HomeMy WebLinkAbout1705 TAMARACK AVE; ; 71-187; Permit' 1
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] /-( f 7 City of CARLSBAD, CALIFORNIA KAR _9_71 ~P~~o tt95**• .} 5j 0 Applicant to complete numbered spaces only. ..
BUILDING PERMIT APPLICATION
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I LOT NO ;/ 8LK TRACT/') 0131) A ~ , I -Q
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4 -~NPr-JJ'--+-y~-----------~-----~~t\~ 5 ENGINEER //VA MAIL ADDRESS PHONE LICENSE NO. ~
-. MAIL ADDRESS BAANCH bt LENDER
6
USE OF' BUILDING
7
8 Class of work: 0 ADDITION 0 ALTERATION 0 REPAIR □MOVE 0 REMOVE
9 Describe work:
10 Change of use from I
'
Change of use to
11 Valuation of work: $ PLAN CHECK FEE
1-S_P_E_C_I_A_L_C_O_N_D_IT_I_O_N_S_: __________________ Type~ A /
Const. .:J---I\/.
I
Size of Bldg. / ()I/ O'
(Total) Sq. Ft./(JftXJ
1---------,f-/---,-----------r-----------t Fire APPLI\TI~ '»YTED ~Y: PLANS CHECKED BY APPROVED FOR ISSUANCE BY. Zone
(J'Vvf\ No. of /
Dwelling Units
l PERMIT FEE /5/, "5>
Occupancy -r-. ,-,-
Group --1--V
No. of
Stories I
Division-
Max.
0cc. Load
u se ~ / Fire Sprinklers
Zone I\ -Required □Yes
OFFSTREET PARKING SPACES:
Covered 2 I Uncovered
~
~
.._, ( , NOTICE Special Approvals Required Received Not Required
SEPARA¥PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB·
ING, HEATING, VENTILATING OR AIR CONDITIONING.
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 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 SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT
PRESUME TO GIVE AUTHORITY TO V IOLATE OR CAN ~L ;THE
PROV~S?Jflg~~y OT~E~T/~~R LOCAL LAW REG LA ING
~sT;;y )1 THCT ~ ANCE o: co~/f uc ~ON.
St~'n.r1'E 0,. CQNTRAC'tOR OR AUTHORIZEO-A-1:'"E,...,-
SIGNATURE 01'" OWNER II,-OWNER BUILDER) DATE)
ZONING
HEAL TH DEPT.
FIRE DEPT.
SOIL REPORT
OTHER (Specify)
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK.
INSPECTOR
CASH
.................. .,. .. ,.. ••• '"IT'C'IOf,,.IATll"\J,,.111.I rn ... 11='r:::'Rl='P..l,..s:' ni::-AII II nltJ(::; nl='f:'"IC":IAI s 50 so. LOS ROBLES PASADENA, CALlrORNIA 9 t10 1
CITY OF CARLSB " SEWER
BUILDING DEPARTMENT PERMIT • APPLICATION
FOR APPLICANT TO FILL IN
LEGAL BUILDING DESCRIPTION LO"f NO. ADDRESS
BLOCK TRACT NEAREST
CROSS ST. USE OF BUILDINGS OWNER
MAIL CONTRACTOR ADDRESS
ADDRESS CITY TEL. N O.
CITY TEL. NO. CONNECTION DATA
CONTRACTOR"S STATE CARLSBAD BUSINESS Lateral Charge Computation
LICENSE NO. LICENSE NO. 30' H., 10' Y. @ 4" = ---6" =---
NO. DESCRIPTION OF WORK FEE Add. Horiz. @ 4" = ___ 6" = -----~ HOUSE SEWER CONNECTING TO Add. Vert. @ 4" = ___ 6" = ---PUBLIC SEWER • $3.00
SEPTIC TANK, SEEPAGE PIT OR
P ITS 0 $!5.00 Total Construction Cost
OVERFLOW SEEPAGE PIT, DRAINFIELD EXTN.,
CESSPOOL. DRYWELL, MANHOLE • $!5.00 10% Service Charge
HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM 0 $1.!SO Total Lateral Charge
CONNECT ADDITIONAL BLDG. OR
WORK TO HOUSE SEWER • $1.!SO Lat. No.: Logged in Plat:
ALTER. REPAIR OR ABANDON HOUSE
SEWER OR DISPOSAL SYSTEM O $2.00 LINE COST DATA --• • A. D. & Assmt, No .
LINE COST: --
OWNER'S I PERMIT • 2 00 C, C. @ __ I dwelling
AUTHORIZATION TOTAL l"EE P. S. @ __ / dwelling
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN OTHER
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED BUILD· TOTAL ING TO THE PUBLIC SEWER.
SIGNED THIS
OWNER OR
DAY OF Grand Total, Lateral, etc.
OWNER"& AGENT FOR SEWER LOCATION
ADDRESS
I HEREBY ACKNOWLEDGE THAT I HA VE READ THIS
APPLICATION AND STATE THAT THE ABOVE IS CORRECT .,: .,: AND AGREE TO COMPLY WITH ALL CITY ORDINANCES AND V) V) STATE LAWS REGULATING PLUMBING AND SEWERS. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED St. AND/OR LICENSED AS REQUIRED B Y T HE CITY OF CARLS-
BAD AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROP. ENGINEERING SEWER DEPT. ERTY.
SIGNATURE
OF PERM ITTEE Signed I Signed
This is • Sewer Permit When Properly Filled Out, Signed and Velida♦-d
Issued By -------------------
PERMIT VALIDATION
NORTH