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Home My WebLink About2475 TUTTLE ST; ; 81-492; Permit.,, z 0 .:: C er: C ..J t,) ... 0 IC I[ 0 t,) rr: IOI 0 ..J 5 ! IOI z 3 0 z 0 .:: ~ z IOI IL ~ 0 t,) .,, a: IOI "" er: 0 3 il O I he< .. by afflnn that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is In full for<:e and effect. I.Jc No _______ Class I her&by affirm that I am uempt from the Con· ¥:~'f~~;~::: ~ ~t~r:.~~~~'8:~~ county whJCh requires a pernut 10 construct alter, improve, demohsh, or repair any structure, poor to ,ts issuance also requires the applicant tor such perm,1 to hie a s,gned statement tllat he ,s I-censed pursuant 10 trte provts1ons of the Con- tracto,'s License Law (C~ter 9 commencing with SectiOO 7CXlO ot 01v1sion 3 of the Business and Pro• tess1ons Code) or that 1s exempt therefrom and the basis tor lhe alleged exemphon. Any v1olat1on of SectK>n 7031 5 by an apphcanl tor a permit subfeets tne applteant to a c1v1I penalty of not more than five hundred dollars (S500). 0 I, as OWMf of the property, Of my employees w.11h wages as their sole compensallon, will do the wotk. and the structure 1s not intended or offered for sale (Sec 704-4, Business and ProtesstOt'ls Code The Contracto,·s license Law does not apply lo an owne, ot property who builds or improves thereon and '1Who does such wOf'k himself or through his own employees. provKSed that such 1mproveme;its are not mtende1 or offered for sale If, however. the budding or improvement is sold within one year of completion, the owner-builder will have the burden of pro..,1ng that ne dtd not build or improve for the 1 purpose of sale) □ I, as owner or the property, am e1tclus1vely contractmQ with hcensea contractors to construct the pro1ect (Sec 70,U, BusmeSs and Professions I Code· The Contractor's Ltcense Law dOes not apply to an owner ol property who builds or improves thereon, and who contracts tor each pro1ects with a 1 contractorts) license pursuant to the Contractor's license Law) . D I am e1tempt under Sec ,8 & PC !or ttus reason _______ _ □ 1 hereby affirm that I ha'f'e a cen1hcate ol consenl to self-insure, or a cert1f1ca1e of Workers· Compensat,on Insurance, or a cen,t1ed copy thereof (Sec 3800, l.a.bOf Code) POLICYNO __ COMPANY □ Copy IS filed with the city 0 Certified capy 1s hereby furnished CERTIFICATl OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This sechon need not be completed 1f lhe permI1 1s for one hundrecl dOllars (SH)()) or less) 0 I cer•uty that 1n the performance ol tne wM for which this permit ,s issued. I shall not emp10y any person ,n any manner so as to become subJecl to tne Wortl;ers· Compensation Laws ot Cahtorn,a NOT.CE TO APPLICANT If. after maktn:J 1nIs Cen, hcate ot Exemption. you should t>ecome sub1ecl I? the Wonters· Compensation provisions of the Labor Code, you must for1hwtth comply w,in such pro\1Is1ons or this permit shall be Oeemed revoked 0 I ttereby alhrm 11'\al there 1s a conslrucllon lendmQ aoency f()f the pe<1ormance of lhe wo111: lor wtuch this perm1! 