HomeMy WebLinkAbout1051 Palm Ave; ; 78-20; PermitPLUMBING PERMIT APPLICATION
City of CARLSBAD, CALIFORNIA 92008
Applicant to complete numbered spaces only. Phone 729-1181
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MA IL ADDRESS ,.,,,,,-4, PHON t STATE LIC. NO,
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[HCINCCIIJ MAIL A0Dlll[55 PHONC LICENSE NO.
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COMPENSATION (NS. CA,RRIER MAIL .&0011£55 llfltANCH
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8 Class of work: □NEW 0 ADDITION 0 ALTERATION 0 REPAIR
9 Describe work : /1/4/M(; ,\,, C'
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PERMIT FEES
No. Type of Fixture or Item
SPECIAL CONDITIONS: WATER CLOSET (TOILET)
BATHTUB
LAVATORY (WASH BASIN)
SHOWER
KITCHEN SINK & DISP.
DISHWASHER
APPLICATION AC,EO BY PLANS Cl-<EC~E0 BY APPROVE 0 FOR ISSUANCE BY . LAUNDRY TRAY
C L OTHES WASHER
I ,/ DATE WATER HEATER
J NOTICE URINAL
THIS PERMIT BECOMES NULL ANO VOID IF WORK OR CONSTRUC· DRINKING FOUNTAIN
TION AUTHORIZED IS NOT COMMENCED WITHIN 120 DAYS.OR IF FLOOR-SINK OR DRAIN CONSTRUCTION OR WORK IS SUSPENDED OR ABANDONED FOR A
PERIOD OF 120 DAYS AT ANY TIME AFTER WORK IS COM-SLOP SINK
MENCED. I GAS SYSTEMS: NO.OUTLETS ~ I HEREBY CERTIFY THAT I HAVE READ AND EXAMINED THIS APPLICATION AND KNOW THE SAME TO Bf TRUE AND CORRECT. WATER PIPING & TREATING EQUIP. ALL PROVISIONS OF LAWS AND ORDINANCES GOVERNING THIS
TYPE OF WORK WILL BE COMPLI ED WITH WHETHER SPECIFIED WASTE INTERCEPTOR HEREIN OR NOT, THE GRANTING OF A PERMIT DOES NOT
PRESUME T O GIVE AUTHORITY TO VIOLATE OR CANCEL THE VACUUM BREAKERS PROVISIONS OF ANY OTHER STATE OR LOCAL LAW REGULATING
CONSTRUCTION OR THE PERFORMANCE OF CONSTRUCTION. LAWN SPRINKLER SYSTEM
SEWER NUMBER CLEANOUTS
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CESSPOOL -..__? /L.-!~1~~ *179 SEPTIC TANK a. PIT
ROOF DRAINS
s1yNATU .. C 0,-CONTlltACTOllt Ollt AUTHO .. IZ.ED AGCMT I IO,,;oty • -
ISSUANCE FEE
SIGNATlllltlr 01" OWN( .. 1, OWJt4CR &UILOCRJ (DATE) TOTAL FEES
WHEN PROPERLY VALIDATED (IN THIS SPACE) THIS IS YOUR PERMIT
PLAN CHECK VALIDATION
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CK. M.O. CASH PERMIT VALIDATION CK.
INSPECTOR
M.O.
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CITY LIC, NO,
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Fee
$
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$ 7
• $ ~·A I".: ·-
CASH
1/-
INSPECTION REPORTS
DATE ITEM REMARKS INSPECTOR
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