HomeMy WebLinkAbout2510 WILSON ST; ; 73-3170; Permit1~ PLUMBING PERMIT APPLICATION
Permit No. 1 / '1/ ( City of CARLSBAD, CALIFORNIA
Applicant to complete numbered spaces only.
JOB ADD" t.SS . S/IJ W1LS6A.I
LCGAL 1 DUCft. I LOT NO, I ILK I T~AC T Q su ATTACHED SHEET)
OWN~#
MAIL ADO .. [SS ZIP PHONE S Tc~t../L-2 <it!J h~//_( ,,J
CONT .. ACTO" ' MAIL ADDRESS PHONE LIC[N5[. NO.
3 // ~ RN..t'U/,u )-~ /)/ \ ~l 7 c::.. 7t¢,4V/LI _:}A/ ,/2,, 9 o
AJIIICHITE.CT OR DESIGNCllt MAIL ADDJIICSS PHONE LICENSE NO.
4
CNGINCCR MAIL ADDRESS PHONE LICE.NS[ NO,
5
LI.MOUi MAIL ADDRESS BRANCH
6 .
USE OP' BUILDING
7
8 Class of work: 0 NEW 0 ADDITION 0 ALTERATION ~PAIR
9 Describe work :
~£, ,,J~c ~ • b A,/ .,ue c 17 P✓J
PERMIT FEES
No. Type of Fixture or Item
SPECIAL CONDITIONS: WATER CLOSET (TOILET)
BATHTUB
LAVATORY (WASH BASIN)
SHOWER
KITCHEN SINK & DISP.
DISHWASHER
APPLICATION ACCEPTED BY PLANS CHECKED BY APPROVED FOA ISSUANCE BY LAUNDRY TRAY
'\ '.,/ _J\...__
CLOTHES WASHER
WATER HEATER .
NOTICE URINAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC· DRINKING FOUNTAIN
TION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF FLOOR-SINK OR DRAIN CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM• SLOP SINK
MENCED. GASSYSTEMS:NO.OUTLETS I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS
APPLICATION ANO KNOW THE SAME TO BE TRUE ANO CORRECT. WATER PIPING & TREATING EQUIP. ALL PROVISIONS OF LAWS ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED WASTE INTERCEPTOR HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE VACUUM BREAKERS PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. LAWN SPRINKLER SYSTEM
I SEWER
. t/, / Ltfi.,,,-
CESSPOOL
1/faJ/?? SEPTIC TANK & PIT
SIGNATO,.E OJ' CONT .. ACTOfl Oft AUTHOllltllltD AGENT ' (OAT [)
PERMIT
SIGNATtJftr o, OWH CIIII: 1, OWNCII: I UILOCR DATE) TOTAL FEE
WHEN PROPERLY VAL IDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M .O. CASH PERM IT VALIDATION CK. M .O.
INSPECTOR
•
.
0 ::; ~ '~ -l"
'-~
..,,
Cl)
3
':t._ l~o lJ.
:z
0
"" "' ..
~ ~ ,,
~ t
~
' ~
" :'-
r
Fee
$
'
-
$ :,;
$ ')if ~,.
CASH
APPLICATION FOR PERMIT TO CONNECT TO CITY SEWER SYSTEM
CITY OF CARLSBAD SE 11 l I BUILDING DEPT. ENG I N EERING D EPART M ENT
729-11 81 EXT. 35 Qc,J.__ ISSUED BY . . "1,l ., _.. " FOR APPLICANT TO FILL IN
---. \J9 , .... c DATE ISSUED I I -\ 'J BUILDING '--510 l,dll ~tJO ADDRESS VALIDATION
OWNER No ,.., I t\ ~r -I' -J r~ .., ,-L
---AL·,,,. -MAILING
ADDRESS
LATERAL CHARGE COMPUTATION
CONTRACTOR \· .J ;i ( 0)r-J-STANDARD 4 " (Max. H. 30', V. 10') I (. ~
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.
I ',-LEGAL DESCRIPTION TOTAL CONSTRUCTION COST -
\1L::i,,J .... r. (. 1)' ., C SERVICE CHARGE (REPAVING ETC.) I 1 t; l ,A TOTAL LATERAL CHARGE , -
REMARKS: J_ I T f-tl. 1.:\ l-LINE COST DATA
.-( ,J ,_J( A .l '°' f' S':.>I (iL\=_ ASSESSMENT DIST. NO. 11 ·-
FRONTAGE COST PER FT. TOTAL
OTHER
LATERAL LOCATION CONNECTION FEE
i--: I I i--: I (/) (/) NO. UNITS COST PER UNIT TOTAL ~
,,,-""\ r ' PUMP STATION FEES
'-,,I '-.,/
NO. UNITS COST PER UNIT TOTAL
I ST. I
TOTAL CHARGES (LATERAL ETC.)
LATERAL NO. INSTALLATION DATE