HomeMy WebLinkAbout1216 LAGUNA ST; ; 70-353; PermitPLUMs1NG~RM1ikiu!~:ioN:>59 ~ ~.
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APR ?.0-70 ~-c,2992**'t••~.0O
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City of CARLSBAD, CALIFORNIA
Applicant to complete numbered spaces only.
JOB ADDRESS
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1 ];~;~~-<O"n ATTACHED 9HUTI I "11:,. ,, I_'\
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MAIL ACPRESS PHONE LICENSE NO, "" ~ J ARCHITECT OR DESLGiNE:A
4
ENGINEER MAIL AD011'11£SS PttONIE 1.1C[.NSE NO .. j
5
~() LEN DE.A 8111ANCH
6
USE OF IUILDING I" l .!l\
7 ( ~ \1 1------------------,.~~C----------------------1~ ~
~· 8 Class of work: □ NEW □ ADDITION LTERATIO,N □ REPAIR ,J
9 Describe work: '"~
~
PERMIT FEES
No. Type of Fixture or Item Fee
SPECIAL CONDITIONS: WATER CLOSET (TOILETI $
BATHTUB
LAVATORY (WASH BASIN)
SHOWER
KITCHEN SINK & DISP.
DISHWASHER
APPLICATION ACCEPTED BY: PLANS CHECKED BY •;r;;:,c'.'' 1---1---~-~-~-:-H-:E-=-:-:-TA_:-:-:-E_R _______________ -+----1
NOTICE
THIS PERMIT BECOMES NULL AND VOi DI F 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 SPECll"IEO 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.
(DATE)
URINAL
DRINKING FOUNTAIN
FLOOR-SINK OR DRAIN
SLOP SINK
GASSYSTEMS:NO.OUTLETS
WATER PIPING & TREATING EQUIP.
WASTE INTERCEPTOR
VACUUM BREAKERS
LAWN SPRINKLER SYSTEM
SEWER
CESSPOOL
SEPTIC TANK 6 PIT
PERMIT
SIGNATLl,il:E OIi' OWNE,. II" 0\IY'l\'IER 51Jtt.DER D .. T~I TOTAL FEE
WHEN PROPERLY VALIDATED ON THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O.
INSPECTOR
$ c:._ (J ,,
CASH
Form 100.2 9-69 REORDER FROM! INTERNATIONAL CONFERENCE OF' BUILDING OFFICIALS e ~o 80. LOS l'IQBLU. PASAOENA, CALIP'ORNI .. ~, ,a,
CITY OF CARLSBA~ SEWER
BUILDING DEPARTMENT PERMIT. APPLICATION
FOR APPLICANT TO FILL IN
LEGAL BUILDING DESCRIPTION LOT NO. ADDRESS
BLOCK TRACT NEAREST
CROSS ST. USE OF
BUILDINGS OWNER
MAIL CONTRACTOR ADDRESS
ADDRESS C ITY TEL. NO.
CITY TEL. NO. CONNECTION DATA
CONTRACTOR'S STATE CARLSBAD BUSINESS Lateral 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 -----
S EPTIC TANK, SEEPAGE PIT OR
P ITS @ $5.00 Total Construction Cost
OVER FLOW SEEPAGE P IT, DRAINFIELO EXTN., I 0% Service Cha rg e CESSPOOL , DRYWELL, MANHO LE @ $5.00
HOUSE SEWER CONNECTING TO Total La teral 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 SEW ER OR DISPOSAL SYSTEM @ $2.00
@ $ A. D. & Assmt. No.
LINE COST:
OWNER'S I PERMIT $ 2 00 C. C. @ ___ / dwelling
AUTHORIZATION TOTAL FEE P. S. @ __ / dwelling
OTHER I HAVE AT THIS DATE A CONTRACT W ITH THE HEREIN
CONTRACTOR TO CONNECT TH E ABOVE DESCRIBED BUILD· TOTAL ING TO THE PUBLIC SEWER.
SIGNED THIS DAY OF Grand Total, Lateral, etc. OWNER OR
OWNER'S AGENT
A D DRESS FOR SEWER LOCATION
I HEREBY AC KNOWLEDGE THAT I HAVE READ THIS APPLICATIO N AND STATE THAT T HE ABOVE IS CORRECT + .... AND AGREE TO COMPLY WITH ALL CITY ORDI NANCES AND V) V) STATE LAWS REGULATING PLUMBING AND SEWERS.
I HEREBY CERTIFY THAT I AM 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 D ESCRIBED RESIDENTIAL PROP. ENGINEERING SEWER DEPT. ERTY.
SIGNATURE Signed -I Signed OF PERMITTEE
This is a Sewer Permit When Properly Filled Out, Signed and Validated
Issued By __________________ _
PERMIT VALIDATION 7