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HomeMy WebLinkAbout1355 FOREST AVE; ; 76-343; Permit0 {~) PLUMBING PERMIT APPLICATION City of CARLSBAD, CALIFORNIA Applicant to complete numbered spaces only Perm it No, JOB AOOR ESS t ...-5 ;' I T~ACT OWNE .. MAIL ADDRESS ll p PHONE 2 ~ I ~{ ,\, ,-' ~ CONTAACTOA ' MAIL ADOAESS PHOHE LICENSE NO. 3 .... I CHITECT OA OESIGNEA MAIL A.OOA[.55 4 £.NCINEER MAIL ADDRESS 5 COMPENSATION (NS. CARRIER MAIL ADDIIIESS 6 US£ 01" &UI LDING 7 8 Class of work: O NEW 0 ADDITION 0 ALTERATION 'l Describe work: .c, 0 v ~ ~ c:...; SPECIAL CONDITIONS: APPLICATION ACCEPTEO ev PLANS CHECKED BY APPROVED FOR ISSUANCE BY DATE NOTICE 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· MEN CED I HEREBY CERTIFY THAT I HAVE READ ANO EXAMI NED THIS APPLICATION ANO KNOW THE SAME TO BE TRUE ANO CO RRECT ALL PROVISIONS OF LAWS ANO ORDINANCES GOVERNING THIS TYPE O F WORK WILL BE COMPLIED WITH WHETHER SPECIFIED HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT PRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE PROVISIONS OF ANY OTH ER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. (DAT£) SIGN,UflU. or CONT,.ACTO,t O,t 4UT:O"t?EO AGtNT ; f"'\.-tf.... "'"' ..:: - SIGNATU"I~ OP' OWN[" tlP' OWNt R 8Ult.O[R) OAT£. PHONE LICENSE NO, PHONE LICENSE NO, &IU,NCH 0 REPAIR PERMIT FEES No. Type of Fixture or Item WATER CLOSET (TOILET) BATHTUB LAVATORY (WASH BASIN) SHOWER K ITCHEN SINK & DISP. DISHWASHER LAUNDRY TRAY CLOTHES WASHER WATER HEATER URINAL DRINKING FOUNTAIN FLOOR -SINK OR DRAIN SLOP SINK GASSYSTEMS NO.OUTLETS WATER PIPING & TREATING EQUIP. WASTE INTERCEPTOR VACUUM BREAKERS LAWN SPRINKLER SYSTEM 7 SEWER CESSPOOL SEPTIC TANK & PIT ROOF DRAINS PERMIT TOTAL FEE WHEN PROPERLY VALIDATED UN THIS SPACE) THIS IS YOUR PERMIT PLAN CHECK VALIDATION CK. M.O . CASH PERMIT VALIDATION CK. M.O. (,_ INSPECTOR 52ti-• ••12.50 '- ST ATE C I TY Fee $ $ J .. 11 IV $, __ ~) CASH INSPECTION REPORTS DATE ITEM REMARKS INSPECTOR 6-t-7~ ,A/,·~., ~---~ ~R. £ ,.,,, ~ ------ '"'?11,19-LL .L_-z~. ~-/~/d ,:;I' ?:"»'~ ., V -/ - USE SPACE BELOW FOR NOTES, FOLLOW-UP, ETC. APPLICATION FOR PERMIT TO CONNECT TO CITY SEWER SYSTEM CITY OF CARLSBAD ENGINEERING DEPARTMENT 729-1181 EXT. 35 FOR APPLICANT TO FILL IN BUI LDING ADDRESS OWNER MAILING ADDRESS CONTRACTOR CONTRACTOR'S ADDRESS 11 NEW BUILDING EXISTING BUILDING LEGAL DESCR IPTION l t r REMARKS: LATERA L LOCATION ST. I i-= Cl) LATERAL NO, _______ INSTA LLATION DATE------~ _> SE 1748 BUILDING DEPT. ISSUED BY ____ ....:..:..==-..:.~--=----'--.:.......:-'---=-------- DATE ISSUED----"-----'.._,_=-------------- VALIDATION LATERA L CHARGE COMPUT ATION STA NDARD 4" (Max. H. 30'. V. 10') _________ _ OVER 30' H. ___ @,,,,.__ ___ FT. _________ _ OVER10'V. @ FT. __ ;__;___;___--'-'--- STANDARD 6" (Max. H. 30', V. 10') _________ _ OVER 30' H. ___ @,,__ ___ FT·---------- OVER 10' V. @ FT.---------- TOTAL CONSTRUCTIO N COST---------- SERVICE CHARGE (REPAVIN G ETC.) _________ _ TOTAL LATE RAL CHARGE---------- LINE COST DATA ASSESSMENT DIST. NO.-------------- FRONTAGE ____ COST PER FT. ____ TOTAL __ _ OTHER ___________ ___;;__ ___ __,,---,-- CONNECTION FEE NO. UNITS_"'--_COST PE R UNIT ___ TOTAL--- PUMP STATION FEES NO. UNITS ___ COST PER UNIT ____ TOTAL--- k716<) TOTAL CHARGES (LATERAL ETC.>------~J.J......,V=---