15 issued (Sec 3097 C1\11I Cooe) Lenders Name ___________ _ Lenders AOOress __________ _ USE BALL POINT PEN ONLY & PRE~S HARD APPLICANT.,.. FILL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS CARLSBA._ BUILDING DEPARTMENT A\.t"'LICATION & PERMIT 1200 Elm, Carlsbad, California 92008 (714) 438-5525 JOB;iR;; 75' 7i#LE ~ A~i.T,, D/ ¼~111IONI BUSINESS LICENSE # VALUATION PERMIT NUMBER .s;r: ..1./..:J.., !) / OWNER'S NAME 19 ~;w;;s;H;E PRIME CONTRACTOR I / CONTRACTORS PHONE • ZONE ~1;;. /) .<1, I ,ll -J" SA-,u'1, ,,1 t:i' l.L /1,JJ 1.J ~ 'f_. OWNER'S MAILING AODRESS CONTRACTOR'S ADDRESS LICENSE NO. PLAN 1.0. # BLDG USE CODE /).. ?/ ~ .LU/ J/ I r/1 S1;,J>r1w/l r.A ~ . ./>tFr LOT 1 BLOCK I SUBDIV•SION ASSESSOR PARCEL'/;NO. J(9' DESIGNER STATE LICENSE >r STANDARO PLAN# BUILDING SO. FOOTAGE .,~-/i '1- DESCRIPTION Of WORK DESIGNER'S ADDRESS OESIGNER'S PHONE - Dp,.r/,-1'1 ~ (' -t.. ~°"t'\. l'J -f /P F LR ELEV. NO OCCGP EDU I I /Oi.i /812251 362.th STORIES vO NO --,00012251 1 I/Oi.i/81 I,~.,.'} I CENSUS TRACT I GP LAND USE I PARKING SPACE I RES UNITS I GRAOING ~ERMIT ISSUED I REDEVELOPMENT TYPE OCC LOAO FIRE SPR AREA CONST y D N 0 vO NO vO NO Not Valid Un~s Machine Certified QTY. PLUMBING PERMIT -ISSUE QTY. MECHANICAL PERMIT -ISSUE SUMMARY/ACCOUNT NUMBER EACH FIXTURE TRAP INSTALL FURN. DUCTS UP TD 100,000 BTU BUILDING PERMIT ~ /,1 U"V- EACH BUILDING SEWER OVER 100,000 BTU SIGN PERMIT EACH WATER HEATER AND/OR VENT BOILER/COMPRESSOR UP TO 3 HP PLAN CHECK EACH GAS SYSTEM 1 TO 4 OUTLETS BOILER/COMPRESSOR 3-15 HP TOTAL PLUMBING EACH GAS SYSTEM 5 OR MORE METAL FIREPLACE ELECTRICAL ~~ ---- EACH INSTA~ .. ALTER, REPAIR WATER PIPE VENT FAN SINGLE DUCT MECHANICAL EACH VACUUM BREAKER MECH EXHAUST -HOOD/DUCTS MOBILEHOME WATER S0FTNER RELOCATION OF EA FURNACE/HEATER M0BILEHOME PARK INSP EACH ROOF DRAIN (INSIDE) SOLAR TOTALME.7 STRONG MOTION ' --C' _:_____ TOTAL PLUMBING I FIRE SPRINKLERS ~ PUBLIC FACILITIES FEE QTY. ELECTRICAL PERMIT -ISSUE QTY. SOLAR -ISSUE /' -BRIDGE FEE ~I 7'.NEW CONST EA AMP/SWT /BK R / I ?ZJ~ ./ COLLECTORS SCHOOL FEE -DISTRICT 1 PH 3 PH I ./ STORAGE TAN KS Carlsbad EXIST BLDG EA AMP/SWT/BKR n / / ROCK STORAGE Encinitas 1 PH 3~« I V . I I/ PUMP San D1eguito REMODEL/ALTER PER~ ... ~/ . I.A PLAN CHECK FEE San Marcos TEMP POLE 200 AMPS IV . • [7 ,,.. OVER 200 AMPS ~ y "/ w ' TEMP OCCUPANCY (30~sf -\-~ I I ./ ..., -. ?L ELECTRICAL ,-6?