HomeMy WebLinkAbout1204 TAMARACK AVE | 1230 TAMARACK AVE; ; 75-1858; PermitPLUMBING PERMIT APPLICATION
City of CARLSBAD CALIFORNIA ' 7 .1 -=-~ rx•',,, Applicant to complete numlfered spaces only. Permit No.
JOB ADDA £55
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LOT NO, I ILK I T•ACT L£0AL I 1 D£5C•.
OWN£,. ~~ :AIL •:7 ZIP PHON£
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COHTIIIACTOIII , MA IL ADOPt£SS PHONC LICtNSt NO, ST ATE C ITY
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AIIICHIT[CT OA DESIGNER MAIL ADDRESS PHONE LICENSE NO.
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ENG INEER MAIL Aoo,u .ss PHONE LICENSC HO,
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COMPENSATION (NS. CARRIER MAIL ADDRESS llfllANCM
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USE 0,-8UILOING
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8 Class of work: ¥NEW 0 ADDITIO N 0 ALTERATION 0 REPAIR
q Describe work: /:"//hl/r-/ ~ ,,,,:I./.,,(,. v")_.,,...,,
PERMIT FEES
No. Type of Fixture or Item Fee
SPECIA L CONDITIONS: WATER CLOSET (TO ILET) $
BATHTUB
LAVATORY (WASH BASIN)
SHOWER
KITCHEN SINK & OISP.
DISHWASHER
APPLICATION ACCEPTED SY JLANS CHECKED BY APPROVED F011 ISSUANCE BY LAUNDRY TRAY /__:,.?/ CLOTHES WASHER
DATE 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
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A FLOOR--SINK OR DRAIN
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-SLOP SINK
MENCED. GASSYSTEMS:NO.OUTLETS I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND 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 SPECIFIED 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. LAWN SPRINKLER SYSTEM , SEWER '> r,c_
CESSPOOL
SEPTIC TANK & PIT
ROOF DRAINS
~;;~;DD~;;Z;D ••ENT
(DATE)
1J/..i..1/7r PERMIT $ / I..)
TOTAL FEE ~ ',..:;., -i,· OWN CR l!IUILOEIII) I (DAT£) J ' SIGNAT1111tr 0,. OWNEllt
WHEN PROPERL#,,, VAilDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M .O. CASH
INSPECTOR
APPLICATION FOR PERMIT TO CONNECT TO CITY SEWER SYSTEM
CITY OF CARLSBAD SE 1708 BUILDING DEPT. ENGINEERING DEPARTMENT
729-1181 EXT. 35 ( ISSUED BY FOR APPLICANT TO Fl LL IN
DATE ISSUED I C ~. ,
BUILDING I ? I lJ. 7~ I 1~Y. ,I{ I~ .. vt ADDRESS , VALIDATION
OWNER L . ( .) ,) L .
' MAILING
ADDRESS ., t " .-• • I • "ll
LATERAL CHARGE COMPUTATION
CONTRACTOR STANDARD 4" (Max. H. 30', V. 10') I ~)I..,_
OVER 30' H. @ FT.
CONTRACTOR'S OVER 10' V. @ FT.
ADDRESS STANDARD 6" (Max. H. 30', V. 10')
OVER 30' H. @ FT.
NEW BUILDING I EXISTING BUILDING I v OVER 10' V. @ FT.
LEGAL DESCRIPTION TOTAL CONSTRUCTION COST
' ..J SERVICE CHARGE (REPAVING ETC.)
TOTAL LATERAL CHARGE '
REMARKS: LINE COST DATA
ASSESSMENT DIST. NO.
FRONTAGE COST PER FT. TOTAL
OTHER
LATERAL LOCATION CONNECTION FEE
i-,: I I i-,:
V) V) NO. UNITS I COST PER UNIT TOTAL
/" r-.. /" '\ PUMP STATION FEES
\.. V '-./
NO. UNITS COST PER UNIT TOTAL
I ST. I
TOTAL CHARGES (LATERAL ETC.) I
LATERAL NO. INSTALLATION DATE