HomeMy WebLinkAbout1196 MAGNOLIA AVE; ; 72-994; Permit, -,
PLUMBING PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA
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LEGAL 1 DUCII,
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MAIL ADDfU:ss
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ZIP PHONE
CONT .. ACTOIII MAIL ADD1'ESS PHONE LICENSE NO,
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AflCHITECT OR OESIGNEIII MAIL ADDRESS PHONE LICENSE NO,
4
!.NGIN El" MAIL ADDJIU:.ss PHONE LICENSE NO.
5
L lNDUI MAIL AOOflESS
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USE o,-BUILDI NG
7
8 Class of work: □NEW □ ADDITION □ ALTERATION ~EPAIR
9 Describe work: J?r. /J I ,; .. (J
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SPECIAL CONDITIONS:
APPLICATION ACCEPTED BY: PLANS CHECKED BY, APPROVED FOR ISSUANCE BY:
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NOTICE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 60 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 AND KNOW THE SAME TO BE TRUE AND CORRECT. ALL PROVISIONS OF LAWS AND 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.
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SICfA"A.,.U"E"" O.P' CONTflt>t-CTOfl Oft AUTHOflllt'ED AGt:.NT
PERMIT FEES
No. Type of Fixture or Item
WATER CLOSET (TOILET)
BATHTUB
LAVATORY (WASH BASIN)
SHOWER
KITCHEN SINK & DISP.
DISHWASHER
LAUNDRY TRAY
CLOTHES WASHER
WATER HEATER
URINAL
DRINKING FOUNTAIN
FLOOR-SINK OR DRAIN
SLOP SINK
GASSYSTEMS:NO.OUTLETS
WATER PIPING & TREATING EQUIP.
WASTE INTERCEPTOR
VACUUM BREAKERS
LAWN SPRINKLER SYSTEM
I SEWER
CESSPOOL
I SEPTIC TANK & PIT J . II
PERMIT
~IGN.&.TLI .. [ OP' OWN[ .. IP' OWNEfl BUILDEfl (DATE) TOTAL FEE
WHEN PROPERLY VALIDATED (IN THIS SPACEI THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O.
AUDIT
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Fee
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$
$
CASH
Form 100,2 9·69 l!IEOIIIIDEIIII P'ftOM: INTERNATIONAL CONFERENCE OF BUILDING OFFICIALS e eo so. LOS .. OBLE.S e PASAOl:.NA, CALIP'ORNIA 0110,
(5 £·PTJC lAiJI(. ?
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APPLICATION FOR PERMIT TO CONNECT TO CITY SEWER SYSTEM /31-.[kr-Pcr'
CITY OF CARLSBAD
ENGINEERING DEPARTMENT
729-1181 EXT. 35
FOR APPLICANT TO Fl LL IN
BUILDING
ADDRESS
OWNER
MAILING
ADDRESS
CONTRACTOR
CONTRACTOR"S
ADDRESS
I l 1r-....
NEW BUILDING EXISTING 6UILDING
LEGAL DESCRIPTION
I..
REMARKS: I H
LATERAL LOCATION
ST.
LATERAL NO. _______ INSTALLATION DATE--------
...PERMITTEES COPY
ISSUED BY -----------------
DATE ISSUED-----------------
VALIDATION
LATERAL CHARGE COMPUTATION
STANDA RD 4" (Max. H. 30", V . 10') ________ _
OVER 30' H. @ FT. ________ _
OVER 10' V. ___ @ ___ FT. ________ _
STAN DA RD 6" (Max. H. 30', V. 10') ________ _
OVER 30' H. ___ @ ___ FT. ________ _
OVER 10' V . @ FT. ________ _
TOTAL CONSTRUCTION COST---------
SERVICE CHA RGE (REPAVING ETC.) ________ _
TOTAL LAT ERA L CHA RGE ________ _
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---