HomeMy WebLinkAbout159 SEQUOIA AVE; ; 76-2235; PermitPLUMBING PERMIT APPLICATION s
City of CARLSBAD, CALIFORNIA 92008 . ·" ~5
Applicant to complete numbered spaces only Phone 729-1181 Permit No
" ~ 713• ·~· 4 12.:.0
?t-o-J.-2..3'..,J-:-
JOB A.00111 C$S
/.5 2
CCOAL l 1 ouc•.
LOT NO ... l TSACT
OWNEIII MAIL A.00111ESS %IP PHONC
2 .,J , , 1c 111 1 r. , ,) I I ... I ,, I I
CON TIIIACTOIII MAIL A0011t£5$ PHONE STATE LIC, NO,
3 l '
AIIICHIT[CT 0111 OE.SIGN[l'I MAIL AOOIIIC5S
4
CNGIN[tlll MAIL AOOIII CSS
5
COMPENSATION (NS. CARRIER MAIL A OOJllllt SS
6
USE or BUILDING
7
8 Class of work: 0 NEW 0 ADDITION 0 ALTERATION
9 Describe work :
SPECIAL CONDITIONS:
APPLICATION ACCEPTED ev PLANS CHECt<EO BY APPROVE O FOR ISSUANCE ev ,. /
/')/ -DATE -NOTICE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC-
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 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 THIS
APPLICATION AND KNOW THE SAME TO Bf TRUE A N D CORRECT,
ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS TYPE OF WORK WILL BE COMPLIED WITH WH ETHER SPECIFIED HEREIN 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 REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
" I .,, .
51GNATUIIIC or CONTIIIACTOfll OR AUTHOIIIIZ.ED AGENT (DATE )
SIC.NATUfllt 0,-0 W"4[,_ 1,-OWNC.111 IIUILOCR) OAT C)
PHONIE LICENSE NO,
PHONE L ICENSE N O,
ltltANCH
0 REPA IR
PERMIT FEES
No. Type of Fixture or Item
WATER CLOSET (TOILET)
BATHTUB
LAVATORY (WASH BASIN)
SHOWER
KITCHEN SINK & DISP.
D ISHWASHER
LAU NDRY T RAY
CLOTHES WASHER
WATER HEATER
URINAL
DRINKING FOUNTAIN
FLOOR-SINK OR DRAIN
SLOP SINK
GAS SYSTEMS: NO.OUTLETS
WATER PIPING & TREATING EQUIP.
WASTE INTERCEPTOR
VA CUUM BREAKERS
LAWN SPRINKLER SYSTEM
) SEWER NUMBER CLEAN0UTS
CESSPOOL
SEPTIC TANK & PIT
ROOF DRAINS
ISSUANCE FEE
TOTAL FEES
WHEN PROPERLY VALIDATED (IN THIS SPACE} THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK . M .O.
INSPECTOR
CITY LIC, NO,
/l"'t,)-G, 7 .
Fee
s
j (''
$ ,1:.:J. :..,--~
CASH
'7& ... ..2d-'3~-
INSPECTION REPORTS
DATE ITEM REMARKS INSPECTOR
..___
-
USE SPACE BELOW FOR NOTES, FOLLOW-UP, ETC.
7-19-76 Good sewer hookup has been done. Left notice to call ns when septic
tank has been filled. T. Mata
APPLICATION FOR PERMIT TO CONNECT TO CITY SEWER SYSTEM
CITY OF CARLSBAD
ENGINEERING DEPARTMENT
729-1181 EXT. 35
FOR APPLICANT TO FI LL IN
BUILDING
ADDRESS /59 ~uo1r:\
OWNER
MAILING
ADDRESS
CONTRACTOR
CONTRACTOR'S
ADDRESS
NEW BUILDING
LEGAL DESCRIPTION
REMARKS:
j.
\
EXISTING BUILDING
L ,, t1 I.,-t I (-
LATERAL LOCATION
ST.
X
LATERAL NO. _______ INSTALLATION DATE----------1
2 BUILDING DEPT.
ISSUED BY ___ __;___c._ __ ::....::....c..:_-=... ______ _
DATE ISSUED __ _c__...=_--=.-=-:.. ________ _
VALIDATION
LATERAL CHARGE COMPUTATION
OVER 30' H. @ FT. _________ _
OVER 10' V. ___ @ ___ FT. _________ _
STANDARD 6" (Max. H. 30', V . 10'l---------:----
OVER 30' H . ___ @,~ ___ FT-----------
OVER 10' V. @ FT.----------
TOTAL CONSTRUCTION COST------'---=--.,---
SERVICE CHARGE (REPAVING ETC.) _____ _...:.----,--,-
TOTAL LATERAL CHARGE------'-------'~--
LINE COST DATA
ASSESSMENT DIST. NO.-------'--------
FRONTAGE ____ COST PER FT. ___ TOTAL __ _
OTHER ___________________ _
CONNECTION FEE
NO. UNITS--i-_COST PER UNIT_c_ __ TOTAL---
PUMP STATION FEES
NO. UNITS ___ COST PER UNIT ____ TOTAL---