eTRAKiT Permit

CITY OF OCEANSIDE
DEVELOPMENT SERVICES
300 N COAST HIGHWAY, City of Oceanside CA 92054
BUILDING INSPECTIONS (760) 435-3925

Applied Date:	7/7/2020
Expiration Date:
Permit No:	WTR20-0106
Permit Type:	WATER RESIDENTIAL

Site Address:

1114 VISTA WAY OCEANSIDE, CA 92054-6451

Site APN:

1533711700

Subdivision:

TOLLE TCT RESUB OF POR

Site Block:

Site Lot:

Valuation:

Site Tract:

Permit Status:

FINALED

Description of Work:

UPSIZE EXIST 5/8 TO 3/4" WM - NEW 1,200sf ADU


Contractor:
Address:
Phone:

Technical Information:

Caption	Value
FIRE SPRINKLER	NO
INSTALL DATE	9/27/2020
INSTALLER	ROMAN GOMEZ
NOTES
ADDTL ADDRESSES
METER LOCATION COMMENT
METER/SERIAL #	0054942629
METER SIZE	0034
METER TYPE	POSITIVE DISPLACEMENT
METER MODEL	T-10
METER MAKER	Neptune
RADIO ID	700574830
CUSTOMER ID	408400
LOCATION ID	105602
FIRE SERVICE	NO
UNIT COUNT	2
WET BAR	NO
SEWER RATE CLASS
READ CYCLE	02
READ ROUTE	04
READ SEQUENCE	24100
RATE CLASS	RE-SINGLE FAMILY RESIDENTIAL
ACCESSORY DWELLING UNIT	YES
SERVICE CODE	BO
LAST METER NUMBER	0051006491
LAST REGISTER ID
LAST READ	2654
LAST METER SIZE	5/8 INCH


Owner:	MELDON MARK&AMY TRUST 12-30-03
Address:	158 C AVE CORONADO CA 92118
Phone:

WORKERS COMPENSATION DECLARATION

WARNING: FAILURE TO SECURE WORKERS' COMPENSATION COVERAGE IS UNLAWFUL, AND SHALL SUBJECT AN EMPLOYER TO CRIMINAL PENALTIES AND CIVIL FINES UP TO ONE HUNDRED THOUSAND DOLLARS ($100,000), IN ADDITION TO THE COST OF COMPENSATION, DAMAGES AS PROVIDED FOR IN SECTION 3706 OF THE LABOR CODE, INTEREST, AND ATTORNEY'S FEES.
I hereby affirm under penalty of perjury one of the following declarations:
____ I have and will maintain a certificate of consent to self-insure for workers' compensation, issued by the Director of Industrial Relations as provided for by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued.
Policy No.
____ I have and will maintain workers' compensation insurance, as required by Section 3700 of the Labor Code, for the performance of the work for which this permit is issued. My workers' compensation insurance carrier and policy number are:
Carrier: Policy Number: Expiration Date:
____ I certify that, in the performance of the work for which this permit is issued, I shall not employ any person in any manner so as to become subject to the workers' compensation laws of California, and agree that, if I should become subject to the workers' compensation provisions of Section 3700 of the Labor Code, I shall forthwith comply with those provisions.

LICENSED CONTRACTOR'S DECLARATION

I hereby affirm under penalty of perjury that I am licensed under provisions of Chapter 9 (commencing with Section 7000) of Division 3 of the Business and Professions Code, and my license is in full force and effect.
License No: Expiration Date: Contractor: Class:

Fees:

Description	Amount	Receipt #	Paid Date
REFUND DUE TO CHANGE IN MTR UPSIZE	$124.00	PR1729	08/05/2020
REFUND DUE TO CHANGE IN MTR UPSIZE	$5,680.00	PR1729	08/05/2020
REFUND DUE TO CHANGE IN MTR UPSIZE	$88.00	PR1729	08/05/2020
REFUND DUE TO CHANGE IN MTR UPSIZE	$3,181.00	PR1729	08/05/2020
UPSIZE METER FEE	$152.00	1433107	07/07/2020
UPSIZE WATER BUY-IN	$8,520.00	1433107	07/07/2020
UPSIZE SDCWA WTR TREAT CAP CHR	$88.00	1433107	07/07/2020
UPSIZE SDCWA CAPACITY CHARGE	$3,181.00	1433107	07/07/2020

TOTAL FEES:	$2,868.00
TOTAL FEES PAID:	$2,868.00
TOTAL FEES DUE:	$0.00

*WTR20-0106*