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HomeMy WebLinkAbout2521 CREST DR; ; 72-353; PermitPLUMBING PERMIT APPLICATION pBrm.rNn7AJ£^ City of CARLSBAD, CALIFORNIA Applicant to complete numbered spaces only JOB AODR ESS ^ _^ £/U^ djL , LOT NO BLK TRACT , LEGAL ] DESCR OWNER -j m V"/ .MAIL ADDRESS* ZIP PHONE CONTRACTOR / * MAIL ADDRESS ENGINEER MAIL ADDRESS a •*—-,.,.. LENDER MAIL ADDRESS PHON E LICENSE NO PHONE LICENSE NO ~ PHONE LICENSE NO _. BRANCH X 1 USE OF BUILDING \ ^ /" ^ 8 Class of work E^tfEW D AOBTTION D ALTERATION D REPAIR 9 Describe work / ^ --S^^f •/^£/>-«f>t ^/, / & •> /£'' SPECIAL CONDITIONS •-" >r -yr^_^Z<-r' ~-^.&s^-/Ls* -S&? ^Cc *~7?2iA*c4 -oricifc. ffsf~iff "VlC-i-Xd;V;x / /' ~/^_ j> ^££&{ "2^u-^- ,,^v/-7 ''.s'LLdL'l- ^,-4-a-^f- ' APPLICATION ACCEPTED BY PLANS CHECKED BY APPROVED FOR ISSUANCE BY NOTICE THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC TION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS OR IFCONSTRUCTION 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 SPECIFIEDHEREIN OR NOT THE GRANTING OF A PERMIT DOES NOTPRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE) Y /--' •' / n // „ , ?-,f* ./* ' ff ^'.i-!' / / & Jr?<» _ •"'l^liX J^jS .-J f f fV__ SIGNATURE OF OWNErfl^tlF OWNER BUILDER) (DATE) *f PERMIT FEES No Type of Fixture or Item WATER CLOSET (TOILET) BATHTUB LAVATORY (WASH BASIN) SHOWER KITCHEN SINK & DISP DISHWASHER LAUNDRY TRAY CLOTHES WASHER WATER HEATER URINAL DRINKING FOUNTAIN FLOOR— SINK OR DRAIN SLOP SINK GAS SYSTEMS NO OUTLETS WATER PIPING & TREATING EQUIP WASTE INTERCEPTOR VACUUM BREAKERS LAWN SPRINKLER SYSTEM SEWER CESSPOOL SEPTIC TANK* PIT PERMIT $ TOTAL FEE $ c 2n <" ^ i 0mso3min 5 i ^o>i> Fee $ sg~ ^<? #~ 00 $~oro CTJ 3 o 1 J 1 WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION CK M O CASH INSPECTOR CITY Of CARLSBAD BUILDING DEPARTMENT SEWER PERMIT - APPLICATION22 SL K. t. :- • • f ':. ? i: i- • .' • I: vi* '. .' ''• ': : 't:'~ : '•'•• FOR APPLICANT TO FILL IN LEGAL -S-ix- / 3 t DESCRIPTION LOT NO •~~*~>Sii '' *~? BLOCK TRACT ^ifc $Gs Jj*l USE OF f *•< , ~-BUILDINGS A-fcJ//.«A-', ."*/£- CONTRACTOR ADDRESS CITY CONTRACTOR S STATE LICENSE NO TEL NO CARLSBAD BUSINESS LICENSE NO NO DESCRIPTION OF WORK FEE HOUSE SEWER CONNECTING TO PUBLIC SEWER 9 $3 OO SEPTIC TANK, SEEPAGE PIT OR PITS 9 $500 OVERFLOW SEEPAGE PIT DRAINFIELD EXTN , CESSPOOL DRYWELL MANHOLE 9 $5 OO HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM @ $1 SO CONNECT ADDITIONAL BLDG OR ALTER REPAIR OR ABANDON HOUSE SEWER OR DISPOSAL SYSTEM 9 $2 OO 9 * OWNER'S AUTHORIZATION - 1 kAVE AT THIS DATE A v" CONTRACTOR TO CONNEC .i'-'lNO TO THE PUBLIC SEW X STONED THIS — , — •-OWNER OR J ADDRESS PERMIT 9 2 OO TOTAL FEE CONTRACT WITH THE HEREIN T THE ABOVE DESCRIBED BUILD ER DAY OF -•( ' t HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS IV APPLICATION AND STATE THAT THE ABOVE IS CORRECT ! ''AN£ AGREE TO COMPLY WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING PLUMBING AND SEWERSH HEREBY CERTIFY THAT i AM PROPERLY REGISTERED • AND/OR LICENSED AS REQUIRED BY THE CITY OF CARLS. " "SAD AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL ' OW^ER OF THE ABOVE DESCRIBED RESIDENTIAL PROP- BtGNATURE ' ' Or* PERMITTEE — — • • £ f*"1*""* ' f : 'l ' ^ cR£sissT /^r^-a^r ^*u<2**s> OWNER ^r£r'-f** y \J . £^F£d(f ^yUS%y MAIL ^- _ ,__. ADDRESS — 'fyf^ffS CITY TEL NO CONNECTION DATA Lateral Charge Computation 301 H , 10' V & 4" — . A" — J&S <— Arlrl hlnriT (8) 6." ~ A" — Adrl Vert ® 4" — k» — Total Construction Cost _ 10% Service Charge /Sfc^ Total lataral Churga -<«^<f^f,^^ Lat No . Logged in Plat: ' LINE COST DATA A D & A«mt No Sl/&'l*4F c c ©^-/^<.ii.na /*^^ *&>& PS © /**»'-/ dwallmg * " /<M *• OTHFR *,'""' *£*„• n, frrfaSr- TOTAI *ffr~' 'l*~'~-"'s~f ^ ** M.£J9&K irfi^ FOR SEWER LOCATION St NORTH ENGINEERING SEWER DEPT. Siqned /^Mgj-f&B, [ Signed '. - i * — ' jnz Tf^ • •• Thit i» a Sewer Permit When Properly Filled Out, Signed andValidated PERMIT VALIDATION 1 -0 1 r 1 ^'? •*.* -;| 1-A 3 S