HomeMy WebLinkAbout1551 BASSWOOD AVE; ; SE679890; PermitLEGAL DESCRIPTION LOT NO.
PERMIT OWNER'S
FOR APPLICANT TO FILL IN
t /s-r/ /54?J L&- ocr/ B U lLDl NG ADDRESS
NEAREST CROSS ST A,
OWNER
MA11
$200
CON~RACTOR.~ STATE CARLS~AD BUSINESS - LICENSE NO. LICENSE NO.
1 OVERFLOW SEEPAGE PIT. DRAINFIELD EXTN.. I I
CESSqOOL. DRYWELL. MANHOLE 8 $5.00
HOUSE SEWER CONNECTING TO PRIVATE DISPOSAL SYSTEM @ $1.50
CONNECT ADDITIONAL BLDG. OR WORK-TO HOUSE SEWER Q $1.50
ALTER, REPAIR OR ABANDON HOUSE SEWER OR DISPOSAL SYSTEM @ $2.00
I HAVE AT THIS DATE A CONTRACT WITH THE HEREIN CONTRACTOR TO CONNECT THE ABOVE DESCRIBED BUILD. ING TO THE PUBLIC SEWER.
SIGNED THIS DAY 6F OWNER OR OWNER'S AGENT
..._..- ADDRESS
CITY TEL. NO.
CONNECTION DATA Lateral Charge Computation
30' H., IO' V. @ 4" = - 6" = -
Add. Horir. @ 4" = - 6" = __
Add. Vert. @ 4" = __ 6" = -
Total Construction Cost
10% Service Charge
Total Lateral Charge
Lat. No.: Logged in Plat:
LINE COST DATA
A. D. & Ass.int. No.
LINE COST:
C. C. Q- / dwelling
P. S. 8- / dwelling
OTHER
TOTAL
Grand Total. Lateral, etc.
FOR SEWER LOCATION
I I
I I
ENGINEERING SEWER DEPT.
st. NORM
I Signed Signed / fir a Seyn Properly Filled Out, Signed and Validated
Issued By
PERMIT VALIDATION
BUILDING DEPARTMENT
OWNER
MBll / U
9 “8;z 7 MrnM
PERMIT - APPLlCATlON
NO. ITEM
2, TOILET @ s1.25
3- BATH TUB BP 1.25
3 WASH BASIN 8 1.28 1 KITCHEN SINK 8 1.25
SHOWER 1.25
~
r
DISHWASHER 0 1.25
LAUNDRY TUB OR TRAY 8 1.25
/ AUTOMATIC WASHER 8 1.25 f
WATER HEATER & VENT @ 1.50
GAS SYSTEM 1 TO 15 .so EA. ADD. 0 1.50
FLOOR DRAIN OR SINK @ 1.25 /
LAWN SPRINKLER 8 2.00
MISC. WATER PIPING 8 1.50
GARBAGE DISPOSAL
VACUUM BREAKER OR BACK FLOW DEVICES 1 To 5
I
PERMIT s
NoO I TOTALFEE B
GRADING PLAN
YES
I- I-
I 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 PLUMBING.
I CERTIFY THAT I AM PROPERLY REGISTERED AND LI- CENSED AS REQUIRED BY THE CITY OF CARLSBAD AND
SIGNATURE OF PERMITTEE
9*7 7
B U I LD I N G ADDRESS
NEAREST CROSS ST.
I
GROUP I ZONE
InsDection Record
APPROVALS I DATE I INSPECTOR’S SIGNATURE
UNDER FLOOR WORK
ROUGH PLUMBING
GAS PIPING
PLUMBING FIXTURES
t-----i
GAS TEST
UTILITY CO. NOTIFIED
FINAL
/ VALIDATION This is a Plumbing Permit When Properly Filled Out, Signed and Validated. Permit void if work is not commenced wifhin 60 days of date of issuance.