HomeMy WebLinkAbout1665 BASSWOOD AVE; ; SE669484; PermitBUILDING DEPARTMENT
BUILDING ADDRESS I, G=-r VJrrWJ
NEAREST f CROSS ST.
OWNER e4
MAIL ADDRESS
I’ -
TEL. NO.
a . LEGAL DESCRIPTION LOT NO.
NO.
HOUSE SEWER CONNECTING TO PUBLIC SEWER
SEPTIC TANK, SEEPAGE PIT OR
rE.$3.00 yr DESCRIPTION OF WORK
PITS Q) $5.00
NO.
CONTRACTOR’S STATE CARLSBAD BUSINESS LICENSE NO. LICENSE NO.
?la Qfu> GXd5
HOUSE SEWER CONNECTING TO PUBLIC SEWER
SEPTIC TANK, SEEPAGE PIT OR
rE.$3.00 yr DESCRIPTION OF WORK
PITS Q) $5.00
PERMIT OWNERS
AUTHORIZATION
I OVERFLOW SEEPAGE PIT. DRAINFIELD EXTN.. I I
E200
-~ ~ -
CESSPOOL. DRYWELL, MANHOLE @ 15.00
HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM @ $1.50
CONNECT ADDITIONAL BLDG. OR WORKTO HOUSE SEWER ~ ~ 0 $1.50
ALTER, REPAIR OR ABANDON HOUSE SEWER OR DISPOSAL SYSTEM @ S2.00 -
I HAVE Ar THIS DATE A CONTRACT WITH THE HEREIN CONTRACTOR TO CONNECT THE ABOVE DESCRIBED BUILD- ING TO THE PUBLIC SEWER.
SIGNED THIS DAY OF OWNER OR OWNER’S AGENT
ADDRESS
I HEREBY ACKNOWLEDGE THAT I HAVE RGAD THlS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERS. I HEREBY CERTIFY ERLY REGISTERED AND/OR LICENS CITY OF CARIS- BAD AND STATE I AM THE LEGAL OWNER OF T&l€ IDENTIAL PROP ERTY. SIGNATURE OF PERMI
CONNECTION DATA Lateral Charge Computation
30’ H., IO’ V. @ 4” = - 6” = -
Add. Horir. @ 4” = ___ - ___
@ 4” = __ 6” = - Add. Vert.
Total Construction Cost
6” -
10% Service Charge
Total Lateral Charge
Lat. No.: Logged in Plat:
LINE COST DATA
A. D. & Assmt. No.
LINE COST:
C. C. @- / dwelling
P. S. @- / dwelling
OTHER
TOTAL
Grand Total, Lateral, etc.
FOR SEWER LOCATION
/i
St. NORTH
ENGINEERING SEWER DEPT.
J Signed Signed
hen Properly Filled Out, Signed and Validated
-. I .’ luued By -.
PERMIT VALIDATION
CITY OF cw
APPROVALS
UNDER FLOOR WORK
ROUGH PLUMBING
GAS PIPING
GAS VENTS
PLUMBING FIXTURES
MI SC.
BUILDING DEPARTMENT
DATE INSPECTOR’S SIGNATURE
. .. ADDRESh 12 I / 1. If
TEL. NO.
CITY r /” & n/ TELL>-ea c
STATE CARLSBAD BLJSINESS LICENSE NO. LICENSE NO.
- SHOWER Q 1.25 3 WASH BASIN 0 1.26 3
/ KITCHEN SINK Q 1.25 I
/ {
I r f DISHWASHER 8 1.26 1
LAUNDRY TUB OR TRAY @ 1.25
/ AUTOMATIC WASHER Q 1.25 J-
I [ FLOOR DRAIN OR SINK
Q 2.00
Q 1.50 L LAWN SPRINKLER
MISC. WATER PIPING ___
VACUUM BREAKER OR BACK
I 1-1-
I I I
GRADING PLAN PERMIT $-- 2 00
YES 0 NoO 1 TOTALFEE $bf l$‘
I 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 PLUMBING.
1 CERTiFY THAT 1 AM PROPERLY REGISTERED AND LI- CENSED AS REQUIRED BY T Y OF CARLSBAD AND STATE OF cALiFaA-* M THE LEGAL OWNER OF THE ABOVE 1 BE ENTIAL PROPERTY.
SIGNATURE OF PERMIT
, i.-=?:‘ PERMIT - APPLICATION I) ‘I4> . ’
i ? u
PAID Aw; 24-66 ?~2633ff****18.S0
BUILDING ADDRESS
NEAREST f CROSS ST.
GROUP I ZONE
inspedion Record
FINAL
d Out, Signed and validated. 60 days of date of issuance.