HomeMy WebLinkAbout1547 CHESTNUT AVE; ; 79-467; PermitMODEL NO..
BUILDING PERMIT APPLICATION
i- City of CARLSBAD, CALIFORNIA 92008
Applicant to complete numbered spaces only. PnORG 729-1 1 81 Perm it
JOB ADDR ESS
LOT NO. - ' , BLK TRACT
LEGAL . . - - QSEE ATTACHED
1 DESCR.. - .' . *"'•".,•' ' ' '; . ' . -
OWNER ". - ' .. MAIL ADDRESS ' -'ZIP
2/ <P/
4??' ?W' . Sioq.
ASSESSOR'S
PARCEL NUMBER
BOOK PAGE PAR.
SHEET)
PHONE
CONTRACTOR MAIL ADDRESS. PHONE STATE LIC. NO. CITY L1C. NO.
3 • ./••' •-.,.."-•' ' ' - •••-,-'
4 • • •' • " '•'•...'. ... . ' ;
ENGINEER ' MAIL ADDRESS PHONE
5 ' . .-"".. • . ' ' •'
COMPENSATION INS. CARRIER MAIL ADDRESS • . .
6 . . ' . • ... '•" ' ' • - -
USE OF BUILDING. -- '-
.'••'" ' . NO. BDRMS
LICENSE NO.
L ICENSE NO.
.BRANCH
NO. BATHS
8 Classofwork: DNEW.. D ADDITION "D ALTERATION D REPAIR D MOVE VH$EMOVE
9 Describe work: ' //? X? /^2_ .
bL^£^yt^l-^~^'&4^-^^i^^j
10 Change of use from •
Change of use to
11 Valuation of work: $ • •
SPECIAL CONDITIONS: .
APPLICATION ACCEPT&ft BY. PLANS CHECKE^RY— - APPROVED FOR ISSUANCE BY
DATE AcX // 1 V DATE
NOTICE
SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB-
ING. HEATING, VENTILATING OR AIR CONDITIONING.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-MENCED.
1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THISAPPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT.ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS
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 OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING
CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
SIGNATURE OP*^ONTlBAC TOR OR1 Au THOR 1 1 ED AGENT (DATE)
(SIGNATURE OF OWNER (IF owNfeft BUILDER) \ (DATE) 1
PLAN CHECK FEE S . P
Type of Occupancy
Const. Group'
Size of Bldg. No. of
(Total) Sq. Ft. - • Stories
Fire Use
Zone . Zone
OFFSTREET FNo. of
Dwelling Units p°' . 5
Special Approvals Required
PLANNING DEPT.
HEALTH DEPT.
FIRE DEPT.
SOIL REPORT
OTHER (Specify)
ENGINEERING DEPT.
WATER DEPT.
V \ WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
ERMIT FEE $ ^ "
MICRO FTtfM FEE
Max.
Occ. Load
Fire Sprinklers
Requ red [HYes DNO
ARKING SPACES:
No.
q. Ft. Open
Received Not Required
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK, M.O. CASH
''••.. ' TOTAL FEES $ i ) •' '