HomeMy WebLinkAbout1178 LAGUNA DR; ; 70-148_MISC; PermitCITY OF CARLSB/r SEWER
BUILDING DEPARTMENT PERMIT • APPLICATION
::1 ~b9,S3) /~ Y-y; 3,'Jo 7c> FOR APPLICANT TO FILL IN
LEGAL BUIL DING DESCRIPTION LOT NO. ADDRESS
BLOCK TRACT NEAREST
CROSS ST. USE OF
BUILDINGS OWNER
MAIL CONTRACTOR ADDRESS
ADDRESS CITY TEL. NO.
CITY TEL. NO. CONNECTION DATA
CONTRACTOR'S STATE CARLSBAD BUSINESS Latoral Charge Computation LICENSE NO. LICENSE NO.
30' H., 10' V. @ 4" = ___ 6" ----
Add. Horiz. @ 4" = ___ 6" -NO. DESCRIPTION OF WORK FEE ----
HOUSE SEWER CONNECTING TO Add. Vert. @ 4" = ---6" -PUBLIC SEWER @ $3.00 ----
SEPTIC TANK, SEEPAGE PIT OR
PITS 0 $!5.00 Total Construction Cost
OVERFLOW SEEPAGE PIT, DRAINFIELD EXTN .• 10% Service Charge CESSPOOL, DRYWELL, MANHOLE • $!5.00
HOUSE SEWER CONNECTING TO Total Lateral Charge PRIVATE DISPOSAL SYSTEM @ $1.!50
CONNECT ADDITIONAL BLDG. OR Lat. No.: Logged in Plat: WORK TO HOUSE SEWER @ $1.!50
ALTER. REPAIR OR ABANDON HOUSE LINE COST DATA SEWER OR DISPOSAL SYSTEM @ $2.00
• $ A. D. & Assmt. No .
LINE COST:
OWNER'S I PERMIT s 2 00 C. C. @ __ / dwelling
AUTHORIZATION TOTAL FEE P. S. @ __ / dwelling
I HAVE AT THIS DATE A CONTRACT W ITH THE HEREIN OTHER
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED BUILD-TOTAL ING TO THE PUBLIC SEWER.
SIGNED THIS DAY OF Grand Toto!, Loterol, etc. OWNER OR
OWNER'S AGENT
FOR SEWER LOCATION ADDRESS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT ..: ..: AND AGREE TO COMPLY WITH ALL C ITY ORDINANCES AND V) V) STATE LAWS REGULATING PLUMBING AND SEWERS.
I HEREBY CERTIFY THAT I A M PROPERLY REGISTERED
AND/OR LICENSED AS REQUIRED BY THE CITY OF CARLS-
BAD AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL St. NORTH
OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROP. ENGINEERING SEWER DEPT. ERTY.
SIGNATURE Signed I Signed OF PERMITTEE
This is a Sewer Permit When Properly Filled Out, Signed and Validated
l11ued By ----------------,,,,lc~--
PERMIT VALIDATION
APPLICATION FOR PERMIT TO CONNECT TO CITY SEWER SYSTEM
CITY OF CARLSBAD
ENGINEERING DEPARTMENT
729-1181 EXT. 35
FOR APPLICANT TO FILL IN
BUILDING
ADDRESS
OWNER
MAILING
ADDRESS
CONTRACTOR
CONTRACTOR'S
ADDRESS
NEW BUILDING
LEGAL DESCRIPTION
REMARKS:
..,:
(I)
EXISTING BUILDING
LATERAL LOCATION
ST.
LATERAL NO, _______ INSTALLATION DATE--------1
BUILDING DEPT.
