HomeMy WebLinkAbout1233 OAK AVE; ; 62-5115; PermitAPPLICATION FOR Bui .aJ DING PERMIT 5115
CITY OF CARLSBAD -BUILDING INSPECTION DIVISION
PHONE PArkway 9-1181 -Ext. 36 ,-.
Owner Name ..... V....D. . .S..£.?...~ .. R:.x······c:?~,.f.'.k~ ... ~ling Address /~~ ..... GL'. ......... <!...r.. .. f!.:..J/.. .................. .
(Ple11se Print) CD (L;t) "(rirst) (Middl~ Number Street CjJ.,(' Phone
Contractor ....................... ~ .................................................... Mailing Address .......... £.~ .................... .
( Ple11se Print) Number Street City Phone
To Construct~ Add D To Alter D To Repair D To Convert D To Move Fr~·r···-..:C:idi~;;································
Typo "'. Co,~~/1,d ol Fo,,d,tlo, ___ _/:l~::,,~.L ..... No. ol Sto,lo, .......... '. ..... To Bo UHd lf'o~"l,:·1!:!~-k .-1,!t,.,o ffe!!,,+.,,tio, (,q. lo,t) •.. 6.~ .................. c ... +. V,l,.tlo, $ ....... ../,.i!t:J. .... ~.'?. ............................................................. .
attached D
Floor Sp11ee of Garage (sq. feet) ................................................. detached OConst. Valuation $ ..................................................................................................... .
LEGAL DESCRIPTION
Lot Block Subdivision
:~e·~~~~···~~··:;~i~i::::22,;;z::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::::~·:~~~z:::::.~·.::·.·.:::·.·.::·.::: .. ~.~.~.~~::::::::::::::::::::::::::::
Assigned House Number
LAND AREA ...................................... NUMBER OF EXISTING DWELLINGS ON PROPOSED BUILDING SITE .................................................... (INDICATE
SIZE, USE AND LOCATION ON PLOT PLAN). WILL THIS CONSTRUCTION INCLUDE ANY PLUMBING INSTALLATION, ALTERATION, OR
NO ..... ~ ADDITION? YES ............... .
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION.
If II check is tendered for p11yment of the above fee and the check is
not honored when presented for payment, your Building Permit will be
immediately revoked.
SIGNATURE OF
PERMITTEE ·······················································································-·······
Front Yard Set Baek ................................................................... . Driveway Permit Required Yes ( No ( ) Fee ................................... .
Grading Permit Required Yes ( )
Rear Yard Set Baek ..................................................................... . Sewer Disposal Plant Capital Cont. Fee .................................................................... .
Distance Between Bldg ............................................................... . Sewer Pumping Station Capital Cont. Fee ................................................................. .
Off Street Parking Spaces ......................................................... . Sewer Main Line Cost ..................................................................................................... .
Sewage Disposal System ............................................................. . Sewer Lateral Connection Charge ............................................................................... .
Zone -Residential ( I ················· ........................................ . Water Stocked Lands Charge ........................................................................................ .
Zone -Commercial ) .............. ·········································• Water Main Pipe Line Fee ............................................................................................ .
Variance Water House Service Charge ....................................................................................... .
Eng. Cheek By ............................................................................. . Water Meter Charge ...................................................................................................... .
Sub Total .................................................................................... .
Plans ApprovpJ-n .. 0 ... ~······-/·······················································Plan Cheek Fee ·············::;··~·~········································································
Approved b/ ..... /\;. .... t:J.~ .... ~ .. ~ ........ Building Permit Fee .... ~ .................................................................................... .
Date .......... 9--... S{-.b .. L-=--:........................................................ Total Charges .. 2:..J1-$:l---·····························································-
CITY OF CARLSBAD
BUILDING DEPARTMENT
FOR APPLICANT TO FILL IN
LEGAL
DESCRIPTION LOT NO.
BLOCK
USE OF
BUILDINGS
TRACT
CONTRACTOR ~I\) tf ~Ide«-i>J..6,,.
ADDRESS oZ.(,9/ .sz;,.£«.
CONTRACTOR'S STATE LICENSE NO. CARLSBAD BUSINESS LICENSE NO.
~/'~(') 33:2,7
NO. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO ~ 1:)0 PUBLIC SEWER @ $3.00
SEPTIC TANK, SEEPAGE PIT OR
PITS 0 $15.00
OVERFLOW SEEPAGE PIT, DRAINFIELD EXTN.,
CESSPOOL, DRYWELL, MANHOLE @ $5.00
HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM @ $1.50
CONNECT ADDITIONAL BLDG. OR
WORK TO HOUSE SEWER • $1.150
ALTER, REPAIR OR ABANDON HOUSE SEWER OR DISPOSAL SYSTEM O $2.00
• s
,___
OWNER'S I PERMIT s 2 00
AUTHORIZATION ..s OQ
TOTAL FEE -
I HAVE AT THIS DATE A CONTRACT WITH THE HERElN
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED BUILD·
ING TO THE PUBLIC SEWER.
SIGNED THIS-----DAY OF---------
OWNER OR
OWNER'S AGENT----------------
ADDRESS
SEWER
PERMIT. APPLICATION
_.!11-68 ~,~~0 1801*******5.0U
~r.
CITY TEL. NO.
CONNECTION DATA
Lateral Charge Computation
30' H., 10' V. @ 4" = 6" ------
Add. Horiz. @ 4" _.L'tJ.! 6" = --
Add. Vert. @ 4" = --6"=--
Total Construction Cost
10% Service Charge
Total Lateral Charge
Logged in Plat:
/10 ?lJ
Lat. No.:
LINE COST DATA
A. D. & Assmt. No. ---------------
LINE COST: ----------------
C. C. @__l_ / dwelling --------'...;.L."--==-
P. S. @ __ / dwelling -------------
OTHER -------------------
TOTAL
Grand Total, Lateral, etc.
FOR SEWER LOCATION
~1----------------1~
St. NORTH
ENGINEERING SEWER DEPT.
Signed--------Signed --------
This is a Sewer Permit When Properly Filled Out, Signed and Validated
Issued By ---------·----------
PERMIT VALIDATION