HomeMy WebLinkAbout175 CHINQUAPIN AVE; ; 61-4010; PermitAPPLICATION FOR BIDDING PERMIT
4010
CITY OF CARLSBAD — BUILDING INSPECTION DIVISION
PHONE PArkway 9 1181 Ext 36
Owner Name
(Please Print)
Contractor
(Please Print)
To Construct D To Add \*T To Alter D
(Middle)
Mailing Address jf /^
Number
Mailing Address
Street P Citf
Number Street Cit/
To Repair D To Convert D To Move From
Phone
Phone
Type of Const «^t<iZ^*«^-<_- Kind of Foundation
(Frame Masonry Etc)
Floor Space of Proposed Construction (sq feet)
Floor Space of Garage (sq feet)
LEGAL DESCRIPTION
Lot
No of Stories
Const Valuation $
attached D
detached QConst Valuation $
Address
To Be Used for
(One Family Dwellmq Store Etc )
Block
or
Located at
Assigned House Number
Section
Street Near
Subdivision
Township Range
LAND AREA NUMBER OF EXISTING DWELLINGS ON PROPOSED BUILDING SITE (INDICATE
SIZE USE AND LOCATION ON PLOT PLANJ^VffLL THIS CONSTRUCTION INCLUDE ANY PLUMBING INSTALLATION AITERATION OR
ADDITION?YES NO
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
immediately revoked
SIGNATURE
PERMITTEE
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 Mam Line Cost
Sewer Lateral Connection Charge
Water Stocked Lands Charge
Water Mam Pipe Line Fee
Water House Service Charge
Water Meter Charge
Sub Total
Fee
Plans Approved
Approved by
Date ~~7- <$*- /~
Plan Check Fee
Building Permit Fee
Total Charges