HomeMy WebLinkAbout1747 MALLOW CT; ; 77-3875; PermitMODEL NO. t I J J " /ff.. _ _;__.:__:_..:....c,_....::.... __ --,-~ .. BUILDING PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA 92008
Applicant to complete numbered spaces only Phone 7 29-1181 Perm 1! No
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L[GAL I .:J ;1.,S--1/ ~ <OS[.[ ATTAC:1-4£0 5H(C.Tl
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OWN CR MAit. ... O0.-css ll P PHONE
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CONT,u,c TOR MAIi.. ADORE$$ PMON E . STATE LIC, NO. CITY LIC. NO.
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A,-CHI TCCT OJII OCSIC.NCR 11 MAIL AOOlll£SS PHONE LICENSE NO. ,.
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CNGINECR MAIL ADO" CS 5 PHONE LIC[t,,j $£ NO.
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COMPENSATION INS. CARRIER MAIL AOOIIICSS 9fU,NCH
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use o, &VII..OINC.
7 NO. BORMS NO. BATHS
8 Class of work: □NEW 0 ADDITION 0 ALTERATION 0 REPAIR 0 MOVE 0 REMOVE I
9 Oescribe work: RC 1/rl ,JI Ne,,' I./Ji1u /7~, IC. I "/ff' -~Pe,,a,_~ I,,, ;;;:S
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10 Change of use from I ~ _J •o
Change of use to
11 Valuation of work: $ _;-,.lt .... ;, rt
I PERMIT FEE $ ' ("'I -PLAN CHECK FEES -
MICRO FILM FEE
SPECIAL CONDITIONS: Type of Occupancy
Const Group
s,ze of Bldg. N o. of Max
!Total) Sq. Ft Stories 0cc. Load
Fire Use Fire Sprinklers
APPLICATION ACCEPTED BY PLANS CHECKED SY APPROVED FOR ISSUANCE SY zone zone Required DYes ONo
No. of OFFSTREET PARKING SPACES
Dwelling Units No. INo.
DATE DATE Covered Sq. Ft. Open
NOTIC E Special Approvals Required Received Not Required
SEPARAT E PERMITS ARE REQUIRED FOR ELECTRICAL, PLUME{-PLANNING DEPT.
ING, HEATING, VENTILATING OR AIR CONDITIONING. HEAL TH DEPT.
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTAUC·
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF FIRE DEPT.
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A SOIL REPORT
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM•
MENCED. OTHER (Specify)
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS ENGINEERING DEPT.
APPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS WATER DEPT.
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.
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$1GNATV,.C or CONTIU,<:TO,t 0,. AUTHOflllZ[D AG(NT (DATC)
SIGNATUftl 01' OWNER 1,-OWNtflll ■UILDEflll OAT£)
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O CASH PERMIT VALIDATION CK. M.O. CASH
( 1
TOTAL FEES$ ________ _
INSPECTOR