HomeMy WebLinkAbout2060 BASSWOOD AVE; ; SE1964; PermitFOR APPLICANT TO Pilt IN
LEGAL DESCRIPTION LOT NO. / 9
E LOCK TRACT
USE OF BU ILDI NOS
CONTRACTOR
ADDRESS && 7 XL-l 6,
CITY TEL. NO. 707 9 -=%a//
CONTRACTOR'S STATE CARLSBAD SUSlNgSS LICENSE NO. LICENSE NO.
PERMIT s2M) I TOTAL FEE .S 6a
OWNER'S
AUTHORIZATION
I HAVE AT 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
AnnRESS . . - -. . ---
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY WITH ALL Clm ORDINANCES AND STATE LAWS REGULATING PLUMBIN6 AND SEWERS. I HEREBY CERTIFY THAT I AM PWERLY REGISTERED AND/OR LICENSED AS REQUIRED BY THE CITY OF CARL& BAD AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL
ERTY.
d4 -IT - APPLICATION
PAID JAM 31 -64 !!~2.652*******S.OO
BUILDING
NEAREST CROSS ST.
OWNER
MAIL ADDRESS +r&
ADDRESS ad L 0
f2EL-d 6,
TEL NO. 7~ 9 -a ,,
CONNECTION DATA Laferal Chargo Computation
30' H., Io' V. @ 4" = __ 6" = __
Add. Horiz. @ 4" = __ 6" = -
Add. Vert. @ 4n = __ 6" = __
Total Construction Cost
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
4 i v) v)
st. NORTH
ENGINEERING SEWER DEPT.
Signed I Signed
This is a Sawor Permif When Properly Filled Out, Signed and Validated
issued By
PERMIT VALIDATION
.. .- __ .__I. . ..,- i . . An
PERMIT - APPLICATION p- SO96
- NO 2
1
-.
I BUILDING DEPARTMENT
FEE ITEM
TOILET @ $1.25 /51
BATH TUB Q 1.25 , 1
SHOWER @ 1.25
WASH BASIN B, 1.25 25 0
KITCHEN SINK 8 1.26
DISHWASHER Q 1.25
LAUNDRY TUB OR TRAY 0 1.25 -
CITY /<&A &-&- TEL. NO. 7a - ai?/s-
STATE CARLSBAD BUSINESS LICENSE NO. LICENSE NO.
/ GARBAGE DISPOSAL @ 1.00 / 08
VACUUM BREAKER OR BACK FLOW DEVICES 1 To 5 @ 2.00
GRADING PLAN
YES 0
I ACKNOWLEDGE THAT I HAVE READ THIS APISLICATION AND STATE THAT THE ABOV@ IS CORRECT AND AGREE TO
COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REGUCATING PLUMBING.
SIGNATURE OF PERMITTEE puw-
CROSS ST.
GROUP 1 ZONE
InsDection Record
I DATE I INSPECTOR'S SIGNATURS APPROVALS
GAS TEST
UTILITY CO. NOTIFIED
FINAL
VALIDATION This is a Plumbing Permit When Properly Filled Out, Signed end Validated. Permif void if work is not commenced within 60 days of date of issuance.