HomeMy WebLinkAbout1737 CEREUS CT; ; 77-3884; PermitMODEINO.
PERMIT APPLICATION
City of GARLSBAD, CALIFORNIA 920O8'>*~;e''"T*»»«««»»
A - ' * ""*""~5f'*** ^ "Jfc •' S'-fSf
Applicant to complete numbered spaces only'. PhOflG 729,-1lo1 Permit Nn. 'J? f !&&'''&
J'OB ADDRESS :•.,'.',
/7J? '.'/'-;/#*> /-,.-..•,;/
,LOTNO. . BLK . TRACT
loESCR. /fjf • . ^,- ,/>v,.
OWNER ' MAIL ADDRESS
2 $?•;;-./&,.<- /-->; , ,> "Mk'^; ,>v - :->, ^.-
CONTRACTOR MAILADDRESS"
'3 . ^,^:.
4 . X/7> . - , .' ,/., j;y
ENGINEER' • MAIL ADDRESS
5
COMPENSATION INS. CARRIER MAIL AODPESS
'6 '. '$?. #:>-,j
USE OF BUILDING
1 ' .^. -;>....
8 - Class of-work: &NEW D ADDITION D ALTERATION
9 Describe work: ,-f •
«*'"''" ' ,'• •> • • .f - ..'f ,-V' 't:£ *»•' ' '••''
¥^ Mr x faL
TO Change of use from <3 /
H^w
Change of use to
11 Valuation of work: $ j? -^ *~^' **ii*4.
SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY- PLANS CHECKE D'BY APPROVED FOR ISSUANCE BY
DATE . . • ' DATE
NOTICE
SEPARATE PERMITS-ARE REQUIRED FOR ELECTRICAL, PLUMB-
ING, HEATING, VENTILATING OR AIR CONDITIONING.
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS, OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
MENCED.
1 HEREBY CERTIFY THAT 1 HAVE READ AND EXAMINED THIS
ALL :PRO VISIONS OF LAWS ; AND OR DIN A'NCES GOVERNING THIS'
HEREIN 6.R NOT, THE GRANTING OF A PERMIT DOES 'NOT
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING
/r , S , / . '
Ajss '/•./,, 4 /{/ft », :; ,2? jr?
' SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) *"/.
SIGNATURE OF. OWNER (IF OWNER BUILDER) . (DATE)
ASSESSOR'S
PARCEL NUMBER
BOOK PAGE PAR.
/ */ x. , Jas"
z i P PHON E
-/-J&l x, . ».^*f
:••• ,• ,Z- <& ;;:.•••!• .'J: -f /tf ^£V$r
PHONE STATE LIC., NO. CITY LIC. NO.
,.yv /;,. .,,-.•,- •_/" : '
PHONE LICENSE NO.
. PHONE LICENSE NO.
BRANCH
NO. BDRMS NO. BATHS
D REPAIR DMOVE D REMOVE
•--• ••'••• • '"""•'• •:' •"•-• . -.•/ -••• -^£.
9 f *L&MHtf
^ 0
/.JO<? . . Qfjg."PLAN CHECK FEE $ f PERMIT FEE $" JP^ .V.A-w"^. •
MICRO FILM FEEType of . Occupancy
Const. ' Group
Size of Bldg. No. of Max.
(Total) Sq. Ft: Stories Occ. Load
Fire ' Use Fire Sprinklers
Zone . Zone Required Qyes QNO
OFFSTREET PARKING SPACES:No. of
Dwelling units go.^ ^ ^ |QO^
Special Approvals Required Received Not Required
PLANNING DEPT.
HEALTH DEPT.
FIRE DEPT.
SOIL REPORT
OTHER (Specify)
ENGINEERING DEPT. ... , ., .,
'*&ATER'D'EPT.;:.-: '••..••':', "••:. ;-..... ' ; : • -~.;.', ' _ ':'-.''v ;. •'.!'-' :;
„ •• . • • .-.-••
'•••'.
- ' " • . -. r .
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK.M.O.CASH PERMIT VALIDATION . CK.M.O.CASH »., "
TOTAL FEES $.
--«v
INSPECTOR