-~ i-TOTAL SOLAR TOTAL FEES PAYABLE I Sb.:2~ I HAVE CAREFULLY EXAMINED THE COMPLETED "APPLICATION AND PERMIT" AND DO HEREBY Exp,rat1on Every permit 1uued by the Building Ott1c1al under the provisions of th•• * AN OSHA PERMIT IS AE0UIAED FOA EXCAVATIONS OVlfl CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE Code shall exp,re by hm,tat1on and become null and void If the building or work s· O" DEEP ANO 0£MOLITION OR CONSTI!UCTION Of' DECLARATIONS ARE TRUE AND CORRECT ANO I FURTHER CERTIFY AND AGREE IF A PERMIT IS authorized by such permit IS not commenced w11hm 180 days from the date of such STAUCTVRES OVEfl 3 STOflt£S IN HEIGHT ISSUED TO COMPLY WITH ALL CITY, COUNTY,AND STATE LAWS GOVERNING BUILDING CON-~:::::o.:i 1~11:~y '::'~:·~e~~.,:~~r:''1t~~~z.:,~~ r .. ::::::,i'~,•~:g:~ or . STRUCTION. WHETHER SPECIFIED HEREIN OR NOT. I ALSO AGREE TO SAVE INDEMNIFY AND APPLICANT'S SIGNATURE • OWNER □ CONTRACTOR 0 APPR~Bl')~ ,Di~/ if I![ KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES, JUDGMENTS. COSTS AND EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE BY PHONE 0 GRANTING OF THIS PERMIT - ~ u: >-~ 0 a. E Q) I- "O 0 C!) C <I! .S! a. i ~I .:.:. C a: (lJ (/) (/) <( I 3: 2 a; >- ui (/) Q) 0 e a.. <I! iii 0 g Q) 0 C <I! C u:: C Q) Q) <, 0 u Q) a. (/) C ~ .c 3: Ill z 0 ;: C CIC C ~ 0 Ill 0 IC I[ 8 CIC Ill 0 ~ 5 ~ Ill z ~ 0 z 0 s z Ill D,. 2 0 0 "' ir Ill >o: a: 0 ~ il 0 I I, f affirm that I am llcensed under p,ovlslo .. _,o()f Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license Is In full force and effect. Lie No _______ Class ____ _ I hereOy aH1rm thot I am exempt from the Con· ~~o;·~~i!"sS: ~w ~~,~~.:~~~~~ county which requires a pemut to construc1 alter, 1mproYe, ~1sh, o, repau any structure. pnor to its 1ss~e also requires the applicant fOf such pe<m,t to hie a signed statement that he ,s licensed pursuant to lhe provisions of the Con· tractor's Lacen:se Law (Chapter 9 commencing with Section 7000 of 01v1s10t1 3 of the Business and Pro-tess,ons Code) or that ,s exempt lherefrom and the basis f0f' the alleged exemptt00 Any v1olat1on of Section 7031 ~ by an applicant tor a pem111 sub(ects tne apphcanl to a civil penalty ot not more than five hunorect oonars (S5COI D t. as owner ot the prOl)eny, or my employees _,1h wages as their sole compensation, w,11 do the wor1t, and lhe structure is not lnlended or offered fOt sale (Sec 70-U, Bus,ness and Professions Code The Contractor's License Law does not acply to an owner of property who bt.11lds or improves thereon and who does such woril himself e< through his own employees. provided that such ,mproveme;its are not lntende1 o, ottered for sale If, howeve1, the bu1ld1ng or ,mproYement 1s sold w1ttnn one year of completion, lhe owner-builder will have the burden of proving lhat he d1d not build Of improve lor the purpose ol sale) □ I, as owner of the property. am e:cclus1vely contracting with hcensed contractors to construct lhe PfOJect (Sec 7(),,iW, Business and Professions Code The Contractor's Lteense Law does not apply to an owner of property who builds o, ,mpro..,es thereon. and who contracts fo, each pro1ects with a cont.ractOl(s) hcense pursuant to the Contractor's Lteense Law). □ tamexemptunderSec _____ ,8 &PC for this reason ___________ _ □ I hereby affirm that I ha't'e a cert1hcate of cons.ent to self-insure. or a cen1f1cate of Workers Compensation Insurance. or a cert1f1ed c0py thereof (Se<: 3800, Labor CoOe). POLICY NO COMPANY 0 Copy IS hied with the City 0 Certified copy 1s hereby furnished CERTIFICATl OF EXEMPTION FROM WORKERS' COMPENSATION INSURANCE (This 5eetu>o need not be completed ,f lhe penmt 1s tor one hundred dollars CS 1()0) or less) 0 I certify that ,n the performance of the work tor which this pemu1 15 ,ssued. I shall not employ any person 1n iln'f manner so as to become sub1ect to lhe Workers· Compensation Laws of CaJ1forn1a NOTICE TO APPLICANT II. after makm;1 lh1s Cer11 ftcate of E:cempuon. you should beeome subJect I'> lhe Workers· Compensation prov,s.ons of 1he Labof Code. you must for1hw1th comply with such pro..,1s1ons or this oerm,t shall be deemed revoked 0 I hereby affirm !hat there 1s a cons1ruc11on tending agency lor the performance ot the work tor which 11''115 pefm11 ,s issued tSec 3097. c,..,,1 Code) Lenders Name ___________ _ Lender's Address __________ _ USE BALL POINT PEN ONLY & PRESS HARO _____________________ A_P_P.;..Ll.;..C_A_N_T -c:1LL IN INFORMATION WITHIN SHADED AREA AND DECLARATIONS CARLSBA BUILDING DEPARTMENT 1200 Elm, Carlsbad, Calllornla 92008 (714) 438-552~ APt'LICATION & PERMIT JOB ADDRESS BUSINESS LICENSE M VALUA TION PERMIT NU!JIBER 2. 'f 7£ 'TIA.Ti t.E. .CT' A~i.T·1;;;E~O;?:f7ION- OWNER'S NAME IJ AIIL~ .:r . ..S AVIDw £t_l, OWNER"S PHONE PRIME CONTRACTOR 'B' _., , CONTRACTORSPHONE• 1 ZONE 1 ~/3 OWNER'S MAILING AO0RESS CONTRACTOR'S ADDRESS LICENSE NO PLAN 1.0. # BLOG USE CODE 11-71 CAtw11t11ro S£n/HfD J<:4-,M, Pf ---·---- LOT I BLOCK I SUBDIVISION I ASSESSOR PARCEL NO. OESIGNER STATE LICENSE# STANOAR0 PLAN # BUILDING SQ. FOOTAGE DESCRIPTION OF WORK 1 c~ rri. P-1 / A ('J c ~ ~ OESIGNeR·s ADORESS DESIGNER'S PHONE F/P vO NO FLA ELEV. NO I occ GP I I I 0/29/811569 2s;.., EDU 0001156~ I 0/29/ 81 STORIES 25~ CENSUS TRACT I GP LANO USE I PARKING SPACE RES UNITS l GRADING ~ERMIT ISSUED YO N 0 REDEVELOPMENT AREA TYPE CONST I occ LOAD I FIRE SPR I 0""1 'Sf-9 01 ·-129 Not Valid Unlt!ss Machine ~rtifi«J vO NO vO NO QTY. PLUMBING PERMIT· ISSUE QTY. MECHANICAL PERMIT· ISSUE SUMMARY/ACCOUNT NUMBER -EACH FIXTURE TRAP I I I INSTALL FURN. DUCTS UP TO 100,000 BTU I I BUILDING PERMIT _:; .s"".:::..- EACH BUILDING SEWER I . OVER 100,000 BTU . SIGN PERMIT EACH WATER HEATER AN010R VENT . BOILER/COMPRESSOR UP TO 31jf . PLAN CHECK EACH GAS SYSTEM 1 TO 4 OUTLETS • BOILER/COMPRESSOR 3-15 HV . TOTAL PLUMBING c_ _ _...EACH GAS SYSTEM 5 OR MORE . METAL FIREPLACE / . ELECTRICAL EACH INSTAl .. ALTER. REPAIR WATER P~ . VENT FAN SINGLE g_w(T . MECHANICAL 1 EACH VACUUM BREAKER I I I MECH EXHAUS -HOOOIOUCTS MOBILEHOME WATER SOFTNER RELOCATI OF EA FURNACE/HEATER MOBILEHOMEPARKINSP EACH ROOF DRAIN (INSIDE) I ! I I I SOLAR LJ___ L _/I~]~-/ TOTt;L MECHANICAL I STRONG MOTION TOTAL PLUMBING I / 171 / FIRE SPRINKLERS QTY. ELECTRICAL PERMIT· ISSUE n I ~TY. SOLAR· ISSUE PUBLIC FACILITIES FEE BRIDGE FEE NEW CONST EA AMP/SWT 1BK R rr 7Y coujcroRs SCHOOL FEE • DISTRICT 1 PH 3 PH 71 _, IW . II I SJ,d'RAGE TANKS Carlsbad EXIST BLOG EA AMP/SWT/BKR ,.,,, ~OCKSTORAGE Encinitas 1 PH 3 PH San D1egui10 IV l_'J ,.) 