HomeMy WebLinkAbout2034 CHESTNUT AVE; ; 63-5404; PermitAPPLICATION FOR iiiiflim;PERMIT
N? " 5404
CITY OF CARLSBAD — BUILDING INSPECTION DIVISION
PHONE PArkway 9-1 181 - Ext. 36
Owner Name ..j........ ........... Mailing Addres
Contractor ^Z3t*?£-*t£-~*^P~~---- Mailing Address
To Construct D To Add To Alter
Number Street
To Repair Q To Convert D To Move From
Phone
^
Phone
Type of Const. ^^
(Frame, Masonry, Etc.)
. Kind of Founda/ionlLr^^S...<L_. No. of Stories / To Be Used for ^^a^^jt^T^^^T:
.} <• ',, ' (One Family DwdlinJ, Store, Etc.)
Floor Space of Proposed Construction
attached Q
Floor Space of Garage (sq. feet) :rr. ^.".".."detached QConst. Valuation $..
(sq. feet) .\./../.....&\. ............. Const. Valuation $ ....... L/-../....^..^.....^I.. ........................ .............................
LEGAL DESCRIPTION
Lot Block Subdivision
.Section Township....
.Street, Near
Range..
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 SIGNATURE OF
immediately revoked. 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 ( ) Fee
Grading Permit Required Yes ( ) No ( )
Sewer Disposal Plant Capital Cont. 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
Plans Approved by Plan Check Fee
Approved by .....JS^.....^fil^l!^^^»^^^^^---.^ Building Permit Fee .
Date K..../...^^.^-^.. /^ O Total Charges