HomeMy WebLinkAbout1144 MAGNOLIA AVE; ; 63-5295; PermitAPPLICATION FOR 8u~n 116 PERMIT
CITY OF CARLSBAD -BUILDING INSPECTION DIVISION
PHONE PArl<way 9-1181 -Erl. 36
5295
?Pr:::.~~;~;).~~ (F;~ • (Middle) t,Aailing Address _/~;'1;.,4·17l~··~·
Contractor .. .d~.±.4~-A-A.~1.~'ailing Address ~5!.~;;;:,-!.!-.... . ...... . (Pleose Print) ,J.r. .. Y. •• ~.7.-."Wr.--lVI Number 1·····,..s+reet Phone
To Construct D To Add D To Alter""'9l To Repai~ To Convert D To Move From ··········----------
Type of Con5t ... 2:-.~ind of Foundation ... ~ ~No,
(Frame, Masonry, Etc.}
of Stories .... / ....... To Be Used for ...... L~--------( One Family Dwelling, Store, Etc.)
Floor Space of Proposed Construction (sq. feet) .... D ____ .Const. Valuation $ .. ---/1---t ... t!.::!?.._~-------·------
attached D Floor Space of Garage (sq. feet) ------------··········detached OConst, Valuation$ ___________________ _
LEGAL DESCRIPTION
Lot Block Subdivision
or ......... . --------------·-------,ection ........ . ..... Township, ______ Rang,, _____ _
Located at /./.-4,Afg;~~-~------0treet, Near
LAND AREA·······---·········· NUMBER OF EXISTING DWELLINGS ON PROPOSED BUILDING SITE··········-------(INDICATE
SIZE, USE AND LOCATION ON PLOT PLAN). WILL THIS CONSTRUCTION INCLUDE ANY PLUMBING INSTALLATION, ALTERATION, OR
ADDITION? YES .... )(..... NO __ _
I HEREBY ACKNOWLEDGE THAT I HAVE READ THIS APPLICATION AND STATE THAT THE ABOVE IS CORRECT AND AGREE TO COMPLY
WITH ALL CITY ORDINANCES AND STATE LAWS REGULATING BUILDING CONSTRUCTION ..•.... JJ .... i.a..... ... . ..... .
If o check is tendered for ptiyment of the ebove fee .!Ind the check is
not honored when presented for payment, your Building Permit will be SIGNATURE OF
immediately revoked. PERMITTEE £-l!1'1,.,''_kf.-i,;(,-?l,L,1..,,~
.f .. ,
Front Yard Set Back ········~
:::r :::: ::: :::: ....... ~··--------
Driveway Permit Required Yes ( No ( } Fee
Grading Permit Required Yes ( ) No ( )
Sewer Disposal Plant Capital Cont,
Distance Between Bldg. Sewer Pumping Station Capital Cont. Fee ...
Zone -Residential {
Zone -Commercial
Variance
Eng. Check By ______________ _ Wator Meter Charge ··········--------------------
Sub Total _______________ _
Plans Approved by _____________________ pf4n Check Fee ······················-~---------------
Approved by ';ii.~~----,, uild;ng PermH Fee .... f.1-. ....... ~ ........... .
Date .......... tf;;(.~ Total Charges .tf;_-"--1/ _____________ _
CITY OF CARLSBAD SEWER
BUILDING DEPARTMENT 792:.. PERMIT. APPLICATION
FOR APPLICANT TO FILL IN
LEGAL
DESCRIPTION LOT NO.
BLOCK
USE OF
BUILDINGS
CONTRACTOR
ADDRESS
CITY
CONTRACTOR'S STATE
LICENSE NO.
TEL. NO.
CARLSBAD BUSINESS
LICENSE NO.
NO. DESCRIPTION OF WORK FEE
HOUSE SEWER CONNECTING TO ~ ~ PUBLIC SEWER 0 $3.00
SEPTIC TANK, SEEPAGE PIT OR PITS 0 $15.00
OVERFLOW SEEPAGE PIT, ORA.INFIELD EXTN.,
CESSPOOL, DRYWELL, MANHOLE @ $15.00
HOUSE SEWER CONNECTING TO
PRIVATE DISPOSAL SYSTEM @ $1.!50
CONNECT ADDITIONAL BLOG. OR
WORK TO HOUSE SEWER 0 $1.150
ALTER, REPAIR OR ABANDON HOUSE
SEWER OR D ISPOSAL SYSTEM @ $2.00
0 $
r--
OWNER'S I PERMIT s 2 00
AUTHORIZATION TOTAL FEE < ... ~
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN
CONTRACTOR TO CONNECT THE ABOVE DESCRIBED BUILD• ,:-.G TO THE PUBLIC SEWER.
SIGNED THIS -----DAY OF---------
OWNER OR
OW NER'S AGENT -----------------
ADDRES S
I HEREBY ACKNOWLEDGE TH A T I HAVE READ THIS
APPLICATION ANO STATE THAT THE ABOVE IS CORRECT
ANO AGREE TO COMPLY WITH ALL CITY ORDINANCES AND
STATE LAWS REGULATING PLUMBING AND SEWERS.
I HEREBY CERTIFY THAT I AM PROPERLY REGISTERED
AND/OR LICENSED AS REQUIRED BY THE CITY OF CARLS· BAO AND STATE OF CALIFORNIA OR THAT I AM THE LEGAL OWNER OF TH E ABOV ESCRIB R I NTIAL PROP.
ERTY. •
SIGNATURE
OF PERMITTE
5 PAID ~c 28·6'4 -cc2lf82*******5.0O
BUILDING
AOORESS
NEAREST
CROSS ST.
OWNER
MAIL
AOORESS
CITY TEL. NO.
CONNECTION DATA
Lateral Charge Computation
30' H., 10' Y. @ 4" ___ b" ----
Add. Horiz. @ 4" = ___ b" ----
Add. Vert. @ 4" = ___ b" ----
Total Construction Cost
10% Service Charge
Total Lateral Charge ____ _
let. No.: Lo ed in Plat:
LINE COST DATA
A. D. & Assmt. No. _______________ _
LINE COST:
C. C. @ __ / dwelling ____________ _
P. S. @ __ / dwelling ____________ _
OTH ER
TOTAL
Grand Total, Lateral, etc.
FOR SEWER LOCATION
~-----------------1~
St.
ENGINEERING SEWER DEPT.
NORTH
Signed ________ _ Signed ________ _
This is a Sewer Permit When Properly Filled Out, Signed and Validated
Issued By ____________________ _
PERMIT VALIDATION