HomeMy WebLinkAbout2785 CREST DR; ; 71-158; PermitA. PLUMBING PERMIT APPLICATION
//-J£>y City of CARLSBAD, CALIFORNIA rans-n
2
97Z«*'
Applicant to complete numbered spaces only
JOB ADDR ESS
LEGAL
DESCR
LJSEE ATTACHED SHEET)
OWNER _2 0
MAIL ADORE
CONTRACTOR MAIL ADDRESS LICENSE NO
ARCHITECf OR DESIGNER AI L'ADDRESS LICENSE NO
MAIL ADDRESS LICENSE NO
MAIL ADDRESS
USE OF BUI LDING
8 Classofwork D NEW D ADDITION D ALTERATION D REPAIR
9 Describe work -*)S — •*t*i
PERMIT FEES
No Type of Fixture or Item Fee
SPECIAL CONDITIONS WATER CLOSET (TOILET)
BATHTUB
LAVATORY (WASH BASIN)
SHOWER
KITCHEN SINK & DISP
DISHWASHER
ACCEPTED BY PLANS CHECKED BY APPROVED FOR ISSUANCE BY LAUNDRY TRAY
CLOTHES WASHER
WATER HEATER
\ NOTICE
THIS PERMIT\BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 60 DAYS, OR IF
CONSTRUCTION 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 THISAPPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECTALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THISTYPE OF WORK WILL. BE COMPLIED WITH WHETHER SPECIFIEDHEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT
PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATINGCONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION
URINAL
DRINKING FOUNTAIN
FLOOR—SINK OR DRAIN
SLOP SINK
GAS SYSTEMS NO OUTLETS
WATER PIPING & TREATING EQUIP
WASTE INTERCEPTOR
VACUUM BREAKERS
LAWN SPRINKLER SYSTEM
SIGNATURE OF OWNER (IF OWNER BUILDER)
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION CK M O CASH
Form 100 2 9-69
INSPECTOR
REORDER FROM INTERNATIONAL. CONFERENCE OF BUILDING OFFICIALS • SO SO LOS ROBLES • PASADENA CALIFORNIA 91101
CITY OF CARLSBAD
BUILDING DEPARTMENT
* SEWER
PERMIT - APPLICATION
ff^- <saf f /
FOR APPLICANT TO FILL IN
LEGAL pj »>--DESCRIPTION LOP NO #-r>V Hf t? L <-.
BLOCK Z_*y *>*?/. ;T~ TR'AC'T ^TI^- S"7"
USE OF _
BUILDINGS >£ ft *\ f j[2 /* A / ~f" i f-b IT
CONTRACTOR
ADDRESS
CITY TEL NO
CONTRACTOR S STATE CARLSBAD BUSINESS
LICENSE NO LICENSE NO
NO DESCRIPTION OF WORK FEE i
HOUSE SEWER CONNECTING TO 1
PUBLIC SEWER @ $3 OO
SEPTIC TANK SEEPAGE PIT OR
PITS @ S5 OO
OVERFLOW SEEPAGE PIT DRAINF1ELD EXTN
CESSPOOL DRYWELL MANHOLE @ $5 OO
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM @ SI SO
CONNECT ADDITIONAL BLDG OR
ALTER REPAIR OR ABANDON HOUSE
SEWER OR DISPOSAL SYSTEM @ S2 OO
@ S
OWNER'S PERMIT $ 2 OO
AUTHORIZATION TOTAL FEE
1 HAVE AT THIS DATE A CONTRACT WITH THE HEREIN
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED BUILD
SIGNED THIS DAY OF
ADDRESS . ... •
1 HEREBY ACKNOWLEDGE THAT 1 HAVE READ THIS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT
AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND
STATE LAWS REGULATING PLUMBING AND SEWERS
1 HEREBY CERTIFY THAT 1 AM PROPERLY REGISTERED
AND/OR LICENSED AS REQUIRED BY THE CITY OF CARLS-
BAD AND STATE OF CALIFORNIA OR THAT 1 AM THE LEGAL
OWNER' OF THE ABOVE DESCRIBED RESIDENTIAL PROP-
SIGNATURE
OF PERMITTEE
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BUILDING *J «"7 ^<T"" X- X3» f <- TADDRESS -*• / X ^J C-«_fe^/ ' \
NEAREST __
CROSS ST A;5« ^t 3 "y/t"
OWNER ^/>-S i*» f^-JKTf-^f^—
MAIL _
ADDRESS 5 &"&(/$
CITY " TEL NO
CONNECTION DATA
Lateral Charge Computation
30 H , !0' V (ffi 4" = -A""— /
Add 1 ion? (n) 4" — h"
Add Vnrl- <8> 4" — h" —
Total Construction Cost *
10% Service Charge
Total Lateral Charge/**
Lat No _. . Logged in Plat
LINE COST DATA
A D & Assmt No /-V/tS/JA/ /J.Q.
1 INT COST
C C f?i5w^*°/ dwpllmn' •*
PS® / dwelling
OTHFR
TOTAl^ •
Grand Total, Lateral, etc f *
FOR SEWER LOCATION
CO
St
ENGINEERING SEWER DEP
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This is a Sewer Permit When Properly Filled Out, Signed and Validated
Issued By
PERMIT VALIDATION
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