'i Ill 7 IPUMP TEMP PO LE REMODEL/ALTER PERCIRCUIT~-~'~'~ £\i 1·-··-.. --···--I I I I 200 AMPS PLAN CHECK FEE San Marcos ~~~:~~~~::~~~~ --~fi\wl -l-----------1t-----------------1 y TOTAL ELECTRICAL I \ TOTAL SOLAR TOTAL FEES PAYABLE 1 ~~ I HAVE CAREFULLY EXAMINED THE COMPLETED •·APPLICATION AND PERMIT" ANO DO HEREBY CERTIFY UNDER PENALTY OF PERJURY THAT ALL INFORMATION HEREON INCLUDING THE DECLARATIONS ARE TRUE AND CORRECT AND I FURTHER CERTIFY AND AGREE IF A PERMIT IS * AN OSHA PERMIT IS AEQUIRED FOA EXCAVATIONS OVER s· o· DEEP AND DEM0UT10N OR CONSTAUCTION Of STAUCT\JAES OVEA 3 STORIES IN HEIGHT bpor■t,on. Every permit issued by the Buoldmg Ott1c11J under the provos1on1 o( th11 Code shall expore by hm1t1hon ■no become null end void If the building or work authorized by such perm,t 11 not commenced w1th1n 180 days from the date of such permit. or 1f the building or work 1uthor1.1ed by such permit 11 suapeoded or ISSUED TO COMPLY WITH ALL CITY COUNT" AND STATE LAWS GOVERNING BUILDING CON l...!•~b•!!n!!;do!!!!!n!ed!!..,!■t!_;■!!n:!1.Jt!!!•m:!):e!,!■lt!!:•!!r:Jt[!!he!..,?w~o!!!,k!..,,!!1•~c:!,Ot!!ffl?,!ffl!!!•!!n!£ced!!J__!!IO,?!r~•µ!it!r:!_!1od!2.JO!?!f.J1!J!80!!,,,!l~L--~~~~~!""'---"'~-------...,"r----'"""'I STRUCTION, WHETHER SPECIFIED HEREIN OR NOT, I ALSO AGREE TO SAVE INDEMNIFY AND ;zp ICANT'S SIG:ZTUAE • OWNE . CONTRACTOR O APPROVED BY 0TE KEEP HARMLESS THE CITY OF CARLSBAD AGAINST ALL LIABILITIES. JUDGMENTS, COSTS AND #I , A EXPENSES WHICH MAY IN ANY WAY ACCRUE AGAINST SAID CITY IN CONSEQUENCE OF THE V'_ ~v. 1 ~ I BY PHONE O VI Lt//~ GRANTING OF THIS PERMIT. ~/1. ,..-rljtf' -.. -, .., ~ u::: >-~ 0 a. E (l) I- I 'O 0 (!) C Cll -~ ~ .,<{ I ~ C a: 0 rt) rt) (l) rt) rt) <( I ~ .2 Q) >- rt) rt) (l) 0 0 a: Cll co 0 §: (l) 0 C Cll C u::: C (l) (l) C, 0 u (l) Q. rt) C !!! .c ~ cI·rv OF CARLSBAD BUILDING DEPARTMENT RELOCATION CORRECTION LIST DATE : November 4, 1981 PERMITTEE: DAVE SANDWELL ADDRESS: 2475 Tuttle Street PHONE ---- BUILDING LOCATION: 2475 Tuttle Street PROPOS ED LOCATION: 2475 Tuttle Street This i s a copy of the corrections and work to be accomplished to the building you have proposed to relocate. It will serve to inform you of the required work to be done before said building can be occupi ed at the new address. The se corrections are the terms and conditions of the Relocation Permit, and are required to be completed within 180 days from the date the permit is issued. NOTE: This is not a permit. Do not move the building or start any work until you have posted the required bond, obtained the Relo ca t ion Permit and Pl anning Commission approval. ITEMS CHECKED ARE YOUR CORRECTIONS . BUILDING: X X X X X l Prov i de two(2) copies foundation and pro- posed site plans . 