HomeMy WebLinkAbout1394 Magnolia Ave; ; 73-567; PermitPLUMBING PERMIT APPLICATION
Permit No. City of CARLSBAD, CALIFORNIA
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A"CHITECT OR DESIGNER
EHG1NEEfl
LENDER
U.SE 01"' BUILDING
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Class of work: □NEW 0 ADDITION 0 ALTERATION
Describe work: /,t,.,
0 REPAIR
PERMIT FEES
No. Type of Fixture or Item
:s
~··
;~.,. ..
Fee
SPECIAL CONDITIONS: , ~ WATER CLOSET (TOILET) $
BATHTUB
~ ./ / • -r'\ ·_ ,,, --(/ ' ~ / LAVATORY (WASH BASIN)
SHOWER
KITCHEN SINK & OISP.
DISHWASHER
APPLICATION ACCEPTED BY PLANS CHECKED evu -APPROVED F,°~~l,IANCE av t---1---LA_U_N_O_R_Y_T_R_A_Y ______________ t-----i-----1
f 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
PERIOO OF 120 DAYS AT ANY TIME AFTER WORK IS COM-
MENCED.
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION ANO KNOW THE SAME TO BE TRUE ANO CORRECT. ALL PROVISIONS OF LAWS ANO 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 VIOLATE OR CANCEL THE PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION.
SIGNATUR!: o, CONTRACTO" OR AUTHORIZED,.AC.CNT (0ATEI
/
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
SEWER
CESSPOOL
SEPTIC TANK & PIT
PERMIT
SI GNATUfl£ 0,. OWN£" II,. OWNER !tUILOER) (OAT£) TOTAL FEE
WHEN PROPERLY VALIDATED IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK. M.O. CASH PERMIT VALIDATION CK. M.O.
INSPECTOR
$
$ -'
\
CASH
APPLICATION FOR PERMIT TO CONNECT TO CITY SEWER SYSTEM
CITY OF CARLSBAD
ENGINEERING DEPARTMENT
729-1181 EXT. 35
FOR APPLICANT TO FILL IN
BUILDING
ADDRESS
OWNER
MAILING
ADDRESS
CONTRACTOR
CONTRACTOR'S
ADDRESS
(
NEW BUILDING EXISTING BUILDING
LEGAL DESCRIPTION
REMARKS:
LATERAL LOCATION
ST.
t--= (/)
LATERAL NO. _______ INSTALLATION DATE---------1
BUILDING DEPT.
ISSUED BY --=::....__:__.....:...__:_:_~..::..._:..__ ______ _
DATE ISSUED--....:.--=---=-'-''---..z._-=-------
VALIDATION
LATERAL CHARGE COMPUTATION
STANDARD 4" (Max. H. 30', V. 10'1-~--------
OVER 30' H. @ FT. _________ _
OVER10'V. ___ @ ___ FT. _________ _
STANDARD 6" (Max. H. 30', V. 10') _________ _
OVER 30' H. ___ @s--__ FT. _________ _
OVER 10' V. @ FT.----------
TOTAL CONSTRUCTION COST----------
SERVICE CHARGE (REPAVING ETC.) _________ _
TOTAL LATERAL CHARGE _________ _
L INE COST DATA
ASSESSMENT DIST. NO.--------------
FRONTAGE ____ COST PER FT. ___ TOTAL __ _
OTHER ___________________ _
CONNECTION FEE
NO. UNITS _ __./t-_COST PER UNIT---TOTAL---
PUMP STATION FEES
NO. UNITS ___ COST PER UNIT ___ TOTAL---
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TOTAL CHARGES (LATERAL ETC.) ______ ...:~=-=U=---