HomeMy WebLinkAbout1324 CYNTHIA LN; ; 61-4021; PermitAPPLICATION FOR BllDISG
CITY OF CARLSBAD — BUILDING INSPECTION DIVISION
PHONE PArkway 9-1 181 - Ext 36
(~ '
"NS 4021
st)(F,rst)Owner Name
(Please Print)
Contractor
(Please Print)
To Construct $f To Add Q To Alter
(M.ddlo)
To Repair
Type of Const /VSJ&O/yKy Kind of Foundation
(Frame, Masonry; Etc)
Floor Space of Proposed Construction (sq feet)
Floor Space of Garage (sq feet) "
LEGAL DESCRIPTION
Lot
Address
•Mailing Address
I To Convert [D
No of Stories
Const Valuation $
attached C]
detached QConst Valuation $
Number 'treet
Number Street
To Move From
City
City
'dress
Phono
Phono
To Be Used for
(One Family Dwelling, Store, Etc )
Block
Located at
LAND AREA
. r A^tjU*/^-
Assigned Housayfaumber
Section
treet, Near
Subdivision
Township Range
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 t^"""^
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 f * ^-> J
immediately revoked PERMITTEE * ( .sCXS^"^S.
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 (
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 b
Approved by
Date
Plan Check Fee
Building Permit Fee
Total Charges