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?
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