HomeMy WebLinkAbout184 CHESTNUT AVE; ; 61-4093; PermitAPPLICATION FOR BllDIHG PERMIT
CITY OF CARLSBAD — BUILDING INSPECTION DIVISION
PHONE PArkway 9-1181 - Ext. 36
"NS 4093
Owner Name ..^.l&.Jf:t&.S.&.&...t....^.?.S.J.~J.tt:. /-'./.;?. Mailing Address
(Please Print) ^ (Last) / (First) (Middle)
Mailing AddressContractor _
(Please Print) Number Street
To Construct D To Add ¥T To Alter D To Repair D To Convert D To Move From
of Foundation...C^7<<>2_/. No. of Stories ./..... To Be Used for L,'Type of Const. "/J
(Frame, Masonry, Etc.)
Floor Space of Proposed Construction {sq. feet) &4r.{5..Q. Const. Valuation
attached \^T
Floor Space of Garage (sq. feet) detached QConst. Valuation $....a :
Block
Address
fiu«z.y
(One Famfy Dwelling, Store, Etc.)
LEGAL DESCRIPTION
Lot
Section .,. Township Range...
Located at ..... /./Q.-X ..... ^fS&a.bf&LtM.^f.. ........................................... Street, Near
Assigned House Number
LAND AREA . - ~ NUMBER OF EXISTING DWELLINGS ON PROPOSED BUILDING SITE (INDICATE
SIZE, USE AND LOCATION ON PLOT PLAN). WILL THIS CONSTRUCTION INCLUDE ANY PLUMBING INSTALLATION, ALTERATION, OR
ADDITION?YES..NO..
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
If a check is tendered for payment of the above fee and the check is
not honored when presented for payment, your Building Permit will be
immediately revoked.
SIGNATURE OF ,
PERMITTEE X...
Front Yard Set Back
Side Yard Set Back
Rear Yard Set Back
Distance Between Bldg
Off Street Parking Spaces
Sewage Disposal System ...
Zone - Residential ( )
Zone - Commercial ( )
Variance
Eng. Check By
Driveway Permit Required Yes [fi No
Grading Permit Required Yes ( ) No
Sewer Disposal Plant Capital Cent. Fee ..
Sewer Pumping Station Capital Cont. Fee
Sewer Main Line Cost
Sewer Lateral Connection Charge
Water Stocked Lands Charge
Water Main Pipe Line Fee
Water House Service Charge
Water Meter Charge
Sub Total
Fee
Plans Approved by ...,_.. ._ Plan Check Feecr^^/T) rApproved by .\./^«r ...^..-rAJS^^^SrA^C^^rrrrrrrrrTr: Building Permit Fee ...
// -~> / /Date //..Tr.Ofe..7r:...ifc?X Total Charges .J$~^-