HomeMy WebLinkAbout2586 HIGHLAND DR; ; 71-202; Permit.,-2 p u Bl 0 a •
PERMIT * 71-'J{):x.-::: City of CARLSBAD, CALIFORNIA IIAR 1 !i-71 5~ 8H**1 •ii ~.{ 0G -cc 0 •
Applicant to complete numbered spaces only. k, • • •
L M NG PERMIT APPLICATION
J08 ADDIIESd" 5 S'b A/4 cJ l,_JJ o. .,,-, d I I t!' L"-j/r.__.t..,,(Je__ ~ i
LOT NO. I"" {) I Tlll:ACT (0SEE ATTACHED SHIEETJ ~-=i
LEGAL I 1 DESCII. ~
OWNEII Iii~·;;~~:?, 7>-,
,,. PHONE f :\:; ~
2 lf2i.LJ. lcr,,1, c ) ·:"-'.)'· ~ 3 OONTftA<TTu /J.A 1 }y\_..•
1 (}JI MAlL:][1__,t J
PHONE LICENSE NO. ~ 'f::-
ARCHITECT OR DESIGNEllt ,
I MAIL ADOIIIESS I PHONE LICENSE NO, ~ 5\ 4 ·""--\, K ....
ENGINEER ~,/ MAIL ADDll:£SS -~ PHONE LICENSE NO. ~ z p
5 ~
LENDER MAIL ADDRESS BIIANCH :i
6 / ~ /
7
USE OF BUI~• " ' .
8 Class of work: □NEW □ ADDITION □ ALTERATION 0 REPAIR r a ,J_j) L,,y (~ -&, \
9 Describe work: <;;-(LL Lf.( ... '1.,_ ,✓
0
PERMIT FEES
No. Type of Fixture or Item Fee
SPECIAL CONDITIONS: WATER CLOSET (TOILET) $
BATHTUB
LAVATORY (WASH BASIN)
SHOWER
KITCHEN SINK & OISP.
DISHWASHER
APPLh.,• ~T~D)BY PLANS CHECKED SY: APPROVED FOR ISSUANCE SY LAUNDRY TRAY
(-CLOTHES WASHER
WATER HEATER
( NOTICE URINAL
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC· DRINKING FOUNTAIN
TION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS. OR IF FLOOR~SINK OR DRAIN CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-SLOP SINK
MENCED. GAS SYSTEMS: -NO, OUTLETS
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ANO KNOW THE SAME TO BE TRUE AND CORRECT. WATER PIPING & TREATING EQUIP.
ALL PROVISIONS OF LAWS ANO ORDINANCES GOVERNING THIS
TYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIF"IED WASTE INTERCEPTOR HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT
PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE VACUUM BREAKERS PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING
CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. . INKLER SYSTEM
7sEWER/ ----
...,.,.,
,/2h/ ,;-#/_. ~ . , Jc/41 ,cESSPOOL
SEPTIC TANK & PIT
SIGNATURE/' C~r AUTMOIIIIZED AGENT Y,AT£)/
PERMIT $ , l)@
SIGNAT"RC' OP' OWNEIII IP' OWNER BU ILOEIII DATE) TOTAL FEE $ CB
WHEN PROPERLY VALIDATED (IN THIS SPACE! THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH
INSPECTOR
----------·· ····-~ ............ ,,., ,.. .... ,c-c-C>C"t..lr'I=" nc-.. ,,11 nlt..lt:: ni=-i=-1r.1At.Sa!IO!!O. LO!! IIIOBLE!I a PASADENA. CALtP'ORNlA ;1101
CITY OF CARllBAD SEWER
BUILDING DEPARTMENT J PERMIT -APPLICATION
FOR APPLICANT TO FILL IN
LEGAL BUILDING DESCRIPTION Lo·r NO, ADDRESS
BLOCK TRACT NEAREST
CROSS ST, USE OF BUILDINGS OWNER
MAIL
CONTRACTOR ADDRESS
ADDRESS CITY TEL. NO,
CITY TEL. NO. CONNECTION DATA
CONTRACTOR•s STATE CARLSBAD BUSINESS Lateral Charge Computation
LICENSE NO. LICENSE NO.
30' H., 10' V. @ 4" = ___ /," ----
Add. Horiz. @ 4" = ___ /," -NO. DESCRIPTION OF WORK FEE ----
HOUSE SEWER CONNECTING TO Add. Vert. @ 4" = ___ /," -PUBLIC SEWER @ $3,00 ----
SEPTIC TANK. SEEPAGE PIT OR
PITS @ 111.00 Total Construction Cost
OVERFLOW SEEPAGE PIT, DRAINFJELD EXTN.,
CESSPOOL, ORYWELL, MANHOLE @ S!l.00 I 0% Service Charge
HOUSE SEWER CONNECTING TO Total Lateral Charge PRIVATE DISPOSAL SYSTEM @ Sl.!10 --CONNECT ADDITIONAL BLDG, OR
WORK TO HOUSE SEWER @ $1.!50 Lat. No.: Logged in Plat:
ALTER, REPAIR OR ABANDON H OUSE LINE COST DATA SEWER OR DISPOSAL SYSTEM @ 12.00
0 • A. D. & Assmt. No.
LINE COST:
OWNER'S I PERMIT s 2 00 C. C. @ __ / dwelling
AUTHORIZATION TOTAL P'EE P. S.@ -I dwolling
OTHER
I H AVE AT THIS DATE A CONTRACT WITH THE HEREIN
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED BUILD, TOTAL ING TO THE PUBLIC SEWER.
SIGNED THIS DAY OF Grand Total, Lateral, etc.
OWNER OR
OWNER'S AGENT FOR SEWER LOCATION
ADDRESS
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT ... + AND AGREE TO COMPLY WITH ALL C ITY 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-St. BAD AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL
OWNER OF THE ABOVE DESCRIBED
ERTY.
RESIDENTIAL PROP. ENGI NEERING SEWER DEPT.
SIGNATURE
OF PERMITTEE Signed -I Signed
This i1 • Sewer Permit When Properly Filled Out, Signed and Validated
Issued By ---------------------
PERMIT VALIDATION
NORTH