2 Provide underfl oor ventilation, access and clearance as per code. 3 Underfloor structure to be al tered meet Code requirements as fo l lows : Additional concrete piers to be added complete. Per imeter founda- tion. 4 Repl ace existing roof covering with fire ·retardant material . 5 Ce ili ng joists, rafters and other structural members to be al tered to meet code as fo 11 mvs : ----- 6 Exteri or surfaces to be repaired, ~aint~d, restuccoe d, or otherwise corrected as fo l lows to provide adequate· weather protection: __ _ 7 Reroofing requ i red to provide wea ther protection . 8 Al l broken doors, windows and screens to be repa i red, replaced, and/or repainted as required. 9 Firepl ace . chimney and/or other masonry units to be corrected as fo llows : ----------- 10 One hour fire resistive construc- t ion to be provided _____ _ X 11 Repair or repla ce f loors, walls and/or ceil i ngs to match existing as fo 11 m1s: ---------- 12 Inadeq uate room s i ze in ___ _ 13 Inadequate ceiling height in __ 14 Inadequate l i ght and ventilation in Dining Room 15 Provide access to attic . --,6 Correct dampness in x 17 Provide landings and-/o_r_s_t_e-ps_a_s_ fo l lows: Rear Entry. PLUMBING: X 18 Separate plumbing and sewer permits required .. 19 Al l abandoned sewers, cesspools, and septic tanks to be fi lled and/ or capped.· 20 Connect house drain to sewer. --21 Drain and vent lines to be altered to meet code as fo ll ows: ----- X 22 Install backflow device on all hose bibs . ------------- 23 Provide water.test on drainage and ven t system to roof. 24 Water lines to be corrected as follows: ------------ _25 Following plumbing fixture(s) to be corrected as noted : ----- 26 Repa ir shower compartment to pro- vide waterproofing . __ 27 Correct gas system as fol lows: X 28 Prov i de gas test. --?.9 lleil tin9 co rrections to br. made as follows: Wall Heater connector flex. X 30 Provide new water heater or correct existing un i t as foll ows: ____ _ RELOCATION CORRECTION LIST PAGE TWO ELECTRICAL: X 31 X 32 Separate electrical permit required. Comp letely rewire structure to meet code. 33 New service required: Amps l 00 Circuits .--,--------Si ze Conduit -------Size Wire --------34 Corr ect non-conforming w1r1ng as follows: Grou nd al l receptacl es and correct panel. 35 Additional outlets required as follows: Bathroom receptacles and GFI protecti on. __ 3~ Additional lights required as follows: Exterior weather proof X 37 receptacle with GFI. Repair or replace all damaged or missing outlets, fixtures, switches, etc. GENERAL REQUIREMENTS: l . Any damage done to the building as result of rel ocation work must be repaired in compliance with Bui lding, Electrical and Plumbing Codes. 