HomeMy WebLinkAbout1017 DAISY AVE; ; 78-2064; PermitELECTRICAL PERMIT APPLICATION5
City of CARLSBAD, CALIFORNIA 92008
Applicant to complete numbered spaces only Phone 729-1181 Permit No _
JOB ADDRESS
'/*
.LEGALIDESCR
LOT NO D SHEET)
hi
MAIL ADDRESS
CONTRACTOR MAIL ADDRESS STATE LIC NO CITY LIC NO
ARCHITECT OR DESIGNER MAIL ADDRESS LICENSE NO
MAIL ADDRESS LICENSE NO
COMPENSATION INS CARRIER MAIL ADDRESS
USE OF BUILDING
8 ClMiofwork $NEW D ADDITION D ALTERATION D REPAIR
9 DMcnbc work '«u Jv>«\>iA »••«,>
CFZ
PERMIT FEES
SPECIAL CONDITIONS SWIMMING POOL WIRING,
NO INCREASE IN SERVICE
No Each Fee
APPLICATION ACCEI PLANS CHECKED BY APPROVED FOR ISSUANCE BV
NEW CONSTRUCTION, FOR EACH
AMPERES OF MAIN SERVICE SWITCH
FUSE OR BREAKER
NOTICE
THIS PERMIT BECOMES NULL AND VOID IF WORK OR CONSTRUC
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS OR IF
CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR APERIOD OF 12O DAYS AT ANY TIME AFTER WORK IS COM
MENCED
I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THISAPPLICATION AND KNOW THE SAME TO BE TRUE AND CORRECTALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THISTYPE OF WORK WILL BE COMPLIED WITH WHETHER SPECIFIEDHEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOTPRESUME TO GIVE AUTHORITY TO VIOLATE OR CANCEL THE
PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATINGCONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION
NEW SERVICE ON EXISTING BLDG
FOR EA AMPERE OF INCREASE
IN MAIN SERVICE SWITCH, FUSE
OR BREAKER
REMODEL ALTERATION NO CHANGE
IN SERVICE FOR EA AMPERE OF
INCREASE
TEMP SERVICE UP TO AND INCLUD-
ING 200 AMP
TEMP SERVICE OVER 200 AMP
PER 100
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT (DATE)
ISSUANCE FEE
SIGNATURE OF OWNER (IF OWNER BUILDERT IOATE1 TOTAL FEES
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK.MO CASH PERMIT VALIDATION CK MO CASH
INSPECTOR
PLUMBING PERMIT APPLICATION *~..
City of CARLSBAD, CALIFORNIA 92008 _
Applicant to complete numbered spaces only PhOFIG 729-1181 Permit No fg
JOB ADOR E1S
VXUi-V-2:.^.
T LOT NO
i°»" | 111
OWNER
CONTRACTOR
( Qwl ** *• K }
ARCHITECT OR DESIGNER
ENGINEER
BLK f
100
COMPENSATION fNS CARRIER
6
MAIL
Vt-
MAI L
MAIL
MAIL
TRACT
ADDRESS ZIP PHONE
ADDRESS PHONE STATE LIC NO CITY LIC NO
ADDRESS PHONE LICENSE NO
ADDRESS PHONE LICENSE NO
ADDRESS BRANCH
USE OF BUI L.DING
7
8 Class of work ^NEW D
9 Describe work
ADDITION D ALTERATION D REPAIR
CiA'- C.»M*" TV» >H. k.\JM FVv»f"«. MfifK. TO ri*ft Mo^it-.^
SPECIAL CONDITIONS
; / 1 J
PLANS CHECKED BY APPROVED FOR ISSUANCE BY
DATE
1 NOTICE
THIS PERMIT BECOMES NULL AND VOID IF WORK
TION AUTHORIZED IS NOT COMMENCED WITHINCONSTRUCTION OR WORK IS SUSPENDED OR ABA
PERIOD OF 120 DAYS AT ANY TIME AFTERMENCED
1 HEREBY CERTIFY THAT 1 HAVE READ AND E
APPLICATION AND KNOW THE SAME TO BE TRUE
ALL PROVISIONS OF LAWS AND ORDINANCES GC
TYPE OF WORK WILL BE COMPLIED WITH WHETHEREIN OR NOT THE GRANTING OF A PERN
PRESUME TO GIVE AUTHORITY TO VIOLATE O
PROVISIONS OF ANY OTHER STATE OR LOCAL LA\
CONSTRUCTION OR THE PERFORMANCE OF C
SIGNATURE OF CONTRACTOR OR AUTHORIZED AGENT
T/Jjfal
SIGNATURE OF OWNER (IF OWNER BUILDER)
WHEN PROPERLY
OR CONSTRUC
20 DAYS OR IFMOONED FOR A
WORK IS COM
XAMINED THIS
AND CORRECT
)VERNING THIS
HER SPECIFIEDdlT DOES NOT
B CANCEL THE
(V REGULATING
ONSTRUCTION
(DATE)
(DATE)
PERMIT FEES *
No
>
/
/
Type of Fixture or Item
WATER CLOSET (TOILET)
BATHTUB
LAVATORY (WASH BASIN)
SHOWER
KITCHEN SINK & DISP
DISHWASHER
LAUNDRY TRAY
CLOTHES WASHER
WATER HEATER
URINAL
DRINKING FOUNTAIN
FLOOR— SINK OR DRAIN
SLOP SINK
GAS SYSTEMS NO OUTLETS
WATER PIPING & TREATING EQUIP
WASTE INTERCEPTOR
VACUUM BREAKERS
LAWN SPRINKLER SYSTEM
SEWER NUMBER CLEANOUTS
CESSPOOL
SEPTIC TANK fc PIT
ROOF DRAINS
ISSUANCE FEE $
TOTAL FEES $
Fee
$
/
/
/•
">
Sol
J>'3
J (.>
JS~l>
n&
trr-
VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION CK M O CASH PERMIT VALIDATION CK M O CASH
INSPECTOR
CITY OF CARLSBAD
BUILDING DEPARTMENT
(714) 729-1181
CERTIFICATION
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
If, after making this certificate, I become subject to the workers' compensation pro-
visions of the California Labor Code, I will forthwith comply with Section 3700 of the
Labor Code
I understand that if I fail to comply with the workers' compensation laws, this permit
shall be deemed revoked
I further certify that if I should contract or subcontract with any person, including any
firm or company, to do all or part of the work for which this permit is issued, I shall assure
compliance by that contractor or subcontractor with Section 3800 of the California Labor
Code
SIGNED
PRINT NAME AND TITLE
JOB ADDRESS ^H ^A^H A\JE
DATED