HomeMy WebLinkAbout2040 BASSWOOD AVE; ; SE1964; Permit* BUILDING DEPARTMENT
NO.
VL, h
DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO PUBLIC SEWER 8 53.00
SEPTIC TANK, SEEPAGE PIT OR P1T.S a 6500
FOR APPLICANT TO FILL IN I
. - ___--
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 @ $1.50
ALTER, REPAIR OR ABANDON HOUSE SEWER OR DISPOSAL SYSTEM @ $2.00
@S
PERMIT s
TOTAL FEE I OWNERS
AUTHORIZATION
I LEGAL DESCRIPTION Lor NO. / 7 I
___ -$
3 0 d
BLOCK TRACT
USE OF BUILDINGS
ADDRESS 53 -5 Q-Ly &”+, &Le I
CITY && 1. TEL. NO. 729 - dd//
CONTRACTOR’S STATE CARLSBAD BUSINESS LICENSE NO. LICENSE NO.
APPLICATTON AND STATE THAT THE ABOVE ISCORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND 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
ERTY. SIGNATURE OF PERMITTEE
BU l LDl NG ADDRESS ,&70 ./
NEAREST CROSS ST.
CONNECTION DATA Lateral Charge Computation
30’ H., IO’ V. @ 4” = - 6” = -
Add. Horiz. @ 4” = ___ 6” = -
Add. Vert. @ 4” = __ 6” = -
Tofal Construction Cost
10% Service Charge
Total Lateral Charge
Lat. No.: Logged in Plat:
LINE COST DATA
A. D. & Assrnt. No.
LINE COST:
C. C. @- / dwelling
P. S. @- / dwelling
OTHER
TOTAL
Grand Total, Lateral, etc.
FOR SEWER LOCATION
st. NORTH
ENGINEERING SEWER DEPT.
Signed I Signed
This is a Sewer Permit When Properly Filled Out, Signed and Validated
Issued By I
PERMIT VAL~DATION
CITY OF CARmAD
BUILDING DWARTMENT
PWmlMG
PERMIT - APPLICATION /T- 6097
OWNER
MAIL
CITY ,&FFdd
ADDRESS 32 7 E:-[-,,> d*
TEL NO ,7.2/- -xa/C
PLUMBER &> ~66,' 4 4 *.
CITY &,W
f cs,u I!' z -6 /CC&.
ARDRESS 7541 Xd-6
TEL NO ;/a9 -3.9/5
CARLSBAD BUSINESS STATE LICENSE NO. LICENSE NO
d/S .rck 4/ r'&& L/
~ NO ITEM FEL - 2 TOILET @ SI25 2 5 ~3
/ BATH ruB 8 125 1 2-3- - 1 SHOWER 0 125 1 ='"i-
2 WASH BASIN 0 125 2- 5&
/ KITCHEN SINK 63 125 /
DISHWASHER @ 125
LRUNDRY TUB OR TRAY 0 125- -
-/ AUTOMATIC WASHER 8 125 1 23- 77 1 .sz,
30 EA ADD 8 150 / .E 3~ GAS SYSTEM I To 15 -
FLOOR DRAIN OR SINK @ 125
LAWN SPRINKLER 63 200
MlSC WATER PIPING 8 150
/ GARBAGE DISPOSAL
VACUUM BREAKER OR BACK FLOW DEVICES 1 TO 5 8 2.00
-t--------ii-
PERMIT NQa I TOTALFEE $
QPADING PLAN
YES 0
I ACKNOWLEDGE THAT I HAVE READ THIS APPLFCA?ION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PLUMBING.
I CERTIFY THAT I AM PROPERLY REGISTERED AND LI- CENSED AS REQUIRED BY THE CITY OF CARLSBAD AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL OWNER OF THE ABOVE DESCSBED RESIDEYTIAL PROPERTY.
SIGNATURE OF PERMITTEE
BUILDING ADDRESS
NEAREST
.? i: 4 C 4 -----&aJ73%?d-
CROSS sr.
I
GROUP 1 ZONE
InsDection Record
APPROVALS 1 DATE 1 INSPECTOR'S SIGNATURE
UNDER FLOOR WORK
PLUMBING FIXTURES
GAS TEST
UTILITY CO. NOTIFIED
FINAL
VALIDATION This is a Plumbina Permit When Properly Filled Out, Signed and Validated. Permit void if work is nof commenced within 60 days of date of issuance.