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HomeMy WebLinkAbout1726 TAMARACK AVE; ; 71-15; Permit-I; BUILDING PERMIT ~PPLICATION 1 / . City of CARLSBAD, CALIFORNIA 15t>A10 JAN 12·7L_ cc 66 BAAN CH 0 REMOVE Change of use to 1 0 ::; z ,., :a 11 Valuation of work : $ PLAN CHECK FEE S-0 .. s_P_E_C_I_A_L_C_O_N_D_I_T_I O_N_S_: __________________ _, Type of Const. Size Of Bldg. 1-----------------------------t (Total) Sq. Ft/7«:J """'lr-+-•1 No. of Dwelling Units I Occupancy "1"- Group .Z:-J No. of Stories Use Zone Covere I Division Max. 0cc. Load Fire Sprinklers Required Dves SPACES: Uncovered 5 '" ► 0 No NOTICE Special Approvals Required Received "Not Required SEPARATE PERMITS ARE REQUIRED FOR ELECTRICAL, PLUMB- ING, HEATING, VENTILATING OR Al R 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 ZONING HEAL TH DEPT. FIRE DEPT. SOIL REPORT OTHER (Specify) PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE 1lt---------+--------+-------+----------1 PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. SIGNATURE. OF CONTAACTO~ OR AUTHOR IZED AGENT (DATE) SIGNATURE OF OWNER IF OWNER l!IIU ll.DERJ CATE WHEN PROPERLY VALIDATED (IN THIS SPACEI THIS IS YOUR PERMIT PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O. CASH INSPECTOR CITY OF CARUIAD SEWER BUILDING DIPARTMENT PERMIT • APPLICATION FOR APPLICANT TO FILL IN LEGAL .✓ BUILDING I C DESCRIPTION LOT NO. ADDRESS ' BLOCK TRACT f--1 NEAREST F t CROSS ST. USE OF /'I'! ~ .~ BUILDINGS ' t OWNER ' , I MAIL CONTRACTOR AOORESS 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" = ___ I/'= --- NO. DESCRIPTION OF WORK FEE Add. Horiz. @ 4" = __ t," = --- HOUSE SEWER CONNECTING TO Add. Vert. @ 4" = ___ t," = ---I PUBLIC SEWER • $3.00 SEPTIC TANK, SEEPAGE PIT OR Total Construction Cost PITS 0 $!5.00 I OVERFLOW SEEPAGE PIT, DRAINl"IELD EXTN., 10% Service Charge CESSPOOL, DRYWELL, MANHOLE 0 $!5.00 HOUSE SEWER CONNECTING TO Total lateral Charge PRIVATE DISPOSAL SYSTEM @ $1.150 CONNECT ADDITIONAL BLOG. OR Lat. No.: Logged in Plat: WORK TO HOUSE SEWER • $1.150 ALTER, REPAIR OR ABANDON HOUSE LINE COST DATA SEWER OR DISPOSAL SYSTEM O $2.00 • • A. D. & Assmt. No . I LINE COST: OWNER'S I s 2 00 C. C. @ __ / dwelling --PERMIT AUTHORIZATION TOTAL FEE 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 DAY OF OWNER OR Grand Total, Lateral, etc. ~ OWNER'S AGENT FOR SEWER LOCATION ADDRESS I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT ..: ..: ANO AGREE TO COMPLY WITH ALL CITY ORDINANCES AND V) V) STATE LAWS REGULATING PLUMBING AND SEWERS. I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED AND/OR LICENSED AS REQUIRED BY THE CITY OF CARLS• BAD AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL St. NORTH OWNER OF THE ABOVE DESCRIBED RESIDENTIAL PROP. ENGINEERING SEWER DEPT. ERTY. ' SIGNATURE Signed I Signed OF PERMITTEE This ls • Sewer Permit When Properly Filled Out, Signed and Validated luued By -------------------- PERMIT VALIDATION ADDRESS /J,:J..t ~~ ki-49 p71-7 C.~?11~ !h/o? ', I r