ISSUED BY ------------------
DATE ISSUED ----'--------------
VALIDATION
LATERAL CHARGE COMPUTATION
STANDARD 4" (Max. H. 30', V. 10') _________ _
OVER 30' H. ___ @..,,,._ ___ FT. _________ _
OVER 10' V. @ FT. _________ _
STANDARD 6" (Max. H. 30', V. 10') _________ _
OVER 30' H, ___ @, ____ FT, _________ _
OVER 10' V. @ FT,----------
TOTAL CONSTRUCTION COST----------
SERVICE CHARGE (REPAVING ETC.) _________ _
TOTAL LATERAL CHARGE _________ _
LINE COST DATA
ASSESSMENT DIST. NO.--------------
FRONTAGE ____ COST PER FT. ___ TOTAL __ _
OTHER ___________________ _
CONNECTION FEE
NO. UNITS ___ COST PER UNIT ___ TOTAL---
PUMP STATION FEES
NO. UNITS ___ COST PER UNIT ___ TOTAL---
.Jiso_ga_ TOTAL CHARGES (LATERAL ETC.) _________ _
May 3, 1977
To Whom It May Concern:
0
J!)e· Se&~Disposal System located
Ul)t,z · 'zUfitc/ has been inspected
determination is failing.
and in my
Department
DATE: 5-3-17
6K
..
PLUMBING PERMIT APPLICATION ~o*~•o• r> ,
City of CARLSBAD, CALIFORNIA 92008 71 J11/
Appt,cant to complete numbered spaces only Phone 729-1181 Permit No -
1 LlGAL I LOT NO. '.)
OlSCfll. , .,,-f'
O" --OWN[.111
2 ( l>. MAIL AOOAtss, ZIP
/10..2.;; ~A-/ cJ £V, ,, ,?rt..'-
PMONt
9~008 (.
C"'Oti.JflAC TOIi!:
3 ' --:---,...,.. ,_ .,.-._ .__ F ..._ <;,-
J.I I
4
5
COMPENSATION INS. CARRI ER
6
US[ o, a ull.OIN'
7
8 Class of work. □NEW 0 ADDITION
9 Describe work:
SPECIAL CONDITIONS~
//1
I
PLANS CHECKED BY
I ./
MAIL A0OAtS.S
MAIL AOOA['tS
MAIL A00,-lS5
MAIL AOOflllSS
0 ALTERATION
/ WJ.' ', pr q
4PPROV(0 FOR •SSU4NC( BY
PHON [ STATE LIC. NO.
• .. ' I
LICtN&l NO,
PHONE LIC[NSE. NO.
alU,NCM
0 REPAIR
PERMIT FEES
No. Type of Fixture or Item
WATER CLOSET !TOILET)
BATHTUB
LAVATORY (WASH BASIN)
SHOWER
KITCHEN SINK & OISP
DISHWASHER
LAUNDRY TRAY
CITY LIC. NO.
Fee
$
APPLICAT10N• A'l!_C PHO BY
I ~ .-I 77 CLOTHES WASHER OATE.J-1/--1---,1--W_A_T_E_R_H_E_A_T_E_R ______________ ..._ _ _.,__~
NOTICE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC·
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-
MENCED
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS
APPLICATION ANO KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS ANO ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING
CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
(DAT[}
51GNATUl111£_ OP' OWNUI 1, OWNl" ■U IL0l" OATt)
/
URINAL
DRINKING FOUNTAIN
FLOOR-SINK OR DRAIN
SLOP SINK
GAS SYSTEMS.NO.OUTLETS
WATER PIPING&, TREATING EQUIP.
WASTE INTERCEPTOR
VACUUM BREAKERS
LAWN SPRINKLER SYSTEM
SEWER
CESSPOOL
NUMBER CLEAN0UTS
SEPTIC TANK a. PIT
ROOF DRAINS
ISSUANCE FEE
TOTAL FEES
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O.
INSPECTOR
$
$
CASH
....-------------------
INSPECTION REPORTS --------
DATE ITEM REMARKS INSPECTOR
-----------~----------------
-------------1
------+----
-------~--1----------1
---------+----------------------------------'------~
___ ...._~ -~ -
USE SPACE BELOW FOR NOTES, FOLLOW-UP. ETC.
5-6-77 Sewe r Hook up: O.K. to hook up. T. Mata
1 I