2. Provide a termite inspection of the ex i sting structure. (A l l require- ments of this inspection must be completed pr i or to occupancy). ADDITIONAL CORRECTIONS: l. Yard to be complete ly cleaned and remova l of acc umulated items of combustible materi als shall comply to the satisfaction of the Fire Marshal and Sanitation De- partment. Nonregistered and nonoperable vehicl es shal l be removed or dis- mant l ed. 2. Deed restrictions are not enforced by this Division; they may prohibit this relocation. Check your deed and other records before moving this structure to proposed site. 3. Occupancy of this building shal l not be permitted until the corrections li sted hereon and all City ordinances and State Laws regulating building co nstructi on have been complied with. 4. Post house numbers . 5. Street improvements required (curb, gutter and sidewalks). Inspecti on of building at present site: Proposed Site: Approved X Den ied __ Approval for rel ocation: By:~~"-=-1---L..J'-'=~:.=.=_-~// ~ total work $ ------- l 0% . $ ______ _ Amount of Bond $ _____ _ I hereby acknowl edge that I have read this correction list. I agree to comply with the corrections listed hereon-and with all City Ordinances and State Laws regu l ating building construction. Signature of Permittee: Name Address MEMORANDUM DATE: November 2, 1981 TO: Building Department FROM: Engineering Department SUBJECT: SEWER CONNECTION FOR 2475 TIITTLE STREET The fee to use the City's sewer system will be $1,000.00. '(_Q:A JiM CENTO JC:ls I APPLICATION FOR PERMIT TO CONNECT TO CITY SEWER SYSTEM. CITY OF CARLSBAD i, SE 182 I ENGINEERING DEPARTMENT 438-5541 ISSUED BY i ·-FOR APPLICANT TO Fl LL IN r ~ J/J h / DATE ISSUED BUILDING 2'17\ 7 '/'/.'I ADDRESS J T✓ F' VALIDATION ' -. OWNER /\ " , I'\ -C" A • I A . • -' I I fl I ..,,,,, V -•# -. ., . • "'1.i'I; ,..._ I • .... ""' _,A "' JIJ r~, ,,-_...,"-:,, ' -MAILING .... ~ ,,,, .. ,, .... . --,~ .. , ADDRESS ,-Ai J\ ...... ,,,.. ,,-A,1,------, ... J • ""''. L ATERAL CHARGE COMPUTATION CONTRACTOR STANDARD 4" (Max. H, 30', V. 10') ~ OVER 30' H. @ FT, CONTRACTOR'S OVER 10' V. @ FT. ADDRESS STANDARD 6" (Max. H. 30', V. 10') OVER 30' H. @ FT. NEW BUILDING I EXISTING BUILDING I OVER 10' V. @ FT. LEGAL DESCRIPTION TOTAL CONSTRUCTION COST SERVICE CHARGE (REPAVING ETC.) TOTAL LATERAL CHARGE REMARKS: LINE COST DATA -t~ovC ASSESSMENT DIST. NO. FRONTAGE COST PER FT. TOTAL OTHER LATERAL LOCATION CONNECTION FEE i--: I I ...= COST PER UNIT4-}~ en en NO. UNITS l TOTAL _ __,, ; ..,....., r I'\ , I\ PUMP STATION FEES '-,./ \.__ 1./ NO. UNITS COST PER UNIT TOTAL I I ST. TOTAL CHARGES (LATERAL ETC.), ~)~ LATERAL NO. INSTALLATION DATE ,, _ - W-HITE: Engineering GREEN: Finance YELLOW: Sanitation PINK: Building GOLDENROD: Permitter