&..G .................... Contractor ??A !.. .! Wkd .......................................................... Mailing Address (Please Print) Address, (One Family Dwelling, Store, Etc.) [Frame, Masonry, Etc.) Floor Space of Proposed Construction (sq. feet) ....... /ad!./! ................. Const. Valuation $ ............................................................................................... Floor Space of Garage (sq. feet) ........ fbJ70 &E2 aluation $ .................................................................................................... ...d+y--4.b.&. ,..~.M?!.HL?p.L2/.7 LEGAL DESCRIPTION ................... q. ot Subdivision or .................................................................................................................................. Section .................................... Township ............................ Range ........................... Located at ../,~..~ d .......& .e.y........u.L..........................Street, Near ..................................................... ...................................... 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 1 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. tf 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 OF PERMITTEE ............................................................................................... Front Yard Set Back ...................................................................... Side Yard Set Back ........................................................................ Rear Yard Set Back ....................................................................... Dislance Between Bldg. ................................................................ Off Street Parking Spaces ................ ............................................ Sewage Disposal System ................................................................ Zone - Residential ( ) ............................................................ Zone - Commercial ( ) ...................................... Driveway Permit Required Yes o() No ( ) Fee %,25 .................................... .. Grading Permi) Required Yes ( ) No ( ) ........................................................ Sewer Disposal Plant Capikl Cont. Fee ............................ Sewer Pumping Station Capital Cont. Fee ............. F\l..o.!.?-!.!k __.________._.____._______._I Sewer Main Line Cost pa.... 8123~6.0 .......... et................ 3+3 Sewer Lateral Conniction Charge ' 7#5'REPTL/ .Za.!...!h%~...!?P.& ..................................... d/Zc.So Water Stocked Lands Charge ....................................................................................... Water Main Pipe Line Fee ........................................................................................... I Water House Service Charge /v/chn ............... , q. s8& ............................................................ ............................ /&$!..&a ..................................... Water Meter Charge Sub Total .................. ............ Plan Check Fee .......................................................... / ..........................................